Impact of contact versus non-contact wide-angle viewing systems on outcomes of primary retinal detachment repair (PRO study report number 5)

Abstract

Background/aimsVitrectomy to repair retinal detachment is often performed with either non-contact wide-angle viewing systems or wide-angle contact viewing systems. The purpose of this study is to assess whether the viewing system used is associated with any differences in surgical outcomes of vitrectomy for primary non-complex retinal detachment repair.MethodsThis is a multicenter, interventional, retrospective, comparative study. Eyes that underwent non-complex primary retinal detachment repair by either pars plana vitrectomy (PPV) alone or in combination with scleral buckle/PPV in 2015 were evaluated. The viewing system at the time of the retinal detachment repair was identified and preoperative patient characteristics, intraoperative findings and postoperative outcomes were recorded.ResultsA total of 2256 eyes were included in our analysis. Of those, 1893 surgeries used a non-contact viewing system, while 363 used a contact lens system. There was no statistically significant difference in single surgery anatomic success at 3 months (p=0.72), or final anatomic success (p=0.40). Average postoperative visual acuity for the contact-based cases was logMAR 0.345 (20/44 Snellen equivalent) compared with 0.475 (20/60 Snellen equivalent) for non-contact (p=0.001). After controlling for numerous confounding variables in multivariable analysis, viewing system choice was no longer statistically significant (p=0.097).ConclusionThere was no statistically significant difference in anatomic success achieved for primary retinal detachment repair when comparing non-contact viewing systems to contact lens systems. Postoperative visual acuity was better in the contact-based group but this was not statistically significant when confounding factors were controlled for.

Incidence and Risk Factors Affecting the Recurrence of Primary Retinal Detachment in a Tertiary Hospital in Spain

“…The three surgeons with less recurrences use non-contact viewing systems for vitrectomy, compared to the contact viewing systems used by the rest of the surgeons. Recently, the PRO study reported no differences in anatomic success between non-contact and contact viewing systems [ 33 ]. Mazinani et al examined the relationship between experience and success rates and observed that primary anatomical success rate became stable after 500 vitreoretinal procedures.…”

Surgical techniques for primary rhegmatogenous retinal detachments between surgeons with high versus low single surgery success rates

“…This study is in compliance with the Health Insurance Portability and Accountability Act, received approval from all institutional review boards, and adhered to the tenets of the Declaration of Helsinki. We report a subgroup analysis from the PRO Study, which has been previously described in detail (Ryan, Joseph, et al., 2020; Ryan, Ryan, et al., 2020; Tieger et al., 2020; Wang et al., 2019). This study compares pre and intraoperative metrics between the surgeons with the highest SSSR versus those with the lowest SSSR for primary RRD surgery as well as the surgical approaches for the following patients: phakic, pseudophakic, superior RRD, inferior RRD, and RRDs with lattice.…”

Primary Retinal Detachment Outcomes Study: summary of reports number 1 to number 18

“…However, when controlling for case complexity, intra-operative 360° laser retinopexy was significantly associated with lower final anatomic success and worse final visual acuity. Following this report, the PRO team focused on outcomes of vitrectomies done with a contact versus a noncontact wide-angle lens during primary RRD repair [10]. In this cohort, there were 363 eyes that underwent surgery with a contact lens system and 1893 eyes in the noncontact viewing system cohort.…”