title: Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment study (SPR study): Risk assessment of anatomical outcome. SPR study report no. 7.
abstract: OBJECTIVE
  The 'Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment study' (SPR study) is a randomized multicentre trial comparing primary vitrectomy (PV) and scleral buckling surgery (SB) for rhegmatogenous retinal detachment (RRD). This subanalysis was conducted to identify risk factors associated with anatomical outcomes.
  
  
  METHODS
  Relating the anatomical success results at the 1-year follow-up visit to pre- and intraoperative findings using multivariate statistical methods.
  
  
  RESULTS
  In the phakic subtrial, anatomical success was negatively associated with the number of breaks (p < 0.0001), break extension > 1 clock hour (p = 0.0005) and intraoperative use of cryotherapy (p = 0.0484). It was positively associated with retinal breaks with irregular edges (p = 0.0353) and subretinal fluid drainage (p = 0.0155). In the pseudophakic/aphakic subtrial, anatomical success was negatively associated with the number of retinal breaks (p = 0.0004) and previous YAG capsulotomy (p = 0.0256), and the combined effect of the surgical procedure and intraoperative use of laser (p = 0.0229).
  
  
  CONCLUSIONS
  Primary anatomical success is an important result for patients undergoing RRD surgery. Our data demonstrate that the final anatomical outcome is related to a higher preoperative number of breaks and cryotherapy in phakic eyes. Additional risk factors varied between phakic and pseudophakic subgroups. Our findings may be used to facilitate the prognosis of future patients with RRD.
authors.affiliation: Department of Ophthalmology, Georg-August University Hospital, Goettingen, Germany. nicolas.feltgen@med.uni-goettingen.de
authors.forename: Nicolas
authors.initials: N
authors.lastname: Feltgen
authors.forename: Heinrich
authors.initials: H
authors.lastname: Heimann
authors.forename: Hans
authors.initials: H
authors.lastname: Hoerauf
authors.forename: Peter
authors.initials: P
authors.lastname: Walter
authors.forename: Ralf-Dieter
authors.initials: RD
authors.lastname: Hilgers
authors.forename: Nicole
authors.initials: N
authors.lastname: Heussen
mesh_terms: D058442:Capsule Opacification / Q000209:etiology / Q000601:surgery; D002387:Cataract Extraction; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use; D057852:Posterior Capsule of the Lens / Q000473:pathology / Q000601:surgery; D011446:Prospective Studies; D019591:Pseudophakia / Q000503:physiopathology; D012160:Retina / Q000502:physiology*; D012163:Retinal Detachment / Q000503:physiopathology / Q000601:surgery*; D012167:Retinal Perforations / Q000473:pathology; D012307:Risk Factors; D012591:Scleral Buckling; D058471:Subretinal Fluid; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*; D014821:Vitrectomy