Similar success rates found for different modalities of retinal detachment repair
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PHILADELPHIA — Scleral buckle, pars plana vitrectomy and combined scleral buckle and vitrectomy had similar surgical success rates for retinal detachment in young adults, according to a speaker at Wills Eye Conference.
Louis Cai, MD, and colleagues conducted a multicenter database study including 212 patients between the ages of 20 and 45 years who underwent primary retinal detachment repair using scleral buckle, pars plana vitrectomy or combined scleral buckle and vitrectomy. The patients were followed for at least 6 months. Outcomes observed were single surgery success, overall retina attachment rate and final visual acuity.
Researchers found that scleral buckle was associated with patients who were younger, less likely to have posterior vitreous detachment, less likely to be pseudophakic and less likely to have a cataract. Patients who were more complex received buckle vitrectomy and had higher risk features, retinal detachment in the other eye, worse preoperative visual acuity and vitreous hemorrhage.
The overall rate for success with one surgery was 84.6%, while the overall rate for success with one or more surgeries was 97.5%; 71.2% of patients achieved a final visual acuity better than 20/40. These results were similar among the different modalities after evaluating the data in a multiple regression analysis for preoperative visual acuity and development of the final cataract.
“For younger adults, these three modalities had similar surgical success rates, which is likely due in part to appropriate surgical modality selection,” Cai said. “Younger phakic patients, like me, without [posterior vitreous detachments] were more likely to have scleral buckles. Patients with complex [retinal detachments] were more likely to undergo [buckle vitrectomy].” – by Erin T. Welsh
Reference:
Cai L. Outcomes of primary retinal detachment in younger adults. Presented at: Wills Eye Conference; March 5-7, 2020; Philadelphia.
Disclosure: Cai reports no relevant financial disclosures.