Takashi Koto1, Ryo Kawasaki2, Keita Yamakiri3, Takayuki Baba4, Koichi Nishitsuka5, Akito Hirakata1, Taiji Sakamoto3. 1. Department of Ophthalmology, Kyorin Eye Center, Kyorin University School of Medicine, Tokyo, Japan. 2. Department of Vision Informatics, Osaka University Graduate School of Medicine, Osaka, Japan. 3. Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan. 4. Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, Japan; and. 5. Department of Ophthalmology and Visual Sciences, Yamagata University Faculty of Medicine, Yamagata, Japan.
Abstract
PURPOSE: To compare clinical outcomes between pars plana vitrectomy (PPV), scleral buckling (SB), and PPV+SB for rhegmatogenous retinal detachment in the Japan-RD Registry. METHODS: This is a nation-wide, multicenter, observational study based on the registry data between 2016 and 2017. The failure levels were defined as Level 1 (a failure of retinal detachment repair), Level 2 (remaining silicone oil), and Level 3 (multiple surgeries to achieve reattachment). We compared cases treated by SB or PPV in the subgroup of simple rhegmatogenous retinal detachment using multivariate Cox proportional hazard models. RESULTS: A total of 2,775 cases were included. Overall, 6 months any levels of failure in total, SB, PPV, and PPV+SB were 9.2% (n = 256), 6.9% (n = 48), 8.2% (n = 157), and 21.3% (n = 51), respectively. Poor visual acuity at baseline in SB and inferior rhegmatogenous retinal detachment and larger retinal tear in PPV were associated with a higher risk of failure. Pars plana vitrectomy was associated with a higher chance of achieving primary success in cases with simple RRD, especially for cases with superior RRD (adjusted hazard ratio 3.61, 95% confidence interval 2.22-5.94, P < 0.001). CONCLUSION: In this nationwide study, surgical anatomic outcomes were equally successful in either SB or PPV. There were different baseline characteristics associated with primary success between SB and PPV.
PURPOSE: To compare clinical outcomes between pars plana vitrectomy (PPV), scleral buckling (SB), and PPV+SB for rhegmatogenous retinal detachment in the Japan-RD Registry. METHODS: This is a nation-wide, multicenter, observational study based on the registry data between 2016 and 2017. The failure levels were defined as Level 1 (a failure of retinal detachment repair), Level 2 (remaining silicone oil), and Level 3 (multiple surgeries to achieve reattachment). We compared cases treated by SB or PPV in the subgroup of simple rhegmatogenous retinal detachment using multivariate Cox proportional hazard models. RESULTS: A total of 2,775 cases were included. Overall, 6 months any levels of failure in total, SB, PPV, and PPV+SB were 9.2% (n = 256), 6.9% (n = 48), 8.2% (n = 157), and 21.3% (n = 51), respectively. Poor visual acuity at baseline in SB and inferior rhegmatogenous retinal detachment and larger retinal tear in PPV were associated with a higher risk of failure. Pars plana vitrectomy was associated with a higher chance of achieving primary success in cases with simple RRD, especially for cases with superior RRD (adjusted hazard ratio 3.61, 95% confidence interval 2.22-5.94, P < 0.001). CONCLUSION: In this nationwide study, surgical anatomic outcomes were equally successful in either SB or PPV. There were different baseline characteristics associated with primary success between SB and PPV.