June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Anatomic and visual outcomes of primary retinal detachment in younger adults: a report from the multicenter Primary Retinal Detachment Outcomes (PRO) Study
Author Affiliations & Notes
  • Louis Cai
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Michael J Ammar
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Ed Ryan
    VitreoRetinal Surgery, Minnesota, United States
  • Jay Wang
    Massachusetts Eye and Ear, Massachusetts, United States
  • Claire Ryan
    VitreoRetinal Surgery, Minnesota, United States
  • Connie M Wu
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Matthew Starr
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Luv Patel
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Antonio Capone
    Associated Retinal Consultants, Michigan, United States
  • Dean Eliott
    Massachusetts Eye and Ear, Massachusetts, United States
  • Geoffrey Emerson
    The Retina Center, Minneapolis, Minnesota, United States
  • Daniel Joseph
    The Retina Institute, Minneapolis, Minnesota, United States
  • Omesh Gupta
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Carl Regillo
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Yoshihiro Yonekawa
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Louis Cai, None; Michael Ammar, None; Ed Ryan, None; Jay Wang, None; Claire Ryan, None; Connie Wu, None; Matthew Starr, None; Luv Patel, None; Antonio Capone, None; Dean Eliott, None; Geoffrey Emerson, None; Daniel Joseph, None; Omesh Gupta, None; Carl Regillo, None; Yoshihiro Yonekawa, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 3710. doi:
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      Louis Cai, Michael J Ammar, Ed Ryan, Jay Wang, Claire Ryan, Connie M Wu, Matthew Starr, Luv Patel, Antonio Capone, Dean Eliott, Geoffrey Emerson, Daniel Joseph, Omesh Gupta, Carl Regillo, Yoshihiro Yonekawa; Anatomic and visual outcomes of primary retinal detachment in younger adults: a report from the multicenter Primary Retinal Detachment Outcomes (PRO) Study. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3710.

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

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Abstract

Purpose : This study aimed to compare surgical outcomes of scleral buckle (SB), pars plana vitrectomy (PPV), and combined scleral buckle and vitrectomy (SB/PPV) for primary retinal detachments (RD) in younger adults (ages 20-45). The primary outcomes examined were single surgery success (SSS) and good visual acuity.

Methods : The Primary Retinal Detachment Outcome study is a multicenter, interventional, cohort study of all non-complex retinal detachment surgeries from January 1, 2015 through December 31, 2016. Frequency tables were used to compare demographic, pre-surgical, surgical, and post-surgical variables. The primary outcomes evaluated in this study were single surgery success (retinal attachment with at least 90 day follow up without subsequent surgery for RD) and achievement of good final visual acuity (VA > 20/50). ANOVA and multiple regression analysis were used to examine differences among the surgical modalities and their relationship to the primary outcomes. Statistical tests were performed in R (R Development Core Team, Vienna, Austria) and MedCalc (MedCalc Software, Ostend, Belgium).

Results : 263 patients aged 20-45 were identified in the cohort who either had SB (n = 129), PPV (n = 54), or SB/PPV (n = 80). SB/PPV had the highest single surgery success rate (mean 83.8%), compared to SB (72.1%) and PPV (64.8%), but there was not a statistically significant difference among the groups (P = 0.135). In contrast, there was a significant difference (P = 0.001) in the percentage of patients who achieved final visual acuity > 20/50 with SB (76.0%), PPV (59.3%), and SB/PPV (52.5%). Multiple regression analysis showed that pre-surgical BCVA and final cataract grade provided the best model to predict final BCVA. Pre-surgical BCVA was worse in eyes with SB/PPV (mean LogMar Snellen 0.97) and PPV (0.80) compared to SB (0.41). Similarly, final cataract grade was different (P = <0.0001) among the surgical modalities with PPV (mean cataract grade 1.4) and SB/PPV (1.3) having higher grade cataracts compared to SB (0.3).

Conclusions : SB and SB/PPV had higher SSS compared to PPV in this young cohort, however this finding was not statistically significant. SB had the best final VA outcomes. Pre-operative visual acuity and final cataract grade were independently associated with visual outcomes.

This is a 2020 ARVO Annual Meeting abstract.

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