Micro-incision vitrectomy surgery for primary rhegmatogenous retinal detachments with posterior vitreous detachments in elderly patients: Preoperative characteristics and surgical outcomes

Abstract

Purpose To assess the preoperative characteristics and surgical outcomes of using micro-incision vitrectomy surgery (MIVS) to treat RRD with posterior vitreous detachment (PVD) in an older and a younger patient group. Methods This retrospective cohort study included 407 eyes from 397 patients with primary RRD with PVD who were consecutively treated in our hospital from February 2016 to February 2020. PVD was diagnosed clinically by the presence of a Weiss ring, or was diagnosed morphologically via optical coherence tomography and subsequently confirmed during surgery. The main outcome measures were preoperative RRD characteristics, best-corrected visual acuity (BCVA), and postoperative complications. Results Data were analysed from 55 eyes in the elderly group (age 70 and older), and 352 eyes in the young group (age 69 and younger). There was no significant inter-group difference in the initial reattachment rate. Preoperative characteristics indicated that elderly patients had a significantly lower rate of phakic eyes, shorter mean axial length, lower lattice incidence, and longer time spans from onset to surgery. There were no significant between-group differences in the incidence of the following complications: fibrin formation, intraocular pressure elevation, epi-retinal membrane on the macula, intraocular lens optic capture, proliferative vitreoretinopathy, and vitreous haemorrhage. While the elderly patients had significant postoperative improvements in BCVA, these improvements were significantly lower than those of the younger patients. Conclusions This study highlighted the characteristics and surgical outcomes of MIVS in elderly patients with RRD. Although the time from onset to surgery was longer, MIVS still can be performed safely to improve older patients’ postoperative BCVA.

Elevated NLRP3 Inflammasome Levels Correlate With Vitamin D in the Vitreous of Proliferative Diabetic Retinopathy

“…Most PDR patients hospitalized for surgery were in the working population, whereas IHM patients in the control group tended to be older when they underwent surgery. It is wellknown that the vitreous becomes more liquefied with age (35). During surgery, we found that vitreous liquefaction occurred in most participants, resulting in a more uniform distribution of factors tested in the vitreous fluid.…”

Stratifying the risk of re-detachment: variables associated with outcome of vitrectomy for rhegmatogenous retinal detachment in a large UK cohort study

“…Only 6% of patients in this study were aged 80 or older. A report from Japan found no difference in the anatomical outcomes of vitrectomy for retinal detachment in elderly and young patients, however, their definition of elderly was >70 years [ 16 ]. In Israel, a study of vitrectomy outcomes in patients aged 85 or older found primary anatomical failure occurred in 45% [ 17 ].…”

“…15 Prince Charles Eye Unit King Edward VII Hospital, Windsor, UK. 16 Royal Victoria Infirmary, Newcastle upon Tyne, UK. 17 East Suffolk & North Essex NHS Foundation Trust, Essex, UK.…”

Effect of surgical modality on visual outcomes for young patients with primary rhegmatogenous retinal detachments: a retrospective cohort study

“…8 9 Some studies have indicated that older age is associated with worse outcomes, 10 while others have shown younger patients have worse outcomes or that there is no difference between the two populations. [11][12][13] There have been few studies comparing outcomes of SB, PPV and PR in young patients given the relative rarity of primary RRDs in younger patients. Election of treatment options for young patients tend to ultimately revolve around surgeons' preference or facilities'availability.…”

“…Given that ageing and PVD are major risk factors for retinal detachment, sample sizes for young (<50 years of age) patients are under-represented in these studies and the effect of age on RRD outcomes remains less clear 8 9. Some studies have indicated that older age is associated with worse outcomes,10 while others have shown younger patients have worse outcomes or that there is no difference between the two populations 11–13…”