Prognostic factors for anatomical and functional results after retinal detachment surgery. The SPR study

Abstract

AbstractPurpose In the "Scleral buckling vs. primary vitrectomy in rhegmatogenous retinal detachment study (SPR study)" two different surgical methods for the treatment of retinal detachment (RD) were compared in a randomised prospective multicentre clinical trial. This secondary analysis was conducted to investigate possible associations between pre‐ and intraoperative factors with the functional and anatomical outcomes.Methods Univariate and multivariate analysis of 48 pre‐ and intraoperative factors and their association with anatomical outcome, functional outcome and the number of secondary surgical interventions.Results In phakic patients, a significant correlation of successful outcome could be associated with number of retinal breaks, large breaks, cryotherapy, duration of symptoms, baseline visual acuity, central RD, total RD, drainage during buckling surgery and chain formation of breaks. In pseudophakic patients, factors identified were number of breaks, capsular fibrosis, Yag‐laser capsulotomy, retinal laser photocoagulation, and inferior RD.Conclusion The most important risk factor for functional and anatomical failure was a higher number of retinal breaks. Other risk factors varied between the phakic and pseudophakic patients as well as between functional and anatomical outcomes. These findings are of clinical importance for identification of patients with a higher risk for failure and for the planning of future trials on RD surgery.