Abstract
Purpose: :
Promising anatomical and functional results have been reported for pars plana vitrectomy (PPV) in the treatment of rhegmatogenous retinal detachments (RRDs), with a slightly better anatomical outcome when an encircling band was added to the surgical procedure.
Methods: :
A clinical trial was designed to include sixty patients, assigned randomly to be treated with PPV combined with 360° endolaser photocoagulation (group 1) or with PPV combined with an encircling band (group 2). Gas or silicone oil was used as intraocular tamponade depending on the complexity of the RRD. Slicone oil removal was planed to be performed three to six months after RRD surgery. Main outcome measures were retinal redetachment rate, surgery-related complications, patients` comfort, refractive change, visual acuity and optical coherence tomography (OCT). Patients were examined preoperatively and one week, one month and 3 and 6 months after RRD surgery, and respectively after silicone oil removal.
Results: :
Up to now 22 patients with a mean follow-up of 12 months were included into group 1 and 18 patients with a mean follow-up of 10 months were included into group 2. Retinal redetachment occurred in two patients in group 1 and in two patients in group 2. Postoperative iris capture occurred in 2 patients in each group and two patients developed an elevated IOP in group 2. Questionnaire responses showed lower patients` comfort after surgery in group 2. Mean postoperative refractive error change was significantly higher in group 2 (-1.75 diopters versus -0.15 diopters). Final visual acuity improved by 3 or more lines in 18 patients in group 1 and in 12 patients in group 2. OCT images were comparable in both groups and no postoperative macular edema occurred.
Clinical Trial: :
www.clinicaltrials.gov NCT00757536
Keywords: retinal detachment • vitreoretinal surgery • laser