Background/aims Patients with rhegmatogenous retinal detachment (RRD) who develop postoperative proliferative vitreoretinopathy (PVR) have been found to have higher preoperative laser flare values than patients with RRD who do not develop this complication. Measurement of laser flare has therefore been proposed as an objective, rapid and non-invasive method for identifying high-risk patients. The purpose of our study was to validate the use of preoperative flare values as a predictor of PVR risk in two additional patient cohorts, and to confirm the sensitivity and specificity of this method for identifying high-risk patients.
Methods We combined data from two independent prospective studies: centre 1 (120 patients) and centre 2 (194 patients). Preoperative aqueous humour flare was measured with a Kowa FM-500 Laser Flare Meter. PVR was defined as redetachment due to the formation of traction membranes that required reoperation within 6 months of initial surgery. Logistic regression and receiver operating characteristic analysis determined whether higher preoperative flare values were associated with an increased risk of postoperative PVR.
Results PVR redetachment developed in 21/314 patients (6.7%). Median flare values differed significantly between centres, therefore analyses were done separately. Logistic regression showed a small but statistically significant increase in odds with increasing flare only for centre 2 (OR 1.014; p=0.005). Areas under the receiver operating characteristic showed low sensitivity and specificity: centre 1, 0.634 (95% CI 0.440 to 0.829) and centre 2, 0.731 (95% CI 0.598 to 0.865).
Conclusions Preoperative laser flare measurements are inaccurate in discriminating between those patients with RRD at high and low risk of developing PVR.
- Aqueous humour
- Treatment Surgery
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Contributors The conception or design of the work: VCM, EHCvD, JR, JCvM and FT. Data acquisition: VCM, JT, EHCvD, KP, FT, Ida van Meurs, Annemiek Krijnen and Vera-Christina Wulff. Analysis and interpretation of data: VCM, JT, JR, JCvM and FT. Drafting the work: VCM. Revising the work: JT, EHCvD, KP, JR, JCvM, FT and Ellen la Heij. Final approval of the version published: VCM, JT, EHCvD, KP, JR, JCvM and FT. Agreement to be accountable for all aspects of the work: VCM, JT, EHCvD, KP, JR, JCvM and FT. Support: Frank Verbraak (Lender Flare Meter).
Funding This research was supported by Combined Ophthalmic Research Rotterdam (CORR Project code: 3.1.0).
Competing interests None declared.
Ethics approval Ethics Committee and Institutional Review Board.
Provenance and peer review Not commissioned; externally peer reviewed.
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