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SMOKING IS A RISK FACTOR FOR PROLIFERATIVE VITREORETINOPATHY AFTER TRAUMATIC RETINAL DETACHMENT

Eliott, Dean MD*,†; Stryjewski, Tomasz P. MD, MPP*,†; Andreoli, Michael T. MD; Andreoli, Christopher M. MD*,‡,§

doi: 10.1097/IAE.0000000000001361
Original Study

Purpose: To determine the incidence of retinal redetachment due to proliferative vitreoretinopathy after open-globe trauma in smokers and nonsmokers.

Methods: A total of 892 patients comprising 893 open-globe injuries, in whom 255 eyes were diagnosed with a retinal detachment, and 138 underwent surgical repair were analyzed in a retrospective case–control study. Time to redetachment was examined using the Kaplan–Meier method and analysis of risk factors was analyzed using Cox proportional hazards modeling.

Results: Within one year after retinal detachment surgery, 47% (95% CI, 39–56%) of all 138 repaired retinas redetached because of proliferative vitreoretinopathy. Being a smoker was associated with a higher rate of detachment (adjusted hazard ratio 1.96, P = 0.01). As shown in previous studies, the presence of proliferative vitreoretinopathy at the time of surgery was also an independent risk factor for failure (adjusted hazard ratio 2.13, P = 0.005). Treatment with vitrectomy-buckle compared favorably to vitrectomy alone (adjusted hazard ratio 0.58, P = 0.04). Only 8% of eyes that redetached achieved a best-corrected visual acuity of 20/200 or better, in comparison to 44% of eyes that did not redetach (P < 0.001).

Conclusion: Proliferative vitreoretinopathy is a common complication after the repair of retinal detachment associated with open-globe trauma, and being a smoker is a risk factor for redetachment. Further study is needed to understand the pathophysiologic mechanisms underlying this correlation.

Supplemental Digital Content is Available in the Text.In patients with an open-globe injury who developed a retinal detachment, 47% of these patients redetached postoperatively because of proliferative vitreoretinopathy. Current smokers had nearly twice the rate of redetachment in comparison to nonsmokers.

*Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts;

Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts;

Department of Ophthalmology, The University of Illinois at Chicago, Chicago, Illinois; and

§Harvard Vanguard Medical Associates, Boston, Massachusetts.

Reprint requests: Dean Eliott, MD, Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114; e-mail: dean_eliott@meei.harvard.edu

None of the authors has any financial/conflicting interests to disclose.

D. Eliott and T. P. Stryjewski are co-first authors.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.retinajournal.com).

© 2017 by Ophthalmic Communications Society, Inc.