Preferences and Trends in Management of Rhegmatogenous Retinal Detachment in Pakistan

Abstract

Purpose: To report the preferences and trends in managing Rhegmatogenous retinal detachment (RRD) in Pakistan.
 Study Design: Cross sectional survey.
 Place and Duration of Study: Shifa International Hospital, Islamabad, from December 2018 to January 2019.
 Method: A survey was conducted in which the vitreo-retinal (VR) surgeons were asked to respond to 10 questions. The questions were meant to assess their practice and management strategies in treating RRD. Duration of survey was 1 month.
 Results: Sixty-two VR surgeons of Pakistan responded to this survey. Most of the VR surgeons belonged to Punjab (56%) followed by Sindh (25%). Regarding their primary practice setting 50% of VR surgeons worked both in government and private practice, 30% practiced in academic/university hospital and 20% of them had only private practice. Seventy percent of VR surgeons in Pakistan preferred local anaesthesia. In non-posterior vitreous detachment (PVD) RRD, majority (69%) performed segmental buckling (SB) with or without encirclement. In pseudophakic superior macula on RRD with a single retinal tear 50% preferred pars plana vitrectomy (PPV) followed by SB in 25% and pneumatic retinopexy in 18%. In inferior macula off RRD with a retinal tear at 7 0’clock position, 56% of the VR surgeon performed PPV alone or combined with SB.
 Conclusion: There is an increased trend towards PPV as a primary procedure for RRD in Pakistani VR surgeons. Local anaesthesia is the preferred anesthesia.
 Key Words: Rhegmatogenous retinal detachment, Retinal break, Pars Plana Vitrectomy, Pneumatic Retinopexy.

Visual and Surgical Outcomes in Late Presentation of Retinal Detachment

“…16 Furthermore, results of another study indicated that, PPV was a successful surgical intervention for RD in any studied group with or without PVR. The primary anatomical reattachment rate for the retina was 89% reported by Awan MA et al 12 Other international studies have reported similar success rate in the range of 81% (95% CI: 78%-83%). 17,18 For improved visual outcomes, timely detection and management are crucial.…”

“…In comparison to the previous decade, "recent developments, advancements in mechanical and technical disciplines, such as the use of perfluorocarbon liquids, high speed cutters, wide angle viewing systems, and micro incision vitrectomy systems", improved visibility and reduced complications. 12 The postoperative BCVA and the rate of retinal re-attachment are typically used to describe the output of vitreoretinal surgery. If retina stays attached for at least six months following the last surgery it is considered as anatomic success.…”

23-Guage Vitrectomy with Internal Gas Tamponade for the Management of Rhegmatogenous Retinal Detachment

“…There is an increased trend towards PPV as a primary procedure for RRD in Pakistani VR surgeons. 9 This trend is definitely due to good results achieved with PPV. The results also indicate that this approach may also reduce the risk of further PVR and failure of result.…”