Abstract
Purpose :
To analyze the incidence of retinal redetachments and other complications following pars plana vitrectomy for retinal detachment repair with silicone oil tamponade and the outcome of facedown positioning duration on these endpoints.
Methods :
The retrospective study was performed on patients with retinal detachment repair via pars plana vitrectomy with silicone oil tamponade between 2015 and 2020. Surgery was performed by 10 physicians associated with a private retina practice in Cleveland, OH. The independent variable of interest was length of post-operative facedown positioning. Outcome variables were retinal re-detachment, epiretinal membrane (ERM) formation, cataract formation, and other complications.
Results :
The study was composed of 227 eyes. The mean age of patients was 62.09±13.65 years with 63% males and 37% female. Of the initial detachments, 27.88% were mac-on and 72.12% were mac-off. Overall, 42 patients had facedown positioning for 1 day, 50 for 3 days, 24 for 5 days, and 99 ≥ 7 days. Redetachment was seen in 45.2% of the 1-day group, 40% of the 3- day group, 41.6% of the 5-day group, and 29.3% of the 7-day group(p=0.246). Cataract formation was seen in 64.7% of the 1-day group, 47.8% of the 3-day group, and 74.5% of the 7- day group(p=0.088). ERM formation showed no clear trend nor statistical significance(p=0.523). Analysis was also performed grouping patients into a ≤6 day group and a ≥ 7-day group. Redetachment was seen in 42.19% of the ≤6-day group and 29.29% of the 7-day group(p=0.045). Relative risk for the 7-day group was 0.694. Cataract formation was seen in 51.9% of patients in the ≤6-day group and 74.5% of the 7-day group (p=0.021). Relative risk was 1.434. No significant difference was found in ERM formation.
Conclusions :
The data suggests a lower rate of retinal redetachment with increasing postoperative facedown positioning time, particularly with 7 days, although the result was not statistically significant. Additionally, there was a suggestive increase of cataract formation in the 7 day group although this also did not meet significance. When comparing patients that positioned ≥ 7 days to all others, significance was achieved. These relationships would be better studied with a larger sample size and a randomized control trial that could further define the associations found here and determine causality.
This is a 2021 ARVO Annual Meeting abstract.