Retinal detachment after small-incision, sutureless pars plana vitrectomy: possible causative agents.
OBJECTIVE
To identify possible agents causing retinal detachment following small-incision, sutureless vitrectomy.


METHODS
Computer-based, retrospective analysis to identify all patients who had undergone small-incision sutureless vitrectomy and presented retinal detachment (RD) in the study eye within 6 months postoperatively. The clinical charts of these patients were reviewed.


RESULTS
The investigation involved 2,598 small-incision, sutureless vitrectomies. Thirty-seven eyes presented subsequent RD. Indications for sutureless vitrectomy were idiopathic epiretinal membrane (n = 15), idiopathic macular hole (n = 15), recurrent macular hole (n = 1), rhegmatogenous retinal detachment (n = 5) and vitreous haemorrhage due to proliferative diabetic retinopathy (PDR) (n = 1). The median time between sutureless vitrectomy and RD presentation was 51 days (range 11-173 days); mean 59 days (SD 46.5). In 14 eyes (38%), the RD was most likely due to the underlying pathology (e.g., unclosed macular hole, reopening of pre-existing retinal tears, worsening of PDR). Twenty-three eyes (62%) presented with new retinal tears that were not in the proximity of the sclerotomies.


CONCLUSIONS
In most cases, the RD was not caused by the sutureless technique itself, but was most likely due to the underlying pathology, or due to new retinal tears that were not in the proximity of the sclerotomies.
Rizzo
Stanislao
S
Azienda Ospedaliera Universitaria Pisana-Cisanello, Eye Surgery Clinic, Via Paradisa 2, 56124, Pisa, Italy. chiroftalmica@ao-pisa.toscana.it
Belting
Claudia
C
Genovesi-Ebert
Federica
F
D000368:Aged; D000369:Aged, 80 and over; D019773:Epiretinal Membrane / Q000473:pathology / Q000601:surgery; D006801:Humans; D008866:Microsurgery; D008875:Middle Aged; D011183:Postoperative Complications; D012163:Retinal Detachment / Q000209:etiology* / Q000473:pathology; D012167:Retinal Perforations / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D013536:Suture Techniques; D014821:Vitrectomy; D014823:Vitreous Hemorrhage / Q000473:pathology / Q000601:surgery
Ophthalmology. 2002 Oct;109(10):1814-20
12359600
Graefes Arch Clin Exp Ophthalmol. 2007 Sep;245(9):1281-8
17318571
Retina. 2008 Oct;28(9):1193-200
18626419
Graefes Arch Clin Exp Ophthalmol. 2006 Apr;244(4):472-9
16421743
Br J Ophthalmol. 2007 Oct;91(10):1327-30
17522152
Ophthalmology. 1999 Sep;106(9):1786-91
10485551
Am J Ophthalmol. 2009 Sep;148(3):427-30
19477712
Retina. 2009 Apr;29(4):456-63
19174725
Retina. 2010 Jul-Aug;30(7):1065-71
20616684
Ophthalmology. 2002 Oct;109(10):1807-12; discussion 1813
12359598
Am J Ophthalmol. 1991 Aug 15;112(2):159-65
1867299
Retina. 2008 Jan;28(1):138-42
18185150
Ann Acad Med Singap. 2006 Mar;35(3):175-80
16625266
J Fr Ophtalmol. 2008 May;31(5):473-80
18641579
Br J Ophthalmol. 2008 Sep;92(9):1261-4
18614566