| Title | Pars plana vitrectomy alone with diffuse illumination and vitreous dissection to manage primary retinal detachment with unseen breaks. | | Author(s) | Martínez-Castillo V, Boixadera A, García-Arumí J | | Institution | Vall d'Hebrón Hospital, Universidad Autónoma de Barcelona, Barcelona, Spain. 31756vmc@comb.es | | Source | Arch Ophthalmol 2009 Oct; 127(10):1297-304. | | MeSH | Acetates
Adult
Aged
Aged, 80 and over
Cryosurgery
Drug Combinations
Female
Fluorocarbons
Humans
Intraoperative Period
Lighting
Male
Middle Aged
Minerals
Prospective Studies
Retinal Detachment
Retinal Perforations
Silicone Oils
Sodium Chloride
Triamcinolone Acetonide
Visual Acuity
Vitrectomy
Vitreous Body
Young Adult
| | Abstract | OBJECTIVE: To report on pars plana vitrectomy with diffuse illumination, wide-angle viewing, and meticulous vitreous dissection for identifying and managing retinal breaks when no breaks were detected before surgery for primary rhegmatogenous retinal detachment.
METHODS: Prospective clinical study of 61 of 800 consecutive eyes (7.6%) (61 of 782 patients) seen at a university hospital during the 48-month study for primary rhegmatogenous retinal detachment in whom no break could be identified preoperatively despite thorough examinations. All of the patients underwent pars plana vitrectomy alone with meticulous peripheral vitreous dissection assisted by diffuse illumination, a wide-angle viewing system, perfluorocarbon liquid, triamcinolone acetonide suspension, and balanced salt solution to identify and manage primary retinal breaks.
RESULTS: Retinal breaks were found intraoperatively in 60 eyes (98%). In 51 of 61 eyes (84%), balanced salt solution was left in the vitreous cavity. Best-corrected visual acuity was 20/40 or better in 25 of 61 study eyes (41%). Primary retinal reattachment was attained in 60 study eyes (98%). Final reattachment was achieved in all 61 eyes (100%).
CONCLUSIONS: Pars plana vitrectomy alone with diffuse illumination and extensive vitreous dissection led to identification and management of retinal breaks undetectable before surgery, achieving a high primary reattachment rate. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 19822846 |
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