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Vitrectomy combined with endolaser or an encircling scleral buckle in primary retinal detachment surgery: a pilot study
Author(s) -
FalknerRadler Christiane I.,
Graf Alexandra,
Binder Susanne
Publication year - 2015
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.12663
Subject(s) - pars plana , scleral buckle , vitrectomy , medicine , retinal detachment , ophthalmology , visual acuity , retinal tear , tamponade , surgery , retinal , refractive error
Abstract Purpose To compare pars plana vitrectomy and 360° endolaser therapy with pars plana vitrectomy and an encircling scleral buckle for the treatment of primary rhegmatogenous retinal detachments in a randomized pilot study including 60 patients. Methods Main outcome measures were single‐surgery anatomic success rate and final best‐corrected visual acuity at 6 months follow‐up. Cofactors analysed were complication rates, patients' comfort, refractive outcome and macula status assessed using a spectral‐domain optical coherence tomography. Results With differences between both treatment groups regarding type of the retinal detachment, localization of retinal tears (p = 0.0085) and the choice of the intraocular tamponade (p < 0.0202), there were no significant differences between the single‐surgery anatomic success rate (93.33% both groups, p = 1.0) and the visual acuity at final follow‐up (≤0.3 logMAR [logarithm of minimum angle of resolution] in 66.67% in the endolaser group versus 40.0% in the scleral buckle group, p = 0.0514). Questionnaire responses showed lower levels of patients’ discomfort in the endolaser group. A significant difference between both groups was found in the refractive error change after surgery (−0.20 ± 0.51 dioptres in the endolaser group versus −0.88 ± 0.88 dioptres in the scleral buckle group, p = 0.0003). Conclusion Primary vitrectomy combined with 360° endolaser therapy seems to be as effective as vitrectomy combined with an encircling scleral buckle in patients with rhegmatogenous retinal detachment, with possible benefits of an improved patients' comfort and a more stable refractive status after surgery.