Our Summary

This research paper investigates the best surgical procedure for treating a specific type of retinal detachment, where the retina (the layer at the back of the eye that senses light) tears at the bottom. This type of detachment is believed to have a higher chance of happening again after treatment.

The study compares two surgical procedures: one called primary pars plana vitrectomy (PPV) and a combination of PPV with another procedure called scleral buckle (PPV/SB). In PPV, the surgeon removes the vitreous (the gel-like substance that fills most of the eye) to access the retina. Meanwhile, a scleral buckle is a piece of silicone sponge, rubber, or semi-hard plastic that the surgeon attaches to the white of the eye (the sclera) to support the retina.

The researchers analyzed data from a year’s worth of surgeries (2015) and found that the combination procedure (PPV/SB) had a higher success rate after one surgery than the PPV alone (87.4% compared to 76.8%). This difference was still significant even when other factors were taken into account. They also found that the combination procedure was especially more successful in eyes with natural lenses (phakic eyes).

In simpler terms, if you have a specific type of retinal detachment that happens at the bottom of the retina, you may have a higher chance of successful treatment with a combination of two procedures (PPV/SB) rather than one procedure (PPV) alone. This is particularly true if your eye still has its natural lens.

FAQs

  1. What is the difference between primary pars plana vitrectomy (PPV) and combination PPV with scleral buckle (PPV/SB)?
  2. What were the success rates of treating rhegmatogenous retinal detachments with inferior retinal breaks using PPV and PPV/SB respectively?
  3. What is the significance of the findings in the study regarding the treatment of retinal detachment with inferior retinal breaks?

Doctor’s Tip

A helpful tip a doctor might give a patient about retinal detachment surgery is to consider a combination of pars plana vitrectomy (PPV) with scleral buckle (PPV/SB) for better success rates, especially if the retinal detachment involves inferior retinal breaks. This combination approach may improve anatomic and visual outcomes, particularly in phakic eyes. It is important to discuss the best treatment option with your ophthalmologist to achieve the best possible results.

Suitable For

Patients with rhegmatogenous retinal detachments with inferior retinal breaks, especially in phakic eyes, are typically recommended retinal detachment surgery. The study mentioned above showed that a combination of pars plana vitrectomy with scleral buckle (PPV/SB) had a higher single-surgery success rate compared to PPV alone for these types of patients.

Timeline

Before retinal detachment surgery:

  1. Patient experiences symptoms such as flashes of light, floaters, and a sudden or gradual decrease in vision.
  2. Patient undergoes a dilated eye exam to confirm the diagnosis of retinal detachment.
  3. Patient may undergo imaging tests such as ultrasound or optical coherence tomography (OCT) to assess the extent of the detachment.
  4. Patient discusses treatment options with their ophthalmologist, including the choice between primary pars plana vitrectomy (PPV) and combination PPV with scleral buckle (PPV/SB).

After retinal detachment surgery:

  1. Patient undergoes the selected surgery, either PPV or PPV/SB, to repair the retinal detachment with inferior retinal breaks.
  2. Patient may experience some discomfort, redness, and swelling in the eye following surgery.
  3. Patient is instructed to follow post-operative care instructions, including using prescribed eye drops and avoiding activities that may strain the eye.
  4. Patient attends follow-up appointments to monitor the healing process and assess visual acuity.
  5. Patient may require additional procedures or interventions if the retinal detachment does not fully resolve or if complications arise.

What to Ask Your Doctor

  1. What is the success rate of retinal detachment surgery for my specific case (with inferior retinal breaks)?
  2. What are the potential risks and complications associated with the surgery?
  3. Will I need to undergo any additional procedures or treatments after the surgery?
  4. What is the recovery process like after retinal detachment surgery?
  5. How long will it take for my vision to improve after the surgery?
  6. Are there any specific precautions or restrictions I should follow post-surgery?
  7. How long will I need to follow up with you after the surgery?
  8. What are the chances of the retinal detachment recurring after the surgery?
  9. Are there any lifestyle changes or habits I should adopt to prevent future retinal detachments?
  10. Can you provide me with any additional resources or information about retinal detachment surgery?

Reference

Authors: Starr MR, Obeid A, Ryan EH, Ryan C, Ammar M, Patel LG, Forbes NJ, Capone A Jr, Emerson GG, Joseph DP, Eliott D, Gupta OP, Regillo CD, Hsu J, Yonekawa Y; Primary Retinal Detachment Outcomes (PRO) Study Group. Journal: Retina. 2021 Mar 1;41(3):525-530. doi: 10.1097/IAE.0000000000002917. PMID: 33600131