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The impact of 360-laser barricade on outcomes of vitrectomy for pseudophakic retinal detachment; The Manchester Pseudophakic Retinal Detachment Study

Eye volume 37, pages 3221–3227 (2023)Cite this article

Subjects

Abstract

Purpose

To investigate the anatomical and functional outcomes and specifically, the effect of 360-degree barrier-laser, in pars plana vitrectomy (PPV) for primary pseudophakic rhegmatogenous retinal detachment (PRD).

Methods

We conducted a single-centre retrospective, continuous and comparative study on eyes that had undergone PPV with focal-retinopexy (laser or cryotherapy) versus 360-laser for PRD repair between 2011–2020 at a single tertiary vitreoretinal centre in the UK. Primary outcomes were single surgery anatomical success (SSAS) rate and final postoperative visual acuity (VA). Multivariable regression covariates for primary re-detachment included age, gender, onset-of-detachment, pre-operative VA, ocular co-morbidities, macula-status, majority inferior (vs superior) PRD, number-of-tears and PRD extent (in clock-hours), 360-laser barricade, and perfluorocarbon liquid (PFCL) use. For VA gain, primary re-detachment was added as a covariate.

Results

We included 467 eyes with a mean follow-up of 388 (161) days. The SSAS was 444/467 (95.1%) overall, and 351/370 (94.9%) and 93/97 (95.9%) in focal-retinopexy and 360-laser groups, respectively (p = 0.798). Compared to the focal-retinopexy group, the 360-laser group had significantly worse post-operative VA but similar logMAR gain (p = 0.812). A multivariable binary logistic regression found that only PFCL use was linked with increased primary re-detachment (OR:5.32 [p = 0.048]) and 360-laser did not contribute to increased SSAS. A multivariable linear regression analysis showed that poor logMAR gain was significantly associated with better pre-operative logMAR, ocular co-morbidities, greater PRD extent, use of 360-laser and primary re-detachment. However, when excluding macula-off RD (n = 211), 360-laser was no longer significant (p = 0.088).

Conclusions

Prophylactic 360-laser does not seem to impact on SSAS and functional outcomes following PPV for primary PRD.

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Fig. 1: Box and whisker plot.
Fig. 2: Box and whisker plot.
Fig. 3: Forest Plots of Multivariable binary logistic regression model following primary pseudophakic retinal detachment repair.

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Data availability

Data are available upon reasonable request.

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Authors and Affiliations

  1. Manchester Royal Eye Hospital, Oxford Road, Manchester, M13 9WL, UK

    Irina-Elena Cristescu, Tsveta Ivanova, George Moussa, Hadi Ziaei, Mariantonia Ferrara, Myrta Lippera, Muhannd El-Faouri, Niall Patton, Kirti M. Jasani, Felipe Dhawahir-Scala & Assad Jalil

  2. The Hashemite University, P.O. Box 330127, Zarqa, 13133, Jordan

    Muhannd El-Faouri

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  1. Irina-Elena Cristescu
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Contributions

All authors have made substantial contributions to the following: (1) the conception and design of the study, or acquisition of data, or analysis and interpretation of data, (2) drafting the article or revising it critically for important intellectual content, (3) final approval of the version to be submitted.

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Correspondence to Assad Jalil.

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The authors declare no competing interests.

Ethics approval and consent to participate

This study was registered and approved by our local clinical effectiveness team (Clinical Effectiveness Department, Manchester Royal Eye Hospital). As this was a retrospective anonymized study, as per our local protocol from our Clinical Effectiveness Department, and as per national guidelines from the National Code of Clinical Research, and the Health Research Authority (HRA), this study has ethical approval exemption. All procedures were completed prior to the design of this study. Patients were diagnosed and treated according to local guidelines and agreements and written consent from patients was acquired prior to all procedures as clinically indicated. This study does not report on the use of new or experimental protocols.

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Patients and the public were not involved in this study due to its retrospective design.

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Cristescu, IE., Ivanova, T., Moussa, G. et al. The impact of 360-laser barricade on outcomes of vitrectomy for pseudophakic retinal detachment; The Manchester Pseudophakic Retinal Detachment Study. Eye 37, 3221–3227 (2023). https://doi.org/10.1038/s41433-023-02495-y

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