Royal College of Ophthalmologists' National Database Study of Vitreoretinal Surgery

Abstract

PRECISA database study of 5,857 primary retinal detachment operations found no difference in failure rate between surgeon grades. 1,3 , David Yorston FRCOphth 3,4 , David HW Steel FRCOphth 3,5,6 , Tom H Williamson MD FRCOphth 3,7 , Timothy L Jackson PhD, FRCOphth 8 , John M Sparrow DPhil FRCOphth 3,9 The RD re-operation rate at 6 months after primary surgery was 13.9% (725/5,202), and did not differ significantly between consultants and trainees (p = 0.382). For surgeons contributing ≥50 cases, the mean (range) reoperation rates were 13.1% (6.7% -26.8%), 15.1% (11.3% -18.2%) and 15.3% (9.4% -22.1%) for consultant, independent non-consultant and trainee surgeons, respectively. The SB failure rate was not significantly different from PPV (p =0.095). Conclusion:The grade of surgeons and the technique of surgery were not associated with a significant difference in primary RD failure rates.3

Risk factors for failure after primary vitrectomy with no scleral buckling for rhegmatogenous retinal detachment

“…(13)(14)(15)(16) Re-detachment rate after primary vitrectomy for RRD may be variable according to several authors but it is estimated to be between 10 and 20% in most of the published series. (12,15,(17)(18)(19) Lens status could be a differential prognostic factor for failure according to Caiado et al, who found a much higher rate of re-detachment after primary vitrectomy for RRD in phakic compared to pseudophakic eyes. (20) In our series, we also found a slight tendency towards a worse PSR in the phakic compared to pseudophakic arm (10.5% versus 7.1%); however, it was not statistically significant (p=0.42).…”

“…For RRDs treated by primary vitrectomy, PSR is reported to range between 80 and 90% in most published series. (9)(10)(11)(12) Despite being vitrectomy the prevalent treatment approach for the disease, several issues are still under debate, such as the usefulness of adding an encircling band, especially in cases with inferior breaks, the type of tamponade that is better in each case, and the potential benefit of 360 degrees peripheral laser photocoagulation in the first surgery.…”