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  • Visual outcomes after surgery for primary rhegmatogenous retinal detachment in era of microincision vitrectomy: Japan-Retinal Detachment Registry Report IV

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Clinical science
Visual outcomes after surgery for primary rhegmatogenous retinal detachment in era of microincision vitrectomy: Japan-Retinal Detachment Registry Report IV
  1. Takayuki Baba1,
  2. Ryo Kawasaki2,
  3. Keita Yamakiri3,
  4. Takashi Koto4,
  5. Koichi Nishitsuka5,
  6. Shuichi Yamamoto1,
  7. Taiji Sakamoto3
  8. On behalf of the Japan-Retinal Detachment Registry Group
  1. 1 Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, Japan
  2. 2 Vision Informatics, Osaka University Graduate School of Medicine, Osaka, Japan
  3. 3 Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
  4. 4 Ophthalmology, Kyorin Eye Center, Kyorin University School of Medicine, Tokyo, Japan
  5. 5 Ophthalmology and Visual Science, Yamagata University Faculty of Medicine, Yamagata, Japan
  1. Correspondence to Dr Taiji Sakamoto, Ophthalmology, Kagoshima University, Kagoshima, Japan; tsakamot{at}m3.kufm.kagoshima-u.ac.jp

Abstract

Background/Aim To determine the preoperative ocular factors and surgical methods that led to best-corrected visual acuity (BCVA) after pars plana vitrectomy (PPV) or scleral buckling (SB) for rhegmatogenous retinal detachment (RRD).

Methods This was a prospective, nationwide, multicentre, observational study. Data from the Japanese Retina and Vitreous Society registry from 2016 to 2017 were used to determine the association between preoperative clinical factors, surgical procedures and postoperative BCVA at 6 months. Japanese individuals >40 years of age were included. Eyes with proliferative vitreoretinopathy were included. The primary outcome was the percentage of eyes that achieved 20/25 vision.

Results Of the 3219 registered cases, 2192 met the inclusion criteria (344 SB, 1738 PPV, 110 PPV+SB). Cases with preoperative BCVA (≤0 logarithm of the minimum angle of resolution (logMAR) units) had good postoperative BCVA (OR=3.97, CI 2.87 to 5.51). Older age (>70 years), low intraocular pressure (<10 mm Hg), high myopia (<−5 dioptres), multiple retinal breaks (>4), giant retinal tear (>90°), wide retinal detachment (>3 quadrants) and macula-off detachment were associated with less probability of postoperative 20/25 vision (OR=0.39, 0.64, 0.62, 0.60, 0.12, 0.51 and 0.36, respectively). Postoperative BCVA was 0.03±0.23 and 0.10±0.32 logMAR units after SB and PPV, respectively. The percentage of cases that achieved 20/25 vision was not significantly different after PPV or SB if cases that had concurrent cataract surgery were excluded (p=0.251).

Conclusions Better BCVA in patients with RRD who had undergone PPV was observed. However, if concurrent cataract surgery is not performed, BCVA will be comparable with either PPV or SB.

  • retina
  • vision
  • treatment surgery

https://doi.org/10.1136/bjophthalmol-2020-315945

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    Footnotes

    • Presented at Part of these data was presented at the XXXIth Meeting of the Club Jules Gonin, Jersey, Channel Islands (GB) and the Vail Vitrectomy, Vail, Colorado, 2019.

    • Contributors Conception and design: TB, RK. Data collection: TB, KY, TK, KN. Analysis and interpretation: TB, RK, TS. Obtained funding: SY, TS. Overall responsibility: TB, RK, KY, TK, KN, SY, TS.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests TB reports personal fees from Bayer Yakuhin, personal fees from Kowa, personal fees from Santen, personal fees from Senju, grants and personal fees from Novartis Pharma KK, personal fees from Alcon Japan, outside the submitted work. RK reports personal fees and other from Topcon, grants and personal fees from Senju, grants and personal fees from Novartis Pharma KK, grants from Pfizer, grants and personal fees from Bayer Yakuhin, personal fees from Roche, personal fees from Takeda, personal fees from Kowa, personal fees from Novo Nordisk, personal fees from Astellas, personal fees from Santen, personal fees from Nitto Medic, personal fees from Office Future, personal fees from Predictive Analytics, personal fees from MICIN, outside the submitted work. KY reports personal fees from Bayer Yakuhin, personal fees from HOYA Corporation, personal fees from Novartis Pharma KK, personal fees from Alcon Japan, personal fees from RE Medical, outside the submitted work. TK reports personal fees from Santen, personal fees from Bayer Yakuhin, personal fees from Novartis Pharma KK, personal fees from HOYA Corporation, personal fees from Ellex, personal fees from Pfizer, personal fees from Kowa, personal fees from Senju, outside the submitted work. KN reports personal fees from Santen, personal fees from RE Medical, personal fees from Carl Zeiss, personal fees from Alcon Japan, personal fees from Novartis Pharma KK, personal fees from Kowa, personal fees from Johnson & Johnson, personal fees from Senju, personal fees from Sanwa Kagaku Kenkyusho, personal fees from HOYA Corporation, outside the submitted work. SY reports grants and personal fees from Santen, grants and personal fees from Jamecs, personal fees from HOYA Corporation, personal fees from Pfizer, personal fees from Senju, personal fees from Alcon Japan, personal fees from Nidek, personal fees from Kowa, personal fees from Bayer Yakuhin, outside the submitted work. TS reports personal fees from Bayer Yakuhin, personal fees from HOYA Corporation, personal fees from Novartis Pharma KK, personal fees from Alcon Japan, personal fees from RE Medical, personal fees from Santen, personal fees from Senju, outside the submitted work.

    • Patient consent for publication Not required.

    • Ethics approval The main study protocol was approved by the Ethics Committee of Kagoshima University (140093 (28-38)), and all the facilities thereafter and the procedures used conformed to the tenets of the Declaration of Helsinki. The collection of data was conducted based on the Ethical Guidelines for Medical and Health Research Involving Human Subjects in Japan (https://www.mhlw.go.jp/file/06-Seisakujouhou-10600000-Daijinkanboukouseikagakuka/0000080278.pdf).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. Data from the J-RD database are available upon reasonable request.

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