Ryan Edwin H, Joseph Daniel P, Ryan Claire M, Forbes Nora J K, Yonekawa Yoshihiro, Mittra Robert A, Parke D Wilkin, Ringeisen Alex, Emerson Geoffrey G, Shah Gaurav K, Blinder Kevin J, Capone Antonio, Williams George A, Eliott Dean, Gupta Omesh P, Hsu Jason, Regillo Carl D
VitreoRetinal Surgery PA, Minneapolis, Minnesota.
The Retina Institute, St. Louis, Missouri.
Ophthalmol Retina. 2020 Aug;4(8):814-822. doi: 10.1016/j.oret.2020.02.014. Epub 2020 Mar 4.
To detail the methodology for a large multicenter retrospective cohort study (RCS) of primary rhegmatogenous retinal detachment (RRD) with detailed data collection and to present overall anatomic outcomes.
This study used an RCS method.
All patients undergoing pars plana vitrectomy (PPV), scleral buckling (SB), and combined PPV/SB for primary RRD in 2015 from 5 large retina groups were included in the database.
To ensure validity of the cohort method, a large and detailed database was generated. Double data entry validation was conducted, and data audits were conducted. Anatomic and visual outcomes for all the cases in the dataset will be described but not compared, because the cases were not matched. In future studies, comparable cases of moderate-complexity RRD will be chosen naive to surgeon, surgery, and outcome for subgroup analysis.
Precision of data entry was confirmed by inter-rater reliability (IRR). Main surgical outcome for each procedure type was single-surgery anatomic success (SSAS).
Inter-rater reliability showed significant agreement among raters (P < 0.001). Of 2620 patients, 2335 had >90 days of follow-up. Of these, 320 eyes (13.7%) underwent SB, 1200 eyes (51.4%) underwent PPV, and 815 eyes (34.9%) underwent PPV/SB. The SSAS was 84.2% for PPV, 91.2% for SB, and 90.2% for PPV/SB.
We compiled a large, accurately documented database of primary RRD cases repaired by PPV, SB, and PPV/SB from which cohort studies of moderately complex RRDs can be carried out. All 3 approaches had a high SSAS rate. Procedures chosen and their outcomes are described, but the broad case mix makes comparisons not possible until future cohort studies are completed.
详细阐述一项针对原发性孔源性视网膜脱离（RRD）的大型多中心回顾性队列研究（RCS）的方法，进行详细的数据收集，并呈现总体解剖学结果。
本研究采用RCS方法。
2015年来自5个大型视网膜研究组的所有因原发性RRD接受玻璃体切割术（PPV）、巩膜扣带术（SB）以及PPV/SB联合手术的患者被纳入数据库。
为确保队列研究方法的有效性，建立了一个大型且详细的数据库。进行了双数据录入验证，并开展了数据审核。将描述数据集中所有病例的解剖学和视觉结果，但不进行比较，因为病例未进行匹配。在未来的研究中，将选择对术者、手术及结果均不了解的中度复杂性RRD的可比病例进行亚组分析。
通过评分者间信度（IRR）确认数据录入的准确性。每种手术类型的主要手术结果为单次手术解剖学成功（SSAS）。
评分者间信度显示评分者之间存在显著一致性（P < 0.001）。在2620例患者中，2335例有超过90天的随访。其中，320只眼（13.7%）接受了SB手术，1200只眼（51.4%）接受了PPV手术，815只眼（34.9%）接受了PPV/SB联合手术。PPV的SSAS为84.2%，SB为91.2%，PPV/SB为90.2%。
我们汇编了一个由PPV、SB和PPV/SB修复的原发性RRD病例的大型、记录准确的数据库，从中可以开展中度复杂性RRD的队列研究。所有3种方法的SSAS率都很高。描述了所选择的手术方法及其结果，但由于病例组合广泛，在未来队列研究完成之前无法进行比较。
