Literature DB >> 35338355

Management of uncomplicated rhegmatogenous retinal detachments: a comparison of practice patterns and clinical outcomes in a real-world setting.

Sally S Ong1,2, Ishrat Ahmed1, Anthony Gonzales1, Ugochi T Aguwa1, Bradley Beatson1, Xi Dai1, Alex T Pham1, Yesha S Shah1, Ashley Zhou1, Lubaina T Arsiwala1, Jiangxia Wang3, James T Handa4.   

Abstract

OBJECTIVE: To investigate practice patterns and clinical outcomes in the repair of uncomplicated rhegmatogenous retinal detachments (RRD) in a real-world setting over a 10-year period.
METHODS: We compared preferences for scleral buckling (SB), pars plana vitrectomy (PPV), PPV/SB, or pneumatic retinopexy (PR) over time, and examined the 1-year single surgery anatomic success (SSAS) and best-corrected visual acuity (BCVA) at a tertiary academic institution from 2008-2018.
RESULTS: Eight hundred eight eyes had RRD repair between 2008-2011 (n = 240), 2012-2014 (n = 271), and 2015-2017 (n = 297). Compared to 2008-2011, PPV was preferred over SB in 2012-2014 (OR: 2.93; 95% CI: 1.86-4.63) and 2015-2017 (OR: 5.94; 95% CI: 3.76-9.38), and over PPV/SB in 2012-2014 (OR: 2.74; 95% CI: 1.65-4.56) and 2015-2017 (OR: 3.16; 95% CI: 31.96-5.12). PR was uncommonly utilized (<10%). Younger surgeons (graduating 2010-2017) favored PPV over SB when compared to older surgeons [graduating 1984-2000 (OR: 1.77; 95% CI: 1.18-2.65) and 2001-2009 (OR 1.73; 95% CI: 1.14-2.65)], but similarly selected PPV vs. PPV/SB as their older counterparts (p > 0.05). Compared to PPV, SSAS was higher with SB (OR: 1.53; 95% CI: 1.03-2.26) and PPV/SB (OR: 2.55; 95% CI: 1.56-4.17). One-year BCVA was markedly improved compared to baseline only for eyes that achieved SSAS (p < 0.001).
CONCLUSIONS: Over the past 10 years, PPV has become the favored approach to repair uncomplicated RRD and this appears to be driven by younger surgeons' preferences. Given the superior long-term SSAS in SB and PPV/SB as compared to PPV, SB and PPV/SB should be more frequently considered when determining the appropriate repair strategy for uncomplicated RRD.
© 2022. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.

Entities:  

Year:  2022        PMID: 35338355     DOI: 10.1038/s41433-022-02028-z

Source DB:  PubMed          Journal:  Eye (Lond)        ISSN: 0950-222X            Impact factor:   3.775


  4 in total

1.  Current popularity of pneumatic retinopexy.

Authors:  W E Benson; P Chan; S Sharma; W B Snyder; M A Bloome; D G Birch
Journal:  Retina       Date:  1999       Impact factor: 4.256

2.  Progress in detachment surgery.

Authors:  C L SCHEPENS
Journal:  Trans Am Acad Ophthalmol Otolaryngol       Date:  1951 Jul-Aug

3.  Vitrectomy: a pars plana approach.

Authors:  R Machemer; H Buettner; E W Norton; J M Parel
Journal:  Trans Am Acad Ophthalmol Otolaryngol       Date:  1971 Jul-Aug

4.  Pars plana vitrectomy versus scleral buckling for repairing simple rhegmatogenous retinal detachments.

Authors:  Ljubo Znaor; Aleksej Medic; Susanne Binder; Ana Vucinovic; Josipa Marin Lovric; Livia Puljak
Journal:  Cochrane Database Syst Rev       Date:  2019-03-08
  4 in total
  1 in total

Review 1.  Scleral Buckling: A Look at the Past, Present and Future in View of Recent Findings on the Importance of Photoreceptor Re-Alignment Following Retinal Re-Attachment.

Authors:  Miguel Cruz-Pimentel; Chyong Yng Huang; Lihteh Wu
Journal:  Clin Ophthalmol       Date:  2022-06-16
  1 in total

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