Refractive Changes Following Vitrectomy

January 14, 2021 updated by: sami yilmaz, Bursa Retina Eye Hospital

Refractive Changes in Pseudophakic Eyes Following Vitrectomy With or Without Gas Tamponade

We aimed o compare the refractive changes associated with pars plana vitrectomy with or without intraocular gas tamponade in pseudophakic eyes. This retrospective study included pseudophakic patients with Nd:YAG laser posterior capsulotomy who underwent 23G PPV between February 2015 and March 2019. Group 1 consisted of patients with regmatogenous RD who underwent PPV and 12% perflouropropane (C3F8) gas tamponade whereas Group 2 consisted of patients who underwent PPV for epiretinal membrane or vitreous hemorrhage (VH). No tamponade was used in Group 2. Minimum follow-up was 12 months.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This research was reviewed by an independent ethical review board and conforms with the principles and applicable guidelines for the protection of human subjects in biomedical research. This was a retrospective, comparative case series including pseudophakic patients who underwent PPV. Group 1 consisted of patients with pseudophakic RRD who underwent PPV and 12% perflouropropane (C3F8) gas tamponade whereas Group 2 consisted of patients with ERM or VH who underwent PPV without any tamponade between February 2015 and March 2019 at Bursa Retina Eye Hospital. Informed consent was obtained from all the participants. The study was in line with the ethical standarts of the Helsinki Declaration

Patient eligibility Patients who underwent uncomplicated cataract surgery with phacoemulsification and in-the-bag IOL implantation and subsequent neodymium:yttrium-aluminum-garnet (Nd:YAG) laser due to capsular opacification were included. Preoperative refractive data obtained after Nd:YAG laser and six months prior to vitrectomy surgery. Postoperative refractive data was obtained at 12 months after vitrectomy. Eyes with a preoperative spherical refractive error > ±6 D or cylindrical refractive error > ±3 D were excluded. Also eyes with corneal disorders were excluded.

Ocular parameters

All patients underwent complete ophtalmic examination including best corrected visual acuity (BCVA) in the logMAR scale, slit-lamp examination, intraocular pressure (IOP) assessment, fundus examination and autokeratorefractometry (auto kerato-refractometer KR-8800 from Topcon, Tokyo, Japan) at preoperative and postoperative month-12. Induced astigmatism values were calculated through vector analysis.

Surgical procedures

All surgeries were performed by the same surgeon (S.Y.). Retrobulbar block anesthesia (a mixture of 2 ml of lidocaine hydrochloride 2% and 2 ml of bupivacaine hydrochloride 0.5%) was used. Three port 23-gauge (G) transconjunctival PPV was performed using the vitrectomy system DORC (Dutch Ophthalmic Research Center, Zuidland, Netherlands) and Zeiss microscope with EIBOS 2 (Haag Streit, Mason, OH, USA) attachment for non-contact fundus viewing.

In group 1, all patients underwent a near-complete vitrectomy including base shaving, laser endo-photocoagulation and C3F8 gas tamponade. In group 2, patients with ERM received a limited vitrectomy including; core vitrectomy, induction of a posterior vitreous detachment if not present and peeling of the ERM and inner limiting membrane (ILM). Peripheral retina was examined with indentation to identify any retinal breaks. Neither laser endo-photocoagulation, nor gas tamponade and vitreous base shaving was performed. For patients with VH patients, a near-complete vitrectomy, including base shaving, laser endo-photocoagulation was performed except for gas tamponade. In both groups, the sclera is sutured with 8-0 polyglactin suture (Vicryl) in case of wound leakage.

Study Type

Observational

Enrollment (Actual)

47

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey
      • Bursa, Turkey, 16130
        • Retina Eye Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Probability Sample

Study Population

Pseudophakic patients treated with neodymium:yttrium-aluminum-garnet Nd: YAG laser and subsequently underwent 23 gauge pars plana vitrectomy for vitreous hemorrhage, epiretinal membrane, or rhegmatogenous retinal detachment.

Description

Inclusion Criteria

  • Patients aged ≥ 18 years
  • Pseudophakic patients who underwent pars plana vitrectomy

Exclusion Criteria

  • Patients aged 18 years >
  • Patients with a spherical refractive error > ±6 D
  • Patients with a cylindrical refractive error > ±3 D

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: Other
  • Time Perspectives: Retrospective

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Group
27 patients, Group 1 consisted of patients with pseudophakic rhegmatogoneous retinal detachment who underwent pars plana vitrectomy and 12% perflouropropane (C3F8) gas tamponade and 20 patients Group 2 consisted of patients with epiretinal membrane or vitreous hemorrhage who underwent PPV without any tamponade
Other: pars plana vitrectomy
23 gauge pars plana vitrectomy was performed for retinal detachment, vitreous hemorrhage or epiretinal membrane

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The rate of spherical and cylindrical refractive changes
Time Frame: 12 months
Changes in spherical and cylindrical refractive error 12 months after pars plana vitrectomy
12 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Bursa Retina Eye Hospital

Investigators

  • Principal Investigator: Sami Yılmaz, MD, Bursa Retina Eye Hospital
  • Study Director: Remzi Avcı, Professor, Bursa Retina Eye Hospital
  • Principal Investigator: Aysegul Mavi Yıldız, MD, Bursa Retina Eye Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 1, 2020

Primary Completion (Actual)

December 25, 2020

Study Completion (Actual)

December 27, 2020

Study Registration Dates

First Submitted

January 12, 2021

First Submitted That Met QC Criteria

January 14, 2021

First Posted (Actual)

January 15, 2021

Study Record Updates

Last Update Posted (Actual)

January 15, 2021

Last Update Submitted That Met QC Criteria

January 14, 2021

Last Verified

January 1, 2021

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • BursaRetinaEyeH

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

Undecided

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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