Our Summary

This research paper reviews the effectiveness of two different types of treatments for a specific type of retinal detachment, a condition where the retina (the light-sensitive tissue at the back of the eye) pulls away from its normal position. The treatments being compared are ‘pars plana vitrectomy’ (PPV), a type of eye surgery, and PPV combined with ‘scleral buckle’ (SB), a procedure that involves placing a silicone band around the eye.

The researchers looked at the final quality of vision after treatment, the success of the treatment in reattaching the retina, and the rates of complications from the treatments. They reviewed studies conducted between 2000 and 2022, involving a total of 696 eyes.

Three out of the four studies found no significant difference in the final quality of vision between the two types of treatment. However, one study found that adding the SB procedure to the PPV surgery led to better vision outcomes. The combined PPV/SB treatment had similar success rates in reattaching the retina to PPV alone, but one study found that adding the SB procedure improved these success rates.

When looking specifically at eyes with a natural lens (phakic eyes), the researchers found that the combined PPV/SB treatment had a slightly higher success rate. There was no significant difference in complication rates between the two treatments.

In conclusion, the two treatments had similar outcomes and risks, but the combined PPV/SB treatment may lead to better results in eyes with a natural lens.

FAQs

  1. What is the difference between PPV and PPV/SB in terms of best-corrected visual acuity?
  2. How does the lens status impact the success of PPV/SB and PPV alone in treating rhegmatogenous retinal detachment due to inferior retinal breaks?
  3. Are there any significant differences in complication rates between PPV alone and PPV with scleral buckle?

Doctor’s Tip

A helpful tip a doctor might tell a patient about vitrectomy is to follow post-operative instructions carefully, including avoiding strenuous activities and taking prescribed medications as directed. It is also important to attend all follow-up appointments to monitor healing and address any concerns promptly.

Suitable For

Patients with rhegmatogenous retinal detachment (RRD) due to inferior retinal breaks (IRB) are typically recommended vitrectomy, either alone or in combination with scleral buckle (SB). This study found that both pars plana vitrectomy (PPV) and PPV with SB yielded similar functional outcomes and risk profiles in terms of final best-corrected visual acuity (BCVA), anatomic success, and complication rates. However, PPV with SB may provide a benefit in terms of single-surgery anatomical success (SSAS) in phakic eyes with RRD due to IRB.

Timeline

Before vitrectomy:

  1. Patient experiences symptoms of retinal detachment such as flashes of light, floaters, and a curtain-like shadow over their vision.
  2. Patient undergoes a comprehensive eye examination to confirm the diagnosis of retinal detachment.
  3. Treatment options are discussed with the patient, including vitrectomy as a surgical option for repairing the detached retina.

After vitrectomy:

  1. Patient undergoes the vitrectomy procedure, which involves removing the vitreous gel from the eye and repairing the retinal detachment.
  2. Patient may experience some discomfort and blurred vision immediately following the surgery.
  3. Patient is monitored closely for any complications or signs of infection post-operatively.
  4. Over time, the patient’s vision gradually improves as the eye heals and the retina reattaches.
  5. Patient may need to follow up with their ophthalmologist for regular check-ups and monitoring of their eye health.

What to Ask Your Doctor

  1. What are the potential risks and benefits of undergoing a vitrectomy procedure?
  2. How will my vision be affected before, during, and after the surgery?
  3. What is the success rate of vitrectomy for my specific condition?
  4. How long is the recovery period after vitrectomy surgery?
  5. Are there any alternative treatments to vitrectomy that I should consider?
  6. Will I need any follow-up appointments or additional treatments after the surgery?
  7. What can I expect in terms of long-term outcomes and potential complications?
  8. How experienced are you in performing vitrectomy procedures?
  9. Can you explain the specific techniques and technologies that will be used during my vitrectomy surgery?
  10. Are there any lifestyle changes or precautions I should take after the surgery to optimize my recovery?

Reference

Authors: Lena ER, Patil NS, Popovic MM, Eshtiaghi A, Dhoot AS, Muni RH, Kertes PJ. Journal: Ophthalmic Surg Lasers Imaging Retina. 2025 Jan;56(1):37-45. doi: 10.3928/23258160-20240801-02. Epub 2024 Aug 1. PMID: 39231113