Surgical drainage methods during pars plana vitrectomy for rhegmatogenous retinal detachment: a systematic review and meta-analysis

Abstract

Purpose: To assess efficacy and safety outcomes of subretinal fluid drainage methods during pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD). Methods: A systematic search strategy was conducted of studies published between January 2000 and October 2022. Included studies reported on either the safety or efficacy of two or more drainage methods during PPV for RRD patients. Results: Two randomized and five observational studies consisting of 1524 eyes were included. Best corrected visual acuity at last study observation and primary reattachment rate were similar across groups. A significantly lower risk of epiretinal membrane formation (ERM) was associated with draining subretinal fluid through pre-existing retinal breaks (PRB) (RR= 0.70, 95% CI=[0.60, 0.83], p=<0.01, I2=0%) or with perfluorocarbon liquid (PFCL) (RR=0.70, 95% CI=[0.59, 0.83], p=<0.01, I2=0%) compared to posterior retinotomy (PR). The risk of an abnormal foveal contour was significantly greater in PFCL-treated eyes relative to PR (RR=1.56, 95% CI=[1.13, 2.17], p=<0.01, I2=0%). Conclusions: No significant differences were observed in final BCVA at last study observation and primary reattachment rates across different drainage methods. There remains limited information on the topic and future research is warranted.