TY - JOUR
T1 - Clinical Outcomes in Sequential, Bilateral Rhegmatogenous Retinal Detachment
T2 - A Multicenter, Paired-Eye Analysis
AU - Xu, David
AU - Belin, Peter J.
AU - Staropoli, Patrick C.
AU - Yannuzzi, Nicolas A.
AU - Vangipuram, Gautam
AU - Chiang, Allen
AU - Shah, Gaurav K.
AU - Townsend, Justin H.
AU - Ryan, Edwin H.
AU - Klufas, Michael A.
N1 - Funding Information:
A.C.: Consultant ? Genentech, Apellis, Orbit Biomedical, Recens Medical; Financial support ? Genentech, Regeneron, Apellis
Publisher Copyright:
© 2020 American Academy of Ophthalmology
PY - 2021/8
Y1 - 2021/8
N2 - Purpose: To assess the clinical outcomes in patients with sequential, bilateral rhegmatogenous retinal detachment (RRD) by using a paired-eye comparison. Design: Multicenter, retrospective cohort study. Participants: Patients with sequential, bilateral RRD treated with pars plana vitrectomy (PPV), scleral buckle (SB), or PPV plus SB over an 11-year period (October 2008–April 2019) from 4 vitreoretinal practices were included. Methods: Data were collected on patient demographics, anatomic characteristics of the RRD, surgical procedures, and best-corrected visual acuity (VA). These variables, along with single-operation anatomic success (SOAS) and type and number of surgical procedures, were assessed with a paired-eye comparison. Main Outcome Measures: Single-operation anatomic success between the initial-eye and subsequent-eye RRD. Results: Five hundred four eyes of 252 patients were included. The mean interval between RRD in either eye was 13.6 ± 13.4 months. Single-operation anatomic success in the initial eye was 82.5% with a mean of 1.2 surgeries (range, 1–4 surgeries). Single-operation anatomic success in the subsequent eye was 83.7% (P = 0.80) with a mean of 1.2 surgeries (range, 1–4 surgeries; P = 0.68). Visual acuity was better in the subsequent eye at presentation (mean, 20/62 vs. 20/149; P < 0.001) and postoperative month 6 (mean, 20/41 vs. 20/49; P = 0.03), but final VA was similar (20/36 vs. 20/37; P = 0.68). Macular detachment was less prevalent (34.1% vs. 56.0%; P < 0.001) with fewer quadrants detached (mean, 1.9 quadrants vs. 2.0 quadrants; P = 0.010) in the subsequent eye. Mean duration of symptoms was shorter in the subsequent eye (mean, 5.9 days vs. 7.5 days; P = 0.008). In patients who underwent a different surgical technique in each eye, PPV plus SB yielded a higher SOAS of 89.7% compared with 69.0% for PPV alone in 116 eyes (P = 0.010). Conclusions: In this study of sequential, bilateral RRD, the SOAS was similar for each eye. The second eye was more likely to be treated earlier and to have less macular involvement, but the final VA outcomes were similar. Pars plana vitrectomy plus SB yielded a significantly higher SOAS than PPV or SB alone.
AB - Purpose: To assess the clinical outcomes in patients with sequential, bilateral rhegmatogenous retinal detachment (RRD) by using a paired-eye comparison. Design: Multicenter, retrospective cohort study. Participants: Patients with sequential, bilateral RRD treated with pars plana vitrectomy (PPV), scleral buckle (SB), or PPV plus SB over an 11-year period (October 2008–April 2019) from 4 vitreoretinal practices were included. Methods: Data were collected on patient demographics, anatomic characteristics of the RRD, surgical procedures, and best-corrected visual acuity (VA). These variables, along with single-operation anatomic success (SOAS) and type and number of surgical procedures, were assessed with a paired-eye comparison. Main Outcome Measures: Single-operation anatomic success between the initial-eye and subsequent-eye RRD. Results: Five hundred four eyes of 252 patients were included. The mean interval between RRD in either eye was 13.6 ± 13.4 months. Single-operation anatomic success in the initial eye was 82.5% with a mean of 1.2 surgeries (range, 1–4 surgeries). Single-operation anatomic success in the subsequent eye was 83.7% (P = 0.80) with a mean of 1.2 surgeries (range, 1–4 surgeries; P = 0.68). Visual acuity was better in the subsequent eye at presentation (mean, 20/62 vs. 20/149; P < 0.001) and postoperative month 6 (mean, 20/41 vs. 20/49; P = 0.03), but final VA was similar (20/36 vs. 20/37; P = 0.68). Macular detachment was less prevalent (34.1% vs. 56.0%; P < 0.001) with fewer quadrants detached (mean, 1.9 quadrants vs. 2.0 quadrants; P = 0.010) in the subsequent eye. Mean duration of symptoms was shorter in the subsequent eye (mean, 5.9 days vs. 7.5 days; P = 0.008). In patients who underwent a different surgical technique in each eye, PPV plus SB yielded a higher SOAS of 89.7% compared with 69.0% for PPV alone in 116 eyes (P = 0.010). Conclusions: In this study of sequential, bilateral RRD, the SOAS was similar for each eye. The second eye was more likely to be treated earlier and to have less macular involvement, but the final VA outcomes were similar. Pars plana vitrectomy plus SB yielded a significantly higher SOAS than PPV or SB alone.
KW - Bilateral
KW - Rhegmatogenous retinal detachment
KW - Scleral buckle
KW - Vitrectomy
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U2 - 10.1016/j.oret.2020.11.002
DO - 10.1016/j.oret.2020.11.002
M3 - Article
C2 - 33197679
AN - SCOPUS:85099495215
VL - 5
SP - 797
EP - 804
JO - Ophthalmology Retina
JF - Ophthalmology Retina
SN - 2468-7219
IS - 8
ER -