TY - JOUR
T1 - Supplemental Scleral Buckle for the Management of Rhegmatogenous Retinal Detachment by Pars Plana Vitrectomy
T2 - A Meta-Analysis of Randomized Controlled Trials
AU - Rosenberg, Daniel M.
AU - Ghayur, Huphy S.
AU - Deonarain, Deven M.
AU - Sarohia, Gurkaran S.
AU - Phillips, Mark R.
AU - Garg, Sunir
AU - Bakri, Sophie J.
AU - Wykoff, Charles C.
AU - Chaudhary, Varun
N1 - Funding Information:
Dr. Chaudhary reports grants and other from Novartis, grants and other from Bayer, and grants from Allergan, outside the submitted work. Dr. Bakri reports personal fees from Adverum, personal fees from Alimera, personal fees from Apellis, personal fees from Allergan, personal fees from Eyepoint, personal fees from Kala, personal fees from Genentech, personal fees from Novartis, Personal fees from Oxurion, personal fees from Roche, and personal fees from Zeiss, outside the submitted work. Dr. Garg reports being a consultant for Allergan, Apellis, Bausch and Lomb, Boehringer Ingelheim, Johnson and Johnson, and Kanaph. He also reports research grants from American Academy of Ophthalmology, Apellis, Boehringer Ingelheim, NGM Bio, and Regeneron, outside the submitted work. Dr Wykoff reported consulting for Acuela, Adverum Biotechnologies, Inc, Aerpio, Alimera Sciences, Allegro Ophthalmics, LLC, Allergan, Apellis Pharmaceuticals, Bayer AG, Chengdu Kanghong Pharmaceuticals Group Co., Ltd, Clearside Biomedical, Dutch Ophthalmic Research Center (DORC), EyePoint Pharmaceuticals, Gentech/Roche, GyroscopeTx, IVERIC bio, Kodiak Sciences Inc, Novartis AG, ONL Therapeutics, Oxurion NV, PolyPhotonix, Recens Medical, Regeron Pharmaceuticals, Inc, REGENXBIO Inc, Santen Pharmaceutical Co., Ltd, and Takeda Pharmaceutical Company Limited and receiving research funding from Adverum Biotechnologies, Inc, Aerie Pharmaceuticals, Inc, Aerpio, Alimera Sciences, Allergan, Apellis Pharmaceuticals, Chengdu Kanghong Pharmaceutical Group Co., Ltd, Clearside Biomedical, Gemini Therapeutics, Genentech/Roche, Graybug Vision, Inc, GyroscopeTx, Ionis Pharmaceuticals, IVERIC bio, Kodiak Sciences Inc, Neurotech LLC, Novartis AG, Opthea, Outlook Therapeutics, Inc, Recens Medical, Regeneron Pharmaceuticals, Inc, REGENXBIO Inc, Samsung Pharm Co., Ltd, Santen Pharmaceutical Co., Ltd, and Xbrane Biopharma AB. The remaining authors have no conflicts of interest to declare.
Publisher Copyright:
© 2021
© 2021 S. Karger AG, Basel.
PY - 2022/5/1
Y1 - 2022/5/1
N2 - Objectives: The present review aimed to synthesize evidence from randomized controlled trials (RCTs) that compared outcomes of pars plana vitrectomy (PPV) with and without a supplementary scleral buckle (SB) for management of rhegmatogenous retinal detachment (RRD). Methods: The authors searched MEDLINE, Embase, and CENTRAL to identify RCTs in English that compared PPV with and without supplemental SB. Risk of bias was assessed according to the Cochrane Risk of Bias 2 tool. We present risk ratios (RRs), mean differences (MDs), and 95% confidence intervals (CIs) estimated using random-effects meta-analyses. Results: We identified 6 RCTs involving 705 eyes. Primary reattachment (6 studies, 345 eyes PPV, 324 eyes PPV + SB; RR 0.99, 95% CI 0.93-1.06, I2 = 0%, p = 0.78) and final anatomic success rates (4 studies, 272 eyes PPV, 267 eyes PPV + SB; RR 1.00, 95% CI 0.98-1.02, I2 = 0%, p = 0.89) were similar between the 2 groups. Postoperative visual acuity improvement (5 studies, 244 eyes PPV, 222 eyes PPV + SB; MD 6.09 letters, 95% CI -0.47-12.64, I2 = 69%, p = 0.07) and frequency of adverse events (6 studies, 1,294 observations PPV, 1,221 observations PPV + SB; RR 0.76, 95% CI 0.57-1.01, I2 = 25%, p = 0.06) likewise did not differ significantly between the treatment groups. Conclusion: Low-certainty evidence from RCTs did not demonstrate a benefit in placement of a supplemental SB during vitrectomy for management of RRD in the current analysis. Additional high-quality trials are needed to provide more precise estimates of the effect.
AB - Objectives: The present review aimed to synthesize evidence from randomized controlled trials (RCTs) that compared outcomes of pars plana vitrectomy (PPV) with and without a supplementary scleral buckle (SB) for management of rhegmatogenous retinal detachment (RRD). Methods: The authors searched MEDLINE, Embase, and CENTRAL to identify RCTs in English that compared PPV with and without supplemental SB. Risk of bias was assessed according to the Cochrane Risk of Bias 2 tool. We present risk ratios (RRs), mean differences (MDs), and 95% confidence intervals (CIs) estimated using random-effects meta-analyses. Results: We identified 6 RCTs involving 705 eyes. Primary reattachment (6 studies, 345 eyes PPV, 324 eyes PPV + SB; RR 0.99, 95% CI 0.93-1.06, I2 = 0%, p = 0.78) and final anatomic success rates (4 studies, 272 eyes PPV, 267 eyes PPV + SB; RR 1.00, 95% CI 0.98-1.02, I2 = 0%, p = 0.89) were similar between the 2 groups. Postoperative visual acuity improvement (5 studies, 244 eyes PPV, 222 eyes PPV + SB; MD 6.09 letters, 95% CI -0.47-12.64, I2 = 69%, p = 0.07) and frequency of adverse events (6 studies, 1,294 observations PPV, 1,221 observations PPV + SB; RR 0.76, 95% CI 0.57-1.01, I2 = 25%, p = 0.06) likewise did not differ significantly between the treatment groups. Conclusion: Low-certainty evidence from RCTs did not demonstrate a benefit in placement of a supplemental SB during vitrectomy for management of RRD in the current analysis. Additional high-quality trials are needed to provide more precise estimates of the effect.
KW - Pars plana vitrectomy
KW - Preferred Reporting Items for Systematic Reviews and Meta-Analysis
KW - Rhegmatogenous retinal detachment
KW - Scleral buckle
KW - Humans
KW - Treatment Outcome
KW - Vitrectomy
KW - Retrospective Studies
KW - Scleral Buckling/adverse effects
KW - Randomized Controlled Trials as Topic
KW - Retinal Detachment/diagnosis
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U2 - 10.1159/000520220
DO - 10.1159/000520220
M3 - Review article
C2 - 34731858
AN - SCOPUS:85129996833
SN - 0030-3755
VL - 245
SP - 101
EP - 110
JO - Ophthalmologica
JF - Ophthalmologica
IS - 2
ER -