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Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment study (SPR Study): predictive factors for functional outcome. Study report no. 6

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To identify risk factors associated with best-corrected visual acuity (BCVA) 1 year after initial surgery following primary vitrectomy (PV) and scleral buckling surgery (SB) for rhegmatogenous retinal detachment (RRD).

Methods

Relating the final BCVA at the 1-year follow-up visit to pre- and intraoperative findings in the “randomized, prospective, multicenter clinical trial comparing scleral buckling versus primary vitrectomy for repair of rhegmatogenous retinal detachment” (SPR Study) using multivariate statistical methods.

Results

In the phakic subtrial, final BCVA is associated with the number of breaks (p = 0.0259), duration of symptoms (p = 0.0476), baseline BCVA (p = 0.0002), retinal detachment central to major vessels arcades (p = 0.0088), total detachment (p = 0.0027), and chain formation of breaks (p = 0.0129). In the pseudophakic/aphakic subtrial, final BCVA is related to the number of retinal breaks (p = 0.0010), secondary cataract or central capsular fibrosis (p = 0.0141), intraoperative laser photocoagulation (p = 0.0373), and inferior detachment with breaks below the 4 and 8 o’clock positions (p = 0.0173).

Conclusion

Final BCVA is the most important outcome for patients undergoing RRD surgery. Our results demonstrate that the final BCVA is related to a higher preoperative number of breaks in both subtrials. Additional risk factors varied between phakic and pseudophakic subgroups.

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Acknowledgements

Active participants of the SPR Study Group

Principal investigators: M.H. Foerster, R.-D. Hilgers, (W. Lehmacher)

Study co-ordinator: C. Weiß

Endpoint committee (alphabetic order): K.U. Bartz-Schmidt, N. Bornfeld, M.H. Foerster, H. Heimann, R.-D. Hilgers, C. Weiß

Advisory board: M.H. Foerster, P. Bauer, K. Lemmen

Biostatisticians and data managers: R.-D. Hilgers, C. Weiß, M. Nodov

Active study surgeons (alphabetic order): K.U. Bartz-Schmidt, S. Binder, S. Bopp, N. Bornfeld, C. Dahlke, F. Faude, M.H. Foerster, W. Friedrichs, V.P. Gabel, J. Garweg, A. Gaudric, W. Göbel, S. Grisanti, C. Groenewald, L.L. Hansen, O. Hattenbach, K. Hille, H. Hoerauf, F. Holz, P. Janknecht, J. Jonas, U. Kellner, B. Kirchhof, F. Koch, F. Körner, H. Laqua, Y. LeMer, M. Löw, A. Lommatzsch, K. Lucke, P. Meier, E. Messmer, U. Mester, M. Partzsch, D. Pauleikhoff, I. Pearce, J. Roider, H. Schilling, W. Schrader, N. Schrage, U. Stolba, P. Walter, B. Wiechens, S. Wolf, D. Wong

Study nurses: N. Alteheld, E. Biewald, L. Garnett, M.A. Macek, G. Rössler

Local study coordinators: N. Feltgen, M. Gök, B. Moustafa, D. Ottenberg, S. Pape, J. Slater

Author information

Authors and Affiliations

  1. Department of Medical Statistics, RWTH Aachen University, Pauwelsstr 30, 52074, Aachen, Germany

    Nicole Heussen & Ralf-Dieter Hilgers

  2. Department of Ophthalmology, Georg-August University Hospital, Robert-Koch Str. 40, 37075, Goettingen, Germany

    Nicolas Feltgen & Hans Hoerauf

  3. Department of Ophthalmology Aachen, Department of Ophthalmology, University Hospital, Pauwelsstr 30, 52074, Aachen, Germany

    Peter Walter

  4. St. Paul`s Eye Unit, Royal Liverpool University Hospital, Prescot Street, Liverpool, L78XP, UK

    Heinrich Heimann

Authors
  1. Nicole Heussen
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  2. Nicolas Feltgen
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  3. Peter Walter
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  4. Hans Hoerauf
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  5. Ralf-Dieter Hilgers
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  6. Heinrich Heimann
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Consortia

The SPR Study Group

Corresponding author

Correspondence to Nicole Heussen.

Additional information

Ralf-Dieter Hilgers has full access to the data in the study, and takes responsibility for the integrity of the data and accuracy of the data analysis. We agree to allow Graefe's Archive for Clinical and Experimental Ophthalmology to review our data upon request.

Financial support

The SPR Study was funded by grants from the German Research Council (Deutsche Forschungsgemeinschaft Number Fo 165/ 2-1 - 2-4; Le 842/ 3-1/2; Hi 541/ 2-1/2), the "Stifterverband of German Science (Friedrich Spicker-Stiftung)" (Number S 050- 10.003/004) and the “Retinologische Gesellschaft”.

Conflict of interest

There is no conflict of interest or commercial interest of any of the authors associated with the contents of the manuscript or the results of the study.

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Heussen, N., Feltgen, N., Walter, P. et al. Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment study (SPR Study): predictive factors for functional outcome. Study report no. 6. Graefes Arch Clin Exp Ophthalmol 249, 1129–1136 (2011). https://doi.org/10.1007/s00417-011-1619-7

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  • DOI: https://doi.org/10.1007/s00417-011-1619-7

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