Our Summary

This research paper investigates the effectiveness of two common treatments for a condition called Rhegmatogenous retinal detachment (RRD). This condition happens when the retina (the layer at the back of the eye that senses light and sends images to the brain) detaches from the underlying layer of cells due to tears in the retina.

The two treatments are called Pars plana vitrectomy (PPV) and scleral buckling. PPV involves removing the gel-like substance in the eye that may be pulling on the retina and causing it to tear. Scleral buckling involves attaching a piece of silicone or plastic to the outside of the eye to push the eye wall and the retina back together.

The study looked at ten previous studies, involving 1307 participants from different parts of the world. They analyzed the results to see if one treatment was better than the other in terms of success rates, vision improvement, and side effects.

The results showed that both treatments had similar success rates and vision improvement. However, there were fewer cases of the retina detaching again in the PPV group. Also, people who had PPV needed fewer extra treatments to fully fix their retina.

In terms of side effects, cataract development and the creation of new breaks in the retina were more common in the PPV group. On the other hand, a side effect called choroidal detachment (where another layer of the eye pulls away) was more common in the scleral buckling group.

Overall, the study concludes that both treatments are equally effective for treating RRD. However, they suggest that PPV might have a slight edge due to fewer cases of the retina detaching again, and fewer additional treatments needed. But this conclusion is based on low-certainty evidence, meaning more research is needed to confirm these findings.

FAQs

  1. What is Rhegmatogenous retinal detachment (RRD) and what are the common treatments for it?
  2. What were the results of the research comparing the effectiveness of Pars plana vitrectomy (PPV) and scleral buckling in treating RRD?
  3. What are the potential side effects of both Pars plana vitrectomy (PPV) and scleral buckling?

Doctor’s Tip

A doctor might tell a patient considering vitrectomy for retinal detachment that both Pars plana vitrectomy and scleral buckling are effective treatments, but Pars plana vitrectomy may have a slightly lower risk of the retina detaching again and may require fewer additional treatments. However, there are potential side effects associated with each treatment, so it is important to discuss these with your doctor and weigh the risks and benefits before making a decision.

Suitable For

Patients who are typically recommended vitrectomy, specifically Pars plana vitrectomy (PPV), for the treatment of Rhegmatogenous retinal detachment (RRD) include:

  1. Patients with severe cases of RRD where the retina has detached significantly from the underlying layer of cells.
  2. Patients who have experienced multiple retinal detachments or have a high risk of recurrent detachments.
  3. Patients with large or complex retinal tears that are difficult to repair using other methods.
  4. Patients with certain eye conditions or diseases that make them more prone to retinal detachment, such as high myopia (nearsightedness).
  5. Patients who have not responded well to other treatments like scleral buckling or pneumatic retinopexy.
  6. Patients with traumatic eye injuries that have resulted in retinal detachment.

It is important for patients to discuss their individual case with their ophthalmologist to determine the most appropriate treatment option for their specific situation.

Timeline

Before vitrectomy:

  • Patient experiences symptoms of Rhegmatogenous retinal detachment (RRD) such as floaters, flashes of light, or a curtain-like shadow in their vision.
  • Patient sees an eye doctor who diagnoses RRD and discusses treatment options.
  • Patient undergoes pre-operative tests and evaluations to determine if they are a suitable candidate for vitrectomy.
  • Patient schedules the vitrectomy surgery and receives instructions on how to prepare for the procedure.

After vitrectomy:

  • Patient undergoes the vitrectomy surgery, which typically lasts 1-2 hours under local or general anesthesia.
  • Patient may experience discomfort, redness, and blurred vision in the days following the surgery.
  • Patient follows post-operative instructions provided by their doctor, including using eye drops, avoiding strenuous activities, and attending follow-up appointments.
  • Patient gradually regains vision as the eye heals, with full recovery typically taking several weeks to months.
  • Patient may experience side effects or complications such as cataract development, new breaks in the retina, or choroidal detachment, which may require further treatment or monitoring.

What to Ask Your Doctor

Some questions a patient should ask their doctor about vitrectomy for Rhegmatogenous retinal detachment (RRD) include:

  1. What are the potential risks and side effects of each treatment option (PPV and scleral buckling)?
  2. What is the success rate of each treatment in fixing the detached retina and improving vision?
  3. How many additional treatments or surgeries might be needed after the initial procedure?
  4. How long is the recovery time for each treatment?
  5. Will I need to make any lifestyle changes or take medications after the procedure?
  6. Are there any long-term effects or complications associated with either treatment?
  7. Are there any specific factors about my eye health or medical history that might affect the choice of treatment?
  8. How experienced are you in performing vitrectomy procedures for RRD?
  9. Are there any alternative treatments or less invasive options that could be considered?
  10. What should I expect in terms of follow-up appointments and monitoring after the procedure?

Reference

Authors: Znaor L, Medic A, Binder S, Vucinovic A, Marin Lovric J, Puljak L. Journal: Cochrane Database Syst Rev. 2019 Mar 8;3(3):CD009562. doi: 10.1002/14651858.CD009562.pub2. PMID: 30848830