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Endoscopy-assisted vitrectomy vs. vitrectomy alone: comparative study in complex retinal detachment with
Flavio A Rezende1, Natalia Vila2, Emmanouil Rampakakis3
1Department of Ophthalmology (Centre Universitaire d'Ophtalmologie), Maisonneuve Rosemont Hospital, CIUSS de l'est d'Ile de Montréal, Montreal, QC Canada.
International Journal of Retina and Vitreous
|August 4, 2020
Summary
Endoscopy-assisted vitrectomy (E-PPV) shows improved reattachment rates for complex retinal detachments (RD) with proliferative vitreoretinopathy (PVR). This technique allows for more thorough examination and dissection, potentially reducing the need for repeat surgeries.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Retinal Diseases
Background:
- Recurrent retinal detachment (RD) remains a significant challenge despite available treatments.
- Proliferative vitreoretinopathy (PVR) is a primary cause of recurrent RD.
- The efficacy of endoscopy-assisted vitrectomy (E-PPV) in complex recurrent RD with PVR is not well-established.
Purpose of the Study:
- To evaluate the potential benefits of E-PPV compared to standard pars plana vitrectomy (PPV) for complex recurrent RD with PVR.
- To compare reattachment rates and surgical outcomes between E-PPV and PPV-only groups.
Main Methods:
- Retrospective, observational study of 101 patients with complex rhegmatogenous RD and PVR.
- Comparison of outcomes between eyes undergoing E-PPV (n=37) and PPV-only (n=64).
- Statistical analysis included t-tests, Fisher's exact test, and Kaplan-Meier survival analysis for redetachment rates.
Main Results:
- E-PPV group showed a significantly lower risk of redetachment (HR 4.1 in PPV-only group, p=0.037).
- The PPV-only group required a higher mean number of surgeries (4.3 vs. 2.6, p<0.001).
- No significant difference in phthisis evolution between groups (p>0.05).
Conclusions:
- E-PPV appears advantageous for achieving better reattachment rates in complex RD with advanced PVR.
- Endoscopic visualization facilitates comprehensive examination and dissection of anterior PVR and vitreous base.
- E-PPV may offer improved outcomes for challenging RD cases.
