Success rates of retinal detachment surgery: routine versus emergency setting

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• 作者：Konrad R. Koch (1)
  Manuel M. Hermann (1)
  Bernd Kirchhof (1)
  Sascha Fauser (1)
  
• 关键词：Rhegmatogenous retinal detachment ; Pars plana vitrectomy ; Anatomical success rate ; Emergency setting ; Surgical experience
• 刊名：Graefe's Archive for Clinical and Experimental Ophthalmology
• 出版年：2012
• 出版时间：December 2012
• 年：2012
• 卷：250
• 期：12
• 页码：1731-1736
• 全文大小：180KB
• 参考文献：1. Doyle E, Herbert EN, Bunce C, Williamson TH, Laidlaw DA (2007) How effective is macula-off retinal detachment surgery. Might good outcome be predicted? Eye 21:534-40 CrossRef
  2. Oshima Y, Yamanishi S, Sawa M, Motokura M, Harino S, Emi K (2000) Two-year follow-up study comparing primary vitrectomy with scleral buckling for macula-off rhegmatogenous retinal detachment. Jpn J Ophthalmol 44:538-49 CrossRef
  3. Salicone A, Smiddy WE, Venkatraman A, Feuer W (2006) Visual recovery after scleral buckling procedure for retinal detachment. Ophthalmology 113:1734-742 CrossRef
  4. Wykoff CC, Smiddy WE, Mathen T, Schwartz SG, Flynn HWJ, Shi W (2010) Fovea-sparing retinal detachments: time to surgery and visual outcomes. Am J Ophthalmol 150:205.e2-10.e2
  5. Diederen RM, La Heij EC, Kessels AG, Goezinne F, Liem AT, Hendrikse F (2007) Scleral buckling surgery after macula-off retinal detachment: worse visual outcome after more than 6 days. Ophthalmology 114:705-09 CrossRef
  6. Yang CH, Lin HY, Huang JS, Ho TC, Lin CP, Chen MS, Yang CM (2004) Visual outcome in primary macula-off rhegmatogenous retinal detachment treated with scleral buckling. J Formos Med Assoc 103:212-17
  7. Sagong M, Chang W (2010) Learning curve of the scleral buckling operation: lessons from the first 97 cases. Ophthalmologica 224:22-9 CrossRef
  8. Hartz AJ, Burton TC, Gottlieb MS, McCarty DJ, Williams DF, Prescott A, Klein P (1992) Outcome and cost analysis of scheduled versus emergency scleral buckling surgery. Ophthalmology 99:1358-363
  9. Ramsay MA (2000) Physician fatigue. Proc (Bayl Univ Med Cent) 13:148-50
  10. Weinger MB, Englund CE (1990) Ergonomic and human factors affecting anesthetic vigilance and monitoring performance in the operating room environment. Anesthesiology 73:995-021 CrossRef
  11. Thelen U, Amler S, Osada N, Gerding H (2010) Outcome of surgery after macula-off retinal detachment -results from MUSTARD, one of the largest databases on buckling surgery in Europe: results from a large German case series. Acta Ophthalmol 1 June [Epub ahead of print]
  12. Hassan TS, Sarrafizadeh R, Ruby AJ, Garretson BR, Kuczynski B, Williams GA (2002) The effect of duration of macular detachment on results after the scleral buckle repair of primary, macula-off retinal detachments. Ophthalmology 109:146-52 CrossRef
  13. Henrich PB, Priglinger S, Klaessen D, Kono-Kono JO, Maier M, Schotzau A, Meyer P, Josifova T, Schneider U, Flammer J, Haritoglou C (2009) Macula-off retinal detachment—a matter of time? Klin Monatsbl Augenheilkd 226:289-93 CrossRef
  14. Lai MM, Khan N, Weichel ED, Berinstein DM (2011) Anatomic and visual outcomes in early versus late macula-on primary retinal detachment repair. Retina 31:93-8 CrossRef
  15. Haritoglou C, Brandlhuber U, Kampik A, Priglinger SG (2010) Anatomic success of scleral buckling for rhegmatogenous retinal detachment–a retrospective study of 524 cases. Ophthalmologica 224:312-18 CrossRef
  16. Goezinne F, La Heij EC, Berendschot TT, Kessels AG, Liem AT, Diederen RM, Hendrikse F (2010) Incidence of redetachment 6 months after scleral buckling surgery. Acta Ophthalmol 88:199-06 CrossRef
  17. Campo RV, Sipperley JO, Sneed SR, Park DW, Dugel PU, Jacobsen J, Flindall RJ (1999) Pars plana vitrectomy without scleral buckle for pseudophakic retinal detachments. Ophthalmology 106:1811-815, discussion 1816 CrossRef
  18. Heimann H, Bartz-Schmidt KU, Bornfeld N, Weiss C, Hilgers RD, Foerster MH (2007) Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment: a prospective randomized multicenter clinical study. Ophthalmology 114:2142-154 CrossRef
  19. Falkner-Radler CI, Myung JS, Moussa S, Chan RV, Smretschnig E, Kiss S, Graf A, D'amico DJ, Binder S (2011) Trends in primary retinal detachment surgery: results of a Bicenter Study. Retina 31:928-36 CrossRef
  
• 作者单位：Konrad R. Koch (1)
  Manuel M. Hermann (1)
  Bernd Kirchhof (1)
  Sascha Fauser (1)
  
  1. Center of Ophthalmology, Department of Vitreo-Retinal Surgery, University of Cologne, 50924, Cologne, Germany
  
• ISSN：1435-702X

文摘

Background Surgery for rhegmatogenous retinal detachment (RRD) should usually be performed as soon as possible. However, a risk of operating in an emergency setting has to be considered against the risk of delaying it. Methods In a retrospective, interventional, non-comparative clinical case series we reviewed the charts of all patients who underwent surgery for primary noncomplex RRD between February 1999 and July 2009. The primary anatomical success (PAS) of RRD surgery was the primary outcome measure, which was defined as permanent reattachment of the retina after a single surgical procedure. All cases were classified as (I) surgical cases, which were performed as emergency procedures the night of the patient’s admission to the hospital (emergency setting), and as (II) those cases, which were operated in a routine setting during daytime (routine setting). Visual acuity was documented 2 and 6?months after surgery Results 1810 cases of primary noncomplex RRD were analysed. PAS rates were 88.0?% in the routine setting and 87.3?% in the emergency setting (p--.67). While expert surgeons-PAS rates did not differ between routine and emergency, non-experts achieved inferior anatomical results, when performing surgery in the emergency setting (81.6?% vs. 88.3?%; p--.02). There was no difference between expert (87.7?%) and non-expert surgeons (88.6?%) in the routine setting (p--.75). There was no statistically significant difference in visual acuity. Conclusions Prompt RRD surgery in an emergency setting did not improve the anatomical outcome and was worse if performed by non-expert surgeons. The possibility to schedule surgery may improve delivery of care without compromising the outcome. Although we did not see a significant functional difference, there was a trend for better visual acuity for experts and routine setting. If one decides that prompt surgery is necessary, it should only be done by an experienced vitreoretinal surgeon.