Abstract
Purpose :
Vitreoretinal (VR) surgery is the third most common intraocular surgery after refractive and cataract surgery. Success rate after primary vitrectomy depends on the indication, being around 90%, with baseline risks known to vary widely between various VR procedures.
The potential beneficial role of statin therapy in the VR surgery outcome remains unrecognized. Our study aimed to explore the association of preoperative statin therapy and need of revitrectomy after primary vitrectomy of adult patients aged 18 years or over, with diverse range of vision-threatening posterior segment eye diseases.
Methods :
DESIGN: Historical, population-based, register-based vitreoretinal surgical cohort
SETTING: Tertiary, academic hospital, Helsinki, Finland. Study population consisted of a total of 5709 VR surgical patients operated during May 12th 2008 with the follow-up period ending at December 31st 2014, covering 6.5 years.
Subgroup analysis was performed as follows: eyes operated due to 1.) rhegmatogenous retinal detachment (RRD, International Classification of Diseases (ICD) H33.0), 2.) vitreoretinal interface diseases (macular pucker H35.38 and macular hole H35.37), 3.) age-related macular degeneration (AMD) with or without submacular hemorrhage H35.39, 4.) diabetic retinopathy (DR) (diabetic maculopathy and proliferative DR, H36.01/H36.06/E10.3/10.7/E10.9/E11.3), 5.) vitreous hemorrhage H43.1, 6.) lens subluxation H27.1, 7.) vitreous opacities H43.2/H43.3/H43.8/H43.9 or 8.) other VR-indication.
MAIN OUTCOME MEASURES:
The primary end-point event was the revitrectomy during postoperative follow-up period of one year due to one of the following causes: retinal re-detachment (H33.0), vitreous re-hemorrhage (H43.1), postoperative endophthalmitis (H44.0) or recurrent pucker or unclosed macular hole (H35.38/H35.37).
Results :
RD (H33.0) was the most frequent indication of VR-surgery, including 1916 patients, with 305 re-operations with rate 0.20 (95% CI 0.18-0.23) per person-year. Statin treatment in time of operation was associated with lower risk of re-operation in patients with RD according to relative scale (IRR 0.72, 95% CI 0.53-0.97), but not in absolute scale (ARD -0.01, -0.04-0.03). No association with statin therapy and vitrectomy outcome was observed in the other VR subgroups.
Conclusions :
Use of statin treatment was associated with 28% lower risk of revitrectomy in patients operated due to RD.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.