Primary Retinal Detachment Outcomes Study: Methodology and Overall Outcomes—Primary Retinal Detachment Outcomes Study Report Number 1

Ryan, Edwin H.; Joseph, Daniel P.; Ryan, Claire; Forbes, Nora J.; Yonekawa, Yoshihiro; Mittra, Robert A.; Parke, David W.; Ringeisen, Alex; Emerson, Geoffrey G.; Shah, Gaurav K.; Blinder, Kevin J.; Capone, Antonio; Williams, George A.; Eliott, Dean; Gupta, Omesh P.; Hsu, Jason; Regillo, Carl D.

doi:10.1016/j.oret.2020.02.014

Cited by 40 publications

(32 citation statements)

References 28 publications

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“…In addition, we considered PPV/SB as a separate entity from PPV and SB, and our definition of anatomic failure is less stringent than that of the SPR (postoperative ERM, macular hole, need for laser not a failure). 14 The overarching goal of the cohort study was to limit the cases analyzed to those that did not have anatomic characteristics that would influence most surgeons toward choosing a specific approach. The inclusions and exclusions were agreed upon a priori by the lead surgeons at each site.…”

Section: Discussionmentioning

confidence: 99%

“…The methodology and overall outcomes have been reported. 14 Five large high-volume centers were recruited to participate. Given that SB was one of the techniques being compared, each group would need expertise in all 3 methods, and it was required that each group regularly performed and taught SB, as well as PPV and PPV/SB.…”

Section: Methodsmentioning

confidence: 99%

“…Given that a prospective study would be exceedingly difficult to organize and carry out, the method chosen here is that of a large, data-intensive, retrospective multicenter cohort study. 14…”

mentioning

confidence: 99%

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Primary Retinal Detachment Outcomes Study Report Number 2

Ryan

Forbes

et al. 2020

Ophthalmology

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Purpose: Anatomically similar rhegmatogenous retinal detachments (RRDs) can be treated with scleral buckle (SB), pars plana vitrectomy (PPV), or SB combined with PPV (PPV/SB). This study compares moderately complex phakic primary RRD treated with SB, PPV, or PPV/SB to review anatomic and visual outcomes.Design: Multicenter, retrospective, interventional cohort study.Participants: Data were gathered on all patients from multiple retina practices in the United States with RRD in 2015 and >90 days of follow-up. The cohort of phakic patients with moderately complex RRD was analyzed.Methods: A large and detailed database was generated. Eyes with findings that would bias toward PPV (vitreous hemorrhage, dense cataract, proliferative vitreoretinopathy, giant retinal tear, among others) were excluded. Age <40 years (bias toward SB) was excluded. Comparable cases of moderately complex RRD were then chosen naive to surgeon, surgery, and outcome for subgroup analysis.Main Outcome Measures: Single surgery anatomic success (SSAS), defined as retinal attachment with no other RRD surgery within 90 days, is the main outcome measure. Final visual acuity is the secondary outcome measure. Pearson's chi-square and analysis of variance were used to test treatment effect of surgery type on SSAS and vision.Results: Single surgery anatomic success was noted in 155 of 169 SB cases (91.7%), 207 of 249 PPV cases (83.1%), and 271 of 297 PPV/SB cases (91.2%). Scleral buckle and PPV/SB were superior to PPV for SSAS (P ¼ 0.0041). For macula-on or split cases, SB had significantly better visual outcomes than PPV or PPV/SB even after controlling for cataract (cases with minimal cataract at final follow-up or after cataract surgery) (P < 0.001).Conclusions: For phakic moderately complex primary RRDs in this study of PPV versus SB versus PPV/SB, SB had the best visual outcomes, and PPV had the worst SSAS outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Primary Retinal Detachment Outcomes Study Report Number 2

Ryan

Forbes

et al. 2020

Ophthalmology

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“…A total of 2620 patients who underwent surgical repair for primary RRD from January 2015 to December 2015 were included in a database. 14 For the purposes of this study, patients who underwent vitrectomy with or without scleral buckle (SB) were included. Patients with giant retinal tear, PVR, or history of prior PPV were excluded from the overall cohort.…”

Section: Methodsmentioning

confidence: 99%

Posterior Retinotomy vs Perfluorocarbon Liquid to Aid Drainage of Subretinal Fluid During Primary Rhegmatogenous Retinal Detachment Repair (PRO Study Report No. 10)

Ryan

et al. 2020

Journal of VitreoRetinal Diseases

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Purpose: This work compares posterior retinotomy vs perfluorocarbon liquid (PFCL) for subretinal fluid (SRF) drainage during pars plana vitrectomy for primary rhegmatogenous retinal detachment (RRD). Methods: In this large, multicenter, retrospective comparative study, 2620 patients underwent pars plana vitrectomy (with or without scleral buckle) for uncomplicated RRD. Patients for whom SRF was drained via the primary break without retinotomy or PFCL were excluded; those who required both retinotomy and PFCL were similarly excluded. Remaining patients were separated into “retinotomy” and “PFCL” cohorts. Subgroup analysis was conducted for macula-on and macula-off subgroups. Postoperative outcomes were analyzed and compared. Results: A total of 760 eyes (82.7%) had retinotomy and 159 eyes (17.3%) had PFCL for drainage of SRF, and baseline characteristics between the 2 groups were similar. Postoperative analysis showed similar outcomes between the retinotomy and PFCL cohorts, including final visual acuity ( P = .19), redetachment rate ( P = .30), anatomic success ( P = .28), presence of postoperative epiretinal membrane ( P = .75), and other macular pathologies ( P > .99). Subgroup analysis yielded similar outcomes for macula-on and macula-off subgroups. Postoperative presence of retained PFCL was 2.4%, possibly a factor in the slightly higher number of subsequent surgical procedures ( P = .03) in the PFCL cohort. Conclusions: Postoperative outcomes for retinotomy vs PFCL during RRD repair are comparable, aside from slightly greater number of subsequent surgical procedures needed in the PFCL cohort. Our analysis suggests both techniques are reasonable tools in the repair of macula-on or macula-off RRD.

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“…We report a subgroup analysis from the Primary Retinal Detachment Outcomes (PRO) study, which has been previously described in detail (Ryan, in Press). For the current study, consecutive patients with primary RRD who underwent repair with either primary PPV or a combination of PPV and scleral buckling from 1 January 2015, through 31 December 2015, from 6 centres across the country were included in the analysis.…”

Section: Ilm Peeled (N = 41) Ilm Not Peeled (N = 1401) P Valuementioning

confidence: 99%