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Preference guides surgical choice for treating retinal detachment
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CHICAGO — Surgeon training is the deciding factor when contemplating which technique to use to repair retinal detachment, a speaker said.
Preoperative factors to consider include extent of retinal detachment, location of retinal breaks, lens status, lattice degeneration and status of the fellow eye, Gaurav K. Shah, MD, said at Retina Subspecialty Day preceding the joint meeting of the American Academy of Ophthalmology and Asia Pacific Academy of Ophthalmology.
“But, quite honestly, it’s surgeon training,” he said.
Among the options for repair of retinal detachment, surgeons increasingly used vitrectomy as well as combination vitrectomy and scleral buckling in the period from 2000 to 2010, Shah said. Use of pneumatic retinopexy and scleral buckling alone decreased over the same period.
“They’re all good procedures, but sometimes failures tend to occur for scleral buckle, vitrectomy and vit/buckle,” he said.
In a consecutive series of 286 eyes that failed initial surgical repair of retinal detachment, 63 eyes underwent scleral buckling, 88 eyes underwent pars plana vitrectomy and 135 eyes underwent combined pars plana vitrectomy and scleral buckling, according to surgeon preference and practice pattern, Shah reported.
“Patients that failed a primary scleral buckle, at least in this study, required fewer number of secondary procedures, about 30%, and were three times as likely to require a silicone oil injection during their secondary repair,” Shah said.
Disclosure: Shah is a consultant for Abbott Medical Optics, Alcon Laboratories, Allergan, DORC International, iScience and NeoVista.