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Christiane I. Falkner-Radler, Jane S. Myung, Sarah Moussa, R.V. Paul Chan, Eva Smretschnig, Szilard Kiss, Alexandra Graf, Donald J. D’Amico, Susanne Binder; Trends in Primary Rhegmatogenous Retinal Detachment Surgery Based on a Bicenter Study. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6175.
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To assess trends in primary rhegmatogenous retinal detachment (RRD) surgery based on a retrospective, interventional bicenter study.
Baseline demographic data, surgical procedures and outcomes from 230 patients with a diagnosis of primary RRD, who underwent surgery between January 2007 and December 2008 at the Rudolf Foundation Clinic, Vienna, Austria (center 1) and the Weill Cornell Medical College and New York-Presbyterian Hospital, New York, United States (center 2), were enrolled and analyzed using a regression model. In addition, all statistical analyses were substratified by year and center.
Retinal reattachment after the primary surgical approach was achieved in 123 patients (88.49%) in center 1 and in 77 patients (84.62%) in center 2, and in all patients (100%) after one or more reoperations. Sixty eight patients in center 1 (48.9%) and 43 patients in center 2 (47.3%) achieved a best corrected visual acuity (BCVA) at final follow-up of at least 0.3 logMAR. Besides the baseline parameters lens status (p=.01), refraction (p=.01), retinal tears (p<.02), PVR (p=.02) and previous treatment (p<.02), the choice of the primary RD procedure (p<.002) was significantly different between the two centers. Scleral buckling was the primary RRD procedure in center 1 (87.77%) whereas vitrectomy was the most common primary procedure in center 2 (83.52%). The main outcome measures retinal reattachment (p=.43) and BCVA at final follow-up (p=.78) were not significantly different between the two centers.
Good and comparable anatomic and visual outcomes, which were not significantly associated with the selection of the primary RRD procedure, were achieved in both centers. Scleral buckling seems to remain the primary RRD procedure in the center in Vienna, particularly in phakic and young RRD cases. There is an agreement on the use of primary vitrectomy in pseudophakic RRD cases in both centers. In addition, there is an increasing trend towards primary vitrectomy for the treatment of phakic and pseudophakic RRD patients in the both centers.
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