Primary Repair of Moderate Severity Rhegmatogenous Retinal Detachment: A Critical Decision-Making Algorithm

Raul VELEZ-MONTOYA; Paola JACOBO-OCEGUERA; Javier FLORES-PRECIADO; Jose DALMA-WEISZHAUSZ; Jose GUERRERO-NARANJO; Guillermo SALCEDO-VILLANUEVA; Gerardo GARCIA-AGUIRRE; Jans FROMOW-GUERRA; Virgilio MORALES-CANTON

Primary Repair of Moderate Severity Rhegmatogenous Retinal Detachment: A Critical Decision-Making Algorithm

Medical hypothesis discovery and innovation in ophthalmology, Vol. 5 No. 1 (2016), 1 March 2016 , Page 18-31
Published

Abstract

We reviewed all the available data regarding the current management of non-complex rhegmatogenous retinal detachment and aimed to propose a new decision-making algorithm aimed to improve the single surgery success rate for mid-severity rhegmatogenous retinal detachment. An online review of the Pubmed database was performed. We searched for all available manuscripts about the anatomical and functional outcomes after the surgical management, by either scleral buckle or primary pars plana vitrectomy, of retinal detachment. The search was limited to articles published from January 1995 to December 2015. All articles obtained from the search were carefully screened and their references were manually reviewed for additional relevant data. Our search specifically focused on preoperative clinical data that were associated with the surgical outcomes. After categorizing the available data according to their level of evidence, with randomized-controlled clinical trials as the highest possible level of evidence, followed by retrospective studies, and retrospective case series as the lowest level of evidence, we proceeded to design a logical decision-making algorithm, enhanced by our experiences as retinal surgeons. A total of 7 randomized-controlled clinical trials, 19 retrospective studies, and 9 case series were considered. Additional articles were also included in order to support the observations further. Rhegmatogenous retinal detachment is a potentially blinding disorder. Its surgical management seems to depend more on a surgeonÂ´s preference than solid scientific data or is based on a good clinical history and examination. The algorithms proposed herein strive to offer a more rational approach to improve both anatomical and functional outcomes after the first surgery.

References

Tabibian D, Hoogewoud F, Mavrakanas N, Schutz JS. Misdirected aqueous flow in rhegmatogenous retinal detachment: A pathophysiology update. Surv Ophthalmol. 2014. PMID: 25223495

Kuhn F, Aylward B. Rhegmatogenous retinal detachment: a reappraisal of its pathophysiology and treatment. Ophthalmic Res. 2014;51(1):15-31. PMID: 24158005

Schwartz SG, Flynn HW, Jr., Mieler WF. Update on retinal detachment surgery. Curr Opin Ophthalmol. 2013;24(3):255-61. PMID: 23429600

Sun Q, Sun T, Xu Y, Yang XL, Xu X, Wang BS, et al. Primary vitrectomy versus scleral buckling for the treatment of rhegmatogenous retinal detachment: a meta-analysis of randomized controlled clinical trials. Curr Eye Res. 2012;37(6):492-9. PMID: 22577767

Chang JS, Smiddy WE. Cost-effectiveness of retinal detachment repair. Ophthalmology. 2014;121(4):946-51. PMID: 24411577

Heimann H, Bartz-Schmidt KU, Bornfeld N, Weiss C, Hilgers RD, Foerster MH. Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment: a prospective randomized multicenter clinical study. Ophthalmology. 2007;114(12):2142-54. PMID: 18054633

Haimann MH, Burton TC, Brown CK. Epidemiology of retinal detachment. Arch Ophthalmol. 1982;100(2):289-92. PMID: 7065947

Haddad WM, Monin C, Morel C, Larricart P, Quesnot S, Ameline B, et al. Retinal detachment after phacoemulsification: a study of 114 cases. Am J Ophthalmol. 2002;133(5):630-8. PMID: 11992860

Olsen T, Jeppesen P. The incidence of retinal detachment after cataract surgery. Open Ophthalmol J. 2012;6:79-82. PMID: 23002414

Weichel ED, Martidis A, Fineman MS, McNamara JA, Park CH, Vander JF, et al. Pars plana vitrectomy versus combined pars plana vitrectomy-scleral buckle for primary repair of pseudophakic retinal detachment. Ophthalmology. 2006;113(11):2033-40. PMID: 17074564

Ah-Fat FG, Sharma MC, Majid MA, McGalliard JN, Wong D. Trends in vitreoretinal surgery at a tertiary referral centre: 1987 to 1996. Br J Ophthalmol. 1999;83(4):396-8. PMID: 10434858

Ma Y, Ying X, Zou H, Xu X, Liu H, Bai L, et al. Cost-utility Analysis of Rhegmatogenous Retinal Detachment Surgery in Shanghai, China. Ophthalmic Epidemiol. 2014. PMID: 24527711

Mehta S, Blinder KJ, Shah GK, Grand MG. Pars plana vitrectomy versus combined pars plana vitrectomy and scleral buckle for primary repair of rhegmatogenous retinal detachment. Can J Ophthalmol. 2011;46(3):237-41. PMID: 21784208

Heimann H, Hellmich M, Bornfeld N, Bartz-Schmidt KU, Hilgers RD, Foerster MH. Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment (SPR Study): design issues and implications. SPR Study report no. 1. Graefes Arch Clin Exp Ophthalmol. 2001;239(8):567-74. PMID: 11585312

Jackson TL, Donachie PH, Sallam A, Sparrow JM, Johnston RL. United Kingdom National Ophthalmology Database study of vitreoretinal surgery: report 3, retinal detachment. Ophthalmology. 2014;121(3):643-8. PMID: 23978624

Soni C, Hainsworth DP, Almony A. Surgical management of rhegmatogenous retinal detachment: a meta-analysis of randomized controlled trials. Ophthalmology. 2013;120(7):1440-7. PMID: 23511114

Gorovoy IR, Porco TC, Bhisitkul RB, de Juan E, Jr., Schwartz DM, Stewart JM. Same-Day Versus Next-Day Repair of Fovea-Threatening Primary Rhegmatogenous Retinal Detachments. Semin Ophthalmol. 2014:1-7. PMID: 25081305

Chong DY, Fuller DG. The declining use of scleral buckling with vitrectomy for primary retinal detachments. Arch Ophthalmol. 2010;128(9):1206-7. PMID: 20837808

Feltgen N, Weiss C, Wolf S, Ottenberg D, Heimann H. Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment study (SPR Study): recruitment list evaluation. Study report no. 2. Graefes Arch Clin Exp Ophthalmol. 2007;245(6):803-9. PMID: 17120014

Laqua H, Honnicke K. [Is scleral buckling still current?]. Ophthalmologe. 2001;98(9):881-5. PMID: 11594231

McLeod D. Is it time to call time on the scleral buckle? Br J Ophthalmol. 2004;88(11):1357-9. PMID: 15489471

Schaal S, Sherman MP, Barr CC, Kaplan HJ. Primary retinal detachment repair: comparison of 1-year outcomes of four surgical techniques. Retina. 2011;31(8):1500-4. PMID: 21606887

Wickham L, Bunce C, Wong D, Charteris DG. Retinal detachment repair by vitrectomy: simplified formulae to estimate the risk of failure. Br J Ophthalmol. 2011;95(9):1239-44. PMID: 21325394

Adelman RA, Parnes AJ, Ducournau D. Strategy for the management of uncomplicated retinal detachments: the European vitreo-retinal society retinal detachment study report 1. Ophthalmology. 2013;120(9):1804-8. PMID: 23601799

Adelman RA, Parnes AJ, Sipperley JO, Ducournau D. Strategy for the management of complex retinal detachments: the European vitreo-retinal society retinal detachment study report 2. Ophthalmology. 2013;120(9):1809-13. PMID: 23601805

Arya AV, Emerson JW, Engelbert M, Hagedorn CL, Adelman RA. Surgical management of pseudophakic retinal detachments: a meta-analysis. Ophthalmology. 2006;113(10):1724-33. PMID: 17011954

Heussen N, Hilgers RD, Heimann H, Collins L, Grisanti S. Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment study (SPR study): multiple-event analysis of risk factors for reoperations. SPR Study report no. 4. Acta Ophthalmol. 2011;89(7):622-8. PMID: 19909291

Huang C, Fu T, Zhang T, Wu X, Ji Q, Tan R. Scleral buckling versus vitrectomy for macula-off rhegmatogenous retinal detachment as accessed with spectral-domain optical coherence tomography: a retrospective observational case series. BMC Ophthalmol. 2013;13:12. PMID: 23587195

Foster WJ, Dowla N, Joshi SY, Nikolaou M. The fluid mechanics of scleral buckling surgery for the repair of retinal detachment. Graefes Arch Clin Exp Ophthalmol. 2010;248(1):31-6. PMID: 19809830

Smiddy WE, Glaser BM, Michels RG, de Bustros S. Scleral buckle revision to treat recurrent rhegmatogenous retinal detachment. Ophthalmic Surg. 1990;21(10):716-20. PMID: 2250856

Feltgen N, Heimann H, Hoerauf H, Walter P, Hilgers RD, Heussen N. Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment study (SPR study): Risk assessment of anatomical outcome. SPR study report no. 7. Acta Ophthalmol. 2013;91(3):282-7. PMID: 22336429

Heussen N, Feltgen N, Walter P, Hoerauf H, Hilgers RD, Heimann H. Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment study (SPR Study): predictive factors for functional outcome. Study report no. 6. Graefes Arch Clin Exp Ophthalmol. 2011;249(8):1129-36. PMID: 21305315

Mansouri A, Almony A, Shah GK, Blinder KJ, Sharma S. Recurrent retinal detachment: does initial treatment matter? Br J Ophthalmol. 2010;94(10):1344-7. PMID: 20576784

Banaee T, Hosseini SM, Ghooshkhanei H, Moosavi M, Khayyatzadeh-Kakhki S. Anatomical and visual outcomes of three different scleral buckling techniques. J Ophthalmic Vis Res. 2009;4(2):90-6. PMID: 23198054

Goezinne F, La Heij EC, Berendschot TT, Kessels AG, Liem AT, Diederen RM, et al. Incidence of redetachment 6 months after scleral buckling surgery. Acta Ophthalmol. 2010;88(2):199-206. PMID: 19432848

Wong CW, Wong WL, Yeo IY, Loh BK, Wong EY, Wong DW, et al. Trends and factors related to outcomes for primary rhegmatogenous retinal detachment surgery in a large asian tertiary eye center. Retina. 2014;34(4):684-92. PMID: 24169100

Kobashi H, Takano M, Yanagita T, Shiratani T, Wang G, Hoshi K, et al. Scleral buckling and pars plana vitrectomy for rhegmatogenous retinal detachment: an analysis of 542 eyes. Curr Eye Res. 2014;39(2):204-11. PMID: 24144398

Kim YK, Woo SJ, Park KH, Yu YS, Chung H. Comparison of persistent submacular fluid in vitrectomy and scleral buckle surgery for macula-involving retinal detachment. Am J Ophthalmol. 2010;149(4):623-9 e1. PMID: 20149338

Thelen U, Amler S, Osada N, Gerding H. Outcome of surgery after macula-off retinal detachment - results from MUSTARD, one of the largest databases on buckling surgery in Europe. Acta Ophthalmol. 2012;90(5):481-6. PMID: 20529077

Martinez-Castillo V, Boixadera A, Garcia-Arumi J. Pars plana vitrectomy alone with diffuse illumination and vitreous dissection to manage primary retinal detachment with unseen breaks. Arch Ophthalmol. 2009;127(10):1297-304. PMID: 19822846

Von Fricken MA, Kunjukunju N, Weber C, Ko G. 25-Gauge sutureless vitrectomy versus 20-gauge vitrectomy for the repair of primary rhegmatogenous retinal detachment. Retina. 2009;29(4):444-50. PMID: 19174723

Albrieux M, Rouberol F, Bernheim D, Romanet JP, Chiquet C. Comparative study of 23-gauge vitrectomy versus 20-gauge vitrectomy for the treatment of rhegmatogenous retinal detachment. Graefes Arch Clin Exp Ophthalmol. 2011;249(10):1459-68. PMID: 21499771

Yanyali A, Celik G, Dincyildiz A, Horozoglu F, Nohutcu AF. Primary 23-gauge vitreoretinal surgery for rhegmatogenous retinal detachment. Int J Ophthalmol. 2012;5(2):226-30. PMID: 22762056

Dell'Omo R, Barca F, Tan HS, Bijl HM, Oberstein SY, Mura M. Pars plana vitrectomy for the repair of primary, inferior rhegmatogenous retinal detachment associated to inferior breaks. A comparison of a 25-gauge versus a 20-gauge system. Graefes Arch Clin Exp Ophthalmol. 2013;251(2):485-90. PMID: 22588289

Mura M, Tan SH, De Smet MD. Use of 25-gauge vitrectomy in the management of primary rhegmatogenous retinal detachment. Retina. 2009;29(9):1299-304. PMID: 19629017

Bernheim D, Rouberol F, Palombi K, Albrieux M, Romanet JP, Chiquet C. Comparative prospective study of rhegmatogenous retinal detachments in phakic or pseudophakic patients with high myopia. Retina. 2013;33(10):2039-48. PMID: 23492949

Sharma YR, Karunanithi S, Azad RV, Vohra R, Pal N, Singh DV, et al. Functional and anatomic outcome of scleral buckling versus primary vitrectomy in pseudophakic retinal detachment. Acta Ophthalmol Scand. 2005;83(3):293-7. PMID: 15948779

Ranta P, Kivela T. Functional and anatomic outcome of retinal detachment surgery in pseudophakic eyes. Ophthalmology. 2002;109(8):1432-40. PMID: 12153792

Halberstadt M, Chatterjee-Sanz N, Brandenberg L, Koerner-Stiefbold U, Koerner F, Garweg JG. Primary retinal reattachment surgery: anatomical and functional outcome in phakic and pseudophakic eyes. Eye (Lond). 2005;19(8):891-8. PMID: 15389274

Williamson TH, Lee EJ, Shunmugam M. Characteristics of Rhegmatogenous Retinal Detachment and Their Relationship to Success Rates of Surgery. Retina. 2014. PMID: 24480842

Kinori M, Moisseiev E, Shoshany N, Fabian ID, Skaat A, Barak A, et al. Comparison of pars plana vitrectomy with and without scleral buckle for the repair of primary rhegmatogenous retinal detachment. Am J Ophthalmol. 2011;152(2):291-7 e2. PMID: 21664592

Orlin A, Hewing NJ, Nissen M, Lee S, Kiss S, D'Amico DJ, et al. Pars plana vitrectomy compared with pars plana vitrectomy combined with scleral buckle in the primary management of noncomplex rhegmatogenous retinal detachment. Retina. 2014;34(6):1069-75. PMID: 24853687

Goto T, Nakagomi T, Iijima H. A comparison of the anatomic successes of primary vitrectomy for rhegmatogenous retinal detachment with superior and inferior breaks. Acta Ophthalmol. 2013;91(6):552-6. PMID: 22691313

Kunikata H, Nishida K. Visual outcome and complications of 25-gauge vitrectomy for rhegmatogenous retinal detachment; 84 consecutive cases. Eye (Lond). 2010;24(6):1071-7. PMID: 20395974

Heussen N, Hilgers RD, Heimann H, Collins L, Grisanti S. Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment study (SPR Study): Multiple-event analysis of risk factors for reoperations. SPR Study report no. 4. Acta Ophthalmol. 2009. PMID: 19909291

Garweg JG, Tappeiner C, Halberstadt M. Pathophysiology of proliferative vitreoretinopathy in retinal detachment. Surv Ophthalmol. 2013;58(4):321-9. PMID: 23642514

Storey P, Alshareef R, Khuthaila M, London N, Leiby B, DeCroos C, et al. Pars plana vitrectomy and scleral buckle versus pars plana vitrectomy alone for patients with rhegmatogenous retinal detachment at high risk for proliferative vitreoretinopathy. Retina. 2014;34(10):1945-51. PMID: 24999720

Sheng Y, Sun W, Mo B, Yu YJ, Gu YS, Liu W. Non-buckled vitrectomy for retinal detachment with inferior breaks and proliferative vitreoretinophathy. Int J Ophthalmol. 2012;5(5):591-5. PMID: 23166870

Adelman RA, Parnes AJ, Michalewska Z, Ducournau D. Clinical variables associated with failure of retinal detachment repair: the European vitreo-retinal society retinal detachment study report number 4. Ophthalmology. 2014;121(9):1715-9. PMID: 24766870

Lee SY, Ang CL. Results of retinal detachment surgery in Marfan syndrome in asians. Retina. 2003;23(1):24-9. PMID: 12652227

Sharma T, Gopal L, Shanmugam MP, Bhende PS, Agrawal R, Shetty NS, et al. Retinal detachment in Marfan syndrome: clinical characteristics and surgical outcome. Retina. 2002;22(4):423-8. PMID: 12172108.

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