Management of uncomplicated primary retinal rhegmatogenous detachment

Abstract

Purpose

The purpose of this study was to compare the vitreoretinal surgery outcomes in patients with uncomplicated rhegmatogenous retinal detachment (RRD).

Design

This was a retrospective, nonrandomized consecutive case series study.

Participants

Six hundred and eighty-three eyes with primary uncomplicated RRD between 2013 and 2017 were included in this study.

Method

Patients were treated by one of the following methods: pars plana vitrectomy (PPV), scleral buckling (SB), and combined PPV with SB (PPV + SB). The success rate was divided into an anatomical and functional one, the anatomical success rate was retinal reattachment, and the functional success rate was defined as a statistically significant improvement in BCVA patients within a 6-month follow-up period.

Results

This study involved 683 eyes; of these, 79 eyes underwent PPV, combined PPV/SB was performed on 180 eyes, and 424 eyes underwent SB. The anatomical success rates were 83.5% for PPV and 80% for combined SB/PPV. The anatomical success rate for the SB group was 75.5%. There were no significant differences between these groups in terms of anatomical success rates (0.191) or functional success rates (p = 0.534). There was no significant difference between the PPV alone and PPV + SB in terms of the likelihood of anatomic success (p-value: 0.503) or functional success (p-value: 0.839). Preoperative worse BCVA and presence of PVR were associated with poor prognosis (p-value: 0.024, 0.013, respectively).

Conclusion

In the setting of appropriate instruments for microincision pars plana deep vitrectomy, it seems the surgical outcomes of scleral buckling and PPV are not different in patients with primary uncomplicated RRD. The supplementary band has not additional benefits in patients who underwent PPV with this type of RRD.

This is a preview of subscription content, access via your institution.

Data Availability

Data of our study are availble in check lists.

References:

  1. 1.

    Bernd Kirchhof KTO, Hartnett ME, Landers MB (2012) Pathogenetic mechanisms of retinal detachment. Retina. 3:1616–1621

    Google Scholar 

  2. 2.

    Mitry D, Charteris DG, Fleck BW, Campbell H, Singh J (2009) The epidemiology of rhegmatogenous retinal detachment: geographical variation and clinical associations. Br J Ophthalmol 94(6):678–684

    Article  Google Scholar 

  3. 3.

    Sodhi A, Leung LS, Do DV, Gower EW, Schein OD, Handa JT (2008) Recent Trends in the Management of Rhegmatogenous Retinal Detachment. Surve Ophthalmol. 53(1):50–67

    Article  Google Scholar 

  4. 4.

    Alyward G (2013) Optimal procedures for retinal detachment repair. Retina 3:1784–1792

    Article  Google Scholar 

  5. 5.

    Thompson JT (2012) The effects and action of scleral buckles in the treatment of retinal detachment. Elsevier Inc.

    Google Scholar 

  6. 6.

    Heimann H, Bartz-Schmidt KU, Bornfeld N, Weiss C, Hilgers RD, Foerster MH (2007) Scleral Buckling versus Primary Vitrectomy in Rhegmatogenous Retinal Detachment: A Prospective Randomized Multicenter Clinical Study. Am Acad Ophthalmol. 114(12):2142–2154

    Google Scholar 

  7. 7.

    Eibenberger K, Georgopoulos M, Rezar-Dreindl S, Schmidt-Erfurth U, Sacu S (2018) Development of surgical management in primary rhegmatogenous retinal detachment treatment from 2009 to 2015. Current Eye Res. 43(4):517–525

    Article  Google Scholar 

  8. 8.

    Cankurtaran VCM, Simsek M, Tekin K, Teke MY (2017) Anatomical and functional outcomes of scleral buckling versus primary vitrectomy in pseudophakic retinal detachment. Bosn J Basic Med Sci 17(1):74–80

    PubMed  PubMed Central  Google Scholar 

  9. 9.

    Sahanne S, Tuuminen R, Haukka J, Loukovaara S (2017) A retrospective study comparing outcomes of primary rhegmatogenous retinal detachment repair by scleral buckling and pars plana vitrectomy in Finland. Clin Ophthalmol 11:503–509

    Article  Google Scholar 

  10. 10.

    Lindsell L, Sisk R, Miller D, Foster R, Petersen M, Riemann C, Hutchins R (2016) Comparison of outcomes: scleral buckling and pars plana vitrectomy versus vitrectomy alone for primary repair of rhegmatogenous retinal detachment. Clin Ophthalmol. 11:47–54

    Article  Google Scholar 

  11. 11.

    Moradian S, Ahmadieh H, Faghihi H, Ramezani A, Entezari M, Banaee T, Heidari E, Behboudi H, Yasseri M (2016) Comparison of four surgical techniques for management of pseudophakic and aphakic retinal detachment: a multicenter clinical trial. Graefe’s Arch Clin Exp Ophthalmol. 254(9):1743–1751

    Article  Google Scholar 

  12. 12.

    Park SW, Kwon HJ, Kim HY, Byon IS, Lee JE, Oum BS (2015) BMC Ophthalmology. 15(1):1–6

    Article  Google Scholar 

  13. 13.

    Rush R, Simunovic MP, Sheth S, Chang A, Hunyor AP (2014) 23-Gauge pars plana vitrectomy versus scleral buckling versus combined pars plana vitrectomy-scleral buckling for medium-complexity retinal detachment repair. Asia Pac J Ophthalmol. 3(4):215–219

    Article  Google Scholar 

  14. 14.

    Soni C, Hainsworth DP, Almony A (2013) Surgical management of rhegmatogenous retinal detachment: a meta-analysis of randomized controlled trials. Am Acad Ophthalmol. 120(7):1440–1447

    Google Scholar 

  15. 15.

    Totsuka K, Inui H, Roggia MF, Hirasawa K, Noda Y, Ueta T (2015) Supplemental scleral buckle in vitrectomy for the repair of rhegmatogenous retinal detachment: a systematic review of literature and meta-analysis. Retina 35(11):2423–2431

    Article  Google Scholar 

  16. 16.

    Wong CW, Wong WL, San Yeo IY, Loh BK, Wong EYM, Wong DWK et al (2014) Trends and factors related to outcomes for primary rhegmatogenous retinal detachment surgery in a large Asian tertiary eye center. Retina 34(4):684–692

    Article  Google Scholar 

  17. 17.

    Rush R, Simunovic MP, Sheth S, Chang A, Hunyor AP (2014) 23-Gauge pars plana vitrectomy versus scleral buckling versus combined pars plana vitrectomy-scleral buckling for medium-complexity retinal detachment repair. Asia Pac J Ophthalmol 3(4):215–219

    Article  Google Scholar 

  18. 18.

    Maitray AJPV, Ratra D (2017) Scleral buckling versus vitrectomy for primary rhegmatogenous retinal detachment. Sci J Med Vis Res Found 35:10–19

    Google Scholar 

Download references

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Farideh Mousavi.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study’s ethical approval code is 94/1–5/16, obtained from Tabriz University of the Medical Science Ethics Committee. This study was performed in line with Helsinki Declaration principle, and all procedures being performed were part of routine care.

Data and material available

This study was done retrospectively, and patients are informed about their data utilizing for investigation in the admission process in our department, and they have given prior written consent.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Taheri, N., Mousavi, F., Ahoor, M.H. et al. Management of uncomplicated primary retinal rhegmatogenous detachment. Int Ophthalmol (2021). https://doi.org/10.1007/s10792-021-01729-w

Download citation

Keywords

  • Retinal rhegmatogenous detachment
  • Scleral buckling
  • Pars plana vitrectomy
  • Supplementary band