Impact of viewing system choice during primary retinal detachment repair

Abstract

Purpose : Vitrectomy can be performed either with non-contact wide-angle viewing systems or wide-angle contact lenses. It is unknown whether there are differences in surgical outcomes based on choice of viewing system. The purpose of this study is to assess whether there are differences in anatomic vitrectomy outcomes of primary non-complex retinal detachment (RD) repair, based on viewing system used.

Methods : This is a multicenter, interventional, retrospective, comparative study. Eyes that underwent non-complex primary RD repair by either pars plana vitrectomy (PPV) alone or in combination with scleral buckle (SB/PPV) were identified. Eyes that underwent repair by primary SB, pneumatic retinopexy, or retinopexy alone were excluded from the analysis. The viewing system used at the time of RD repair was identified. The primary outcome of our study was single surgery anatomic success (SSAS), which was defined as no re-operations for RD during the post-operative 90-day window. Significance was determined using Pearson’s X² test.

Results : A total of 1811 eyes were included in our analysis. Of those, 1529 (84.4%) had RD repaired using non-contact viewing systems, while 282 (15.6%) were repaired using a contact lens system. SSAS for non-contact viewing systems was 86.5% and 86.9% for contact lenses, which was not statistically different (p=0.87). A total of 1073 eyes had PPV alone for RD repair, of which 916 (85.4%) were performed using non-contact viewing systems. Of those eyes repaired by PPV alone, non-contact systems had an 84.3% SSAS compared to 84.1% for contact lenses. This difference was not significant (p=0.94). Similarly, a total of 738 eyes were repaired using a combined SB/PPV approach, 613 (83.1%) of which were repaired using non-contact viewing systems. Of those eyes repaired by a combined SB/PPV approach there was no statistically significant difference between the two viewing systems, with an 89.9% SSAS for non-contact systems vs. 90.4% for contact lenses (p=0.86).

Conclusions : There was no significant difference in SSAS for primary RD repair when comparing non-contact viewing systems to contact lens systems.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.