23-gauge sutureless vitreo-retinal surgery for superior rhegmatogenous retinal detachment.
OBJECTIVE
To determine the results of 23-gauge sutureless vitreo-retinal surgery for superior/supero-temporal rhegmatogenous retinal detachment (RRD).


METHODS
Quasi experimental study.


METHODS
LRBT, Free Base Eye Hospital, Karachi, from January 2010 to December 2011.


METHODS
Adult patients who underwent 23-gauge sutureless vitreo-retinal surgery along with use of Perfluoropropane (C3F8) gas as internal tamponading agent for fresh (upto 3 weeks) superior/supero-temporal RRD was reviewed. Major outcome measures were anatomical success, best corrected visual acuity (BCVA) with Log Mar and complications during and after surgery. Postoperative follow-up was done on 1st day and at 1st, 4th, 8th and finally at 12th week.


RESULTS
Sixty eyes of 60 patients, age between 30 - 60 years including 37 (61.67%) males and 23 (38.33%) females having superior or superatemporal RRD underwent 23-guage sutureless vitreo-retinal surgery with the use of perfluoropropane (C3 F8) gas as internal temponade at the end of procedure. Anatomical success rate was 81.66% (49 out of 60 eyes) with first surgery and raised to 90% (54 cases) with second surgery. Log Mar BCVA significantly improved from mean baseline 0.93 to 0.49 with mean difference of 0.43 (p < 0.001), 95% confidence interval. Postoperative complications were sub-conjunctival haemorrhage in 11 eyes (18.33%), wound leak in 7 eyes (11.66%), anterior chamber became shallow in 6 eyes (10%), cataract developed in 5 eyes (8.33%), re-retinal detachment in 4 eyes (6.66%), ocular hypotony and sterile inflammatory reaction in 3 eyes (5%) each, while iatrogenic breaks developed in 2 eyes (3.33%).


CONCLUSIONS
The 23-gauge sutureless vitreo-retinal surgery for superior rhegmatogenous retinal detachment achieved high anatomical success and significant visual improvement. Sub-conjunctival haemorrhage was the most frequent procedural complication.
Department of Ophthalmology, LRBT, Free Base Eye Hospital, Karachi.
Shakir
S
Zafar
Department of Ophthalmology, LRBT, Free Base Eye Hospital, Karachi.
Washoo
W
Mal
Department of Ophthalmology, LRBT, Free Base Eye Hospital, Karachi.
Munira
M
Shakir
Department of Ophthalmology, LRBT, Free Base Eye Hospital, Karachi.
Zeeshan
Z
Kamil
Department of Ophthalmology, LRBT, Free Base Eye Hospital, Karachi.
Syeda Aisha
SA
Bokhari
Department of Ophthalmology, LRBT, Free Base Eye Hospital, Karachi.
Syed Fawad
SF
Rizvi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D005466:Fluorocarbons; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011184:Postoperative Period; D011446:Prospective Studies; D012163:Retinal Detachment / Q000209:etiology / Q000601:surgery*; D013630:Tampons, Surgical; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*; D057586:Vitreoretinal Surgery; D055815:Young Adult
D003287:Contrast Media; D005466:Fluorocarbons; C042852:perflutren