Impact of contact versus non-contact wide-angle viewing systems on outcomes of primary retinal detachment repair (PRO study report number 5).


Journal

The British journal of ophthalmology
ISSN: 1468-2079
Titre abrégé: Br J Ophthalmol
Pays: England
ID NLM: 0421041

Informations de publication

Date de publication:
03 2021
Historique:
received: 27 01 2020
revised: 14 04 2020
accepted: 17 04 2020
pubmed: 16 5 2020
medline: 16 6 2021
entrez: 16 5 2020
Statut: ppublish

Résumé

Vitrectomy to repair retinal detachment is often performed with either non-contact wide-angle viewing systems or wide-angle contact viewing systems. The purpose of this study is to assess whether the viewing system used is associated with any differences in surgical outcomes of vitrectomy for primary non-complex retinal detachment repair. This is a multicenter, interventional, retrospective, comparative study. Eyes that underwent non-complex primary retinal detachment repair by either pars plana vitrectomy (PPV) alone or in combination with scleral buckle/PPV in 2015 were evaluated. The viewing system at the time of the retinal detachment repair was identified and preoperative patient characteristics, intraoperative findings and postoperative outcomes were recorded. A total of 2256 eyes were included in our analysis. Of those, 1893 surgeries used a non-contact viewing system, while 363 used a contact lens system. There was no statistically significant difference in single surgery anatomic success at 3 months (p=0.72), or final anatomic success (p=0.40). Average postoperative visual acuity for the contact-based cases was logMAR 0.345 (20/44 Snellen equivalent) compared with 0.475 (20/60 Snellen equivalent) for non-contact (p=0.001). After controlling for numerous confounding variables in multivariable analysis, viewing system choice was no longer statistically significant (p=0.097). There was no statistically significant difference in anatomic success achieved for primary retinal detachment repair when comparing non-contact viewing systems to contact lens systems. Postoperative visual acuity was better in the contact-based group but this was not statistically significant when confounding factors were controlled for.

Sections du résumé

BACKGROUND/AIMS
Vitrectomy to repair retinal detachment is often performed with either non-contact wide-angle viewing systems or wide-angle contact viewing systems. The purpose of this study is to assess whether the viewing system used is associated with any differences in surgical outcomes of vitrectomy for primary non-complex retinal detachment repair.
METHODS
This is a multicenter, interventional, retrospective, comparative study. Eyes that underwent non-complex primary retinal detachment repair by either pars plana vitrectomy (PPV) alone or in combination with scleral buckle/PPV in 2015 were evaluated. The viewing system at the time of the retinal detachment repair was identified and preoperative patient characteristics, intraoperative findings and postoperative outcomes were recorded.
RESULTS
A total of 2256 eyes were included in our analysis. Of those, 1893 surgeries used a non-contact viewing system, while 363 used a contact lens system. There was no statistically significant difference in single surgery anatomic success at 3 months (p=0.72), or final anatomic success (p=0.40). Average postoperative visual acuity for the contact-based cases was logMAR 0.345 (20/44 Snellen equivalent) compared with 0.475 (20/60 Snellen equivalent) for non-contact (p=0.001). After controlling for numerous confounding variables in multivariable analysis, viewing system choice was no longer statistically significant (p=0.097).
CONCLUSION
There was no statistically significant difference in anatomic success achieved for primary retinal detachment repair when comparing non-contact viewing systems to contact lens systems. Postoperative visual acuity was better in the contact-based group but this was not statistically significant when confounding factors were controlled for.

Identifiants

pubmed: 32409294
pii: bjophthalmol-2020-315948
doi: 10.1136/bjophthalmol-2020-315948
doi:

Types de publication

Comparative Study Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

410-413

Informations de copyright

© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: All disclosures are listed in the manuscript.

Auteurs

Marisa G Tieger (MG)

Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.

Marianeli Rodriguez (M)

Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.

Jay C Wang (JC)

Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.

Anthony Obeid (A)

Mid Atlantic Retina, Wills Eye Hospital, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.

Claire Ryan (C)

VitreoRetinal Surgery, Minneapolis, Minnesota, USA.

Xinxiao Gao (X)

Mid Atlantic Retina, Wills Eye Hospital, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.

Srividya Kakulavarapu (S)

Nova Southeastern University College of Osteopathic Medicine, Fort Lauderdale, Florida, USA.

Patrick J Mardis (PJ)

University of Tennessee, Knoxville, Tennessee, USA.

Malika L Madhava (ML)

Mid Atlantic Retina, Wills Eye Hospital, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.

Sean M Maloney (SM)

Mid Atlantic Retina, Wills Eye Hospital, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.

Adam Z Adika (AZ)

Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA.

Krishi V Peddada (KV)

Department of Ophthalmology, Drexel University College of Medicine, Philadelphia, PA, USA.

Kareem Sioufi (K)

Mid Atlantic Retina, Wills Eye Hospital, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.

James A Stefater (JA)

Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.

Nora J Forbes (NJ)

Mid Atlantic Retina, Wills Eye Hospital, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.

Antonio Capone (A)

Associated Retinal Consultants, Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA.

Geoffrey G Emerson (GG)

The Retina Center, Minneapolis, MN, USA.

Daniel P Joseph (DP)

The Retina Institute, St. Louis, Missouri, USA.

Carl Regillo (C)

Mid Atlantic Retina, Wills Eye Hospital, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.

Jason Hsu (J)

Mid Atlantic Retina, Wills Eye Hospital, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.

Omesh Gupta (O)

Mid Atlantic Retina, Wills Eye Hospital, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.

Dean Eliott (D)

Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.

Edwin H Ryan (EH)

VitreoRetinal Surgery, Minneapolis, Minnesota, USA.

Yoshihiro Yonekawa (Y)

Mid Atlantic Retina, Wills Eye Hospital, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA yyonekawa@midatlanticretina.com.

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Classifications MeSH