Comparing the randomized trial outcomes of 3D low-light intensity-assisted and traditional eyepiece-assisted pars plana vitrectomy for rhegmatogenous retinal detachment.

Abstract

Purpose: Pars Plana Vitrectomy (PPV) is a primary surgical method for rhegmatogenous retinal detachment (RRD). The introduction of the 3D head-up system has provided ophthalmologists with a new surgical experience. This study aims to compare the surgical outcomes between 3D low-light intensity-assisted and traditional eyepiece-assisted PPV for RRD. Trial Registration and Design: A prospective randomized controlled design was employed to compare the surgical outcomes of 3D low-light intensity-assisted and traditional eyepiece-assisted PPV for RRD. Forty eyes of 40 eligible patients were randomly assigned to either the 3D group or the eyepiece group. Surgical parameters, intraoperative conditions, and postoperative recovery were assessed over a six-month follow-up period. The research protocol underwent review and approval by the Medical Ethics Committee of Xuzhou First People's Hospital (xyy11 [2012] 026) and registered with the China Clinical Trial Registration Center (No. ChiCTR2200600522, Registration Date: 2022.06.04).

Methods: The optical intensity parameters of optical fibers and chandeliers were set according to the minimum lighting standard for 25G PPV. Surgery duration and intraoperative conditions were documented. Post-surgery, the light intensity of the optical fiber and chandeliers during surgery was measured using a photometer. Patients were followed up for six months to assess their postoperative recovery. Statistical analysis was performed using SPSS 26.0 software, with p < 0.05 indicating statistically significant differences.

Results: There was no statistically significant difference between the two groups in baseline data (p > 0.05). PPV was completed in all patients, and there was no statistically significant difference in surgery time between the two groups (p > 0.05). The optical fiber and chandelier light intensity in the 3D group were significantly lower than those in the eyepiece group, and the difference being statistically significant (p < 0.001). Six months after surgery, the retinal attachment rate was 100 %. Post-surgery, both best corrected visual acuity (BCVA) and intraocular pressure (IOP) were significantly higher than pre-surgery levels. There were no significant differences between the two groups in terms of retinal attachment rate, BCVA, IOP, and flash electroretinogram (p > 0.05).

Conclusions: Compared to the traditional eyepiece, the 3D head-up system can effectively complete surgery under lower illumination intensity. The anatomical restoration and functional success of the retina after surgery are equivalent.