Abstract
Purpose:
To evaluate the relation between the incidence of redetachment and post-operative days of hospitalization in patients with diagnosis of retinal detachment who underwent surgery: or ab-externo approach (scleral buckling and encircling) or ab-interno approach (vitrectomy and oil-gas tamponade).
Methods:
The retrospective study starting from June 2010 to November 2012 (from August 2012 surgery is performed in day surgery mode according to economic policy), included 268 eyes with diagnosis of first retinal detachment episode of 268 patients: 127 males (47%) and 141 (53%) females; mean age of 64.1±17.3 years. 46 patients (17%) underwent a surgical ab-externo approach, instead 222 patients (83%) underwent a surgical ab-interno approach. Patients were graded by “Retinal detachment grading system of Royal college of ophthalmologists” and treated within 5 days after symptoms beginning. In all patients, retina is completely attached. The surgeon and the operatory theatre were ever the same. Patients were divided into four groups depending on days of post-operative hospitalization and grade: group A without days of hospitalization (day surgery) consists of 57 ”all grades” patients (21%; 48 ab-interno and 9 ab-externo); group B with one day of hospitalization consists of 75 “grade 1-2” patients (28%; 67 ab-interno and 8 ab-externo), group C with two days of hospitalization consists of 79 “grade 3” patients (29%; 65 ab-interno and 14 ab-externo) and group D with three or more days of hospitalization consists of 57 “grade 4” patients (21% ; 42 ab-interno and 15 ab-externo). Redetachment was considered within 30 days after surgery.
Results:
In the group A global redetachment rate was 3,50% (5,22% for ab-interno technique and 0% for ab-externo techniques). In the group B global redetachment rate was 1,33% (1,49% for ab-interno technique and 0% for ab-externo techniques).In the group C global redetachment rate was 3,80% (4,62% for ab-interno techniques and 0%.for ab-externo techniques). In the group D global redetachment rate was 12,28% (14,29% for ab-interno techniques for 6,67% ab-externo techniques). Group A incidence of redetachment is comparable to other groups and less than group D.
Conclusions:
The incidence of retinal redetachment is not increased in day surgery mode. Patients should be discharged in shortest time to reduce medical cost and problems related to hospitalization. Further studies are needed for patients’ security.
Keywords: 697 retinal detachment •
688 retina •
762 vitreoretinal surgery