DRAINAGE RETINOTOMY IS A RISK FACTOR FOR SURGICAL FAILURE AFTER PARS PLANA VITRECTOMY IN PATIENTS WITH PRIMARY UNCOMPLICATED RHEGMATOGENOUS RETINAL DETACHMENT. Issue 12 (December 2022)

• Record Type: Journal Article
• Authors: Ohara, Hiromi; Yuasa, Yuki; Harada, Yosuke; Hiyama, Tomona; Sadahide, Ayako; Minamoto, Akira; Hirooka, Kazuyuki; Kiuchi, Yoshiaki
• Is Part Of: Retina. Volume 42:Issue 12(2022)
• Page Start: 2307
• Page End: 2314
• Publication Date: 2022-12
• Subjects: drainage retinotomy -- pars plana vitrectomy -- propensity score-matched analysis -- rhegmatogenous retinal detachment -- surgical failure; Retina -- Diseases -- Periodicals; Retinal Diseases; Vitreous Body; 617.735
• DOI: 10.1097/IAE.0000000000003608
• Languages: English
• ISSNs: 0275-004X

Abstract

Abstract : In 519 eyes that underwent small-gauge vitrectomy for primary rhegmatogenous retinal detachment, drainage retinotomy was significantly associated with surgical failure in a propensity matching score. Postoperative epiretinal membrane was also associated with drainage retinotomy. Avoidance of drainage retinotomy may lead to better surgical success and less frequent epiretinal membrane formation. Abstract : Purpose: To identify risk factors for recurrent retinal detachment after uncomplicated pars plana vitrectomy in patients with primary rhegmatogenous retinal detachment (RRD). Methods: This single-center retrospective study included patients with primary RRD who underwent 23-gauge and 25-gauge pars plana vitrectomy at Hiroshima University Hospital between January 2016 and May 2021. All patients had ≥3 months of follow-up. Patients were excluded if they had preoperative proliferative vitreoretinopathy worse than Grade C1; giant retinal tears; tractional, exudative, or traumatic retinal detachment; or the use of perfluorocarbon liquid. Factors that influenced RRD treatment outcome and postoperative complications were evaluated. Results: We analyzed 519 eyes of 509 patients who underwent pars plana vitrectomy for primary RRD. The primary and final success rates were 93.8% and 99.8%, respectively. Drainage retinotomy was a risk factor for surgical failure in both multivariate analysis (odds ratio 2.36, 95% confidence interval 1.08–5.15, P = 0.0314) and a propensity score-matching analysis (odds ratio 3.20, 95% confidence interval 1.14–9.04, P = 0.0277). Postoperative epiretinal membrane was associated with drainage retinotomy in multivariate analysis (odds ratio 1.93, 95% confidence interval 1.04–3.57, P = 0.0358). Conclusion: The avoidance of drainage retinotomy during small-gauge pars plana vitrectomy in patients with RRD may lead to better surgical success and less frequent epiretinal membrane formation.