title: SMOKING IS A RISK FACTOR FOR PROLIFERATIVE VITREORETINOPATHY AFTER TRAUMATIC RETINAL DETACHMENT.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
authors: *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.
authors: Dean
authors: D
authors: Eliott
authors: Tomasz P
authors: TP
authors: Stryjewski
authors: Michael T
authors: MT
authors: Andreoli
authors: Christopher M
authors: CM
authors: Andreoli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015807:Eye Injuries, Penetrating / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D012008:Recurrence; D012163:Retinal Detachment / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D013997:Time Factors; D014792:Visual Acuity; D057586:Vitreoretinal Surgery; D018630:Vitreoretinopathy, Proliferative / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult