REtinal Detachment Outcomes Study
- Conditions
- Retinal Detachment
- Interventions
- Procedure: Pars plana vitrectomyProcedure: Pars plana vitrectomy with scleral buckleOther: Sulfur hexafluoride gas tamponadeOther: Perfluoropropane gas
- Registration Number
- NCT05863312
- Lead Sponsor
- CHU de Quebec-Universite Laval
- Brief Summary
Background: Few large randomized controlled trials provide strong evidence to guide surgical repair of primary rhegmatogenous retinal detachment (RRD) repair. The purpose of this factorial, single-blind, randomized controlled trial is to analyze and compare the surgical outcomes, functional visual outcomes, complications, and quality of life associated with RRD repair using (A) pars plana vitrectomy only (PPV) or PPV with scleral buckle (PPV-SB) and (B) sulfur hexafluoride gas (SF6) or perfluoropropane gas (C3F8) tamponade.
Methods: Eligible patients with moderately complex RRD will be randomized 1:1 to PPV or PPV-SB and 1:1 to SF6 or C3F8 gas tamponade. Approximately 560 patients will be recruited to be able to detect a difference of around 10% in SSAS rate between groups. Patients will be followed using multimodal imaging and quality of life questionnaires before and after the surgical repair until 1 year postoperative. The primary outcome will be single surgery anatomic success (SSAS), defined as absence of reoperation for recurrent RRD in the operating room. Secondary outcomes will be pinhole visual acuity (PHVA) at 8-10 weeks and 6 months, final best-corrected visual acuity (BCVA), final retina status (i.e., attached or detached), time to onset of RRD recurrence, severity and number of complications, and questionnaire results.
Discussion: This will be the first 2 × 2 factorial randomized controlled trial examining repair techniques in primary RRD. It will also be the first randomized controlled trial to compare gas tamponade between the two most common agents. Notably, it will be adequately powered to detect a clinically significant effect size. The use of multimodal imaging will also be a novel aspect of this study, allowing us to compare head-to-head the impact of adding an SB to the retina's recovery after RRD repair and of differing gas tamponades. Until now, the treatment of RRD has been largely guided by pragmatic retrospective cohort studies. There is a lack of strong evidence guiding therapeutic decisions and this trial will address (1) whether supplemental SB is justified and (2) whether longer duration gas tamponade with C3F8 is necessary.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 560
- Age ≥18 years
- Diagnosis of rhegmatogenous retinal detachment
Exclusion Criteria, retinal detachment with:
- Proliferative vitreoretinopathy (PVR) grade ≥C2
- Chronic RRD with duration >3 months
- Proliferative diabetic retinopathy with tractional retinal detachment (RD)
- Macular holes
- Epiretinal membrane grade 3 or 4
- Traumatic RD
- Giant retinal tears
- Retinal dialysis
- Foveoschisis
- Wet age-related macular degeneration
- Endophthalmitis
- Acute retinal necrosis
- Coats disease
- Retinopathy of prematurity
- Retinoschisis
- Retinal colobomas
- Prior glaucoma surgery or strabismus surgery (favoring PPV only)
- Superior RD extent less than 3 clock hours (favoring PPV only)
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- FACTORIAL
- Arm && Interventions
Group Intervention Description Pars plana vitrectomy + sulfur hexafluoride gas tamponade Sulfur hexafluoride gas tamponade - Pars plana vitrectomy with scleral buckle + sulfur hexafluoride gas tamponade Sulfur hexafluoride gas tamponade - Pars plana vitrectomy with scleral buckle + perfluoropropane gas tamponade Perfluoropropane gas - Pars plana vitrectomy + sulfur hexafluoride gas tamponade Pars plana vitrectomy - Pars plana vitrectomy + perfluoropropane gas tamponade Perfluoropropane gas - Pars plana vitrectomy with scleral buckle + sulfur hexafluoride gas tamponade Pars plana vitrectomy with scleral buckle - Pars plana vitrectomy + perfluoropropane gas tamponade Pars plana vitrectomy - Pars plana vitrectomy with scleral buckle + perfluoropropane gas tamponade Pars plana vitrectomy with scleral buckle -
- Primary Outcome Measures
Name Time Method Single surgery anatomic success Until final 1 year follow-up Freedom from reoperation for recurrent RRD
- Secondary Outcome Measures
Name Time Method Quality of life questionnaire 2 weeks, 8-10 weeks, 6 months, 12 months Pinhole visual acuity 8-10 weeks, 6 months Time to onset of RD recurrence Until final 1 year follow-up Severity and number of complications Until final 1 year follow-up Best-corrected visual acuity 1 year
Trial Locations
- Locations (1)
Hôpital du Saint-Sacrement, CHU de Québec - Université Laval
🇨🇦Québec, Quebec, Canada