Risk factors for failure after primary vitrectomy with no scleral buckling for rhegmatogenous retinal detachment
ABSTRACT Objective To assess pre-operative conditions that could influence primary anatomical success rate in a cohort of patients with rhegmatogenous retinal detachments (RRD) treated with primary vitrectomy and no scleral buckling. Methods A retrospective analysis was performed in a group of p...
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Sociedade Brasileira de Oftalmologia
2023-07-01
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| Series: | Revista Brasileira de Oftalmologia |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-72802023000100216&lng=en&tlng=en |
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| author | Mariano Iros Juan Manuel Lopez Nicolás Crim Evangelina Espósito Julio A. Urrets-Zavalía |
| author_facet | Mariano Iros Juan Manuel Lopez Nicolás Crim Evangelina Espósito Julio A. Urrets-Zavalía |
| author_sort | Mariano Iros |
| collection | DOAJ |
| description | ABSTRACT Objective To assess pre-operative conditions that could influence primary anatomical success rate in a cohort of patients with rhegmatogenous retinal detachments (RRD) treated with primary vitrectomy and no scleral buckling. Methods A retrospective analysis was performed in a group of patients that underwent primary pars plana vitrectomy with gas tamponade and without scleral buckling for RRD between 2014 and 2019, with a minimum follow-up of 4 months. Results 305 eyes of 301 patients were included; 59.01% eyes were phakic, 39.01% were pseudophakic and 1.96% aphakic. 13.11% of patients had proliferative vitreoretinopathy grade B and 3.28% proliferative vitreoretinopathy grade C at the time of diagnosis while 83.61% had proliferative vitreoretinopathy grade 0 or A. 53.1% had superior breaks, 15.4% inferior breaks and 31.5% a combination of both. Primary success rate was obtained in 90.82% of eyes (95%CI 87.58-94.06). 9.18% of eyes (95%CI 5.94-12.42) re-detached. In 3.27% the cause of re-detachment was proliferative vitreoretinopathy, and in the remaining 5.90% because of a new or a missed break, the leakage of a previously treated break, or an area of shallow peripheral detachment with no detectable break. Of 181 phakic eyes, 10.49% re-detached, whereas in over 126 aphakic or pseudophakic eyes 7.75% re-detached (p=0.42). 16.39% eyes of the entire cohort had preoperative grade B or C proliferative vitreoretinopathy, whereas 32.14% of re-detached eyes had preoperative grade B or C proliferative vitreoretinopathy (95%CI 17.29-46.99; p=0.02). Th eyes that re-detached after the first surgery had a mean of 2.5 (95%CI 1.86-3.13) retinal tears, against a mean of 1.87 (95%CI 1.73-2.00) retinal tears of those that did not re-detach after the first surgery (p=0.02). Conclusion We found location of breaks and lens status to be independent factors not related to a lower single operation success rate, whereas the number or size of breaks and preoperative proliferative vitreoretinopathy stages B or C were independent factors related to a higher likelihood of re-detachment. |
| first_indexed | 2024-03-12T22:00:38Z |
| format | Article |
| id | doaj.art-022de7ad7e3f40109d8a9bef4032e3a2 |
| institution | Directory Open Access Journal |
| issn | 1982-8551 |
| language | English |
| last_indexed | 2024-03-12T22:00:38Z |
| publishDate | 2023-07-01 |
| publisher | Sociedade Brasileira de Oftalmologia |
| record_format | Article |
| series | Revista Brasileira de Oftalmologia |
| spelling | doaj.art-022de7ad7e3f40109d8a9bef4032e3a22023-07-25T07:47:18ZengSociedade Brasileira de OftalmologiaRevista Brasileira de Oftalmologia1982-85512023-07-018210.37039/1982.8551.20230035Risk factors for failure after primary vitrectomy with no scleral buckling for rhegmatogenous retinal detachmentMariano Iroshttps://orcid.org/0000-0001-6060-2183Juan Manuel Lopezhttps://orcid.org/0000-0002-8481-5834Nicolás Crimhttps://orcid.org/0000-0002-4604-1874Evangelina Espósitohttps://orcid.org/0000-0002-7289-7465Julio A. Urrets-Zavalíahttps://orcid.org/0000-0003-2267-2783ABSTRACT Objective To assess pre-operative conditions that could influence primary anatomical success rate in a cohort of patients with rhegmatogenous retinal detachments (RRD) treated with primary vitrectomy and no scleral buckling. Methods A retrospective analysis was performed in a group of patients that underwent primary pars plana vitrectomy with gas tamponade and without scleral buckling for RRD between 2014 and 2019, with a minimum follow-up of 4 months. Results 305 eyes of 301 patients were included; 59.01% eyes were phakic, 39.01% were pseudophakic and 1.96% aphakic. 13.11% of patients had proliferative vitreoretinopathy grade B and 3.28% proliferative vitreoretinopathy grade C at the time of diagnosis while 83.61% had proliferative vitreoretinopathy grade 0 or A. 53.1% had superior breaks, 15.4% inferior breaks and 31.5% a combination of both. Primary success rate was obtained in 90.82% of eyes (95%CI 87.58-94.06). 9.18% of eyes (95%CI 5.94-12.42) re-detached. In 3.27% the cause of re-detachment was proliferative vitreoretinopathy, and in the remaining 5.90% because of a new or a missed break, the leakage of a previously treated break, or an area of shallow peripheral detachment with no detectable break. Of 181 phakic eyes, 10.49% re-detached, whereas in over 126 aphakic or pseudophakic eyes 7.75% re-detached (p=0.42). 16.39% eyes of the entire cohort had preoperative grade B or C proliferative vitreoretinopathy, whereas 32.14% of re-detached eyes had preoperative grade B or C proliferative vitreoretinopathy (95%CI 17.29-46.99; p=0.02). Th eyes that re-detached after the first surgery had a mean of 2.5 (95%CI 1.86-3.13) retinal tears, against a mean of 1.87 (95%CI 1.73-2.00) retinal tears of those that did not re-detach after the first surgery (p=0.02). Conclusion We found location of breaks and lens status to be independent factors not related to a lower single operation success rate, whereas the number or size of breaks and preoperative proliferative vitreoretinopathy stages B or C were independent factors related to a higher likelihood of re-detachment.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-72802023000100216&lng=en&tlng=enProliferative vitreoretinopathyRetinal detachmentsVitrectomyScleral buckling |
| spellingShingle | Mariano Iros Juan Manuel Lopez Nicolás Crim Evangelina Espósito Julio A. Urrets-Zavalía Risk factors for failure after primary vitrectomy with no scleral buckling for rhegmatogenous retinal detachment Revista Brasileira de Oftalmologia Proliferative vitreoretinopathy Retinal detachments Vitrectomy Scleral buckling |
| title | Risk factors for failure after primary vitrectomy with no scleral buckling for rhegmatogenous retinal detachment |
| title_full | Risk factors for failure after primary vitrectomy with no scleral buckling for rhegmatogenous retinal detachment |
| title_fullStr | Risk factors for failure after primary vitrectomy with no scleral buckling for rhegmatogenous retinal detachment |
| title_full_unstemmed | Risk factors for failure after primary vitrectomy with no scleral buckling for rhegmatogenous retinal detachment |
| title_short | Risk factors for failure after primary vitrectomy with no scleral buckling for rhegmatogenous retinal detachment |
| title_sort | risk factors for failure after primary vitrectomy with no scleral buckling for rhegmatogenous retinal detachment |
| topic | Proliferative vitreoretinopathy Retinal detachments Vitrectomy Scleral buckling |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-72802023000100216&lng=en&tlng=en |
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