Retinal Detachment Clinical Trial
Official title:
Pneumatic Retinopexy Versus Vitrectomy With Gas for Retinal Detachment Due to Myopic Macular Hole
To undertake a prospective randomized clinical study for treating retinal detachment due to myopic macular holes, utilizing pneumatic retinopexy versus pars plana vitrectomy with gas tamponade.To determine the efficiency of pneumatic retinopexy with C3F8 in the treatment of retinal detachment due to myopic macular hole.
Retinal detachment caused by macular hole predominantly happened in high myopic eyes. This
is a common type of retinal detachment in Asia and often seen in the old people aged around
50 ~ 60, mainly in female. Treatment of retinal detachment due to macular holes has changed
over the years, and several methods have been described. Some surgeons have used
transscleral diathermy or cryotherapy or laser photocoagulation and drainage subretinal
fluid without sclera buckling, other surgeons have used radial silicone explants beneath the
macular combined with cryo, diathermy or laser. This method entails the difficulty of
placing sclera sutures far posterior, especially hazardous if there is a posterior
staphyloma with very thin sclera. Besides the technically difficult, the extensive macular
scarring caused by different coagulations limited the functional result to peripheral vision
only. Because of this, it is not generally used in the initial treatment.
In 1982, Gonvers and Machemer4 proposed a new treatment technique that combined pars plana
vitrectomy (PPV), partial air–fluid exchange, and face down positioning for 24 hours. Since
then vitrectomy with gas tamponade become the most common procedure for retinal detachment
with macular hole.
In 1984, Miyake performed a simple gas injection into the vitreous followed by a face-down
position. The effective of this simplified method was then reported by many observers.But
these studies may have insufficiency because of small sample, nonrandomized, no defined
eligibility criteria for patients selection.
Intraocular gas tamponade with or without pars plana vitrectomy (PPV) has commonly been
performed nowadays. We conducted a multicenter randomized controlled clinical trial to
compare their anatomic results and visual outcomes of both surgical techniques, to estimate
the efficiency of both surgical methods in the treatment of retinal detachment with myopic
macular hole.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind, Primary Purpose: Treatment
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