Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.
Mid Atlantic Retina, Wills Eye Hospital, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
Br J Ophthalmol. 2021 Mar;105(3):410-413. doi: 10.1136/bjophthalmol-2020-315948. Epub 2020 May 14.
BACKGROUND/AIMS: Vitrectomy to repair retinal detachment is often performed with either non-contact wide-angle viewing systems or wide-angle contact viewing systems. The purpose of this study is to assess whether the viewing system used is associated with any differences in surgical outcomes of vitrectomy for primary non-complex retinal detachment repair.
This is a multicenter, interventional, retrospective, comparative study. Eyes that underwent non-complex primary retinal detachment repair by either pars plana vitrectomy (PPV) alone or in combination with scleral buckle/PPV in 2015 were evaluated. The viewing system at the time of the retinal detachment repair was identified and preoperative patient characteristics, intraoperative findings and postoperative outcomes were recorded.
A total of 2256 eyes were included in our analysis. Of those, 1893 surgeries used a non-contact viewing system, while 363 used a contact lens system. There was no statistically significant difference in single surgery anatomic success at 3 months (p=0.72), or final anatomic success (p=0.40). Average postoperative visual acuity for the contact-based cases was logMAR 0.345 (20/44 Snellen equivalent) compared with 0.475 (20/60 Snellen equivalent) for non-contact (p=0.001). After controlling for numerous confounding variables in multivariable analysis, viewing system choice was no longer statistically significant (p=0.097).
There was no statistically significant difference in anatomic success achieved for primary retinal detachment repair when comparing non-contact viewing systems to contact lens systems. Postoperative visual acuity was better in the contact-based group but this was not statistically significant when confounding factors were controlled for.
背景/目的：修复视网膜脱离的玻璃体切除术通常使用非接触广角观察系统或广角接触观察系统进行。本研究的目的是评估所使用的观察系统是否与原发性单纯性视网膜脱离修复的玻璃体切除术的手术结果存在差异。
这是一项多中心、干预性、回顾性、对照研究。评估 2015 年接受单纯性玻璃体切除术（PPV）或巩膜扣带/PPV 联合治疗的原发性单纯性视网膜脱离修复的眼。确定视网膜脱离修复时使用的观察系统，并记录术前患者特征、术中发现和术后结果。
共有 2256 只眼纳入我们的分析。其中，1893 例手术使用非接触式观察系统，363 例手术使用接触镜系统。在 3 个月时单次手术解剖成功率（p=0.72）或最终解剖成功率（p=0.40）方面无统计学差异。基于接触的病例的平均术后视力为 logMAR 0.345（20/44 斯耐伦等效），而非接触式的为 0.475（20/60 斯耐伦等效）（p=0.001）。在多变量分析中控制了许多混杂变量后，观察系统的选择不再具有统计学意义（p=0.097）。
在比较非接触式观察系统和接触镜系统时，原发性视网膜脱离修复的解剖成功率没有统计学差异。基于接触的组的术后视力更好，但在控制混杂因素后这没有统计学意义。
