Comparison of Two surgical treatments for Rhegmatogenous Retinal Detachment
Tal Yahalomi1*, Idan Hecht2,3, Michal Lifshitz1, Roee Arnon1, Halit Winter1 and Joseph Pikkel1
1Department of Ophthalmology, Samson Assuta Ashdod Hospital, Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel
2Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
3Department of Ophthalmology, Shamir Medical, Zerifin, Israel
*Corresponding Author: Tal Yahalomi, Department of Ophthalmology, Samson Assuta Ashdod Hospital, Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel.
November 22, 2021; Published: December 15, 2021
Purpose: To compare the success rate of pars plana vitrectomy (PPV) and scleral buckling in terms of visual outcomes, repeated surgeries and postoperative complications for the treatment of rhegmatogenous retinal detachment.
Methods: We collected data of all patients operated in one tertiary medical center in Israel during the year 2019. Patient over the age of 18 years with at least one year of follow-up were included. Retinal attachment rate, visual outcomes and postoperative complications were compared.
Results: Included were 30 patients that underwent posterior vitrectomy and 36 that underwent scleral buckling. All patients were operated by the same surgeon. Success rate of retina re-attachment were almost the same in both groups (86.7% vs 86.1 for vitrectomy and scleral buckle respectively, p = 0.948). In both groups there was a significant improvement of the final visual acuity compared to the pre-operative visual acuity (0.146 ± 0.1 vs 0.149 ± 0.1 Log MAR improvement for vitrectomy and scleral buckle respectively, p = 0.411). A strong correlation existed between the number of operations to reattachments -any additional surgery drops the chance of reattachment by 2.4% (odds ratio: 0.024, 95% CI 0.003 - 0.208, p ≤ 0.001).
Conclusion: Among a modern cohort of patients with retinal detachment, no differences were seen in success rates or visual outcomes between patients treated with posterior vitrectomies compared to scleral buckling.
Keywords: Pars Plana Vitrectomy; PPV; Scleral Buckling; SB; Rhegmatogenous Retinal Detachment; RRD
- Dan L Longo. “Harrison’s Principles of Internal Medicine”. 18e, chapter 28 ed (2021).
- Znaor L., et al. “Pars plana vitrectomy versus scleral buckling for repairing simple rhegmatogenous retinal detachments”. Cochrane Database Systematic Reviews3 (2019).
- Tasman W and Jaeger E. “Duane’s Foundations of Clinical Ophthalmology”. 2006, chapter 27. Lippincott Williams and Wilkins (2006).
- Myron Yanoff M., et al. “Ophthalmology”. 5th edition (2018).
- Cankurtaran V., et al. “Anatomical and functional outcomes of scleral buckling versus primary vitrectomy in pseudophakic retinal detachment”. Bosnian Journal of Basic Medical Sciences1 (2017): 74-80.
- Ah-Fat FG., et al. “Trends in vitreoretinal surgery at a tertiary referral centre: 1987 to 1996”. British Journal of Ophthalmology 4 (1999): 396-398.
- Olsen G and Olson RJ. “Update on a long-term, prospective study of capsulotomy and retinal detachment rates after cataract surgery”. Journal of Cataract and Refractive Surgery 7 (2009): 1017-1021.
- Javitt JC., et al. “National Outcomes of Cataract Extraction I: Retinal Detachment after Inpatient Surgery”. Ophthalmology6 (1999): 895-902.
- Lois N and Wong D. “Pseudophakic retinal detachment”. Survey of Ophthalmology5 (2003): 467-487.
- Speicher MA., et al. “Primary Vitrectomy Alone for Repair of Retinal Detachments Following Cataract Surgery”. Retina5 (2000): 459.
- Bartz-Schmidt KU., et al. “Primary vitrectomy for pseudophakic retinal detachment”. British Journal of Ophthalmology 4 (1996): 346-349.
- Stone TW and Mittra RA. “ASRS 2013 Preferences and Trends Membership Survey, Chicago, IL, USA”. American Society of Retina Specialists (2013).
- W E Benson., et al. “Current popularity of pneumatic retinopexy-PubMed”. Retina (1999): 238-241.
- Kawano S., et al. “Scleral buckling versus pars plana vitrectomy in simple phakic macula-on retinal detachment: A propensity score-matched, registry-based study”. British Journal of Ophthalmology (2021).
- Gharbiya M., et al. “Macular Ganglion Cell Layer Thickness after Macula-Off Rhegmatogenous Retinal Detachment Repair: Scleral Buckling versus Pars Plana Vitrectomy”. Journal of Clinical Medicine5 (2000): 1411.
- Heimann H., et al. “Scleral Buckling versus Primary Vitrectomy in Rhegmatogenous Retinal Detachment. A Prospective Randomized Multicenter Clinical Study”. Ophthalmology 12 (2007).
- Brazitikos PD., et al. “Primary pars plana vitrectomy versus scleral buckle surgery for the treatment of pseudophakic retinal detachment: A randomized clinical trial”. Retina8 (2005): 957-964.
- S Lake., et al. “Management of pseudophakic retinal detachment with various intraocular lens types-PubMed”. Annals of Ophthalmology (1993): 381-384.
- Yoshida A., et al. “Retinal Detachment after Cataract Surgery: Surgical Results”. Ophthalmology 3 (1992): 460-465.
- Cousins S., et al. “Pseudophakic Retinal Detachments in the Presence of Various IOL Types”. Ophthalmology9 (1986): 1198-1208.
- Yoshida A., et al. “Retinal Detachment after Cataract Surgery: Predisposing Factors”. Ophthalmology 3 (1999): 453-459.