TY - JOUR
T1 - Vitrectomy versus Vitrectomy with Scleral Buckling in the Treatment of Giant Retinal Tear Related Retinal Detachments
T2 - An International Multicenter Study
AU - Ong, Sally S.
AU - Ahmed, Ishrat
AU - Gonzales, Anthony
AU - Al-Fakhri, Abdullmajeed S.
AU - Al-Subaie, Hamad F.
AU - Al-Qhatani, Faisal S.
AU - Alsulaiman, Sulaiman M.
AU - Mura, Marco
AU - Maia, Mauricio
AU - Kondo Kuroiwa, Dante Akira
AU - Maia, Natalia Trench
AU - Berrocal, Maria H.
AU - Wu, Lihteh
AU - Zas, Marcelo
AU - Francos, Juan Pablo
AU - Cubero-Parra, Juan Manuel
AU - Arsiwala, Lubaina T.
AU - Handa, James T.
AU - Arevalo, J. Fernando
N1 - Funding Information: This project was supported by an unrestricted grant from Research to Prevent Blindness (Wilmer Eye Institute) and the Wilmer Biostatistics Core Grant P30EY001765. Dr Handa is the Robert Bond Welch Professor and Dr Arevalo is the Edmund and Virginia Ball Professor. The funding organizations had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication. Funding Information: This project was supported by an unrestricted grant from Research to Prevent Blindness (Wilmer Eye Institute) and the Wilmer Biostatistics Core Grant P30EY001765. Dr Handa is the Robert Bond Welch Professor and Dr Arevalo is the Edmund and Virginia Ball Professor. The funding organizations had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication. The authors made the following disclosures: J.F.A.: Grants – TOPCON: payments made to the institution; Royalties – Springer SMBLLC; Consulting fees – DORC International B.V., Allergan Inc. Bayer, Genentech. HUMAN SUBJECTS: Human subjects were included in this study. The study adhered to the Declaration of Helsinki and was Health Insurance Portability and Accountability Act compliant. Approval was obtained from the institutional review board (IRB) or IRB equivalent at each of the participating institutions. The IRB or IRB equivalent also granted a waiver of written informed consent as the study was a retrospective medical chart review and posed minimal risk to the research participants. Obtained funding: N/A Publisher Copyright: © 2022 American Academy of Ophthalmology
PY - 2022/7/1
Y1 - 2022/7/1
N2 - Purpose: To determine the practice pattern for treating giant retinal tear (GRT) related detachments, and their anatomic and visual outcomes with pars plana vitrectomy (PPV) with or without scleral buckling (SB). Design: Retrospective cohort study. Subjects: Eyes with GRT detachments repaired from 2008 to 2020 with at least 6 months of follow-up from 7 institutions in North and South America, Europe, and Asia. Methods: Eyes repaired using PPV versus PPV/SB were compared. Main Outcome Measures: Anatomic and functional outcomes. Results: A comparable number of eyes underwent PPV (n = 101) and PPV/SB (n = 99). Except for history of developmental abnormalities, prior intraocular surgery, and lens status, no differences in baseline demographics, ocular characteristics, or intraoperative surgical adjuncts were observed. The overall single surgery anatomic success (SSAS) at 6 months and 1 year were similar between the groups (82.2% and 77.2% of PPV, and 87.9% and 85.7% of PPV/SB). When stratified by age, the 1-year SSAS rate was higher for PPV/SB (88.5%) than PPV (56.3%) (P = 0.03) for children <18 years. For both children and adults, the mean best-corrected visual acuity (BCVA) at baseline did not differ between the PPV and PPV/SB groups. However, for children, mean BCVA at 1 year was better in the PPV/SB than PPV groups (P = 0.001) while for adults, no difference was found between the 2 groups. The mean time to the first redetachment was 7.9 months in the PPV group and 5.5 months in the PPV/SB group (P = 0.8). Proliferative vitreoretinopathy was the most common cause for redetachment (70.4% of PPV and 93.8% of PPV/SB in redetached eyes; P = 0.1). Postoperative complications were also similar between the 2 groups, including ocular hypertension, epiretinal membrane, and cataract formation. Conclusions: PPV and PPV/SB are equally popular among surgeons globally for managing GRT detachments and have comparable anatomic and visual outcomes in adults. In children, PPV/SB is superior to PPV for anatomic and functional success at 1 year. In adults, the relief of traction by the GRT may reduce peripheral traction and obviate the need for an SB. However, in children, a supplemental SB can be beneficial as complete vitreous shaving and posterior hyaloid detachment, and postoperative positioning, are difficult in this group.
AB - Purpose: To determine the practice pattern for treating giant retinal tear (GRT) related detachments, and their anatomic and visual outcomes with pars plana vitrectomy (PPV) with or without scleral buckling (SB). Design: Retrospective cohort study. Subjects: Eyes with GRT detachments repaired from 2008 to 2020 with at least 6 months of follow-up from 7 institutions in North and South America, Europe, and Asia. Methods: Eyes repaired using PPV versus PPV/SB were compared. Main Outcome Measures: Anatomic and functional outcomes. Results: A comparable number of eyes underwent PPV (n = 101) and PPV/SB (n = 99). Except for history of developmental abnormalities, prior intraocular surgery, and lens status, no differences in baseline demographics, ocular characteristics, or intraoperative surgical adjuncts were observed. The overall single surgery anatomic success (SSAS) at 6 months and 1 year were similar between the groups (82.2% and 77.2% of PPV, and 87.9% and 85.7% of PPV/SB). When stratified by age, the 1-year SSAS rate was higher for PPV/SB (88.5%) than PPV (56.3%) (P = 0.03) for children <18 years. For both children and adults, the mean best-corrected visual acuity (BCVA) at baseline did not differ between the PPV and PPV/SB groups. However, for children, mean BCVA at 1 year was better in the PPV/SB than PPV groups (P = 0.001) while for adults, no difference was found between the 2 groups. The mean time to the first redetachment was 7.9 months in the PPV group and 5.5 months in the PPV/SB group (P = 0.8). Proliferative vitreoretinopathy was the most common cause for redetachment (70.4% of PPV and 93.8% of PPV/SB in redetached eyes; P = 0.1). Postoperative complications were also similar between the 2 groups, including ocular hypertension, epiretinal membrane, and cataract formation. Conclusions: PPV and PPV/SB are equally popular among surgeons globally for managing GRT detachments and have comparable anatomic and visual outcomes in adults. In children, PPV/SB is superior to PPV for anatomic and functional success at 1 year. In adults, the relief of traction by the GRT may reduce peripheral traction and obviate the need for an SB. However, in children, a supplemental SB can be beneficial as complete vitreous shaving and posterior hyaloid detachment, and postoperative positioning, are difficult in this group.
KW - giant retinal tear
KW - pars plana vitrectomy
KW - retinal detachment
KW - scleral buckling
UR - http://www.scopus.com/inward/record.url?scp=85128729087&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.oret.2022.03.004
DO - https://doi.org/10.1016/j.oret.2022.03.004
M3 - Article
C2 - 35304304
SN - 2468-6530
VL - 6
SP - 595
EP - 606
JO - Ophthalmology Retina
JF - Ophthalmology Retina
IS - 7
ER -