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2017 ; 86
(1
): 15-19
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Outcome of primary rhegmatogenous retinal detachment surgery in a tertiary
referral centre in Northern Ireland - A regional study
#MMPMID28298707
Mikhail MA
; Mangioris G
; Casalino G
; McGimpsey S
; Sharkey J
; Best R
; Chan WC
Ulster Med J
2017[Jan]; 86
(1
): 15-19
PMID28298707
show ga
PURPOSE: To report the primary and final success, functional outcome and
complication rates of patients with primary rhegmatogenous retinal detachment
(RRD) who underwent retinal detachment surgery in a tertiary referral centre in
Northern Ireland. VENUE: Vitreoretinal service, Royal Victoria Hospital, Belfast,
Northern Ireland. METHODS: This is a retrospective case series of all patients
who underwent primary RRD repair between 1st of January 2013 and 31st of December
2013. Charts were reviewed. Patients' demographics, overall primary and final
success, functional outcome, complication rates were identified and recorded.
Subgroup analysis according to lens status and foveal attachment was also
performed. RESULTS: A total of 212 cases of primary RRD were included. Mean age
at time of surgery was 56.6 years (range 9-90 years); 175(82.5%) had pars plana
vitrectomy (PPV), 27 (12.5%), scleral buckle (SB) repair and 10 (5%) pneumatic
retinopexy (PR). Overall primary and final success rate were 86% and 95.6%
respectively. Overall mean visual acuity improved from 1.1 to 0.4 LogMAR
postoperatively after a mean follow-up of 9 months. There was no significant
difference in the primary success rate in relation to the baseline lens status
(?(2) = 3.4, P = 0.2) and to the baseline macular status (?(2) = 0.6, P = 0.7).
Presence of proliferative vitreoretinopathy (PVR) negatively affected the primary
success rate (?(2)=7.2, P = 0.03). Poor prognostic factors for success were PVR
at presentation, inferior breaks and increasing number of detached quadrants.
CONCLUSIONS: This study demonstrates a success rate comparable with other centres
with a low rate of final failure. Despite sub-specialism and the great advances
in VR surgery, the biology of RRD dictates a failure rate. New therapies may
improve results in the future.