Retinal Detachment Surgery

The Dilemma Between Personal Experience and Clinical Trials

Peter Walter


Expert Rev Ophthalmol. 2012;7(5):441-447. 

In This Article

Five-year View

Currently, it is difficult to perform clinical trials in vitreoretinal surgery due to limited chances for receiving grants of public funding institutions. Funding programs are usually based on competitive review processes and trials in vitreoretinal surgery have less chance to be successful when compared with trials in neurology or cardiology. However, there is no doubt that there is the need to perform such trials under good clinical practice conditions to overcome the reported dilemma. Therefore it is estimated that by installing highly efficient networks between retinal surgeons and by using web-based data collections and processing, multicenter clinical trials focused on surgical topics may be performed easier in the future.

Another striking feature of retinal detachment surgery is that even after many years of improvements of techniques the failure rates are not changing. When looking at all studies, it is obvious that all techniques have their failures. Two main reasons for failure should be mentioned. One is overlooking of breaks leading to early redetachment. It seems that vitrectomy helps to reduce the risk of overseeing breaks because of better visualization. Another reason for failure is PVR. Basic and clinical research will help to identify those patients who are at risk of developing PVR and in whom pharmaceutical adjuncts to surgery will help to avoid these failures.[77]

Papers of special note have been highlighted as: