title: Vitrectomy combined with endolaser or an encircling scleral buckle in primary retinal detachment surgery: a pilot study.
abstract: OBJECTIVE
  To compare pars plana vitrectomy and 360° endolaser therapy with pars plana vitrectomy and an encircling scleral buckle for the treatment of primary rhegmatogenous retinal detachments in a randomized pilot study including 60 patients.
  
  
  METHODS
  Main outcome measures were single-surgery anatomic success rate and final best-corrected visual acuity at 6 months follow-up. Cofactors analysed were complication rates, patients' comfort, refractive outcome and macula status assessed using a spectral-domain optical coherence tomography.
  
  
  RESULTS
  With differences between both treatment groups regarding type of the retinal detachment, localization of retinal tears (p = 0.0085) and the choice of the intraocular tamponade (p < 0.0202), there were no significant differences between the single-surgery anatomic success rate (93.33% both groups, p = 1.0) and the visual acuity at final follow-up (≤0.3 logMAR [logarithm of minimum angle of resolution] in 66.67% in the endolaser group versus 40.0% in the scleral buckle group, p = 0.0514). Questionnaire responses showed lower levels of patients' discomfort in the endolaser group. A significant difference between both groups was found in the refractive error change after surgery (-0.20 ± 0.51 dioptres in the endolaser group versus -0.88 ± 0.88 dioptres in the scleral buckle group, p = 0.0003).
  
  
  CONCLUSIONS
  Primary vitrectomy combined with 360° endolaser therapy seems to be as effective as vitrectomy combined with an encircling scleral buckle in patients with rhegmatogenous retinal detachment, with possible benefits of an improved patients' comfort and a more stable refractive status after surgery.
authors: Department of Ophthalmology, The Ludwig Boltzmann Institute of Retinology and Biomicroscopic Laser Surgery, Rudolf Foundation Clinic, Vienna, Austria.
authors: Christiane I
authors: CI
authors: Falkner-Radler
authors: Section of Medical Statistics, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
authors: Alexandra
authors: A
authors: Graf
authors: Department of Ophthalmology, The Ludwig Boltzmann Institute of Retinology and Biomicroscopic Laser Surgery, Rudolf Foundation Clinic, Vienna, Austria.
authors: Susanne
authors: S
authors: Binder
mesh_terms: D000368:Aged; D058450:Endotamponade; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D017075:Laser Coagulation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012029:Refraction, Ocular / Q000502:physiology; D012163:Retinal Detachment / Q000503:physiopathology / Q000601:surgery*; D012167:Retinal Perforations / Q000601:surgery; D012591:Scleral Buckling / Q000379:methods*; D011795:Surveys and Questionnaires; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000379:methods*
chemical_list: D005466:Fluorocarbons
keywords: encircling band; endolaser; pars plana vitrectomy; primary retinal detachment surgery; rhegmatogenous retinal detachment; scleral buckling
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