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How We Currently Choose to Repair Retinal Detachment in the United States Medicare Population

Three very different methods are currently used to repair acute retinal detachments. Elsewhere in this issue of the Journal , Hwang 1 reviews data obtained from Medicare part B summaries, finding regional differences in the choice of procedure for repair of retinal detachment. The author gives us an interesting snapshot of practice patterns in the current era regarding retinal detachment repair in patients 65 and older. Several limitations exist in the study, however. First, we cannot determine, within the group of patients who underwent vitrectomy, what percentage of this group also had placement of a scleral buckle. Second, we have no data regarding outcomes, nor do we know whether the procedure performed was primary or a reoperation, particularly if pneumatic retinopexy was chosen initially. Third, we have no data regarding lens status. Interesting findings in this study are the high rate of pneumatic retinopexy use, especially in the Northeast, and the remarkably low rate of scleral buckling alone nationwide. Review of Literature on Pneumatic Retinopexy and Vitrectomy vs Scleral Buckling The single-procedure reattachment rate for surgical treatment of retinal detachment was much higher for scleral buckling than pneumatic retinopexy in most studies. Han and associates 2 reported a http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Ophthalmology Elsevier
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