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Zack Oakey, Ian Holmen, Jonathan S Chang, Elaine Downie, Michael S Ip, Michael M Altaweel, Justin Gottlieb, T Michael Nork; Retinal Detachment Repair Outcomes in Patients who Received Preoperative Evaluation with a Different Surgeon. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6588.
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© ARVO (1962-2015); The Authors (2016-present)
It is a common practice among US vitreoretinal surgeons to diagnose rhegmatogenous retinal detachment (RRD) and refer the patient to a colleague for surgical therapy. In this study we investigate visual and anatomic outcomes for patients who were treated by the diagnosing physician and compare those with surgeries performed by a separate physician who was not the diagnosing physician.
Retrospective chart review was performed for patients > age 18 with minimum 2 months of follow-up and had surgery for RRD from 2012 to 2017. Inclusion was no previous vitreoretinal surgery and diagnosis with rhegmatogenous detachment. Patients excluded if they had nonrhegmatogenous detachment, other ocular disease like uveitis that may affect outcome. Outcomes compared: primary anatomic success (PAS), visual acuity at diagnosis, final acuity, presence of proliferative vitreoretinopathy (PVR) before surgery, macular and lens status, gender, and days follow-up. We recorded if the patient underwent surgery by the diagnosing physician (the “same” physician) or by a referred physician (a “different” physician) within our practice.
A total of 343 cases met inclusion criteria, with 137 in the same surgeon group and 206 in the different surgeon group. Primary anatomic success was not different between the two groups (p=0.348). Pre- and post-operative visual acuity were not different between the groups, even when stratifying for lens and macula status. Follow-up duration did not differ. There was no difference between the two groups in preoperative PVR. There was a statistically significant difference between the two groups in time from diagnosis to surgery, with those in the different surgeon category having less time to surgery (mean 2.91 days) than the same surgeon category (mean 5.155), p=0.0023.
Our chart review reveals no anatomic or functional difference in retinal reattachment outcomes when surgery is performed by diagnosing or referring physician. There was significantly less time between diagnosis and surgery when patients were treated by a different physician. Both the shared and different surgeon groups did not demonstrate a difference in preoperative PVR, visual acuity, gender, lens or macula status. These results suggest that it is safe for patients to undergo retinal detachment repair without preoperative clinic evaluation by the operating surgeon.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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