Universität zu Köln

Walter, Peter ORCID: 0000-0001-8745-6593, Hellmich, Martin, Baumgarten, Sabine, Schiller, Petra, Limburg, Endrik, Agostini, Hansjuergen, Pielen, Amelie, Helbig, Horst, Lommatzsch, Albrecht, Roessler, Gernot and Mazinani, Babac (2017). Vitrectomy with and without encircling band for pseudophakic retinal detachment: VIPER Study Report No 2-main results. Br. J. Ophthalmol., 101 (6). S. 712 - 719. LONDON: BMJ PUBLISHING GROUP. ISSN 1468-2079

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Abstract

Background It is unclear whether or not an additional encircling band improves outcome in vitrectomy for pseudophakic retinal detachment (PRD). Also unclear is whether small gauge transconjunctival trocar-guided vitrectomy is as successful as conventional 20 gauge (G) vitrectomy. Methods 257 adult patients with uncomplicated PRD were enrolled in 14 vitreoretinal centres across Germany. Contingent on availability of qualified surgeons, eligible patients were randomly assigned either (i) with ratio 1: 1 to 20 G vitrectomy plus encircling band (group E1) or 20 G vitrectomy without any buckle (group C) or (ii) with ratios 1: 1: 1 to group E1, C or 23/25 G vitrectomy without any buckle (group E2). Treatment success was defined as no indication for any retina reattaching procedure during the follow-up of 6 months. Results Success was reached in 79.0% (=79/100, group E1) versus 73.5% (=72/98, group C) (p=0.558, OR 1.32, 95% CI 0.65 to 2.65. In group E2 87.7% (=50/57) of patients reached success compared with 78.7% (=48/61) in group C, demonstrating noninferiority of E2 to C regarding the prespecified margin of 0.8 (OR scale; p=0.05, OR 2.17, 95% CI 0.80 to 5.89). Best corrected visual acuity significantly increased after surgery independent of technique, that is, on average -0.7 (from 1.0 to 0.3) logMAR. Patients suffered from a shift in spherical refraction of -1.0 D in group E1 compared with -0.1 D in group C. Similarly, intraoperative complications (15.2% vs 8.8% of patients) and serious adverse events (30.3% vs 22.5% of patients) were more frequent in group E1. Conclusions Vitrectomy with gas is an efficient and safe treatment for uncomplicated PRD. An additional encircling band does not significantly reduce the risk for any second procedure necessary to reattach the retina in 20 G vitrectomy. Small gauge transconjunctival vitrectomy is not inferior to the conventional 20 G technique.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Walter, Peter UNSPECIFIED orcid.org/0000-0001-8745-6593 UNSPECIFIED Hellmich, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Baumgarten, Sabine UNSPECIFIED UNSPECIFIED UNSPECIFIED Schiller, Petra UNSPECIFIED UNSPECIFIED UNSPECIFIED Limburg, Endrik UNSPECIFIED UNSPECIFIED UNSPECIFIED Agostini, Hansjuergen UNSPECIFIED UNSPECIFIED UNSPECIFIED Pielen, Amelie UNSPECIFIED UNSPECIFIED UNSPECIFIED Helbig, Horst UNSPECIFIED UNSPECIFIED UNSPECIFIED Lommatzsch, Albrecht UNSPECIFIED UNSPECIFIED UNSPECIFIED Roessler, Gernot UNSPECIFIED UNSPECIFIED UNSPECIFIED Mazinani, Babac UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-229106
DOI:	10.1136/bjophthalmol-2016-309240
Journal or Publication Title:	Br. J. Ophthalmol.
Volume:	101
Number:	6
Page Range:	S. 712 - 719
Date:	2017
Publisher:	BMJ PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	1468-2079
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PARS-PLANA VITRECTOMY; TRANSCONJUNCTIVAL SUTURELESS VITRECTOMY; 20-GAUGE VITRECTOMY; SCLERAL BUCKLE; REPAIR; 25-GAUGE; OUTCOMES; MULTICENTER; BREAK; 23-G Multiple languages Ophthalmology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/22910