Abstract
Purpose :
This retrospective study aimed to compare single surgery anatomic success (SSAS) between pars plana vitrectomy (PPV) and vitrectomy with scleral buckle (PPV/SB) for primary retinal detachment repair.
Methods :
Charts of patients who presented to Texas Retina Associates between August 2010 to February 2020 for retinal detachment were reviewed. An initial cohort was randomly generated for preliminary analysis. The primary outcome measure was single surgery anatomic success (SSAS), defined as attachment at 3 months after primary surgery without any additional surgeries during that interval. Patients with <90 days of follow-up data were excluded. Other collected data included pre-operative and final visual acuity, detachment morphology, macular status, lens status, demographic information, and length of follow-up. Group comparison of categorical data was performed with Pearson’s chi-square and Fisher’s exact test.
Results :
2,103 eyes were identified in our cohort, which were treated with PPV (n = 1791) or PPV/SB (n = 312). Overall, PPV/SB had significantly higher single surgery success rate (94.2%) compared to PPV (87.8%, p = 0.001). In 909 phakic eyes, the SSAS was significantly higher with PPV/SB (94.9%, 187/197) compared to PPV alone (87.2%, 621/712, p = 0.002). In contrast, there was no statistically significant difference in SSAS between PPV/SB and PPV among the 1,167 pseudophakic eyes (92.9% vs 88.8%, p = 0.18). In phakic eyes with inferior pathology, those undergoing PPV/SB reported significantly greater SSAS than PPV (96.9% vs 79.7%, p < 0.001), however the difference was not significant in superior pathology (p = 0.53). Mean change in visual acuity was similar for PPV/SB and PPV (logMAR Snellen 0.48 and 0.44 respectively, p = 0.73).
Conclusions :
The addition of scleral buckle to vitrectomy may improve surgical outcomes in patients with primary retinal detachments, particularly in phakic eyes and in those with inferior detachments. We report higher single surgery anatomic success rates than previously described in literature. Despite the differences observed in surgical outcomes, visual recovery was similar for PPV and PPV/SB in our cohort.
This is a 2021 ARVO Annual Meeting abstract.