Galvin JC, Earnest A, Egwunye J, Essex RW, Fung AT. Cryotherapy versus Laser Does Not Influence Anatomical Success following Vitrectomy for Primary Rhegmatogenous Retinal Detachment Repair: Registry Analysis of 2413 Patients.
Ophthalmol Retina 2022;
6:985-991. [PMID:
35659942 DOI:
10.1016/j.oret.2022.05.025]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 05/22/2022] [Accepted: 05/23/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE
To determine if a difference exists between cryotherapy and endolaser photocoagulation retinopexy in the rates of anatomical success following primary rhegmatogenous retinal detachment (RRD) repair with pars plana vitrectomy (PPV).
DESIGN
Registry-based, non-randomized, observational cohort study.
SUBJECTS
Eyes with primary RRD in a bi-national retinal surgery registry who underwent repair with PPV and had a minimum of 3-months follow-up.
METHODS
Cases were recorded prospectively by participating surgeons, and outcome was entered at 3 months. A generalized mixed model approach was used to compare the effect of retinopexy type on outcome. Variables known to be associated with retinal surgical success were considered as covariates for the final model. Eyes were divided into two groups: Cryo group (receiving cryotherapy as the only form of retinopexy) and Laser group (receiving endolaser as the only form of retinopexy).
MAIN OUTCOME MEASURES
The primary endpoint was the proportion of patients with stable retinal re-attachment without the need for further retinal detachment surgery, assessed 3-months post-operatively. Failure was defined as either retinal re-detachment, or foveal attachment with long-term silicone oil tamponade at endpoint. The secondary outcome measured was visual acuity at 3-months compared with baseline measurements.
RESULTS
Of a total 2413 patients included, the overall single-procedure success rate was 85%. There was no statistically significant difference in surgical success between the adjusted proportion of successful reattachment for the Cryo group (87%) when compared to the Laser group (82%) (p = 0.84, OR 1.04, 95% CI 0.74, 1.46). There was no difference between groups for the mean change in visual outcomes at 3-months (adjusted mean change of -0.48 logMAR for Cryo vs. -0.50 logMAR for Laser group, p=0.82).
CONCLUSIONS
Choice of cryotherapy versus endolaser retinopexy was not observed to influence the anatomical success of PPV for RRD, nor visual acuity outcomes at 3-months post-operatively.
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