Vitrectomy versus Vitrectomy with Scleral Buckling in the Treatment of Giant Retinal Tear Related Retinal Detachments: An International Multicenter Study.

Autor:	Ong SS; Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland; Department of Ophthalmology, Wake Forest University School of Medicine, Winston-Salem, North Carolina., Ahmed I; Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland., Gonzales A; Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland., Al-Fakhri AS; Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia., Al-Subaie HF; Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia., Al-Qhatani FS; Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia., Alsulaiman SM; Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia., Mura M; Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia., Maia M; Vitreoretinal Surgery, Federal University of Sao Paulo, Brazil., Kondo Kuroiwa DA; Vitreoretinal Surgery, Federal University of Sao Paulo, Brazil., Maia NT; Vitreoretinal Surgery, Federal University of Sao Paulo, Brazil., Berrocal MH; University of Puerto Rico, San Juan, Puerto Rico., Wu L; Asociados de Macula, Vitreo y Retina de Costa Rica, San Jose, Costa Rica., Zas M; Sección Retina, Hospital de Clínicas de la Universidad de Buenos Aires, Buenos Aires, Argentina., Francos JP; Sección Retina, Hospital de Clínicas de la Universidad de Buenos Aires, Buenos Aires, Argentina., Cubero-Parra JM; Unidad de Retina y Vitreo, Hospital la Arruzafa, Córdoba, Spain., Arsiwala LT; Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland; Wilmer Biostatistics Center, Johns Hopkins School of Medicine, Baltimore, Maryland., Handa JT; Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland., Arevalo JF; Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland. Electronic address: arevalojf@jhmi.edu.
Jazyk:	angličtina
Zdroj:	Ophthalmology. Retina [Ophthalmol Retina] 2022 Jul; Vol. 6 (7), pp. 595-606. Date of Electronic Publication: 2022 Mar 15.
DOI:	10.1016/j.oret.2022.03.004
Abstrakt:	Purpose: To determine the practice pattern for treating giant retinal tear (GRT) related detachments, and their anatomic and visual outcomes with pars plana vitrectomy (PPV) with or without scleral buckling (SB). Design: Retrospective cohort study. Subjects: Eyes with GRT detachments repaired from 2008 to 2020 with at least 6 months of follow-up from 7 institutions in North and South America, Europe, and Asia. Methods: Eyes repaired using PPV versus PPV/SB were compared. Main Outcome Measures: Anatomic and functional outcomes. Results: A comparable number of eyes underwent PPV (n = 101) and PPV/SB (n = 99). Except for history of developmental abnormalities, prior intraocular surgery, and lens status, no differences in baseline demographics, ocular characteristics, or intraoperative surgical adjuncts were observed. The overall single surgery anatomic success (SSAS) at 6 months and 1 year were similar between the groups (82.2% and 77.2% of PPV, and 87.9% and 85.7% of PPV/SB). When stratified by age, the 1-year SSAS rate was higher for PPV/SB (88.5%) than PPV (56.3%) (P = 0.03) for children <18 years. For both children and adults, the mean best-corrected visual acuity (BCVA) at baseline did not differ between the PPV and PPV/SB groups. However, for children, mean BCVA at 1 year was better in the PPV/SB than PPV groups (P = 0.001) while for adults, no difference was found between the 2 groups. The mean time to the first redetachment was 7.9 months in the PPV group and 5.5 months in the PPV/SB group (P = 0.8). Proliferative vitreoretinopathy was the most common cause for redetachment (70.4% of PPV and 93.8% of PPV/SB in redetached eyes; P = 0.1). Postoperative complications were also similar between the 2 groups, including ocular hypertension, epiretinal membrane, and cataract formation. Conclusions: PPV and PPV/SB are equally popular among surgeons globally for managing GRT detachments and have comparable anatomic and visual outcomes in adults. In children, PPV/SB is superior to PPV for anatomic and functional success at 1 year. In adults, the relief of traction by the GRT may reduce peripheral traction and obviate the need for an SB. However, in children, a supplemental SB can be beneficial as complete vitreous shaving and posterior hyaloid detachment, and postoperative positioning, are difficult in this group. (Copyright © 2022 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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