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Graefes Arch Clin Exp Ophthalmol. 2018 Nov;256(11):2069-2073. doi: 10.1007/s00417-018-4106-6. Epub 2018 Aug 23.

Vitrectomy with and without encircling band for pseudophakic retinal detachment with inferior breaks: VIPER Study Report No. 3.

Author information

1
Department of Ophthalmology, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany. sabaumgarten@ukaachen.de.
2
Institute of Medical Statistics and Computational Biology, University of Cologne, Cologne, Germany.
3
Department of Ophthalmology, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany.
4
Eye Center, Albert-Ludwigs-University of Freiburg, Freiburg im Breisgau, Germany.
5
University Eye Hospital, Hannover Medical School, Hannover, Germany.
6
Department of Ophthalmology, University of Regensburg, Regensburg, Germany.
7
Department of Ophthalmology, Franziskus Hospital, Münster, Germany.

Abstract

PURPOSE:

To test if an encircling band improves outcomes in vitrectomy for pseudophakic retinal detachment (PRD) with inferior or with multiple (4 or more) breaks.

METHODS:

Subgroup analysis of a prospective randomized controlled multicenter trial in patients with uncomplicated PRD assigned either to 20 G vitrectomy plus encircling band (group E1), or 20 G vitrectomy without any buckle (group C), or 23/25 G vitrectomy without any buckle (group E2). The primary endpoint was defined as no indication for any retina reattaching procedure during the review period of 6 months. One hundred out of 257 patients were identified with inferior breaks and 63 patients had 4 or more breaks.

RESULTS:

In patients with retinal breaks between 5:00 and 7:00, treatment was successful in 77.4% (24/31, treatment arm E1) versus 57.1% (16/28, treatment arm C) (p = 0.301, odds ratio (OR) 1.83, 95% confidence interval (CI) 0.48 to 7.17). In patients with multiple breaks, success rates were 68.2% (15/22, E1) versus. 72.4% (21/29, C, p = 0.46, OR 0.52, CI 0.08-3.65).

CONCLUSION:

Combining an encircling band with vitrectomy in patients with pseudophakic retinal detachment and inferior or multiple breaks does not significantly improve primary anatomical success in comparison to treatment with 20 G or 23/25 G vitrectomy alone.

KEYWORDS:

Inferior breaks; Pseudophakic; Randomized clinical trial; Retinal detachment; Scleral buckling; Vitrectomy

PMID:
30140963
PMCID:
PMC6208723
DOI:
10.1007/s00417-018-4106-6
[Indexed for MEDLINE]
Free PMC Article

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