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Randomized Controlled Trial
. 2018 Nov;256(11):2069-2073.
doi: 10.1007/s00417-018-4106-6. Epub 2018 Aug 23.

Vitrectomy with and without encircling band for pseudophakic retinal detachment with inferior breaks: VIPER Study Report No. 3

Sabine Baumgarten  1 , Petra Schiller  2 , Martin Hellmich  2 , Peter Walter  3 , Hansjürgen Agostini  4 , Bernd Junker  5 , Horst Helbig  6 , Albrecht Lommatzsch  7 , Babac Mazinani  3 ; VIPER Study Group
Collaborators, Affiliations
Randomized Controlled Trial

Vitrectomy with and without encircling band for pseudophakic retinal detachment with inferior breaks: VIPER Study Report No. 3

Sabine Baumgarten et al. Graefes Arch Clin Exp Ophthalmol. 2018 Nov.

Abstract

Purpose: To test if an encircling band improves outcomes in vitrectomy for pseudophakic retinal detachment (PRD) with inferior or with multiple (4 or more) breaks.

Methods: Subgroup analysis of a prospective randomized controlled multicenter trial in patients with uncomplicated PRD assigned either to 20 G vitrectomy plus encircling band (group E1), or 20 G vitrectomy without any buckle (group C), or 23/25 G vitrectomy without any buckle (group E2). The primary endpoint was defined as no indication for any retina reattaching procedure during the review period of 6 months. One hundred out of 257 patients were identified with inferior breaks and 63 patients had 4 or more breaks.

Results: In patients with retinal breaks between 5:00 and 7:00, treatment was successful in 77.4% (24/31, treatment arm E1) versus 57.1% (16/28, treatment arm C) (p = 0.301, odds ratio (OR) 1.83, 95% confidence interval (CI) 0.48 to 7.17). In patients with multiple breaks, success rates were 68.2% (15/22, E1) versus. 72.4% (21/29, C, p = 0.46, OR 0.52, CI 0.08-3.65).

Conclusion: Combining an encircling band with vitrectomy in patients with pseudophakic retinal detachment and inferior or multiple breaks does not significantly improve primary anatomical success in comparison to treatment with 20 G or 23/25 G vitrectomy alone.

Keywords: Inferior breaks; Pseudophakic; Randomized clinical trial; Retinal detachment; Scleral buckling; Vitrectomy.

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Conflict of interest statement

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Figures

Fig. 1
Fig. 1
Primary outcome analysis with respect to the subgroups. (Primary outcome is defined as absence of indication for reattaching procedure; thus, the odds ratio (OR) states the chance of achieving a successful outcome after vitrectomy with EB (E1) compared to vitrectomy without EB (C), CI confidence interval.)
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