Stratifying the risk of re-detachment: variables associated with outcome of vitrectomy for rhegmatogenous retinal detachment in a large UK cohort study
Year: 2023
Type: article
Study design: Observational Study
Abstract: Introduction To identify variables associated with primary anatomical outcome following vitrectomy and internal tamponade for rhegmatogenous retinal detachment (RD). Methods A retrospective analysis of prospectively collected data, using a database of RD treated with vitrectomy and internal tamponade. Collected data complied with the RCOphth Retinal Detachment Dataset. The main outcome measure was anatomical failure within six months of surgery. Results There were 6377 vitrectomies. 869 eyes were excluded, either because no outcome was recorded, or inadequate follow up, leaving 5508 operations for analysis. 63.9% of patients were male, and the median age was 62. Primary anatomical failure occurred in 13.9%. On multivariate analysis, the following were associated with increased risk of failure: age <45, or >79, inferior retinal breaks, total detachment, one quadrant or greater inferior detachment, low density silicone oil, and presence of proliferative vitreoretinopathy. C 2 F 6 tamponade, cryotherapy, and 25 G vitrectomy, were associated with reduced risk of failure. The area under the receiver operator curve was 71.7%. According to this model, 54.3% of RD are at low risk (<10%), 35.6% are at moderate risk (10–25%), and 10.1% are at high risk (>25%) of failure. Conclusions Previous attempts to identify high risk RD have been limited by small numbers, the inclusion of both scleral buckling and vitrectomy, or by excluding some types of RD. This study examined outcomes in unselected RD, treated by vitrectomy. Identification of the variables associated with anatomical outcome after RD surgery enables accurate risk stratification, which is valuable for patient counselling and selection, and for future clinical trials.
Source: Eye
Authors: David Yorston, Paul H. J. Donachie, D. A. Laidlaw, David H. Steel, G. W. Aylward, Tom H. Williamson, the BEAVRS database study group, David Steel, Andrew Morris, Craig Goldsmith, Stephen Winder, Richard Sheard, Jonathan Smith, Tony Casswell, Diego Sanchez-Chicharro, Atiq Babar, Tim Cochrane, Vaughan Tanner, Vasileios Papastavrou, Deepak Vayalambrone, Tsveta Ivanova, Jonathan Park, Assad Jalil, Kurt Spiteri Cornish, Abdallah Ellabban, Sonali Tarafdar, Imran Khan, Edward Hughes, Kam Balaggan, Laura Wakely, Steve Charles, Huw Jenkins, Izabela Mitrut
Institutions: Gartnavel General Hospital, Royal College of Ophthalmologists, Gloucestershire Hospitals NHS Foundation Trust, Guy's and St Thomas' NHS Foundation Trust, Sunderland Eye Infirmary, Newcastle University, Moorfields Eye Hospital, Royal Bournemouth Hospital, James Paget University Hospital, James Paget University Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Brighton and Sussex University Hospitals NHS Trust, Martin University Hospital, Hull University Teaching Hospitals NHS Trust, Maidstone and Tunbridge Wells NHS Trust, King Edward VII Hospital, Royal Victoria Infirmary, East Suffolk and North Essex NHS Foundation Trust, Manchester Royal Eye Hospital, Musgrove Park Hospital, Ninewells Hospital, University Hospitals of North Midlands NHS Trust, Sussex Eye Hospital, Glangwili General Hospital
Language: English
Topic: Retinal and Macular Surgery
Subfield: Ophthalmology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,990
OpenAlex ID: W4366997684