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  • Two-year outcomes of different subretinal fluid drainage techniques during vitrectomy for fovea-off rhegmatogenous retinal detachments: ELLIPSOID-2 study

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Retina
Two-year outcomes of different subretinal fluid drainage techniques during vitrectomy for fovea-off rhegmatogenous retinal detachments: ELLIPSOID-2 study
  1. Bryon R McKay1,2,
  2. Aditya Bansal1,
  3. Michael Kryshtalskyj3,
  4. David T Wong4,
  5. Alan R Berger4,
  6. Rajeev H Muni1,5
  1. 1 Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
  2. 2 Department of Ophthalmology and Vision Science, The University of British Columbia, Vancouver, British Columbia, Canada
  3. 3 Department of Ophthalmology and Vision Sciences, University of Calgary, Calgary, Alberta, Canada
  4. 4 VitreoRetina, St Michael's Hospital, Toronto, Ontario, Canada
  5. 5 Department of Ophthalmology, St Michael's Hospital, Toronto, Ontario, Canada
  1. Correspondence to Dr Bryon R McKay; mckaybr.phd{at}gmail.com

Abstract

Background The purpose of the study is to compare visual acuity, complications and outer retinal integrity following subretinal fluid (SRF) drainage from the peripheral retinal breaks (PRBs) versus posterior retinotomy (PR) versus perfluorocarbon liquid (PFCL) for macula-off rhegmatogenous retinal detachments (RRDs) at 2 years post-surgery.

Methods Retrospective analysis of 300 consecutive patients with primary RRD undergoing 23-gauge pars plana vitrectomy with SRF drainage through (1) PRB (n=100), (2) PR (n=100) or (3) with PFCL (n=100). Primary outcomes were visual acuity (best-corrected visual acuity (BCVA)) and complications (cystoid macular oedema (CMO) and epiretinal membrane (ERM)). Secondary outcomes were discontinuity of the external limiting membrane (ELM), ellipsoid zone (EZ) and interdigitation zone (IDZ) at 2 years post-surgery.

Results Mean (±SD) logMAR BCVA at 24 months was better in the PRB compared with PR and PFCL, with PFCL having the worst BCVA (PRB 0.5±0.6; PR 0.7±0.5; PFCL 0.9±0.7, p=0.001). CMO was higher with PFCL (PRB 29.7%; PR 30.2%; PFCL 45.9%, p=0.0015) and ERM formation was higher in PR (PRB 62.6%; PR 93.0%; PFCL 68.9%, p=0.002). There were no differences in ELM or EZ discontinuity. However, IDZ discontinuity was higher in PFCL (PRB 34%; PR 27%; PFCL 46%, p=0.002) at 2 years.

Conclusions Visual acuity was worse and discontinuity of the IDZ and CMO was greater in eyes with PFCL-assisted drainage compared with PRB or PR. Drainage technique may impact long-term visual acuity and photoreceptor integrity.

  • Retina
  • Vitreous
  • Treatment Surgery

Data availability statement

No data are available.

https://doi.org/10.1136/bjo-2023-323879

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    Data availability statement

    No data are available.

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    Footnotes

    • Presented at Presented at the American Society of Retina Specialists Annual Meeting in New York, New York, USA in July 2022.

    • Contributors Conception and study design—BRM and RHM. Data acquisition—BRM, MK, DTW, ARB and RHM. Data analysis—BRM, ARB and RHM. Data interpretation—BRM and RHM. Manuscript preparation—BRM, AB, MK, DTW, ARB and RHM. Final manuscript approval—BRM, AB, MK, DTW, ARB and RHM. Guarantor: RHM.

    • 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.

    • Disclaimer RHM and all of the authors had full access to all the patient data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

    • Competing interests None declared.

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