Cryotherapy vs laser photocoagulation in scleral buckle surgery: A randomized clinical trial
| Autor: | Maurício Abujamra Nascimento, Heitor Panetta, Carlos Eduardo Leite Arieta, Rodrigo Pessoa Cavalcanti Lira, Iuuki Takasaka, Roberto Caldato |
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| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Visual acuity medicine.medical_treatment Visual Acuity Adhesion (medicine) Vitrectomy Cryotherapy Scleral buckle law.invention Postoperative Complications Randomized controlled trial law Ophthalmology medicine Humans Laser Coagulation business.industry Retinal Detachment Retinal detachment Recovery of Function Middle Aged medicine.disease Prognosis Sclera Surgery Scleral Buckling medicine.anatomical_structure Female medicine.symptom business |
| Zdroj: | Archives of ophthalmology (Chicago, Ill. : 1960). 128(12) |
| ISSN: | 1538-3601 |
| Popis: | Objective To compare the reattachment rate and visual acuity results among patients with rhegmatogenous retinal detachment who underwent scleral buckle surgery with retinopexy by intraoperative cryotherapy (cryopexy) vs postoperative (1 month later) laser photocoagulation (laserpexy). Methods Eighty-six patients with rhegmatogenous retinal detachment scheduled for scleral buckle surgery were randomly assigned to the cryopexy or laserpexy group. Main Outcome Measures The primary outcome was the 1-week reattachment rate. Other outcome measures included later reattachment rate (1 month and 6 months), best-corrected visual acuity, rate of subsequent operations, and postoperative complications. Results The 1-week, 1-month, and 6-month anatomical success rates were similar in the 2 groups: 93% (40 patients), 100%, and 100% in the cryopexy group and 95% (41 patients), 100%, and 100% in the laserpexy group, respectively. Three patients in the cryopexy group and 2 in the laserpexy group underwent 1 additional rhegmatogenous retinal detachment surgery (pars plan vitrectomy) after primary failure at 1-week follow-up. The types of postoperative complications were similar in both groups, except for eyelid edema. Visual recovery was slower in the cryotherapy group, but the difference in visual acuity after 6 months was not significant. Conclusions In patients with uncomplicated retinal detachment, both techniques of retinopexy have shown satisfactory anatomical and functional success. Laserpexy offers faster visual acuity recuperation with fewer postoperative complications but requires a second intervention and costs more than cryotherapy. Application to Clinical Practice Laserpexy is a successful alternative to cryopexy in creating chorioretinal adhesion for scleral buckle surgery. Trial Registration clinicaltrials.gov Identifier:NCT01068379 |
| Databáze: | OpenAIRE |
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