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Ophthalmology. 2014 Mar;121(3):643-8. doi: 10.1016/j.ophtha.2013.07.015. Epub 2013 Aug 23.

United Kingdom National Ophthalmology Database study of vitreoretinal surgery: report 3, retinal detachment.

Author information

1
King's College London, London, United Kingdom. Electronic address: t.jackson1@nhs.net.
2
The Royal College of Ophthalmologists' National Ophthalmology Database, London, United Kingdom; Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, United Kingdom.
3
Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, United Kingdom.
4
The Royal College of Ophthalmologists' National Ophthalmology Database, London, United Kingdom; Bristol Eye Hospital, Bristol, United Kingdom.

Abstract

PURPOSE:

To describe rhegmatogenous retinal detachment (RD) surgery.

DESIGN:

National Ophthalmology Database study.

PARTICIPANTS:

A total of 3403 eyes from 3321 patients undergoing primary RD surgery.

METHODS:

Participating centers prospectively collected clinical data using a single electronic medical record system, with automatic extraction of anonymized data to a national database, from 2002 to 2010.

MAIN OUTCOME MEASURES:

Description of the primary procedures performed, intraoperative complication rate, and proportion of eyes undergoing subsequent RD or cataract surgery. We undertook an exploratory analysis of change in visual acuity (VA) using the data available.

RESULTS:

Of 3403 operations, 2693 (79.1%) were pars plana vitrectomy (PPV), 413 (12.1%) were retinopexy with a scleral buckle (SB), and 297 (8.7%) were PPV with an SB (PPV-SB). For PPV and PPV-SB, 18.8% were with hexafluoroethane, 12.1% were with perfluoropropane, 43.1% were with sulfahexafluoride, 1.8% were with air, 17.9% were with silicone oil, and 10.7% were with cataract surgery. Within 1 year of vitrectomy, 52.1% of phakic eyes had undergone cataract surgery. For all RD operations combined (and excluding cataract surgery complications), 5.1% had 1 or more intraoperative complication, 13.0% underwent further RD surgery, and 8.3% had silicone oil in situ at last review. The RD reoperation rate was 13.3%, 12.3%, and 14.5% for PPV, SB, and PPV-SB, respectively. For 961 eyes with a baseline and final VA measurement, the median presenting logarithm of the minimum angle of resolution VA improved from 1.0 to 0.5 (20/200-20/63) after a median follow-up of 0.6 years.

CONCLUSIONS:

These results may help vitreoretinal surgeons to benchmark their intraoperative complication rate and reoperation rate and to compare their surgical techniques with their peers'. They suggest that the benefits of RD surgery greatly outweigh the risks.

PMID:
23978624
DOI:
10.1016/j.ophtha.2013.07.015
[Indexed for MEDLINE]

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