Abstract
Purpose :
To determine whether tobacco smoking was associated with an increased risk of retinal detachment surgery failure.
Methods :
Retrospective consecutive case series using coding data from a single large tertiary referral eye hospital (the Royal Victorian Eye and Ear Hospital, Melbourne, Australia) over the time period July 1998 to June 2019.
Eyes were included if they underwent at least one retinal detachment procedure. For each eye we determined whether repeat retinal detachment surgery was performed, in which case the outcome of surgery was defined as failure. The timing of repeat surgery was recorded, and the last date of review was captured for eyes with no repeat surgery. The accuracy of our coding-based method of determining retinal detachment surgery outcome has been validated elsewhere (in press).
Baseline demographic data including age, gender, socioeconomic status, remoteness, smoking (defined as daily use of tobacco products), and diabetes was collected, as was tamponade use (gas vs. oil), type of procedure (vitrectomy vs. buckle) and number of previous retinal detachment procedures.
Time-to-event analysis techniques were used to observe the (adjusted) association of smoking with retinal detachment failure.
Results :
6917 retinal detachment procedures were identified. 846 were excluded due to lack of any follow-up in the hospital system, leaving 6071 procedures in 5271 eyes of 5034 patients. Patients were coded as being current smokers at the time of surgery in 16.9% of surgeries (1028/6071).
The success rate of all surgeries was 84.2% (5114/6071), although was higher for primary surgery than for revision surgery (86.1% vs. 71.8%. P<0.001). Smokers were more likely to need revision surgery than non-smokers (19.55% vs 14.99%, P<0.001, Chi square). The adjusted hazard ratio for failure in smokers vs. non-smokers was 1.25 (95%CI 1.06 to 1.47, P=0.007; adjusted for age, sex, number of previous procedures, remoteness, type of surgery and tamponade used. Cox proportional hazards).
Conclusions :
Smoking was observed to be associated with an increased hazard of retinal detachment surgery failure. This is consistent with previous work suggesting smoking increases the risk proliferative vitreoretinopathy formation. To our knowledge this is the first study to present an effect of somoking on overall surgical success rates.
This is a 2020 ARVO Annual Meeting abstract.