Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment (SPR Study): Design issues and implications

Heimann, Heinrich; Hellmich, Martin; Bornfeld, Norbert; Bartz-Schmidt, Karl-Ulrich; Hilgers, Ralf-Dieter; Foerster, Michael

doi:10.1007/s004170100319

Cited by 101 publications

(104 citation statements)

References 38 publications

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“…Although this undertaking has been reported to lower the redetachment rate due to new breaks, 20 investigators are not of one mind as to the benefits it confers. 16,21 However, although not statistically significant, the anatomical success rates after primary scleral buckling plus vitrectomy in phakic and pseudophakic eyes were lower than after scleral buckling alone. This may relate to the circumstance that vitrectomy was reserved for complicated cases of RD.…”

Section: Discussionmentioning

confidence: 92%

Primary retinal reattachment surgery: anatomical and functional outcome in phakic and pseudophakic eyes

Halberstadt

Chatterjee-Sanz

Brandenberg

et al. 2004

Eye

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Aim To compare the anatomical and functional success of primary scleral buckling, performed either alone or in combination with vitrectomy, for primary retinal detachment (RD) in phakic eyes and in eyes had undergone uneventful phacoemulsification and had received posterior chamber lens implantations. Methods A total of 243 consecutive patients were included in this retrospective, nonrandomized comparative study. In all, 165 phakic and 78 pseudophakic individuals with primary RD underwent scleral buckling alone or in combination with vitrectomy and were followed up for 6 months. Pre-, intra-and postoperative findings including anatomical success, best-corrected visual acuity (BCVA), complications, and the development of proliferative vitreoretinopathy (PVR), macular pucker, or secondary cataracts were recorded. Cases requiring more than one surgical intervention were defined having failed, although further surgical intervention might have led to success. Results At 6 months after scleral buckling alone, the anatomical success was similar in phakic (88.98%) and pseudophakic (87.65%) eyes (log rank ¼ 0.310). The corresponding results after scleral buckling with vitrectomy were 82.13 and 77.63% for phakic and pseudophakic eyes, respectively (log rank ¼ 0.799). At 6 months after scleral buckling alone, BCVA was similar in phakic and pseudophakic eyes (0.6270.30 vs 0.7070.29; P ¼ 0.227). Likewise, after scleral buckling with vitrectomy, BCVA did not differ significantly (P ¼ 0.322) between phakic (0.3470.32) and pseudophakic eyes (0.5070.27). Conclusion The anatomical and functional outcome of primary retinal reattachment surgery, involving scleral buckling alone or in combination with vitrectomy, is similar in phakic and pseudophakic eyes.

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Section: Discussionmentioning

confidence: 92%

Primary retinal reattachment surgery: anatomical and functional outcome in phakic and pseudophakic eyes

Halberstadt

Chatterjee-Sanz

Brandenberg

et al. 2004

Eye

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“…This includes the number of breaks, the extent of the retinal detachment, the presence of PVR before surgery, the involvement of the macular region, the height of the retinal detachment (bullous or not), refractive errors , the lens status and others. The effect of these factors on the functional and anatomic outcome of retinal detachment surgery has been previously investigated in the ‘Scleral Buckling versus Primary Vitrectomy in Rhegmatogenous Retinal Detachment (SPR)’ trials [9,10,11], which were designed to compare SB surgery and primary pars plana vitrectomy in rhegmatogenous retinal detachments of medium complexity. The categories of severity described in our study are based on the inclusion and exclusion criteria of the SPR trail [11].…”

Section: Discussionmentioning

confidence: 99%

Anatomic Success of Scleral Buckling for Rhegmatogenous Retinal Detachment – A Retrospective Study of 524 Cases

2010

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Background/Aim: Our purpose was to investigate the anatomic success of scleral buckling surgery for rhegmatogenous retinal detachment. Material and Methods: A total of 524 consecutive patients were retrospectively analysed. Several parameters including the lens status, number of breaks and extent of retinal detachment, preoperative proliferative vitreoretinopathy and refractive errors were examined. The minimum follow-up was 6 months. The primary success rate was defined as anatomic success being stable over a period of at least 6 months after surgery. The secondary success rate was defined as anatomic success after the second intervention if necessary. Besides an analysis over all patients, the patients were grouped according to the severity of the preoperative situation in simple, medium and severe cases. Results: The overall primary anatomic success rate was 84.7% and the secondary success rate 96.4% after 1 initial scleral buckling surgery and 1 additional surgery in case of persisting retinal detachment, and 19.1% of the patients with an initially attached retina after 1 scleral buckling surgery experienced a redetachment in the postoperative course and were successfully treated in 60/85 cases. In phakic patients (n = 359) the primary success rate was 89.7%, whereas in pseudophakic patients (n = 165) a primary success rate of 73.9% was obtained. The primary success was additionally influenced by the extent of the retinal detachment measured in clock hours (p < 0.001), undetected holes (p = 0.004), small (p = 0.037) and no gas tamponade (p = 0.021). In simple, medium and severe cases, phakic patients always achieved better anatomic results (89.9, 89.1 and 90.2%) compared to pseudophakic ones (82.5, 70.3 and 36.4%). Conclusion: Scleral buckling is a very good surgical option in phakic patients irrespective of the preoperative severity and simple cases in pseudophakic patients. Scleral buckling represents a surgical technique worth being trained and performed in the light of favourable results especially in phakic eyes.

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“…This causes a separation of the neuroretina from the retinal pigment epithelium. 1 If untreated, most RRD will progress to a complete detachment and subsequently result in vision loss of the affected eye. 1 The annual incidence of RRD is about 10 per 100 000 persons.…”

Section: Introductionmentioning

confidence: 99%

“…1 If untreated, most RRD will progress to a complete detachment and subsequently result in vision loss of the affected eye. 1 The annual incidence of RRD is about 10 per 100 000 persons. 2,3 The following predictors were found to be risk factors for functional and anatomic success after primary RRD repair: more than 6 days of visual loss, 4 macular involvement and the size of detachment area.…”

Section: Introductionmentioning

confidence: 99%

Patient ignorance is the main reason for treatment delay in primary rhegmatogenous retinal detachment in The Netherlands

Goezinne

Heij

Berendschot

et al. 2008

Eye

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Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment (SPR Study): Design issues and implications

Cited by 101 publications

References 38 publications

Primary retinal reattachment surgery: anatomical and functional outcome in phakic and pseudophakic eyes

Primary retinal reattachment surgery: anatomical and functional outcome in phakic and pseudophakic eyes

Anatomic Success of Scleral Buckling for Rhegmatogenous Retinal Detachment – A Retrospective Study of 524 Cases

Patient ignorance is the main reason for treatment delay in primary rhegmatogenous retinal detachment in The Netherlands

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