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


METHODS
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.
Mendrinos
Efstratios
E
Department of Ophthalmology, Vitreo-Retinal Unit, Geneva University Hospitals, 22 rue Alcide Jentzer, Geneva 14, Switzerland.
Dang-Burgener
Nathalie P
NP
Stangos
Alexandros N
AN
Sommerhalder
Jorg
J
Pournaras
Constantin J
CJ
D000368:Aged; D000369:Aged, 80 and over; D017679:Cryotherapy; D004322:Drainage / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D019591:Pseudophakia / Q000601:surgery*; D012008:Recurrence; D012163:Retinal Detachment / Q000601:surgery*; D012591:Scleral Buckling; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
D013459:Sulfur Hexafluoride