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N. Feltgen, C. Weiss, S. Wolf, H. Heimann, SPR–Study Group; Scleral Buckling versus Primary Vitrectomy (SPR) Study: Evaluation of the Recruitment List . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5478.
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Background: A complex rhegmatogenous retinal detachment (RRD) can be treated by different surgical procedures. The Scleral Buckling Versus Primary Vitrectomy in Rhegmatogenous Retinal Detachment (SPR) Study addresses the question whether scleral buckling or pars plana vitrectomy as first surgical intervention is the treatment of choice in RRD not complicated by proliferative vitreoretinopathy. Within the setting of a prospective, randomised trial, all patients of the 27 participating centres with RRD have been listed in a recruitment list. The study goals are to check the real distribution of complicated versus simple RRDs, which is not known in the literature; to re–evaluate patients with RRD who were excluded for various reasons despite possible eligibility; and, hence, to assess the quality of the data base of the included patients in the SPR–study. Methods: The fundus drawings of all patients with RRD from the year 2000 were evaluated by 3 experienced retinologists. Feasible inclusion into the study was dependant on the number of retinal holes, the area of detached retina, the involved retinal quadrants, and the presence of macular detachment and/or vitreous haemorrhage. The SPR exclusion criterias, which could not be evaluated from the fundus drawings (e.g. pregnancy), were not considered in this evaluation. Results: 1503 fundus drawings were evaluated. In 1437 (95.1%) cases, the fundus drawing was of sufficient quality for assessment. Most patients had a single retinal hole (n=620; 41.3%). In 305 patients, no hole was present (35.4% pseudophakic); the highest score of retinal holes was 17. The size of the affected area of the retinal detachment extended from 0 to 12 clock hours, the most frequent size being 5 clock hours (n=228; 15.2%). The macula was attached in 671 (44.6%) cases. 448 (29.8%) patients would have been eligible for the SPR Study judged by evaluation of fundus drawings alone but only 176 of these had been included. Conclusions: The complicated RRD comprise one third of all detachments and represents a frequently encountered situation in routine retinal service. Therefore, the results of the SPR–study are likely to have an significant impact on the routine management of patients with RRD. The variation in evaluating the eligibility of patients may show surgeon–based bias concerning the first method of choice for surgical repair for RRD, resulting in exclusion of eligible patients into the SPR–study.
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