目的：探讨玻璃体切割(PPV)术后成功复位的孔源性视网膜脱离(RRD)患者发生视物变形的危险因素。方法：回顾性临床研究。纳入2017-01/2019-01在我院确诊的RRD患者94例94眼进行研究。所有患者均行经睫状体平坦部标准23G PPV手术。首次PPV后视网膜解剖复位。于PPV术前及术后1、6、12mo，至末次随访，行BCVA、眼压、裂隙灯显微镜、间接检眼镜、视物变形评分表(M-chart表)、OCT检查，并分析发生视物变形的危险因素。结果：术后1mo，94眼中50眼(53%)存在视物变形，视物变形(+)组平均M值为0.68±0.28，累及黄斑和未累及黄斑的RRD患者发生视物变形有差异(P<0.01)，术后不同随访时间M值变化有差异(F=26.442，P<0.01)。多因素Logistic回归分析结果显示：视网膜脱离累及黄斑(OR= 9.020，95% CI：1.808～45.011，P=0.007)、EZ完整性中断(OR=10.570，95% CI：2.909～38.400，P<0.01)是RRD复位术后视物变形发生的独立影响因素。结论：PPV术后成功复位的RRD患者术后发生视物变形程度逐渐减轻，视网膜脱离累及黄斑和EZ完整性中断是发生视物变形的独立危险因素。

AIM: To identify factors associated with metamorphopsia in patients with rhegmatogenous retinal detachment(RRD)who underwent primary vitrectomy(PPV). METHODS:This retrospective study included 94 patients(94 eyes)who underwent 23G PPV for repair of RRD between January, 2017 and January, 2019. Each patient were examined both eyes preoperatively and postoperatively(at 1, 6, 12mo and last visits). At each time-point, patients received a complete ophthalmological examination, including best corrected visual acuity(BCVA), intraocular pressure, slit-lamp biomicroscopy, optical coherence tomography(OCT), and M-chart examination.RESULTS: One month after surgery, metamorphopsia occurred in 53%(n=50), the mean M value was 0.68±0.28. The metamorphopsia rate differed significantly between macula-off and macula-on RRD(P<0.01). There was significant difference in M-chart among the different time(F=26.442, P<0.01). Univariate analysis demonstrated that the macula status, location of retinal breaks, and disrupted EZ was a risk factor that was significantly associated with metamorphopsia. In multivariate analysis, macula-involving retinal detachment(OR=9.020, 95% CI:1.808-45.011, P=0.007)and disrupted EZ(OR=10.570, 95% CI:2.909-38.400, P<0.01)was a significant predictors of metamorphopsia.CONCLUSION: The metamorphopsia was improved after anatomically successful RRD surgery. Macular involvement retinal detachment and disrupted EZ were more likely to develop metamorphopsia.

保定市科技计划项目(No.1941ZF048)