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Primary vitrectomy without scleral buckling for pseudophakic rhegmatogenous retinal detachment.
Am J Ophthalmol. 2008 Jun; 145(6):1063-1070.AJ

Abstract

PURPOSE

To report the anatomic and functional results of primary vitrectomy without scleral buckling for the treatment of pseudophakic rhegmatogenous retinal detachment (PsRD).

DESIGN

Prospective, nonrandomized surgical technique study.

METHODS

One hundred eyes of 98 patients with PsRD were operated by vitrectomy alone. Internal subretinal fluid drainage, cryocoagulation and/or endolaser and fluid-air exchange with sulfur hexafluoride 20% was applied in all cases. The preoperative and postoperative characteristics were analyzed. Main outcome measures were anatomic success rates after initial surgical intervention and after reoperation for primary failures, visual outcome at the last follow-up visit, and complications.

RESULTS

Mean follow-up +/- standard deviation (SD) was 12 +/- 6.3 months (range, seven to 36 months). Mean final visual acuity +/- SD was 0.42 +/- 0.45 logarithm of the minimum angle of resolution (logMAR) compared with 0.95 +/- 0.73 logMAR before surgery (P < .01). Mean number +/- SD of retinal breaks found before surgery was 1.36 +/- 1.12 (range, zero to five), and an additional 1.58 +/- 2.26 (range, zero to 15) retinal breaks were found during surgery. The retina was reattached successfully after a single surgery in 92 eyes (92%). Recurrence of retinal detachment occurred in eight eyes (8%), caused by proliferative vitreoretinopathy in six eyes (75%) and by new breaks in two eyes (25%). Final anatomic reattachment was obtained in these cases after a mean of 1.75 subsequent operations. Three eyes required permanent silicone oil tamponade so that final anatomic success was achieved in 97 eyes (97%). The most common postoperative complication was ocular hypertonia of more than 21 mm Hg, observed in 36 (36%) eyes, which was managed successfully.

CONCLUSIONS

Primary vitrectomy without scleral buckling provides a high anatomic success rate in eyes with PsRD and is associated with few complications.

Authors+Show Affiliations

Department of Ophthalmology, Vitreo-Retinal Unit, Geneva University Hospitals, 22 rue Alcide Jentzer, Geneva 14, Switzerland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18342828

Citation

Mendrinos, Efstratios, et al. "Primary Vitrectomy Without Scleral Buckling for Pseudophakic Rhegmatogenous Retinal Detachment." American Journal of Ophthalmology, vol. 145, no. 6, 2008, pp. 1063-1070.
Mendrinos E, Dang-Burgener NP, Stangos AN, et al. Primary vitrectomy without scleral buckling for pseudophakic rhegmatogenous retinal detachment. Am J Ophthalmol. 2008;145(6):1063-1070.
Mendrinos, E., Dang-Burgener, N. P., Stangos, A. N., Sommerhalder, J., & Pournaras, C. J. (2008). Primary vitrectomy without scleral buckling for pseudophakic rhegmatogenous retinal detachment. American Journal of Ophthalmology, 145(6), 1063-1070. https://doi.org/10.1016/j.ajo.2008.01.018
Mendrinos E, et al. Primary Vitrectomy Without Scleral Buckling for Pseudophakic Rhegmatogenous Retinal Detachment. Am J Ophthalmol. 2008;145(6):1063-1070. PubMed PMID: 18342828.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Primary vitrectomy without scleral buckling for pseudophakic rhegmatogenous retinal detachment. AU - Mendrinos,Efstratios, AU - Dang-Burgener,Nathalie P, AU - Stangos,Alexandros N, AU - Sommerhalder,Jorg, AU - Pournaras,Constantin J, Y1 - 2008/03/14/ PY - 2007/11/13/received PY - 2008/01/17/revised PY - 2008/01/21/accepted PY - 2008/3/18/pubmed PY - 2008/6/25/medline PY - 2008/3/18/entrez SP - 1063 EP - 1070 JF - American journal of ophthalmology JO - Am J Ophthalmol VL - 145 IS - 6 N2 - PURPOSE: To report the anatomic and functional results of primary vitrectomy without scleral buckling for the treatment of pseudophakic rhegmatogenous retinal detachment (PsRD). DESIGN: Prospective, nonrandomized surgical technique study. METHODS: One hundred eyes of 98 patients with PsRD were operated by vitrectomy alone. Internal subretinal fluid drainage, cryocoagulation and/or endolaser and fluid-air exchange with sulfur hexafluoride 20% was applied in all cases. The preoperative and postoperative characteristics were analyzed. Main outcome measures were anatomic success rates after initial surgical intervention and after reoperation for primary failures, visual outcome at the last follow-up visit, and complications. RESULTS: Mean follow-up +/- standard deviation (SD) was 12 +/- 6.3 months (range, seven to 36 months). Mean final visual acuity +/- SD was 0.42 +/- 0.45 logarithm of the minimum angle of resolution (logMAR) compared with 0.95 +/- 0.73 logMAR before surgery (P < .01). Mean number +/- SD of retinal breaks found before surgery was 1.36 +/- 1.12 (range, zero to five), and an additional 1.58 +/- 2.26 (range, zero to 15) retinal breaks were found during surgery. The retina was reattached successfully after a single surgery in 92 eyes (92%). Recurrence of retinal detachment occurred in eight eyes (8%), caused by proliferative vitreoretinopathy in six eyes (75%) and by new breaks in two eyes (25%). Final anatomic reattachment was obtained in these cases after a mean of 1.75 subsequent operations. Three eyes required permanent silicone oil tamponade so that final anatomic success was achieved in 97 eyes (97%). The most common postoperative complication was ocular hypertonia of more than 21 mm Hg, observed in 36 (36%) eyes, which was managed successfully. CONCLUSIONS: Primary vitrectomy without scleral buckling provides a high anatomic success rate in eyes with PsRD and is associated with few complications. SN - 0002-9394 UR - https://www.unboundmedicine.com/medline/citation/18342828/Primary_vitrectomy_without_scleral_buckling_for_pseudophakic_rhegmatogenous_retinal_detachment_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9394(08)00080-9 DB - PRIME DP - Unbound Medicine ER -