Clinical Ophthalmology (Mar 2023)
Comparison of Surgical Outcomes for Uncomplicated Primary Retinal Detachment Repair
Abstract
Stanton Heydinger,1 Rafael Ufret-Vincenty,2,3 Zachary M Robertson,2,3 Yu-Guang He,2,3 Angeline L Wang2,3 1University of Texas Southwestern Medical School, University of Texas Southwestern, Dallas, TX, USA; 2Department of Ophthalmology, University of Texas Southwestern, Dallas, TX, USA; 3Department of Ophthalmology, Parkland Hospital, Dallas, TX, USACorrespondence: Stanton Heydinger, Department of Ophthalmology, University of Texas Southwestern, 5323 Harry Hines Blvd, Dallas, TX, USA, Tel +1 816-500-9088, Email [email protected]: To compare the outcomes of primary uncomplicated rhegmatogenous retinal detachment (RRD) repair using pars plana vitrectomy (PPV), scleral buckling (SB), or combined scleral buckling with vitrectomy (SB/PPV).Patients and Methods: Single-institution, retrospective, observational study of 179 patients with primary RRD managed at a large academic hospital system. We excluded patients with less than 6 months of follow-up, previous vitrectomy or buckle, giant retinal tears, aphakia, recurrent forms of RRD, or extensive proliferative vitreoretinopathy (Grade C or worse) documented on exam or requiring membrane peel. Outcome measures included primary anatomical success at 6 months, functional success defined as BCVA ≥ 20/200, and best corrected visual acuity (BCVA) using logMAR scoring. Subgroup analysis was performed in the following patient groups: phakic, pseudophakic, inferior detachments, and prior pneumatic retinopexy.Results: Primary anatomical success was achieved in 145 of 179 eyes (81.0%), with SB/PPV showing a significantly greater success rate (p = 0.046) when compared to SB and PPV. Functional success was achieved in 137 of the 145 anatomically successful eyes (94.5%), with values ranging between 92% and 97% amongst the interventions (p = 0.552). No difference was found in final BCVA (p = 0.367). Patients with inferior detachment had an odds ratio of 2.15 for primary anatomic failure. Prior pneumatic retinopexy did not significantly affect any of the primary outcomes.Conclusion: SB/PPV yielded a significantly better primary anatomical success rate when compared to SB and PPV. Functional success and final BCVA was similar amongst the interventions. Inferior detachments were associated with worse primary anatomic outcomes. Prior pneumatic retinopexy did not significantly affect surgical outcomes.Keywords: anatomical success, retina, scleral buckling, vitrectomy
