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Non-complicated Retinal detachment management: variations in 4 years. Retina 1 project; report 1
  1. Enrique Rodríguez de la Rúa (mariajogleztorre{at}hotmail.com),
  2. Jose Carlos Pastor (pastor{at}ioba.med.uva.es),
  3. Itziar Fernandez,
  4. María Rosa Sanabria-Ruiz Colmenares,
  5. José García- Arumí,
  6. Vicente Martínez- Castillo,
  7. Rosa Coco,
  8. Lucia Manzanas,
  9. Ismael Miranda
  1. IOBA; Hospital Clínico Valladolid; University of Valladolid, Spain
  2. Instituto Universitario de Oftalmobiologia Aplicada, Spain
  3. IOBA; University of Valladolid, Spain
  4. Hospital Rio Hortega; IOBA (Valladolid), Spain
  5. Hospital Universitario Vall'd'Hebró; Barcelona, Spain
  6. Hospital Universitario Vall'd'Hebró, Barcelona, Spain
  7. IOBA; University of Valladolid, Spain
  8. Hospital Clínico; Valladolid, Spain
  9. Hospital Nuestra Señora de Sonsoles; Avila, Spain

    Abstract

    Purpose: To assess variations in the characteristics and management of two series of non-complicated rhegmatogenous retinal detachments (RD) carried out 4 years apart in Spain.

    Methods: Prospective, multicentric, non-randomized comparative study. 339 consecutive cases of RD treated in 5 hospitals were included. Group 1(G1) (n: 186) included cases operated on from 1999 to 2001; group 2 (G2) (n: 153) included cases from 2004 to 2006. 83 variables related to preoperative characteristics of RD, surgical management and postoperative evolution were recorded. Surgeons were allowed to treat patients following their personal criteria. Differences in preoperative characteristics, rate of vitrectomy and anatomical outcome were studied. Quantitative variables were compared by Mann-Whitney U test and qualitative ones by standard contingency tables. Multivariate analysis was carried out by logistic regression analysis.

    Results: G1 showed significant longer delay in performing surgery since first symptoms appeared (G1: 29% 50 days; G2: 22% 55; p < .001) and more RD without visible retinal break than G2 (G1:17.4%; G2: 9.2%; p = .028). In G2, cases with multiple retinal breaks (G1: 31.6%; G2: 44.6%) were more frequent (p = .022). No significant differences in other preoperative variables were observed. Vitrectomy was performed in 30.1% in G1 and in 78.4% in G2 as a primary surgical approach (p < .001). Regardless of the characteristics of the RD, rate of vitrectomy was higher in G2. Reattachment rate was over 94% in both groups (p = .833). Pseudophakic RD showed better anatomical outcomes in G2 (G1: 83.9%; G2: 96.4%; p = .028).

    Conclusion: There is an increasing tendency to treat RD with primary vitrectomy, which is neither related with a higher complexity of cases nor with better anatomical results.

    • Vitreous
    • Retina
    • Treatment Surgery
    • Epidemiology
    • Proliferative vitreoretinopathy
    • Retinal detachment
    • Scleral buckling
    • Vitrectomy

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