title: Comparison of four surgical techniques for management of pseudophakic and aphakic retinal detachment: a multicenter clinical trial.
abstract: OBJECTIVE
  To compare the visual and anatomical outcomes of four surgical techniques to manage pseudophakic and aphakic retinal detachment (PARD).
  
  
  METHODS
  In a multicenter randomized clinical trial, 211 eyes of 211 patients with PARD and proliferative vitreoretinopathy (PVR) grade B or less were randomly assigned to one of the four treatment groups: (1) scleral buckling (SB), 50 eyes, (2) vitrectomy without band, 51 eyes, (3) vitrectomy with encircling band (EB), 58 eyes, and (4) triamcinolone acetonide (TA) assisted vitrectomy, 52 eyes. Patients were followed for 12 months after the surgery. The best-corrected visual acuity (BCVA) and retinal reattachment rate at each follow-up time point were considered as the primary outcome measures. PVR, macular pucker, and cystoid macular edema were considered as the secondary outcomes.
  
  
  RESULTS
  Visual improvement was achieved in all treatment groups relative to the baseline at all time points (all Ps < 0.001). There were no statistically significant differences among the groups with regard to BCVA changes. However, there was a significant difference in the slope of visual improvement curve: the SB group had a more rapid visual improvement compared to the vitrectomy with buckle group at month 12 (P = 0.032). The retinal reattachment rates at month 12 were 75, 64.7, 68.5, and 66.7 % in SB, vitrectomy without buckle, vitrectomy with EB, and TA-assisted vitrectomy groups respectively (P > 0.99). There were no statistically significant differences among the groups in terms of adverse events.
  
  
  CONCLUSIONS
  SB, TA-assisted vitrectomy, and vitrectomy with and without buckle had comparable outcomes in the management of PARD.
authors.affiliation: Ophthalmic Epidemiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Siamak
authors.initials: S
authors.lastname: Moradian
authors.affiliation: Ophthalmic Research Center, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Pasdaran Ave. Boostan 9 St., Tehran, 16666, Iran. hahmadieh@hotmail.com.
authors.forename: Hamid
authors.initials: H
authors.lastname: Ahmadieh
authors.affiliation: Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Hooshang
authors.initials: H
authors.lastname: Faghihi
authors.affiliation: Ophthalmic Research Center, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Pasdaran Ave. Boostan 9 St., Tehran, 16666, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Ramezani
authors.affiliation: Ophthalmic Research Center, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Pasdaran Ave. Boostan 9 St., Tehran, 16666, Iran.
authors.forename: Morteza
authors.initials: M
authors.lastname: Entezari
authors.affiliation: Retina Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Touka
authors.initials: T
authors.lastname: Banaee
authors.affiliation: Nikookari Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Ebadollah
authors.initials: E
authors.lastname: Heidari
authors.affiliation: Eye Research Center, Amiralmomenin Hospital, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Hassan
authors.initials: H
authors.lastname: Behboudi
authors.affiliation: Ophthalmic Research Center, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Pasdaran Ave. Boostan 9 St., Tehran, 16666, Iran.|Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Yasseri
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001035:Aphakia / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019591:Pseudophakia / Q000150:complications*; D012160:Retina / Q000000981:diagnostic imaging*; D012163:Retinal Detachment / Q000175:diagnosis / Q000601:surgery*; D012591:Scleral Buckling / Q000379:methods*; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*; D055815:Young Adult
keywords: Aphakic retinal detachment; Pseudophakic retinal detachment; Scleral buckling; Triamcinolone; Vitrectomy