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Primary vitrectomy versus conventional retinal detachment surgery in phakic rhegmatogenous retinal detachment.
Acta Ophthalmol Scand. 2007 Aug; 85(5):540-5.AO

Abstract

PURPOSE

This study aimed to compare the results of primary vitrectomy and conventional scleral buckling procedures (conventional retinal detachment surgery) in phakic rhegmatogenous retinal detachment (RRD).

METHODS

We carried out a randomized, prospective, clinical controlled trial of 61 consecutive phakic eyes with primary RRD, not complicated by proliferative vitreoretinopathy >or= grade C. Subjects were randomized to either scleral buckling (group 1) or pars plana vitrectomy (group 2).

RESULTS

At 6 months follow-up, the primary reattachment rate was 80% (24/30 cases) in group 2 and 80.6% (25/31 cases) in group 1; the difference between the two groups was not statistically significant (p = 0.213). Best corrected visual acuity improved significantly from a preoperative median of 1.78 (1/60) (mean 1.73 +/- 0.91, range 0.3-3) to a median of 0.6 (6/24) (mean 0.689 +/- 0.35, range 0.18-1.48) in group 2 and from a preoperative median of 1.48 (2/60) (mean 1.43 +/- 0.92, range 0-3) to a median of 0.6 (6/24) (mean 0.608 +/- 0.36, range 0-1.78) in group 1; the difference between the two groups was not statistically significant (p = 0.376). Cataract developed in five cases (17%) in the vitrectomy group (group 2), with a statistically significant difference of p = 0.018.

CONCLUSIONS

Although primary vitrectomy can achieve anatomical and functional success rates comparable with those achieved by scleral buckling in uncomplicated forms of phakic RRD, the major drawback of the procedure is the high incidence of postoperative cataract formation. Moreover, visual rehabilitation takes place earlier with scleral buckling than with vitrectomy. Scleral buckling should thus be used as the primary surgical modality in the treatment of uncomplicated RRD where the media are sufficiently clear.

Authors+Show Affiliations

Vitreo-Retina Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. rajvardhanazad@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

17355251

Citation

Azad, Raj Vardhan, et al. "Primary Vitrectomy Versus Conventional Retinal Detachment Surgery in Phakic Rhegmatogenous Retinal Detachment." Acta Ophthalmologica Scandinavica, vol. 85, no. 5, 2007, pp. 540-5.
Azad RV, Chanana B, Sharma YR, et al. Primary vitrectomy versus conventional retinal detachment surgery in phakic rhegmatogenous retinal detachment. Acta Ophthalmol Scand. 2007;85(5):540-5.
Azad, R. V., Chanana, B., Sharma, Y. R., & Vohra, R. (2007). Primary vitrectomy versus conventional retinal detachment surgery in phakic rhegmatogenous retinal detachment. Acta Ophthalmologica Scandinavica, 85(5), 540-5.
Azad RV, et al. Primary Vitrectomy Versus Conventional Retinal Detachment Surgery in Phakic Rhegmatogenous Retinal Detachment. Acta Ophthalmol Scand. 2007;85(5):540-5. PubMed PMID: 17355251.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Primary vitrectomy versus conventional retinal detachment surgery in phakic rhegmatogenous retinal detachment. AU - Azad,Raj Vardhan, AU - Chanana,Bhuvan, AU - Sharma,Yog Raj, AU - Vohra,Rajpal, Y1 - 2007/03/09/ PY - 2007/3/16/pubmed PY - 2007/9/26/medline PY - 2007/3/16/entrez SP - 540 EP - 5 JF - Acta ophthalmologica Scandinavica JO - Acta Ophthalmol Scand VL - 85 IS - 5 N2 - PURPOSE: This study aimed to compare the results of primary vitrectomy and conventional scleral buckling procedures (conventional retinal detachment surgery) in phakic rhegmatogenous retinal detachment (RRD). METHODS: We carried out a randomized, prospective, clinical controlled trial of 61 consecutive phakic eyes with primary RRD, not complicated by proliferative vitreoretinopathy >or= grade C. Subjects were randomized to either scleral buckling (group 1) or pars plana vitrectomy (group 2). RESULTS: At 6 months follow-up, the primary reattachment rate was 80% (24/30 cases) in group 2 and 80.6% (25/31 cases) in group 1; the difference between the two groups was not statistically significant (p = 0.213). Best corrected visual acuity improved significantly from a preoperative median of 1.78 (1/60) (mean 1.73 +/- 0.91, range 0.3-3) to a median of 0.6 (6/24) (mean 0.689 +/- 0.35, range 0.18-1.48) in group 2 and from a preoperative median of 1.48 (2/60) (mean 1.43 +/- 0.92, range 0-3) to a median of 0.6 (6/24) (mean 0.608 +/- 0.36, range 0-1.78) in group 1; the difference between the two groups was not statistically significant (p = 0.376). Cataract developed in five cases (17%) in the vitrectomy group (group 2), with a statistically significant difference of p = 0.018. CONCLUSIONS: Although primary vitrectomy can achieve anatomical and functional success rates comparable with those achieved by scleral buckling in uncomplicated forms of phakic RRD, the major drawback of the procedure is the high incidence of postoperative cataract formation. Moreover, visual rehabilitation takes place earlier with scleral buckling than with vitrectomy. Scleral buckling should thus be used as the primary surgical modality in the treatment of uncomplicated RRD where the media are sufficiently clear. SN - 1395-3907 UR - https://www.unboundmedicine.com/medline/citation/17355251/Primary_vitrectomy_versus_conventional_retinal_detachment_surgery_in_phakic_rhegmatogenous_retinal_detachment_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=1395-3907&date=2007&volume=85&issue=5&spage=540 DB - PRIME DP - Unbound Medicine ER -