Comparison of four surgical techniques for management of pseudophakic and aphakic retinal detachment: a multicenter clinical trial

Siamak Moradian, Hamid Ahmadieh, Hooshang Faghihi, Alireza Ramezani, Morteza Entezari, Touka Banaee, Ebadollah Heidari, Hassan Behboudi, Mehdi Yasseri

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To compare the visual and anatomical outcomes of four surgical techniques to manage pseudophakic and aphakic retinal detachment (PARD). Methods: In a multicenter randomized clinical trial, 211 eyes of 211 patients with PARD and proliferative vitreoretinopathy (PVR) grade B or less were randomly assigned to one of the four treatment groups: (1) scleral buckling (SB), 50 eyes, (2) vitrectomy without band, 51 eyes, (3) vitrectomy with encircling band (EB), 58 eyes, and (4) triamcinolone acetonide (TA) assisted vitrectomy, 52 eyes. Patients were followed for 12 months after the surgery. The best-corrected visual acuity (BCVA) and retinal reattachment rate at each follow-up time point were considered as the primary outcome measures. PVR, macular pucker, and cystoid macular edema were considered as the secondary outcomes. Results: Visual improvement was achieved in all treatment groups relative to the baseline at all time points (all Ps < 0.001). There were no statistically significant differences among the groups with regard to BCVA changes. However, there was a significant difference in the slope of visual improvement curve: the SB group had a more rapid visual improvement compared to the vitrectomy with buckle group at month 12 (P = 0.032). The retinal reattachment rates at month 12 were 75, 64.7, 68.5, and 66.7 % in SB, vitrectomy without buckle, vitrectomy with EB, and TA-assisted vitrectomy groups respectively (P > 0.99). There were no statistically significant differences among the groups in terms of adverse events. Conclusions: SB, TA-assisted vitrectomy, and vitrectomy with and without buckle had comparable outcomes in the management of PARD.

Original languageEnglish (US)
Pages (from-to)1743-1751
Number of pages9
JournalGraefe's Archive for Clinical and Experimental Ophthalmology
Volume254
Issue number9
DOIs
StatePublished - Sep 1 2016
Externally publishedYes

Keywords

  • Aphakic retinal detachment
  • Pseudophakic retinal detachment
  • Scleral buckling
  • Triamcinolone
  • Vitrectomy

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

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