SpringerLink
Log in

Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment study (SPR Study): recruitment list evaluation. Study report no. 2

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

Abstract

Background

Accompanying the patient recruitment within the “Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment multicentre trial (SPR)”, all patients with primary rhegmatogenous retinal detachment (RRD) had to be documented in a detailed recruitment list. The main goal of this analysis was to estimate the prevalence of “medium-severe” RRD (SPR Study eligible) as defined by the SPR Study inclusion criteria. In addition, the detailed anatomical situation of medium-severe RRD is investigated.

Methods

SPR Study recruitment was evaluated via a standardised questionnaire, which contained a coloured fundus drawing and information regarding possible reasons for exclusion from the SPR Study in each case. A team of three experienced vitreoretinal surgeons evaluated all fundus drawings from a 1-year period. The review led to a decision on SPR Study eligibility on the pure basis of anatomical assessment. The main outcome measures were assessment of feasible inclusion into the SPR Study by the evaluation team based on the fundus drawing and anatomical details.

Results

A total of 1,115 patients with RRD from 13 European centres were prospectively enrolled in the year 2000. The quality of the drawings sufficed for assessment in 1,107 cases (99.3%). Three hundred and twelve fundus drawings (28.2%) met the anatomic inclusion criteria of the SPR Study. RRD of medium severity is characterised by an average number of 2.6 (SD 2.4) retinal breaks, 5.8 (SD 2.8) clock hours of detached retina, unclear hole situation in 15.1% of cases (n=47), attached macula in 42.9% (n=134), bullous detachment in 15.1% (n=47) and vitreous haemorrhage/opacity in 7.7% (n=24).

Conclusions

In the recruitment lists of the SPR Study of the year 2000, RRD of medium severity was present in nearly one third of the patients with primary RRD. These findings emphasise the clinical relevance of the SPR Study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Afrashi F, Erakgun T, Akkin C, Kaskaloglu M, Mentes J (2004) Conventional buckling surgery or primary vitrectomy with silicone oil tamponade in rhegmatogenous retinal detachment with multiple breaks. Graefes Arch Clin Exp Ophthalmol 242:295–300

    Article  PubMed  Google Scholar 

  2. Algvere PV, Jahnberg P, Textorius O (1999) The Swedish retinal detachment register. I. A database for epidemiological and clinical studies. Graefes Arch Clin Exp Ophthalmol 237:137–144

    Article  PubMed  CAS  Google Scholar 

  3. Ambresin A, Wolfensberger TJ, Bovey EH (2003) Management of giant retinal tears with vitrectomy, internal tamponade, and peripheral 360 degrees retinal photocoagulation. Retina 23:622–628

    Article  PubMed  Google Scholar 

  4. Barrie T, Kreissig I, Heimann H, Holz ER, Mieler WF (2003) Repair of a primary rhegmatogenous retinal detachment. Br J Ophthalmol 87:782

    Article  Google Scholar 

  5. Bartz-Schmidt KU, Kirchhof B, Heimann K (1996) Primary vitrectomy for pseudophakic retinal detachment. Br J Ophthalmol 80:346–349

    PubMed  CAS  Google Scholar 

  6. Bornfeld N (2001) Ablation surgery. From the inside, from the outside, or both? Ophthalmologe 98:879–880

    Article  PubMed  CAS  Google Scholar 

  7. Comer MB, Newman DK, George ND, Martin KR, Tom BD, Moore AT (2000) Who should manage primary retinal detachments? Eye 14:572–578

    PubMed  Google Scholar 

  8. Duquesne N, Bonnet M, Adeleine P (1996) Preoperative vitreous hemorrhage associated with rhegmatogenous retinal detachment: a risk factor for postoperative proliferative vitreoretinopathy? [see comments]. Graefes Arch Clin Exp Ophthalmol 234:677–682

    Article  PubMed  CAS  Google Scholar 

  9. el-Asrar AM (1997) Primary vitrectomy for bullous rhegmatogenous retinal detachments due to complex breaks. Eur J Ophthalmol 7:322–326

    PubMed  CAS  Google Scholar 

  10. Ghartey KN, Tolentino FI, Freeman HM, McMeel JW, Schepens CL, Aiello LM (1980) Closed vitreous surgery. XVII. Results and complications of pars plana vitrectomy. Arch Ophthalmol 98:1248–1252

    PubMed  CAS  Google Scholar 

  11. Girard P, Karpouzas I (1995) Pseudophakic retinal detachment: anatomic and visual results. Graefes Arch Clin Exp Ophthalmol 233:324–330

    Article  PubMed  CAS  Google Scholar 

  12. Heimann H, Hellmich M, Bornfeld N, Bartz-Schmidt KU, Hilgers RD, Foerster MH (2001) Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment (SPR Study): design issues and implications. SPR Study report no. 1. Graefes Arch Clin Exp Ophthalmol 239:567–574

    PubMed  CAS  Google Scholar 

  13. Holz ER, Mieler WF (2003) View 3: The case for pneumatic retinopexy. Br J Ophthalmol 87:787–789

    Article  PubMed  CAS  Google Scholar 

  14. Kreissig I (2003) View 1: minimal segmental buckling without drainage. Br J Ophthalmol 87:782–784

    Article  PubMed  CAS  Google Scholar 

  15. Laqua H (1983) Current concepts in the management of complex retinal detachments. Trans Ophthalmol Soc U K 103:133–138

    PubMed  Google Scholar 

  16. Laqua H, Honnicke K (2001) Is scleral buckling still current? Ophthalmologe 98:881–885

    Article  PubMed  CAS  Google Scholar 

  17. Leaver P (1993) Expanding the role of vitrectomy in retinal reattachment surgery [editorial; comment]. Br J Ophthalmol 77:197

    PubMed  CAS  Google Scholar 

  18. Leaver PK (1999) Trends in vitreoretinal surgery-time to stop and think [editorial; comment]. Br J Ophthalmol 83:385–386

    Article  PubMed  CAS  Google Scholar 

  19. Machemer R, Buettner H, Norton EW, Parel JM (1971) Vitrectomy: a pars plana approach. Trans Am Acad Ophthalmol Otolaryngol 75:813–820

    PubMed  CAS  Google Scholar 

  20. McLeod D (2004) Is it time to call time on the scleral buckle? Br J Ophthalmol 88:1357–1359

    Article  PubMed  CAS  Google Scholar 

  21. Miki D, Hida T, Hotta K, Shinoda K, Hirakata A (2001) Comparison of scleral buckling and vitrectomy for retinal detachment resulting from flap tears in superior quadrants. Jpn J Ophthalmol 45:187–191

    Article  PubMed  CAS  Google Scholar 

  22. Minihan M, Tanner V, Williamson TH (2001) Primary rhegmatogenous retinal detachment: 20 years of change. Br J Ophthalmol 85:546–548

    Article  PubMed  CAS  Google Scholar 

  23. Oshima Y, Yamanishi S, Sawa M, Motokura M, Harino S, Emi K (2000) Two-year follow-up study comparing primary vitrectomy with scleral buckling for macula-off rhegmatogenous retinal detachment. Jpn J Ophthalmol 44:538–549

    Article  PubMed  CAS  Google Scholar 

  24. Pournaras CJ, Kapetanios AD (2003) Primary vitrectomy for pseudophakic retinal detachment: a prospective non-randomised study. Eur J Ophthalmol 13:298–306

    PubMed  CAS  Google Scholar 

  25. Richardson EC, Verma S, Green WT, Woon H, Chignell AH (2000) Primary vitrectomy for rhegmatogenous retinal detachment: an analysis of failure. Eur J Ophthalmol 10:160–166

    PubMed  CAS  Google Scholar 

  26. Schmidt JC, Rodrigues EB, Hoerle S, Meyer CH, Kroll P (2003) Primary vitrectomy in complicated rhegmatogenous retinal detachment—a survey of 205 eyes. Ophthalmologica 217:387–392

    Article  PubMed  CAS  Google Scholar 

  27. Schwartz SG, Kuhl DP, McPherson AR, Holz ER, Mieler WF (2002) Twenty-year follow-up for scleral buckling. Arch Ophthalmol 120:325–329

    PubMed  Google Scholar 

  28. Spiegel D, Nasemann J, Nawrocki J, Gabel VP (1997) Severe ocular trauma managed with primary pars plana vitrectomy and silicone oil [see comments]. Retina 17:275–285

    PubMed  CAS  Google Scholar 

  29. SPR Study goup (2003) View 2: the case for primary vitrectomy. Br J Ophthalmol 87:784–787

    Article  Google Scholar 

  30. Tewari HK, Kedar S, Kumar A, Garg SP, Verma LK (2003) Comparison of scleral buckling with combined scleral buckling and pars plana vitrectomy in the management of rhegmatogenous retinal detachment with unseen retinal breaks. Clin Exp Ophthalmol 31:403–407

    Article  Google Scholar 

  31. Wang JZ (1993) Vitreo-retinal surgery for complicated retinal detachment. Chung Hua Yen Ko Tsa Chih 29:205–207

    CAS  Google Scholar 

  32. Wickham L, Connor M, Aylward GW (2004) Vitrectomy and gas for inferior break retinal detachments: are the results comparable to vitrectomy, gas, and scleral buckle? Br J Ophthalmol 88:1376–1379

    Article  PubMed  CAS  Google Scholar 

  33. Wilkinson CP (1998) Wanted: optimal data regarding surgery for retinal detachment [editorial]. Retina 18:199–201

    Article  PubMed  CAS  Google Scholar 

  34. Wilkinson CP (1999) Discussion to “Pars plana vitrectomy without scleral buckle for pseudophakic retinal detachment”. Ophthalmology 106:1816

    Article  Google Scholar 

  35. Wong D, Billington BM, Chignell AH (1987) Pars plana vitrectomy for retinal detachment with unseen retinal holes. Graefes Arch Clin Exp Ophthalmol 225:269–271

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The SPR Study was supported by - Deutsche Forschungsgesellschaft (DFG Number Fo 165/ 2–1 – 2–4; Le 842/ 3–1/2; Hi 541/ 2–1/2) - Stifterverband für die Deutsche Wissenschaft (Friedrich Spicker-Stiftung) Number S 050– 10.003/004–Retinologische Gesellschaft.

Participants

Principal clinical investigator: M.H. Foerster

Principal investigator medical statistics: D.-H. Hilgers

Study co-ordinator: C. Weiss

Surgeons and coworkers (alphabetical order): K.-U. Bartz-Schmidt, 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, L. Hattenbach, K. Hille, H. Hoerauf, F. Holz, P. Janknecht, J. Jonas, U. Kellner, B. Kirchhof, F. Koch, F. Körner, H. Laqua, Y. LeMer, M. Loew, A. Lommatzsch, K. Lucke, P. Meier, E. Messmer, U. Mester, M. Partsch, D. Pauleikhoff, I. Pearce, J. Roider, H. Schilling, W. Schrader, N. Schrage, U. Stolba, P. Walter, B. Wiechens, S. Wolf, D. Wong.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, University of Freiburg, Killianstrasse 5, 79106, Freiburg, Germany

    Nicolas Feltgen

  2. Institute of Medical Statistics, RWTH Aachen University, Aachen, Germany

    Claudia Weiss

  3. Department of Ophthalmology, Inselspital, University of Bern, Bern, Switzerland

    Sebastian Wolf

  4. Department of Ophthalmology, Charité Campus Benjamin Franklin, Free University Berlin, Berlin, Germany

    Dominique Ottenberg

  5. St Paul’s Eye Unit, Royal Liverpool University Hospital, Liverpool, UK

    Heinrich Heimann

Authors
  1. Nicolas Feltgen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Claudia Weiss
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sebastian Wolf
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Dominique Ottenberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Heinrich Heimann
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

SPR Study Group

Corresponding author

Correspondence to Nicolas Feltgen.

Additional information

This work was in part presented at the annual meeting of the Association for Research in Vision and Ophthalmology (ARVO), Fort Lauderdale, May 2005; at the Deutsche Retinologische Gesellschaft, Bern, June 2005; and at the Deutsche Ophthalmologische Gesellschaft /Societas Ophthalmologica Europaea, Berlin, September 2005.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Feltgen, N., Weiss, C., Wolf, S. et al. Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment study (SPR Study): recruitment list evaluation. Study report no. 2. Graefe's Arch Clin Exp Ophthalmol 245, 803–809 (2007). https://doi.org/10.1007/s00417-006-0399-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-006-0399-y

Keywords

Search

Navigation