A meta-analysis of uncomplicated retinal detachment surgery after cataract surgery

Abstract

Objective To compare the efficacy and safety of pars plana vitrectomy (PPV) versus scleral buckling (SB) on rhegmatogenous retinal detachment (RRD) after cataract surgery.Methods A computerized search was conducted in the Cochrane Library,Medline,Embase,China National Knowledge Infrastructure (CNKI),Chinese Biological Medicine Database (CBM) combined with manually searching of related literatures.Randomized controlled trials (RCT) comparing PPV with SB for RRD after cataract surgeries were collected.Best corrected visual acuity (BVCA),reattachment rate after primary surgery,final reattachment rate and complications between the two operations were compared.Results A total of four RCTs were included in this meta analysis,including 690 eyes of 690 patients (331 eyes in the PPV group,359 eyes in the SB group).There was no difference in reattachment rates after primary surgery between two groups [odds ratio (OR) =1.68; 95％ confidence interval (CI),0.81-3.49; P=0.16).Final reattachment rate were in favor of PPV (OR =1.97; 95％ CI,1.04-3.73; P =0.04).There was no significant difference in the proportion of BCVA at six months (weighted mean difference =0.06 ; 95 ％ CI,-0.01-0.14; P=0.11).PPV was associated with a significantly lower frequency of diplopia/extrocular muscle dysfunction than SB (OR=6.59; 95％ CI 1.16-37.27; P=0.03),whereas other complications,such as proliferative vitreoretinopathy,macular pucker,cystoid macular edema,and choroidal detachment did not differ statistically (P＞0.05).Conclusion Compared with SB,PPV is more likely to achieve a favorable final reattachment rate for RRD after cataract surgery,and with a lower rate of diplopia/extrocular muscle dysfunction. Key words: Retinal detachment/surgery; Vitrectomy; Cataract extraction; Meta-analysis