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Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment study (SPR Study): predictive factors
Nicole Heussen1, Nicolas Feltgen, Peter Walter
1Department of Medical Statistics, RWTH Aachen University, Pauwelsstr 30, 52074 Aachen, Germany. nheussen@ukaachen.de
Purpose:
To identify risk factors associated with best-corrected visual acuity (BCVA) 1 year after initial surgery following primary vitrectomy (PV) and scleral buckling surgery (SB) for rhegmatogenous retinal detachment (RRD).
Methods:
Relating the final BCVA at the 1-year follow-up visit to pre- and intraoperative findings in the "randomized, prospective, multicenter clinical trial comparing scleral buckling versus primary vitrectomy for repair of rhegmatogenous retinal detachment" (SPR Study) using multivariate statistical methods.
Results:
In the phakic subtrial, final BCVA is associated with the number of breaks (p = 0.0259), duration of symptoms (p = 0.0476), baseline BCVA (p = 0.0002), retinal detachment central to major vessels arcades (p = 0.0088), total detachment (p = 0.0027), and chain formation of breaks (p = 0.0129). In the pseudophakic/aphakic subtrial, final BCVA is related to the number of retinal breaks (p = 0.0010), secondary cataract or central capsular fibrosis (p = 0.0141), intraoperative laser photocoagulation (p = 0.0373), and inferior detachment with breaks below the 4 and 8 o'clock positions (p = 0.0173).
Conclusion:
Final BCVA is the most important outcome for patients undergoing RRD surgery. Our results demonstrate that the final BCVA is related to a higher preoperative number of breaks in both subtrials. Additional risk factors varied between phakic and pseudophakic subgroups.
