Efficacy and Safety Profile of 25-Gauge Pars Plana Vitrectomy in Rhegmatogenous Retinal Detachment in Pakistan: A Multicenter Retrospective Study

Abstract

Introduction This study aims to evaluate the primary anatomical success and visual outcomes of 25-gauge pars plana vitrectomy (25g PPV) in patients with rhegmatogenous retinal detachment (RRD) in Pakistan. Design This is a five-year retrospective, interventional cohort study conducted at tertiary care hospitals in Pakistan from October 2013 to October 2018. Methods This is a retrospective, interventional cohort study of 418 consecutive patients with RRD who underwent 25g PPV. All surgeries were performed by two experienced surgeons at tertiary care hospitals in Pakistan. Consecutive patients who underwent 25g PPV surgery as the treatment for RRD from October 2013 to October 2018 were included. We excluded patients who had a history of previous retinal surgery or did not complete the 4-8 weeks of primary outcome visit. We used the Statistical Package for the Social Sciences (SPSS) version 23.0 (IBM Corporation, Armonk, NY, USA) for statistical analysis. A p-value of <0.05 was considered significant. Results We identified 452 patients through the coding system of our hospitals who underwent 25g PPV surgery for RRD during the study period. A total of 441 patient files were reviewed for the study, of which 418 patients met the criteria for final analysis. The mean age was 49 ± 15.8 years. There was a higher number of males (n = 284, 67.9%). In our study, 186 (44.4%) patients were phakic at the time of presentation. The macula was detached in 361 (86.4%) patients. At the primary outcome visit (4-8 weeks of follow-up), the primary anatomical success rate was 89.47%. The most common cause of failure was proliferative vitreoretinopathy (PVR) (n = 20), followed by missed breaks (n = 5). Conclusions The surgical outcomes of RRD with 25g PPV surgery in our study were similar to the outcomes reported in the developed world. We propose a prospective multicenter national study to prospectively evaluate the risk factors for RRD surgical failure in the Pakistani population.

Demographic and Clinical Characteristics of Patients Diagnosed with Retinal Detachment Against the Background of Common Eye Diseases – Effectiveness of Laser Coagulation in Their Treatment

“…However, as in literature sources, clinical characteristics of patients are diff erent in our observation. This is because the availability of high-tech ophthalmic care is not the same in individual countries Awan and co-authors [5] in a large-scale observational sample (452 patients) showed that in the majority of patients the detachment involved the macula (77.3%), with severe proliferative vitreoretinopathy (stage C) occurring in 22.7% of cases. In our observation, the results are diff erent, grade C proliferative vitreoretinopathy was recorded in more patients (34.0±4.6%).…”

“…Examination and treatment of patients diagnosed with retinal detachment is carried out in high-tech institutions (ophthalmology results and university clinics) [5][6][7]. The clinical characteristics of patients in these institutions are diff erent.…”

“…The clinical characteristics of patients in these institutions are diff erent. Thus, the average age of patients in Pakistan was 49±15.8 years, the proportion of men was 67.9% [5], and in India these indicators were 41.8±16.6 years and 69.8%, respectively [4]. The distribution of patients according to the area of retinal detachment was also diff erent: total detachment was 30.3 [3] and 61.0% [6].…”

Visual and Surgical Outcomes in Late Presentation of Retinal Detachment

“…Sample size was calculated by using Open Epi sample size calculator. Taking statistics of Treatment success(no re-detachment) as 89% 15 at margin of error of 9% and confidence interval of 95%. All the cases were included through non-probability consecutive sampling technique.…”