Single Surgery Success Rate Research Articles

Surgical Outcomes of Retinal Detachment in Knobloch Syndrome

To describe the rate, characteristics, and outcomes of rhegmatogenous retinal detachment (RD) in patients with Knobloch syndrome. A single-center retrospective cohort study. 50 patients with Knobloch syndrome diagnosed clinically with or without molecular confirmation of recessive pathogenic COL18A1 variants. A retrospective chart review of all patients diagnosed with Knobloch syndrome from November 1st, 1983, to March 31st, 2023. Demographic data, ophthalmic evaluation at baseline and follow-up, interventions, and final anatomic and visual outcomes were collected. Rate, time of onset, characteristics, and treatment outcomes of RD. Fifty patients with Knobloch syndrome were included. Males constituted 56% of cases. The diagnosis was confirmed with molecular genetic testing in 37 (74%) patients. 22 patients (44%) had documented occipital bony defects or scalp lesions. Forty-eight of 100 eyes (48%) developed RD at a mean age of 6.5 (SD = 6.1) years. The mean follow-up was 7.7 (SD = 5.6) years [range 6 months - 24.3 years]. Macular hole-related RD comprised 33% of RD cases. The overall single surgery success rate was 36% and the final anatomical success rate was 70%. Macular hole-related RD carried a slightly worse prognosis with a 58% final anatomical success rate. Vitrectomy with adjunct scleral buckle and silicone oil tamponade provided the highest single surgery success (62.2%). In eyes with measurable best corrected visual acuity (BCVA), the mean preoperative BCVA was 1.2 logMAR (Snellen equivalent 20/320). After successful repair, mean VA was 1.3 logMAR (Snellen equivalent 20/500). Retinal Detachment in Knobloch syndrome is frequent and occurs in young children. Macular hole retinal detachment comprises one-third of RD cases and requires careful macular evaluation. Vitrectomy, combined with scleral buckling and silicone oil tamponade appear to provide the best anatomical outcomes.

38-Gauge Cannula-Based Endodrainage of Posteriorly Trapped Intraoperative Subretinal Fluid during Vitrectomy for Retinal Detachment

The DRAIN STUDY evaluated a novel use of a 38-gauge Polytip® cannula for posteriorly trapped intraoperative subretinal fluid endo-drainage during pars plana vitrectomy in rhegmatogenous retinal detachment. Sixteen patients underwent this procedure, with an 81% single surgery success rate at 3 months postoperatively. Median visual acuity improved from 20/300 to 20/80. Two cases developed cystoid macular edema and epiretinal membrane. No postoperative residual subretinal fluid was observed. The 38-gauge cannula-based SRF drainage proved effective, offering an alternative to conventional methods for managing posteriorly trapped intraoperative subretinal fluid.

Impact of the COVID-19 Pandemic on the Number, Clinical Characteristics, Surgical Types, and Anatomical Outcome of Patients with Primary Rhegmatogenous Retinal Detachment during and after COVID-19 Lockdown in Thailand

Background: During lockdown in 2020 from the outbreak of coronavirus disease 2019 (COVID-19), rhegmatogenous retinal detachment (RRD) has been affected in several aspects including prevalence alteration, delayed presentations, and poorer treatment outcomes. These effects are unknown after lockdown by comparing with the preceding year. Objective: To determine the impact of the COVID-19 pandemic on the number, clinical characteristics, type of surgical procedure, and anatomical outcome of primary RRD during and after lockdown compared with those parameters in the same periods of the previous year. Materials and Methods: In the present retrospective cohort study, the medical records of patients with primary RRD underwent retinal surgery at Mettapracharak Hospital during and after the first lockdown in 2020 and the corresponding period in 2019 were reviewed. These four periods had an equal number of days as the first lockdown period. The following data were analyzed, baseline demographics, initial clinical presentations, type of surgical procedure, and outcome. Results: Four hundred fifty-five patients, for 455 eyes, underwent surgery for primary RRD. One hundred seven patients were treated during lockdown, 106 patients after lockdown, whereas 117 patients and 125 patients were treated in identical periods in the previous year, respectively. A decrease of 8.5% of RRD cases during lockdown and of 15.2% of RRD cases post-lockdown were documented. No significant differences were found with respect to demographic features, clinical characteristics, type of surgical procedure, or the anatomical single surgery success rate of RRD patients among all time periods. However, a significantly lower prevalence of right-eye involvement and shorter waiting time for surgery after lockdown were documented. Conclusion: The authors revealed the impact of the COVID-19 pandemic on the reduction in the number of surgical procedures for primary RRD during and after lockdown. Our findings could aid redefinition of a strategic plan for RRD management after the COVID-19 pandemic had subsided. Keywords: Rhegmatogenous retinal detachment; COVID-19; Pandemic; Lockdown; Tertiary hospital; Eye

The State of Pediatric Retinal Detachment Surgery in the United States: a Nationwide Aggregated Health Record Analysis.

In this study, we aim to identify the demographics of retinal detachment in children in the United States, and to report the treatment modalities chosen by vitreoretinal surgeons, and associated outcomes. This was a multicenter cohort analysis of the Vestrum Health LLC Database (Naperville, Illinois). Children (1-17 years) with rhegmatogenous retinal detachment (RRD), as identified by ICD10 and CPT codes, between January 2015 and August 2021. Demographic, comorbidity, visual acuity, and treatment modality data were analyzed. A total of 168,152 RRDs were identified, of which 2200 (1.3%) were 1-17 years old. Mean age was 12.7 years, and 821 (37%) were female. The prevalence of RRD increased with age (P =0.009). Associated co-morbidities included myopia (17.3%), ocular trauma (7.5%), and history of prematurity (5.7%). Laser retinopexy alone was used as the initial treatment modality in 19%, primary vitrectomy in 23%, primary scleral buckle in 25%, and vitrectomy with scleral buckle in 33%. The single surgery success rate for all procedures was 73.3%. Of the incisional surgical modalities, primary scleral buckling had the best single surgery success rate (79.0%) compared to vitrectomy alone (64.5%) and vitrectomy with scleral buckle (67.2%) (p < 0.001 and p = 0.004, respectively). Younger age resulted in worse SSSR overall (coefficient = 0.151, R2 = 0.746, p = 0.027). Rhegmatogenous retinal detachments in children increased with age. Myopia, trauma, and history of retinopathy of prematurity were common risk factors. Treatment techniques varied, but primary scleral buckling had the best anatomic and visual outcomes.

Effect of Macular Internal Limiting Membrane Peeling on Single Surgery Success Rates of Vitrectomy for Uncomplicated, Primary Macula-Off Retinal Detachment.

Purpose: To determine the anatomic and visual outcomes of pars plana vitrectomy for uncomplicated, primary macula-off rhegmatogenous retinal detachment (RRD) with and without internal limiting membrane (ILM) peeling. Methods: This retrospective chart review comprised 129 patients with uncomplicated, primary macula-off RRD presenting between January 1, 2016, and May 31, 2021. Thirty-six patients (27.9%) had ILM peeling and 93 (72.0%) did not. The primary outcome was the rate of recurrent RRD. Secondary outcomes included preoperative and postoperative best-corrected visual acuity (BCVA), epiretinal membrane (ERM) formation, and macular thickness. Results: No significant difference was found in the risk for recurrent RRD between patients who had ILM peeling and those who did not (2.8% [1/36] and 5.4% [5/93], respectively) (P = 1.00). The final postoperative BCVA was better in eyes that did not have ILM peeling (P< .001). No ERM occurred in the group with ILM peeling, whereas ERM occurred in 27 patients (29.0%) who did not have ILM peeling. The temporal macular retina was thinner in eyes in which ILM peeling was performed. Conclusions: The risk for recurrent RRD was not statistically lower in eyes having ILM peeling of the macula in uncomplicated, primary macula-off RRD. Despite a reduction in postoperative ERM formation, eyes having macular ILM peeling had worse postoperative VA.

Outcomes and complications of primary rhegmatogenous retinal detachment repair with pars plana vitrectomy in young adults

BackgroundScleral buckling has been the standard for rhegmatogenous retinal detachment repair in young patients given the typical lack of posterior vitreous detachment, phakic status, and lower risk of proliferative vitreoretinopathy. In older patients, pars plana vitrectomy alone is typically used for rhegmatogenous retinal detachment repair. We report the outcomes and complications of pars plana vitrectomy for rhegmatogenous retinal detachment in young eyes.MethodsRetrospective, single-center cohort study. Medical records of patients between 15 to 45 years of age undergoing primary pars plana vitrectomy for rhegmatogenous retinal detachment repair between 2010 and 2020 were carefully reviewed. All analyses were performed using the Kruskal–Wallis tests for numeric covariates between age groups.ResultsEyes were stratified by age: 15–24 (group 1, n = 10), 25–34 (group 2, n = 14), and 35–45 (group 3, n = 38). The average number of surgeries were 1.9, 1.4, and 1.1 in groups 1, 2, and 3, respectively (p = 0.004). Single surgery success rates were 50%, 64%, and 92% in groups 1, 2 and 3, respectively (p = 0.005). Final reattachment rates were 80%, 93%, 100% in groups 1, 2, and 3, respectively (p = 0.568). Proliferative vitreoretinopathy developed in 50%, 7%, and 8% of eyes in groups 1, 2, and 3, respectively (p < 0.001).ConclusionWhile the final reattachment rates were excellent in all groups, the higher rates of proliferative vitreoretinopathy and lower single surgery success rate in younger patients may suggest that primary pars plana vitrectomy may not be the optimal repair method in these age groups.

Effect of race and ethnicity on surgical outcomes for rhegmatogenous retinal detachments

ObjectiveTo evaluate the effect of socioeconomic and demographic factors on outcomes in rhegmatogenous retinal detachments (RRDs). DesignRetrospective cohort study. MethodsA total of 71 white and 124 black and/or Hispanic patients who had surgical repair of RRDs between October 2013 and September 2021 at a single-centre safety net hospital. Main outcomes were single surgery success rates (SSSR) and postoperative visual acuity at 6-month and final follow-up. ResultsBlack and (or) Hispanic patients were significantly younger (black and [or] Hispanic, 50.7 years vs white, 57.6 years; p = 0.003), had lower mean household incomes (black and [or] Hispanic, $80,932 vs white, $92,911; p = 0.007), were more likely to have more than 1 retinal break (black and [or] Hispanic, 65% vs white, 49%; p = 0.04), and had higher rates of proliferative vitreoretinopathy (PVR) at presentation (black and [or] Hispanic, 35% vs white, 18%; p = 0.02). SSSR was similar (black and [or] Hispanic, 73.4% vs white, 73.2%; p = 0.98), but black and (or) Hispanic patients had worse visual acuity postoperatively (black and [or] Hispanic, 20/63 vs white, 20/40 at final follow-up; p = 0.03). While race was linked to visual outcome in univariate testing; multivariate analysis revealed only macula status (p = 0.007 at 6 months; p = 0.01 at final follow-up), presence of PVR (p < 0.001 at both time points), and SSSR (p = 0.003 at final follow-up) as predictors of worse visual outcomes. ConclusionsPreoperative factors such as higher rates of PVR may contribute to worse vision outcomes in black and (or) Hispanic patients undergoing surgical repair for RRD.

PREVALENCE, CHARACTERISTICS, AND OUTCOMES OF RHEGMATOGENOUS RETINAL DETACHMENT IN EYES WITH TRABECULECTOMY OR GLAUCOMA DRAINAGE DEVICES.

To describe the prevalence, management, and outcomes of rhegmatogenous retinal detachment (RRD) after incisional glaucoma filtering surgery. All patients with a history of trabeculectomy or glaucoma drainage device surgery who were subsequently diagnosed with an RRD from January 1, 2016, to January 1, 2021, at the Wills Eye Hospital were identified. Forty-six eyes met the inclusion criteria. The mean age was 60.7 ± 19.6 years, and 15 patients (32.6%) were female. Of all eyes, 34 (73.9%) were diagnosed with primary open-angle glaucoma. The mean time from most recent incisional glaucoma surgery to RRD diagnosis was 1,133 ± 1,644 days. There were 19 eyes (41.3%) with preoperative proliferative vitreoretinopathy (9 eyes [19.6%] with Grade C proliferative vitreoretinopathy) and 35 eyes (76.1%) had macula-off RRD at the time of presentation. At RRD presentation, 4 eyes (8.7%) had concomitant endophthalmitis, 5 (10.9%) had concurrent choroidal detachment, and 2 (4.7%) had concurrent vitreous hemorrhage. Primary vitrectomy was performed in most (91.3%) cases. Silicone oil tamponade was often required (71.1%). The single surgery success rate was 65.2% (30 of 46). The mean preoperative logarithm of the minimum angle of resolution visual acuity was 1.72 ± 0.78 (Snellen acuity 20/1,050), and the mean final postoperative logarithm of the minimum angle of resolution was 1.59 ± 0.89 (20/778, P = 0.2853). Of glaucoma surgeries performed, the 5-year prevalence of RRD was 0.71% (26 of 3,664, 95% Poisson confidence interval 0.48%-1.04%). The 5-year prevalence of RRDs after trabeculectomy or glaucoma drainage device was 0.71%. Most patients presented with macula-involving detachments, often with proliferative vitreoretinopathy. Anatomical and visual outcomes were poor.

Pars plana vitrectomy combined with phacoemulsification versus pars plana vitrectomy only for treatment of phakic rhegmatogenous retinal detachment: a systematic review and meta-analysis.

To compare the visual, refractive, and anatomical outcomes and incidence of complications between combined pars plana vitrectomy and phacoemulsification (phacovitrectomy) versus pars plana vitrectomy (PPV-only) in phakic eyes with rhegmatogenous retinal detachment (RRD). Two independent reviewers searched MEDLINE, Cochrane Central, and Web of Science to identify relevant articles. Prospective or retrospective studies comparing PPV-only and phacovitrectomy for RRD were included. Recruited studies provided information about at least anatomical success or refractive outcomes. Meta-analysis was performed for single surgery success rate, final best-corrected visual acuity (BCVA), postoperative complications, mean predicted refractive error, and mean absolute predicted refractive error. Seven studies (788 eyes) were selected, including two clinical trials and five retrospective comparative case series. The single surgery success rate was similar in PPV-only and phacovitrectomy groups (risk ratio [RR] = 1.02; 95% confidence interval [CI] 0.95-1.10; P = 0.57). Mean final BCVA was significantly better in the PPV-only group than the phacovitrectomy group (MD = 0.06; 95% CI 0.00-0.12; P = 0.04). The risk of epiretinal membrane formation was significantly higher in eyes that underwent phacovitrectomy than PPV-only (RR = 2.85; 0.95% CI 1.5-5.41; P = 0.001). Phacovitrectomy group showed a more myopic final mean predicted refractive error than PPV-only group (MD = -0.31; 95% CI -0.55--0.07; P = 0.01). There was no significant difference between the two groups regarding the anatomical outcome. Slightly better visual and refractive results were observed in the PPV-only group. However, the results should be interpreted with caution as the majority of included studies were low-quality retrospective studies.

Surgical Outcomes of Acute Retinal Necrosis–Related Retinal Detachment in Polymerase Chain Reaction–Positive Patients: A Single-Center Experience

To evaluate the clinical features, operative techniques, and surgical outcomes of patients who underwent surgery for acute retinal necrosis (ARN)-related retinal detachment (RD). Retrospective, longitudinal, consecutive case series. Patients with polymerase chain reaction-positive ARN presenting from 2011 to 2021 who underwent vitreoretinal surgery for ARN-related RD at our institution. Univariate, multivariate, and survival analyses were used to determine predictors of anatomic and functional outcomes. Single-surgery anatomic success rate, recurrent RD, and visual acuity (VA) at 1year. Thirty-four eyes of 34 patients (32.4% women, mean age, 45.1 ± 20.4 years) were included for analysis with a median follow-up of 2.5 years (interquartile range [IQR], 0.8-5.5 years). Presenting VA was 1.1±0.8 logarithm of the minimum angle of resolution (LogMAR) (Snellen ∼20/250). The median time from presentation to RD surgery was 1.7 months (IQR, 0.8-4.1 months), and the mean preoperative VA was 1.6 ± 0.8 LogMAR (Snellen ∼20/800). Small-gauge pars plana vitrectomy (PPV) with or without a scleral buckle (SB) was performed for all eyes with an overall single-surgery success rate of 63.6%, with no statistically significant differencesin visual/anatomic outcomes between PPV and PPV/SB cases. Silicone oil was used for tamponade in 33 (97.1%) cases and was removed in 10 (30.3%) with good anatomic and final functional outcomes (Snellen∼20/80). Independent predictors of recurrent RD included the female sex (hazard ratio, 8.38; 95% confidence interval, 2.03-34.68; P < 0.01) and zone 1 retinitis involvement at presentation (hazard ratio, 10.95; 95% confidence interval, 2.12-56.48; P < 0.01). The mean VA at 1 year (VA1year) and at the final follow-up both had a Snellen equivalent of 20/640 (P > 0.05 for both compared with preoperative VA, respectively). Eyes that achieved single-surgery success had VA1year of 20/200 versus hand movements in those with single-surgery failure (P < 0.01). On multivariate linear regression, younger age (P= 0.04) and better presenting VA (P<0.01) were both associated with better VA1year. Moderate single-surgery anatomic success can be achieved with modern vitreoretinal surgical techniques for ARN-related RD, although visual outcomes remain poor. Further studies investigating interventions for increasing single-surgery success rates, for the inflammatory complications of ARN, and for preventing ARN-related RD are needed.

Combined epiretinal and internal limiting membrane retracting door flaps for large macular holes associated with epiretinal membranes.

To assess the closure rate of large full-thickness macular holes (FTMH) associated with epiretinal membrane (ERM) with a combined epiretinal and internal limiting membrane retracting door flap. Retrospective chart review of patients treated at a single tertiary retina practice between January 2017 and November 2019. Individuals with FTMH larger than 400μm and co-diagnosis of ERM who underwent surgical repair with an ERM flap were included. Patients underwent pars plana vitrectomy with peeling of ERM that was positioned as a retracting door flap to cover the FTMH. Primary outcome was closure rate at 6months following surgery. Final surgical success rate and visual acuity were secondary outcomes. Among 7 eyes of 7 patients, 6 eyes achieved primary surgical success and final surgical success rate was achieved in all 7 eyes with a large FTMH repaired with ERM flap. The mean minimum linear diameter of the FTMH was 681μm ± 295. All patients had follow-up greater than 6months, with a mean duration of 17months (range 14-23months). Visual acuity improved from a mean of 0.9 ± 0.3 logMar (20/160) before surgery to 0.3 ± 0.5 logMar (Snellen 20/40), postoperatively. Large FTMH with concurrent ERM that are managed with an ERM flap have high single-surgery success rate.

COMPARATIVE EVALUATION OF OUTCOMES OF DRAINAGE TECHNIQUES IN VITRECTOMY FOR RHEGMATOGENOUS RETINAL DETACHMENT.

To compare the anatomical and functional outcomes of drainage through posterior retinotomy versus perfluorocarbon liquid (PFCL)-assisted drainage in vitreoretinal surgery for rhegmatogenous retinal detachment and to study intraoperative and postoperative complications. This was a prospective randomized study of 52 cases who underwent vitreoretinal surgery for rhegmatogenous retinal detachment. Group 1 underwent PFCL-assisted drainage through preexisting break, whereas Group 2 had posterior retinotomy to drain subretinal fluid. Cases were evaluated for retinal reattachment rates, visual outcomes, optical coherence tomography parameters, and postoperative metamorphopsia. The patients were followed up for minimum period of 3 months. Two groups were comparable in terms of demographic and preoperative parameters. Both groups had single surgery success rate of 100% by the end of follow-up. Final best-corrected visual acuity in Group 1 was 0.61 ± 0.33 and 0.61 ± 0.32 in Group 2 (P = 0.77). Optical coherence tomography parameters (foveal contour, retinal layers, central macular thickness, and epiretinal membrane formation) were similar between the two groups. Subjective metamorphopsia was present in 30.77% (8 of 26) patients in Group-1 and 69.23% (18 of 26) patients in Group-2 (P = 0.034). One eye had retained subretinal PFCL away from the macula in Group 1. Anatomical and functional outcomes were similar in vitrectomy using PFCL-assisted drainage versus posterior retinotomy drainage. Postoperative metamorphopsia was lesser in patients who underwent PFCL-assisted drainage through the pre-existing break.

Scleral Buckling for Primary Retinal Detachment: Outcomes of Scleral Tunnels versus Scleral Sutures.

Purpose There are primarily two techniques for affixing the scleral buckle (SB) to the sclera in the repair of rhegmatogenous retinal detachment (RRD): scleral tunnels or scleral sutures.MethodsThis retrospective study examined all patients with primary RRD who were treated with primary SB or SB combined with vitrectomy from January 1, 2015 through December 31, 2015 across six sites. Two cohorts were examined: SB affixed using scleral sutures versus scleral tunnels. Pre- and postoperative variables were evaluated including visual acuity, anatomic success, and postoperative strabismusResults The mean preoperative logMAR VA for the belt loop cohort was 1.05 1.06 (Snellen 20/224) and for the scleral suture cohort was 1.03 1.04 (Snellen 20/214, p = 0.846). The respective mean postoperative logMAR VAs were 0.45 0.55 (Snellen 20/56) and 0.46 0.59 (Snellen 20/58, p = 0.574). The single surgery success rate for the tunnel cohort was 87.3% versus 88.6% for the suture cohort (p = 0.601). Three patients (1.0%) in the scleral tunnel cohort developed postoperative strabismus, but only one patient (0.1%) in the suture cohort (p = 0.04, multivariate p = 0.76). All cases of strabismus occurred in eyes that underwent SB combined with PPV (p = 0.02). There were no differences in vision, anatomic success, or strabismus between scleral tunnels versus scleral sutures in eyes that underwent primary SB.ConclusionScleral tunnels and scleral sutures had similar postoperative outcomes. Combined PPV/SB in eyes with scleral tunnels might be a risk for strabismus post retinal detachment surgery.

Результаты лечения локальной регматогенной отслойки сетчатки с использованием микроинвазивной комбинированной лазер-хирургической технологии

Rhegmatogenous retinal detachment (RRD) is one of the leading causes of vision loss world-wide. Despite advances in surgical techniques, rates of redetachment and vision loss remain high. Patients with RRD require a secondary surgery approximately 10 – 40% of the time. To achieve a high anatomical result, reduce the risk of reoperations and maintain high visual functions, it is necessary to develop and analyze microinvasive technologies to eliminate the main cause of RRD - the traction component. Purpose. To evaluate the results of microinvasive combined laser-surgical technology for RRD treatment. Material and мethods. The study included 43 eyes of 43 patients who underwent microinvasive laser-surgical technology for rhegmatogenous retinal detachment treatment, which included 3 consecutive steps: 1) YAG-laser excision of the horseshoe tear zone with vitreoretinal adhesion (VRA); 2) pneumatic retinopexy with 12% C3F8 (immediately after the first step); 3) barrier laser photocoagulation after complete retinal attachment (2-3 days after pneumatic retinopexy). The results were evaluated for anatomical efficacy (rates of retinal attachment and the occurrence of recurrent rhegmatogenous retinal detachment), functional efficacy (uncorrected (UCVA) and bestcorrected (BCVA) visual acuity, intraocular pressure (IOP)), and safety of technology (any intra- and postoperative complications). Results. In 40 patients (93%), the retina was attached with one surgical intervention. The success rate was significantly lower in patients with pseudophakia and a large retinal tear after YAG-laser excision of VRA zone. UNCA, BCVA and IOP after microinvasive combined laser-surgical technology was not significantly different from the initial values (p&gt;0,05). Сlinically significant complications included gas migration into the subretinal space and epiretinal membrane formation. Conclusion. Microinvasive combined laser-surgical technology is characterized by high single surgery success rate (93%), preservation of initially high visual functions, a low rate of redetachment (7,5%) and clinically significant complications (7%). Key words: rhegmatogenous retinal detachment, optical coherence tomography, horseshoe tear, YAG-laser retinotomy, pneumatic retinopexy, vitreoretinal traction.

Pars Plana Vitrectomy vs Combined Pars Plana Vitrectomy-Scleral Buckle for Primary Repair of Pediatrics Retinal Detachment.

PurposeTo evaluate the outcome of pars plana vitrectomy (PPV) and combined pars plana vitrectomy with scleral buckle (PPV-SB) in the primary pediatrics rhegmatogenous retinal detachment repair.DesignA retrospective cohort study.MethodsA retrospective study was conducted in patients under 18 years of age, who presented with rhegmatogenous retinal detachment at King Khaled Eye Specialist Hospital between January 2014 and October 2018. Primary measurable outcomes were single surgery success rate (SSSR) and rate of postoperative complications.ResultsA total of 122 eyes of 117 patients were included in the study; 80 eyes in PPV group and 42 eyes in PPV-SB group. Mean follow-up period after surgery was 18.2 months ±11 months. SSSR was 76.3% (n=61) and 66.7% (n=28) for PPV and PPV-SB, respectively. No statistically significant difference was found between the two methods of RRD repair in single surgery success rate with an OR of 1.3 (P=0.45). Complication rates were comparable in both groups in the last follow-up.ConclusionIn this series, PPV and PPV-SB have comparable results in regard to anatomical success and rate of postoperative complications. More complicated cases were selected to undergo PPV-SB upon surgeons’ preference.

Incidence and surgical care of retinal detachment during the first SARS-CoV-2 lockdown period at a tertiary referral center in Austria.

PurposeTo assess the influence of the SARS-CoV-2 lockdown in spring on frequency, severity and quality of care of rhegmatogeneous retinal detachments (RRD) in a tertiary referral center in Vienna, Austria.MethodsSingle center, consecutive case series with historical controls. Patients presenting with primary RRD during the first Austrian SARS-CoV-2 lockdown (March 16th–May 3rd 2020) and a corresponding control group consisting of the same time period of the preceding 3 years.ResultsThe mean number of patients with RD in the reference group (RG) was 22 (± 1) and in the lockdown group (LG) 15. Median total delay, defined as onset of symptoms until surgery, in the RG was 5 (lower quartile: 3.0; upper quartile: 8.0) compared to 7 (3.0; 12.0) days in the LG, (p = 0.740). During the lockdown 67% of patients were referred from an external ophthalmologist compared to 52% in the RG, (p = 0.395). 34% of patients in the RG presented with an attached macula compared to 33% in the LG (p = 0.597). PVR was present in 49% of cases in the RG compared to 73% in the LG. Single surgery success (SSS) rates were lower in the LG (73.3%) compared to the RG (85.3%), (p = 0.275).ConclusionPatients with RRD during the SARS-CoV-2 lockdown presented and were treated within acceptable time limits, showed the same macula-on ratios but a higher PVR rate and a tendency towards worse SSS rates compared to the time period of the preceding 3 years.

Scleral Buckle Removal: Indications, Timing, Complications, and Long-Term Outcomes

To report indications, timing, complications, and outcomes of scleral buckle (SB) removal surgery. Retrospective observational case series. Eyes that underwent SB removal between 2010 and 2016 with greater than 1 year of follow-up were included. Main outcome measures were post-SB removal complications and best-corrected visual acuity (BCVA). Fifty eyes that underwent SB removal met the inclusion criteria. Indications include exposed SB (54%), infection (26%), diplopia (16%), and recurrent retinal detachment (4%). Mean and median intervals between SB placement and removal were 65 months and 30 months. Complications include recurrent retinal detachment (12%), transient ocular hypertension (6%), and persistent diplopia (4%). There was no significant change in mean BCVA after SB removal (P = .979). Exposed SB, infection, and diplopia are the most common indications for SB removal. The single-surgery success rate is high and the risk for complications is relatively low. [Ophthalmic Surg Lasers Imaging Retina. 2021;52:138-144.].

Pars Plana Vitrectomy Outcomes for Rhegmatogenous Retinal Detachment Qualifying for Pneumatic Retinopexy.

PurposeTo investigate real-world outcomes of pars plana vitrectomy (PPV) for eyes with primary rhegmatogenous retinal detachments (RRD) eligible for pneumatic retinopexy (PnR).MethodsThis was a single center retrospective case series looking at consecutive patients with primary RRDs. A database was created on all patients with a primary RRD from 2010 to 2018 based on billing code 67108. Eyes anatomically eligible for PnR were reviewed for preoperative, intraoperative and postoperative characteristics. The main outcome assessed was single surgery anatomical success (SSAS), final anatomical success (FAS), and postoperative LogMAR vision.ResultsA total of 720 eyes (age, 62.9 ± 9.1 years; 61.7% were male) met inclusion criteria for PnR and underwent PPV. SSAS was 94.0% and FAS was 99.9%. Preoperative and final LogMAR vision was 0.853 and 0.293 (P<0.001) in eyes with SSAS vs 0.714 and 0.648 (P=0.686) in eyes with primary failure. PVR was the most common etiology of primary surgical failure (n=21, 49%). Patients who failed primary repair had a mean of 1.12 additional surgeries with a median time of 45 days between surgeries.ConclusionA robust single surgery success rate with good visual outcomes was achieved across 8 years and multiple surgeons utilizing PPV to treat primary RRDs in eyes which anatomically qualified for pneumatic retinopexy in a real-world setting.

PHACOVITRECTOMY FOR PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT REPAIR: A Retrospective Review.

To analyze the single surgery success rate and anterior segment complications related to phacoemulsification and intraocular lens implantation in a series of patients undergoing phacovitrectomy for all types of primary rhegmatogenous retinal detachment. We performed a retrospective interventional case series on 302 eyes undergoing phacovitrectomy for primary rhegmatogenous retinal detachment repair between November 1, 2016, and February 2, 2019, in Edmonton, Canada. Primary outcomes included single surgery retinal reattachment rate and anterior segment complications. Secondary outcomes included the effects of proliferative vitreoretinopathy and macula and/or peripheral internal limiting membrane peeling on the rate of surgical success. The single surgery success rate of phacovitrectomy for all types of primary rhegmatogenous retinal detachment was 85.1%. The presence of proliferative vitreoretinopathy was associated with lower surgical success (odds ratio, 0.33; P = 0.01). Macular internal limiting membrane peeling was associated with higher surgical success (odds ratio, 2.4; P = 0.05). Anterior segment complications included posterior capsular opacification (28.8%), posterior synechiae (10.9%), and posterior capsular rupture (2.3%). Phacovitrectomy is a safe and effective treatment option for the primary repair of rhegmatogenous retinal detachments. This study provides evidence to support the safe incorporation of phacoemulsification and intraocular lens implantation with retinal surgery.

IOCT-assisted macular hole surgery: outcomes and utility from the DISCOVER study

Background/aimsThis study aimed to characterise the clinical outcomes and utility of intraoperative optical coherence tomography (iOCT)-assisted macular hole (MH) repair.MethodsThis was a post hoc analysis of eyes in the Determinationof...