Format

Send to

Choose Destination
See comment in PubMed Commons below
Ophthalmology. 2013 Sep;120(9):1804-8. doi: 10.1016/j.ophtha.2013.01.070. Epub 2013 Apr 16.

Strategy for the management of uncomplicated retinal detachments: the European vitreo-retinal society retinal detachment study report 1.

Collaborators (188)

Ducournau D, Lucke K, Md JN, Md TP, Adelman RA, Md CB, Md SB, Md FK, Md HM, Md IF, Nowosielska A, Facino M, Benmerzouga N, Metti F, Razzari A, Miesbauer P, Schönherr U, Zeynalova Z, Bashir SJ, Jacob J, Koch P, Ladha R, Smets E, Stalmans P, Dare A, Daskalov V, Tanev I, Devenyi R, Lam WC, Shaheeda M, Potamitis T, Belfinova S, Dusova J, Fiser I, Rusnak S, Veith M, Christensen SR, El Rayes E, Mortada H, Shouman A, Holm M, Albinet P, Amar JP, Becquet F, Berrod JP, Boulze M, Boscher C, Courjaret JC, Denion E, Ducournau D, Fourmaux E, Guigou S, Hamon F, Lafontaine PO, Le Rouic JF, Leynaud JL, Nochez Y, Perone JM, Rysanek B, Soyeur R, Bopp S, Brix A, Höhn F, Kusserow C, Lucke K, Mohr A, Schüler A, Weinberger A, Gotzaridis S, Karatzenis D, Stefaniotou M, Tsilimbaris MK, Tsouris D, Tsang CW, Gabor R, Szijarto Z, Babu N, Banker AS, Bapaye M, Kelkar A, Entezari M, Moghadam HF, Ramezani A, Safarpour Lima B, Omer K, Boscia F, Freno MC, Cian R, Donvito G, Facino M, Lesnoni G, Liuzzi F, Mete M, Mininni F, Mochi B, Primavera V, Romano M, Pertile G, Turco I, Vastarella P, Fong K, Lee MW, Loo AV, Harrison OA, Flores-Aguilar M, Montero LM, Hernandez GL, Velasco I, Boeyden V, Bosscha M, De Vries Knoppert W, Lindstedt E, De Lavalette VW, Van Den Biesen PR, Alhassan M, Baerland TP, Bober AM, Forsaa V, Fossen K, Varhaug P, Atienza NF Jr, Cisiecki S, Fryczkowski P, Kowal-Lange A, Michalewska Z, Michalewski J, Nawrocki J, Nowosielska A, Odrobina D, Pietras Trzpiel M, Zakrzewska A, Meireles A, Teixeira S, Elshafei M, Danielescu C, Talu S, Altynbaev U, Gorin A, Serejine I, El Deeb M, Davidovic S, Ignjatovic Z, Stefanickova J, Venter L, Chang W, Jo YJ, Kim JY, Lee J, Lim ST, Sagong M, Ascaso FJ, Castro J, Cordoves L, Esteban CD, Manresa JM, Vilaplana D, Janiec S, Tomic Z, Yahia SB, Acar N, Güngel H, Kapran Z, Osmanbasoglu O, Ozdek S, Topbas S, Totan Y, Ünver YB, Chichur D, Dobrovolskey O, Kozlovska I, Lytvynchuk L, Phylypchuk O, Postolovska A, Sergiienko A, Shevchyk V, Winder S, Culotta J, Kim S, King J, Kurup SK, Lin SJ, Pacurariu R, Roth D, Sinclair S, Sipperley J, Weber P, Doan H, Tung T.

Author information

1
Department of Ophthalmology & Visual Science, Yale University School of Medicine, New Haven, Connecticut, USA. ron.adelman@yale.edu

Abstract

OBJECTIVE:

To study success and failure in the treatment of uncomplicated rhegmatogenous retinal detachments (RRDs).

DESIGN:

Nonrandomized, multicenter retrospective study.

PARTICIPANTS:

One hundred seventy-six surgeons from 48 countries spanning 5 continents provided information on the primary procedures for 7678 cases of RRDs including 4179 patients with uncomplicated RRDs.

METHODS:

Reported data included specific clinical findings, the method of repair, and the outcome after intervention.

MAIN OUTCOME MEASURES:

Final failure of retinal detachment repair (level 1 failure rate), remaining silicone oil at the study's conclusion (level 2 failure rate), and need for additional procedures to repair the detachment (level 3 failure rate).

RESULTS:

Four thousand one hundred seventy-nine uncomplicated cases of RRD were included. Combining phakic, pseudophakic, and aphakic groups, those treated with scleral buckle alone (n = 1341) had a significantly lower final failure rate than those treated with vitrectomy, with or without a supplemental buckle (n = 2723; P = 0.04). In phakic patients, final failure rate was lower in the scleral buckle group compared with those who had vitrectomy, with or without a supplemental buckle (P = 0.028). In pseudophakic patients, the failure rate of the initial procedure was lower in the vitrectomy group compared with the scleral buckle group (P = 3×10(-8)). There was no statistically significant difference in failure rate between segmental (n = 721) and encircling (n = 351) buckles (P = 0.5). Those who underwent vitrectomy with a supplemental scleral buckle (n = 488) had an increased failure rate compared with those who underwent vitrectomy alone (n = 2235; P = 0.048). Pneumatic retinopexy was found to be comparable with scleral buckle when a retinal hole was present (P = 0.65), but not in cases with a flap tear (P = 0.034).

CONCLUSIONS:

In the treatment of uncomplicated phakic retinal detachments, repair using scleral buckle may be a good option. There was no significant difference between segmental versus 360-degree buckle. For pseudophakic uncomplicated retinal detachments, the surgeon should balance the risks and benefits of vitrectomy versus scleral buckle and keep in mind that the single-surgery reattachment rate may be higher with vitrectomy. However, if a vitrectomy is to be performed, these data suggest that a supplemental buckle is not helpful.

FINANCIAL DISCLOSURE(S):

The author(s) have no proprietary or commercial interest in any materials discussed in this article.

PMID:
23601799
DOI:
10.1016/j.ophtha.2013.01.070
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center