Scleral Buckling versus Primary Vitrectomy in Rhegmatogenous Retinal Detachment

Heimann, Heinrich; Bartz‐Schmidt, Karl Ulrich; Bornfeld, Norbert; Weiß, Claudia; Hilgers, Ralf-Dieter; Foerster, Michael

doi:10.1016/j.ophtha.2007.09.013

Cited by 557 publications

(509 citation statements)

References 25 publications

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“…The submacular surgery trial 13 and diabetic retinopathy vitrectomy study 14 were undertaken before the widespread introduction of wide-angle viewing systems and small-gauge surgery, which may alter the detection and occurrence of retinal breaks, respectively. 11,12 There are recent, large prospective studies of PPV for the treatment of retinal detachment, 15,16 and these reported that iatrogenic retinal breaks occur in 8-13% of cases, 16 a The value shown is the percentage of all eyes undergoing pars plana vitrectomy (PPV), despite the fact that lens touch would not occur in a pseudophakic eye. Of the 6986 eyes undergoing primary PPV, 668 had previously had cataract surgery and were therefore known to be pseudophakic, 1897 had combined PPV and cataract surgery and were therefore phakic at the time of their primary PPV, and 1238 subsequently had cataract surgery and were therefore also known to be phakic during their primary PPV.…”

Section: Resultsmentioning

confidence: 99%

“…Cataract is by far the most common postoperative complication of PPV, 16,17 and this study was able to access the NOD cataract data, for eyes undergoing primary PPV. Figure 2 shows that, in those not lost to follow-up, half of the eyes required cataract surgery within a year of primary PPV.…”

Section: Resultsmentioning

confidence: 99%

“…This is consistent with data from large clinical trials. [15][16][17] All the contributing centres offer cataract surgery, and are likely to treat their own post-vitrectomy cataracts, but it is possible that some eyes had cataract surgery elsewhere and were lost to follow-up. In addition, eyes that had combined cataract surgery and primary PPV were necessarily excluded from the analysis of PVCS.…”

Section: Resultsmentioning

confidence: 99%

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United Kingdom National Ophthalmology Database Study of Vitreoretinal Surgery: Report 1; Case mix, complications, and cataract

Jackson

Donachie

Sparrow

et al. 2013

Eye

113

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Aim To report the vitreoretinal (VR) surgical case mix in the United Kingdom, the intraoperative complication rate of pars plana vitrectomy (PPV), and the incidence of postvitrectomy cataract extraction. Methods Participating hospitals prospectively collected ophthalmic data using a single electronic medical record system, with automatic extraction of anonymised data to a national database. This study included the subset of 11 618 VR operations undertaken on 9619 eyes, of 8741 patients, over 8 years, from 27 sites. Surgical data included the indication for surgery, all procedure elements, and whether or not an intraoperative complication occurred. Postvitrectomy cataract data were also analysed. The main outcome measures were a description of the indications for surgery, intraoperative PPV complication rate, and percentage of eyes undergoing postvitrectomy cataract surgery (PVCS). Results The most common indications for VR intervention were retinal breaks and rhegmatogenous retinal detachment (48.5%), macular hole (9.8%), epiretinal membrane (9.6%), and diabetic eye disease (7.3%). Overall, 7.8% of PPVs had at least one intraoperative complication-the most common were iatrogenic retinal breaks (3.2%), and lens touch (1.2-1.6% of phakic eyes). PVCS occurred in 50.2, 68.7, and 74.0% of eyes at 1, 2, and 3 years, respectively.Conclusion VR surgery is undertaken for a wide range of conditions, but a small number of diagnoses encompass the majority of cases. Intraoperative PPV complications are not uncommon, and post-vitrectomy cataract is to be expected in most phakic eyes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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United Kingdom National Ophthalmology Database Study of Vitreoretinal Surgery: Report 1; Case mix, complications, and cataract

Jackson

Donachie

Sparrow

et al. 2013

Eye

113

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“…The evidence base already suggests to us that we should be performing more SB, and if we did we might achieve better visual outcomes for our patients [4,5]. Myopic retinal detachment secondary to atrophic round holes and without posterior vitreous detachment can be treated primarily with SB with excellent anatomical and visual results [14].…”

mentioning

confidence: 82%

“…Increasingly and throughout the world, the trend is to treat rhegmatogenous retinal detachments using vitrectomy [1,2]. Yet the consensus is that there is a continuing role for SB [3]; the evidence base is that some groups of patients may achieve better vision receiving primary SB rather than vitrectomy [4,5]. It has been suggested that the only way to reverse this trend is to make the skill set for scleral buckling more like those of vitrectomy.…”

mentioning

confidence: 99%

Scleral buckling versus vitrectomy: can the trend be reversed suprachoroidally?

Wong

Sandri

Steel

2016

Graefes Arch Clin Exp Ophthalmol

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Pars Plana Vitrectomy Alone With Diffuse Illumination and Vitreous Dissection to Manage Primary Retinal Detachment With Unseen Breaks

Martínez-Castillo

Boixadera²,

García‐Arumí³

2009

Arch Ophthalmol

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To report on pars plana vitrectomy with diffuse illumination, wide-angle viewing, and meticulous vitreous dissection for identifying and managing retinal breaks when no breaks were detected before surgery for primary rhegmatogenous retinal detachment. Methods: Prospective clinical study of 61 of 800 consecutive eyes (7.6%) (61 of 782 patients) seen at a university hospital during the 48-month study for primary rhegmatogenous retinal detachment in whom no break could be identified preoperatively despite thorough examinations. All of the patients underwent pars plana vitrectomy alone with meticulous peripheral vitreous dissection assisted by diffuse illumination, a wide-angle viewing system, perfluorocarbon liquid, triamcinolone acetonide suspension, and balanced salt solution to identify and manage primary retinal breaks. Results: Retinal breaks were found intraoperatively in 60 eyes (98%). In 51 of 61 eyes (84%), balanced salt solution was left in the vitreous cavity. Best-corrected visual acuity was 20/40 or better in 25 of 61 study eyes (41%). Primary retinal reattachment was attained in 60 study eyes (98%). Final reattachment was achieved in all 61 eyes (100%). Conclusions: Pars plana vitrectomy alone with diffuse illumination and extensive vitreous dissection led to identification and management of retinal breaks undetectable before surgery, achieving a high primary reattachment rate.

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Scleral Buckling versus Primary Vitrectomy in Rhegmatogenous Retinal Detachment

Cited by 557 publications

References 25 publications

United Kingdom National Ophthalmology Database Study of Vitreoretinal Surgery: Report 1; Case mix, complications, and cataract

United Kingdom National Ophthalmology Database Study of Vitreoretinal Surgery: Report 1; Case mix, complications, and cataract

Scleral buckling versus vitrectomy: can the trend be reversed suprachoroidally?

Pars Plana Vitrectomy Alone With Diffuse Illumination and Vitreous Dissection to Manage Primary Retinal Detachment With Unseen Breaks

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