June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Factors Associated with Increased Operative Time in Scleral Buckle Surgery for Retinal Detachment Repair
Author Affiliations & Notes
  • Jonah Blumenthal
    Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
  • Ryan Sameen Meshkin
    Massachusetts Eye and Ear Department of Ophthalmology, Boston, Massachusetts, United States
  • Sandra Hoyek
    Massachusetts Eye and Ear Department of Ophthalmology, Boston, Massachusetts, United States
  • Yilin Feng
    Massachusetts Eye and Ear Department of Ophthalmology, Boston, Massachusetts, United States
  • Nimesh Patel
    Massachusetts Eye and Ear Department of Ophthalmology, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Jonah Blumenthal None; Ryan Meshkin None; Sandra Hoyek None; Yilin Feng None; Nimesh Patel None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 4578. doi:
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    • Get Citation

      Jonah Blumenthal, Ryan Sameen Meshkin, Sandra Hoyek, Yilin Feng, Nimesh Patel; Factors Associated with Increased Operative Time in Scleral Buckle Surgery for Retinal Detachment Repair. Invest. Ophthalmol. Vis. Sci. 2023;64(8):4578.

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

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Abstract

Purpose : Predicting intraoperative time is critical to understanding patient outcomes, physician reimbursement, and operating room costs and scheduling. This retrospective, observational clinical study aims to determine the various factors affecting the duration of scleral buckle surgery.

Methods : We reviewed retinal detachments (RD) repaired via scleral buckle (SB) at Massachusetts Eye and Ear Infirmary between 2019-2021. To be included, a procedure had to be the operative eye’s first RD surgical repair and the procedure needed to be performed by an academic surgeon who completed more than 7 cases between 2019-2021. Surgeries including any other procedure were excluded. Nine surgeons completed 108 qualifying procedures which met the inclusion criteria. The primary outcome was operative time. Other clinical characteristics and surgical methods collected included age, race, gender, surgery ending after 5 pm, macular involvement, presence of lattice or proliferative vitreoretinopathy (PVR), laterality, number of breaks, RD clock hours, element use, gas use, external drainage of subretinal fluid, cryopexy and number of anterior chamber paracentesis. Factors associated with greater surgery time were identified using regression analysis.

Results : The mean duration of 108 primary RD scleral buckle repairs was 106±35 minutes (range 52 - 231). The mean number of breaks was 2.15 ± 1.5 (range 0- 10). The mean width of the retinal detachment measured in clock hours was 4.3 ± 2 (range = 0 – 9). The mean duration of follow up with a retinal physician was 489 days ± 355 (range 0 – 1316). Of the 108 procedures 20 (19%) required a future retinal surgical intervention.
A regression analysis revealed the following main risk factors for prolonged RD repair via SB: number of breaks (β=5.98; P=.005), use of radial elements (β=52.09; P=.001), and gas injection (β=31.27; P<.01).

Conclusions : Risk factors for a prolonged SB operative time include multiple breaks, the use of radial elements, and the use of gas injection.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

Linear Regression Using Operative Time as the Dependent Variable

Linear Regression Using Operative Time as the Dependent Variable

 

Descriptive Statistics

Descriptive Statistics

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