title: Pars plana vitrectomy with 360° versus localized laser retinopexy in the management of retinal detachment with undetected breaks intraoperatively: a retrospective, comparative, interventional study.
abstract: The purpose of this study is to compare the efficacy of intraoperative 360° and localized laser retinopexy in 23-gauge pars plana vitrectomy (PPV) for rhegmatogenous retinal detachments (RRD) with undetected retinal breaks intraoperatively. This is a retrospective, comparative, interventional study. Medical records of 48 consecutive eyes with RRD of intraoperative undetected retinal breaks were reviewed. Nineteen patients (group I) received 360° laser retinopexy in PPV, while the remaining 29 patients (group II) underwent localized laser retinopexy. In group I, a triple row of confluent medium-white laser burns were placed posterior to the ora serrata. Anatomical and visual outcomes of the two groups were compared. The mean follow-up period was 13.46 ± 3.02 months. No significant difference was identified in baseline characteristics. A single-operation reattachment rate of 89.47% was achieved in group I, which was significantly higher than that of group II (55.17%, p = 0.01), and this trend was not weakened after adjustment for the confounding factor (odds ratio 0.15, p = 0.03). Moreover, greater improvement of postoperative best-corrected visual acuity was observed in group I. Significant complications sufficient to require further operation included proliferative vitreoretinopathy in 2 (4.17%) eyes and epiretinal membrane in 4 (8.33%) eyes. Three hundred sixty-degree laser retinopexy was associated with better anatomic and visual outcomes in RRD patients with unseen breaks intraoperatively, when compared with localized laser retinopexy in PPV.
authors.affiliation: Department of Ophthalmology, Ninth People's Hospital of Shanghai, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Chuandi
authors.initials: C
authors.lastname: Zhou
authors.affiliation: Department of Ophthalmology, First People's Hospital of Shanghai, Shanghai Jiaotong University, 100 Haining Road, Hongkou District, Shanghai, 200080, China.
authors.forename: Zhi
authors.initials: Z
authors.lastname: Zheng
authors.affiliation: Department of Ophthalmology, First People's Hospital of Shanghai, Shanghai Jiaotong University, 100 Haining Road, Hongkou District, Shanghai, 200080, China. qinghuaqiu@163.com.
authors.forename: Qinghua
authors.initials: Q
authors.lastname: Qiu
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D003710:Demography; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D007834:Lasers; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000209:etiology; D011184:Postoperative Period; D012163:Retinal Detachment / Q000601:surgery*; D012167:Retinal Perforations / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000009:adverse effects
keywords: Laser retinopexy; Pars plana vitrectomy; Rhegmatogenous retinal detachment; Undetected retinal breaks