July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Comparing the Outcomes for Repair of Rhegmatogenous Retinal Detachment in Patients with and without Posterior Vitreous Detachment
Author Affiliations & Notes
  • Yao Wang
    Dept. of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota, United States
  • Claire Ryan
    VitreoRetinal Surgery, PA, Minneapolis, Minnesota, United States
  • Omar Yasin
    Dept. of Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States
  • Wilkin Parke
    VitreoRetinal Surgery, PA, Minneapolis, Minnesota, United States
  • Ed Ryan
    VitreoRetinal Surgery, PA, Minneapolis, Minnesota, United States
  • Footnotes
    Commercial Relationships   Yao Wang, None; Claire Ryan, None; Omar Yasin, None; Wilkin Parke, None; Ed Ryan, None
  • Footnotes
    Support  VitreoRetinal Surgery Foundation Research Award ($1200)
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 4237. doi:
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      Yao Wang, Claire Ryan, Omar Yasin, Wilkin Parke, Ed Ryan; Comparing the Outcomes for Repair of Rhegmatogenous Retinal Detachment in Patients with and without Posterior Vitreous Detachment. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4237.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To compare anatomical and functional outcomes of scleral buckle (SB), pars plana vitrectomy (PPV), or combined SB-PPV in treating patients with primary rhegmatogenous retinal detachment (RRD) with and without posterior vitreous detachment (PVD).

Methods : This was a retrospective cohort study conducted at VitreoRetinal Surgery, PA. All 2015 primary RRD cases were extracted. Preoperative retinal findings, surgical procedure, visual and anatomical outcomes were analyzed for patients with and without PVD. Cases included patients with greater than 90-day follow-up. Single surgery anatomic success (SSAS) was defined as retinal detachment with no other RRD surgery within 90 days. We calculated chi-squared test for statistical significance within each surgical subgroup for patients with or without PVD.

Results : A total of 411 cases were included in the final analysis. 280 patients (68.1%) were documented to have PVD on examination. 131 patients (31.9%) were documented to not have PVD on examination. Average age for patients with and without PVD was 62.1 and 56.9, respectively. In patients documented to have a PVD, 34 (12.1%) underwent SB, 123 (43.9%) underwent combined SB-PPV, and 123 (43.9%) underwent PPV. In patients without a PVD, 32 (24.4%) underwent SB, 64 (48.9%) underwent combined SB-PPV, and 35 (26.7%) underwent PPV. There was no difference in visual acuity (VA) outcomes within each surgical procedure based on PVD status. VA improvement was greatest in the combined SB-PPV for patients with and without PVD (59.0% and 79.7%, respectively). SSAS (95.1%) was greatest for patients with PVD who underwent SB-PPV and greatest for patients without PVD who underwent SB (90.6%).

Conclusions : PVD can precipitate a retinal tear that progresses into a RRD. In some cases, a slowly progressive RRD can occur while the vitreous remains intact, as seen in younger patients. Our study demonstrated a younger patient population for those without a PVD compared to patients with a PVD. Having a PVD on clinical exam did not alter final VA outcomes for each surgical procedure. Further, SSAS rate of 95.1% was found in patients with a PVD who underwent combined SB-PPV. Primary SB demonstrated a SSAS rate of 90.6% in patients without a PVD. Therefore, despite the trend away from SB for RRD in the era of PPV, there is still an important indication for SB in eyes with or without a PVD.

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

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