The Comparison of Surgical Outcomes in the Inferior Rhegmatogenous Retinal Detachment With Medium Severity

Ji Yong Ryou; Yun Young Kim

doi:10.3341/jkos.2010.51.9.1224

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Ryou and Kim: The Comparison of Surgical Outcomes in the Inferior Rhegmatogenous Retinal Detachment With Medium Severity

Original Article

Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2010; 51(9): 1224-1230.

Published online: 30 September 2010

DOI: https://doi.org/10.3341/jkos.2010.51.9.1224

The Comparison of Surgical Outcomes in the Inferior Rhegmatogenous Retinal Detachment With Medium Severity

Ji Yong Ryou, MD, Yun Young Kim, MD, PhD

Department of Ophthalmology, The Catholic University of Daegu School of Medicine, Daegu, Korea.

Address reprint requests to Yun Young Kim, MD, PhD. Department of Ophthalmology, The Catholic University of Daegu School of Medicine, #3056-6 Daemyeung-4dong, Nam-gu, Daegu 705-718, Korea. Tel: 82-53-650-4728, Fax: 82-53-627-0133, yykim@cu.ac.kr

Received 31 March 2010 Accepted 24 May 2010

Abstract

Purpose

To compare the surgical results between scleral buckling (SB) and pars plana vitrectomy (PPV) for patients with inferior rhegmatogenous retinal detachment (RRD) of medium severity.

Methods

Two different types of surgery was performed on patients with inferior RRD of medium severity and divided into group 1 (PPV) and group 2 (SB). The preoperative clinical features, anatomical success rate, and changes of visual acuity (VA) were retrospectively evaluated.

Results

Preoperative phakic status in group 2 was statistically significantly high, as compared to the group 1 (p=0.02), but other preoperative clinical features were not different between the 2 groups. The primary surgical success rates were 88% and 92% in group 1 and 2, respectively. The final success rate was 100% in both groups. No statistically significant correlation between surgical method and recurrence was found. The preoperative logMAR VA was 0.96 in group 1 and 0.71 in group 2 and improved postoperatively to 0.42 and 0.40, respectively; these were statistically significant changes. However, the final VA between the 2 groups showed no statistically significant difference.

Conclusions

No statistically significant differences of primary and final success rate between SB and PPV groups were found for inferior RRD associated with medium severity. However, preoperative phakic status could influence the selection of the surgical method for RRD.

Keywords: Inferior rhegmatogenous retinal detachment, Medium severity, Pars plana vitrectomy, Scleral buckling

Figures and Tables

Figure 1

Preoperative and postoperative visual acuity changes.

Table 1

Modified inclusion and exclusion criteria

^*Anterior and posterior.

Table 2

Preoperative demographic findings

^*Independent t-test; ^†Pearson's chi square test; ^‡Mann-Whitney test.

Table 3

Break characteristics of both group

^*Different anterior and posterior.

Table 4

Intraoperative features

^*Segmental circumferential buckling; ^†Radial buckling; ^‡Encircling buckling.

Table 5

Postoperative comparisons between two groups

^*Independent t-test; ^†Fisher's exact test; ^‡Pearson's chi-square test; ^§Complication.

References

1. Leaver P. Expanding the role of vitrectomy in retinal reattachment surgery. Br J Ophthalmol. 1993. 77:197.

2. Wong D, Billington BM, Chignell AH. Pars plana vitrectomy for retinal detachment with unseen retinal holes. Graefes Arch Clin Exp Ophthalmol. 1987. 225:269–271.

3. Heimann H, Hellmich M, Bornfeld N, et al. Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment (SPR Study): Design issues and implications SPR Study Report No.1. Graefes Arch Clin Exp Ophthalmol. 2001. 239:567–574.

4. Schwartz SG, Kuhl DP, McPherson AR, et al. Twenty-year follow-up for scleral buckling. Arch Ophthalmol. 2002. 120:325–329.

5. Alexander P, Ang A, Poulson A, Snead MP. Scleral buckling combined with vitrectomy for the management of rhegmatogenous retinal detachment associated with inferior retinal breaks. Eye. 2008. 22:200–203.

6. Ozdek S, Kiliç A, Gurelik G, Hasanreisoglu B. Scleral buckling technique for longstanding inferior rhegmatogenous retinal detachments with subretinal bands. Ann Ophthalmol. 2008. 40:35–38.

7. Hotta K, Sugitani A, Uchino Y. Pars plana vitrectomy without long-acting gas tamponade for primary rhegmatogenous retinal detachment. Ophthalmologica. 2004. 218:270–273.

8. Sharma A, Grigoropoulos V, Williamson TH. Management of primary rhegmatogenous retinal detachment with inferior breaks. Br J Ophthalmol. 2004. 88:1372–1375.

9. Fawcett IM, Williams RL, Wong D. Contact angles of substances used for internal tamponade in retinal detachment surgery. Grafes Arch Clin Exp Ophthalmol. 1994. 232:438–444.

10. Heimann H, Zou X, Jandeck C, et al. Primary vitrectomy for rhegmatogenous retinal detachment: an analysis of 512 cases. Graefes Arch Clin Exp Ophthalmol. 2006. 244:69–78.

11. Martínez-Castillo V, Verdugo A, Boixadera A, et al. Management of inferior breaks in pseudophakic rhegmatogenous retinal detachment with pars plana vitrectomy and air. Arch Ophthalmol. 2005. 123:1078–1081.

12. Martínez-Castillo V, Boixadera A, Verdugo A, García-Arumí J. Pars plana vitrectomy alone for the management of inferior breaks in pseudophakic retinal detachment without facedown position. Ophthalmology. 2005. 112:1222–1226.

13. Martínez-Castillo V, Zapata MA, Boixadera A, et al. Pars plana vitrectomy, laser retinopexy, and aqueous tamponade for pseudophakic rhegmatogenous retinal detachment. Ophthalmology. 2007. 114:297–302.

14. Tanner V, Minihan M, Williamson T. Management of inferior retinal breaks during pars plana vitrectomy for retinal detachment. Br J Ophthalmol. 2001. 85:480–482.

15. Heimann H, Bartz-Schmidt KU, Bornfeld N, et al. Scleral Buckling versus primary vitrectomy in rhegmatogenous retinal detachment. Ophthalmology. 2007. 114:2142–2154.

16. Minihan M, Tanner V, Williamson TH. Primary rhegmatogenous retinal detachment: 20 years of change. Br J Ophthalmol. 2001. 85:546–548.

17. Heimann H, Bornfeld N, Friedrichs W, et al. Primary vitrectomy without scleral buckling for rhegmatogenous retinal detachment. Grafes Arch Clin Exp Ophthalmol. 1996. 234:561–568.

18. Chaudhry NA, Flynn HW, Murray TG, et al. Combined cataract surgery and vitrectomy for recurrent retinal detachment. Retina. 2000. 20:257–261.

19. Jung CI, Kim SY, Kim SD. Comparison of surgical result of vitrectomy vs combined phacoemulsification and vitrectomy in patients with diabetic vitreous hemorrhage. J Korean Ophthalmol Soc. 2000. 41:2375–2380.

20. Senn P, Schipper I, Perren B. Combined pars plana vitrectomy, phacoemulsification, and intraocular lens implantation in the capsular bag: a comparison to vitrectomy and subsequent cataract surgery as a two-step procedure. Ophthalmic Surg Lasers. 1995. 26:420–428.

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