Primary Retinal Detachment Outcomes Study Report Number 2: Phakic Retinal Detachment Outcomes

Area of Science:

• Ophthalmology
• Retinal Surgery
• Surgical Outcomes

Background:

• Rhegmatogenous retinal detachment (RRD) is a sight-threatening condition.
• Scleral buckle (SB), pars plana vitrectomy (PPV), and combined PPV/SB are surgical options for RRD.
• Comparing outcomes for moderately complex phakic primary RRDs is crucial for surgical decision-making.

Purpose of the Study:

• To compare the anatomic and visual outcomes of SB, PPV, and PPV/SB for treating moderately complex phakic primary RRDs.
• To identify the most effective surgical approach for achieving single surgery anatomic success and optimal visual acuity.

Main Methods:

• A multicenter, retrospective, interventional cohort study analyzed data from US retina practices (2015, >90 days follow-up).
• Phakic patients with moderately complex RRD were included, excluding cases with factors biasing toward specific surgical techniques.
• Subgroup analysis compared comparable cases of RRD naive to surgeon, surgery, and outcome.

Main Results:

• Single surgery anatomic success (SSAS) rates were 91.7% for SB, 83.1% for PPV, and 91.2% for PPV/SB.
• SB and PPV/SB were statistically superior to PPV for SSAS (P = 0.0041).
• SB demonstrated significantly better visual outcomes than PPV or PPV/SB for macula-on or split RRDs, even after controlling for cataract (P < 0.001).

Conclusions:

• For phakic, moderately complex primary RRDs, SB achieved the best visual outcomes.
• PPV demonstrated the lowest single surgery anatomic success rates among the compared techniques.
• SB and PPV/SB offer comparable and superior anatomic success rates compared to PPV alone.