Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment study (SPR Study): predictive factors for functional outcome. Study report no. 6

Graefes Arch Clin Exp Ophthalmol. 2011 Aug;249(8):1129-36. doi: 10.1007/s00417-011-1619-7. Epub 2011 Feb 9.

Abstract

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.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Humans
  • Intraoperative Care
  • Laser Coagulation
  • Lens, Crystalline / physiology
  • Prospective Studies
  • Pseudophakia / physiopathology
  • Retinal Detachment / physiopathology
  • Retinal Detachment / surgery*
  • Risk Factors
  • Scleral Buckling*
  • Treatment Outcome
  • Vision Disorders / physiopathology*
  • Visual Acuity / physiology*
  • Vitrectomy*