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This abstract is assigned to session FAB: Fluorescein Angiography Club Belgium
Presentation typeOB - oral
TitleThe EVRS Retinal Detachment Study
PurposeTo determine the parameters influencing the outcome of surgery for rhegmatogenous retinal detachment.
MethodsRetrospective multi-center European study of 7678 cases of surgery for primary rhegmatogenous retinal detachment with PVR less then stage C2 between April 2010 and May 2011.
Results4 clinical variables were independently linked to the effective failure rate: PVR stage C1, complete retinal detachment, hypotony with choroidal detachment and a large tear size all increased the failure rate. However, lens status and number of tears were not found to be determining variables of the failure rate.
Buckling technique is very relevant for PVR stages 0 and A and most surgeons used segmental buckle. Cryo technique, whether reinforced or not by focal laser led to better outcomes than transpupillary laser alone. Most surgeons use SF6 gas as a tamponade and in 81% of cases an external drainage was performed. However, there is no significant influence of drainage on the failure rate.
Machine parameters for vitrectomy were also evaluated. The results show that a peristaltic pump delivers a better surgical result. Small gauge surgery (23G&25G) outperforms 20G systems. Posterior hyaloid removal and avoidance of retinotomy decreased the failure rate. Applying cryoretinopexy provided better results than focal laser coagulation alone. The use of gas tamponade is superior to silicone oil, particularly for PVR stage C1. A scleral buckle combined with vitrectomy offers no advantage.
ConclusionA decision tree is proposed for the treatment of different types of rhegmatogenous retinal detachments.
Author 1
Last nameJACOB
DepartmentDept. Ophthalmology UZLeuven
Author 2
Last nameStalmans P on behalf of the EVRS study group
DepartmentDept. Ophthalmology UZLeuven
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