June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Strategy for the Management of Complex Retinal Detachments: The European Vitreo-Retinal Society Retinal Detachment Study
Author Affiliations & Notes
  • Aaron Parnes
    Ophthalmology, Yale University, New Haven, CT
  • Didier Ducournau
    Clinique Sourdille, Nantes, France
  • Jack Sipperley
    Retinal Consultants of Arizona, Phoenix, AZ
  • Ron Adelman
    Ophthalmology, Yale University, New Haven, CT
  • Footnotes
    Commercial Relationships Aaron Parnes, None; Didier Ducournau, None; Jack Sipperley, None; Ron Adelman, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 2846. doi:
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      Aaron Parnes, Didier Ducournau, Jack Sipperley, Ron Adelman, ; Strategy for the Management of Complex Retinal Detachments: The European Vitreo-Retinal Society Retinal Detachment Study. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2846.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To study the outcome of the treatment of complex rhegmatogenous retinal detachments.

Methods: In this non-randomized, multi-center retrospective study, 176 surgeons from 48 countries spanning 5 continents provided information regarding the primary procedures for 7,678 rhegmatogenous retinal detachments. Reported data included clinical manifestations, the method of repair, and the outcome following treatment.

Results: The main categories of complex retinal detachments evaluated in this investigation are those associated with: 1) Grade B PVR (n = 917), 2) Grade C-1 PVR (n = 637), 3) choroidal detachment or significant hypotony (n = 578), 4) large or giant retinal tears (n = 1,167), and 5) macular hole detachments (n = 153). In detachments with Grade B PVR, the final failure rate was higher when treated with a scleral buckle alone versus vitrectomy (p=0.0017). In cases with Grade C-1 PVR, there was no statistically significant difference in the final failure rate between those treated with vitrectomy, with or without scleral buckle, and those treated with scleral buckle alone (p = 0.7). Those that received vitrectomy with a supplemental buckle had an increased failure rate compared to those that did not receive a buckle (p = 0.007). There was no statistically significant difference in final failure rate between tamponade with gas versus silicone oil in patients with Grade B or C1 PVR. Cases with choroidal detachment or hypotony treated with vitrectomy had a significantly lower failure rate versus treatment with scleral buckle alone (p = 0.0015). Cases with large or giant retinal tears treated with vitrectomy also had a significantly lower failure rate versus treatment with scleral buckle (p = 7 x 10 -8).

Conclusions: In patients with retinal detachment, when choroidal detachment, hypotony, a large tear, or a giant tear is present, vitrectomy is the procedure of choice. In retinal detachments with PVR, tamponade with either gas or silicone oil can be considered. If a vitrectomy is to be performed, this data suggests that a supplemental buckle may not be helpful.

Keywords: 697 retinal detachment • 655 proliferative vitreoretinopathy  
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