Inferior retinal detachment repair using vitrectomy with or without scleral buckling.

PURPOSE: To compare outcomes in inferior rhegmatogenous retinal detachment (RRD) repair using pars plana vitrectomy (PPV) or PPV with scleral buckle (PPV-SB). METHODS: Patients operated for inferior RRD at a tertiary care center between 2014 and 2018 were included. Inferior RRD was defined as retinal detachment with tears between 4:00 and 8:00 clock hours in detached retina. Non-RRD etiologies (e.g., traumatic, tractional), proliferative vitreoretinopathy (PVR) grade ≥C2, and silicone oil use were excluded. Single surgery anatomic success (SSAS) was defined as absence of reoperation for recurrent RRD during follow-up. RESULTS: There were 366 patients included of which 260 (71%) were operated using PPV-SB. SSAS was achieved in 96 (91%) of PPV patients and 227 (87%) of PPV-SB patients (p=0.38) over a median follow-up of 15 months. At final follow-up, PHVA was 0.18 [0.10, 0.30] among PPV patients and 0.18 [0.10, 0.40] among PPV-SB (Snellen equivalent: 20/30; p=0.03). After adjusting for demographic (i.e., age and sex) and preoperative characteristics (i.e., macula on status, baseline PHVA, and grade C1 PVR), PPV-SB did not alter SSAS (p=0.210). CONCLUSIONS: Following inferior RRD repair, there were no significant differences in SSAS between patients undergoing PPV and PPV-SB in this large, retrospective cohort.

Bilateral sequential and simultaneous rhegmatogenous retinal detachments: anatomic and functional outcomes.

OBJECTIVE: To assess the anatomic and functional outcomes in sequential and simultaneous bilateral rhegmatogenous retinal detachment (BRRD) repair. DESIGN: Retrospective cohort study. PARTICIPANTS: A total of 218 eyes in 109 patients. METHODS: Patients diagnosed with BRRD between 2014 and 2020 at the University Centre of Ophthalmology-CHU de Québec-Laval University were reviewed. Main outcomes were single-surgery anatomic success (SSAS) and final pinhole visual acuity (PHVA) in logMARs. RESULTS: Of the 109 patients, 86 (79%) were male, and median (Q1, Q3) age at presentation for the first eye was 60 years (range, 54-66 years). Of these patients, 92% (n = 100) had sequential BRRD and 8% (n = 9) simultaneous BRRD. Median (Q1, Q3) duration of symptoms was shorter for second eyes (first, 7 days [range, 3-15 days] vs second, 4 days [range, 2-10 days]; p = 0.028). Second eyes also had less retinal tears (first, 2.94 ± 2.76 tears vs second, 2.38 ± 1.79 tears; p = 0.031) and better median preoperative PHVA (first, 0.46 logMAR [range, 0.14-2.30 logMAR] vs second, 0.24 logMAR [range, 0.06-0.95 logMAR]; p = 0.012). SSAS was achieved in 100 (92%) and 101 (93%) of first and second eyes, respectively (p = 1.00). Final PHVA was better for the first eye (first, 0.14 logMAR [range, 0.04-0.30 logMAR] vs second, 0.20 logMAR [range, 0.04-0.43 logMAR]; p = 0.010) but comparable at 3 months (first, 0.30 logMAR [range, 0.14-0.48 logMAR] vs second, 0.34 logMAR [range, 0.13-0.70 logMAR]; p = 0.36). CONCLUSIONS: SSAS was similar for both eyes. The subsequent eye was more likely to be treated earlier with less advanced presentations, but at 3 months, PHVA was not significantly different between eyes. Difference in final PHVA may be attributable to longer follow-up in first eyes.