BackgroundTo evaluate the efficacy of micro-incision vitrectomy surgery (MIVS) using Lumera and Resight non-contact sutureless wide-angle viewing systems (WAVS) for primary rhegmatogenous retinal detachment (RRD), and to analyze the anatomical and visual outcomes.MethodsThe retrospective, non-comparative, interventional case series reported here was conducted from June 2014 through November 2016. Enrolled patients presented with primary RRD and received MIVS with/without cryopexy by one surgeon using the Lumera and Resight non-contact sutureless WAVS. All patients were followed-up for a minimum of 12 months. Variables collected included patient demographics, best-corrected visual acuity, and macular status. The number and position of retinal break(s), and the use of cryopexy, were also recorded. Outcome measures included operative time, single-operation anatomical success rate, final anatomical success rate, recurrent rate, postoperative best-corrected visual acuity, and surgical complications. The end points were operative time, anatomical outcome, and functional outcome.ResultsIn total, 110 eyes from 110 patients (68 men and 42 women) were treated. Of these, 103 (93%) eyes were reattached after primary vitrectomy. One hundred ten eyes (100%) reached final anatomical success. The mean operative time was 50.55 min. Multivariate analyses were performed with best model selection principle based on general linear model by Akaike Information Criteria for detecting possible factors related to operation time, and with multivariate logistic regression analysis for revealing probable clinical parameters which might influence the anatomical outcome after first operation and final visual outcome. Intraoperative cryopexy and multiple breaks increased operative time significantly. More favorable BCVA was significantly correlated with shorter operation time and the preoperative macula-on status. Multivariate logistic regression on the group of patients who have received the cataract surgery revealed that the pre-operative BCVA is a significant factor which can predict the visual outcome after MIVS.ConclusionsThe outcome of primary RRD repaired by MIVS using the Lumera and Resight sutureless WAVS was not inferior to any other published method. This instrument combination resulted in a relatively rapid and comfortable procedure without serious postoperative complications. Cryopexy and multiple breaks affected operative time significantly. Shorter operative times and preoperative macula-on status are associated with better final visual outcomes.
Background
To evaluate the efficacy of micro-incision vitrectomy surgery using a non-contact wide-angle viewing system for fovea-attached type epiretinal membrane, and to report the factors influencing the outcome.
Methods
A retrospective, comparative case series that included 50 patients with fovea-attached type epiretinal membrane who received micro-incision vitrectomy surgery using a non-contact wide-angle viewing system.
Results
All patients were followed-up for a minimum of 12 months. Seven cases were classified as group 1A (mainly outer retinal thickening), 17 were group 1B (more tenting of outer retina and distorted inner retina), and 26 were group 1C (prominent inner retina thickening and inward tenting of outer retina). Outcome measures included operation time, recurrent rate, postoperative BCVA, and CRT. The mean operative time was 26.2 minutes. The mean change of BCVA (LogMAR) was −0.43 (p< 0.001). The mean change of CRT was 135.3 μm (p< 0.001). The mean change of CRT was significantly higher in group 1C. Worse preoperative BCVA, male gender, and longer operative time can predict better postoperative BCVA found by multivariate logistic regression and multiple regression models.
Conclusion
Significant improvement in BCVA and CRT is noted after micro-incision vitrectomy surgery to operate fovea-attached type epiretinal membranes. Worse preoperative BCVA, male, and longer operation time could predict better improvement. These findings may assist surgeons in better evaluating the potential of this method to help their patients with epiretinal membranes.
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