マルコ　イチロウ   Maruko Ichirou   丸子　一朗    所属   医学部 医学科（東京女子医科大学病院）    職種   准教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Scleral buckling versus pars plana vitrectomy in simple phakic macula-on retinal detachment: a propensity score-matched, registry-based study.
掲載誌名	正式名：The British journal of ophthalmology 略　 称：Br J Ophthalmol ISSNコード：14682079/00071161
掲載区分	国外
巻・号・頁	pp.00
著者・共著者	Kawano Sumihiro, Imai Takumi, Sakamoto Taiji,
発行年月	2021/01
概要	BACKGROUND/AIMS:To assess the anatomical and visual results of uncomplicated phakic macula-on retinal detachment (RD) in patients treated with pars plana vitrectomy (PPV) or scleral buckling (SB).METHODS:A retrospective cohort of patients aged <65 years and diagnosed with uncomplicated phakic macula-on primary RD, who were registered in the Japan-Retinal Detachment Registry, was compiled between February 2016 and March 2017. We performed propensity score matching using preoperative findings and surgeon-related factors as covariates to account for relevant confounders. The primary outcome was anatomical failures at 6 months postoperatively, classified as follows: level 1, an inoperable state; level 2, anatomical recovery with silicone oil tamponade; and level 3, need for additional surgery to repair the detachments. The secondary outcome was change in best-corrected visual acuity (BCVA).RESULTS:Of the 822 included patients, 552 underwent PPV and 270 underwent SB. After propensity score matching, 137 matched cases between the PPV and SB groups were analysed. The total proportion of surgical failures in the PPV group was higher than that in the SB group (risk difference, 0.10 (0.02 to 0.18), p=0.011, McNemar's test). Conversely, the change in BCVA was not significantly different between the two groups (logMAR units, -0.015 (-0.084 to 0.053), p=0.66, paired samples t-test).CONCLUSIONS:Although the indications for PPV are becoming broader, PPV may not be the optimal approach for repairing all types of RD. Therefore, careful consideration is needed when selecting the right surgical technique for treating uncomplicated phakic macula-on RD cases.
DOI	10.1136/bjophthalmol-2020-318451
PMID	33514527