Abstract
To evaluate the anatomical and functional results in patients with rhegmatogenous retinal detachment (RRD) who underwent 25-gauge pars plana vitrectomy (PPV) with gas tamponade. A retrospective evaluation of 126 eyes of 126 patients (79 men, 47 women) with RRD who underwent 25-gauge PPV with gas tamponade (13% C3F8 in 87 eyes, 20% SF6 in 39 eyes). 113 patients (89.7%), were operated on under local anaesthesia, 13 patients (10.3%) under general anaesthesia. Macula was detached in 85 eyes (67.5%). 53 eyes had pseudophakic RRD, 73 eyes were phakic. Anatomical success of the primary intervention, change in best corrected visual acuity (BCVA) and incidence of complications were assessed. An average follow-up period is 7.2 months (6-15). With single operation, retinal attachment was achieved in 125 eyes (99.2%); the final anatomical success was 100%. The initial mean BCVA was 0.89 logMar (2.00 to 0.00); at the end of the follow-up period, it improved to 0.23logMAR (1.00 to -0.10), P < 0,0001. During the first post-intervention day, hypotony of the eye below 10 mmHg was observed in 1 patient (0.8%); on the contrary, intraocular pressure was temporarily increased to 25 mmHg and more in 36 patients (28.6%). The surgical treatment of RRD using 25-gauge PPV with expansive gas tamponade renders excellent anatomical results and improvement in BCVA. The incidence of complications and necessity of sclerotomy suturing are low.
Highlights
Rhegmatogenous retinal detachment (RRD) is a serious, vision-threatening condition which affects approximately 1 out of 10.000 people every year
The first generation of 25-gauge pars plana vitrectomy (PPV) was presented by Fuji in 2002
In 2010, the second generation instrumentation was introduced, offering better fluid dynamics, improved rigidity of tools and a wide-field illumination. It quickly became a preferred technique for surgeons who began to use it not just for the solution of vitreous opacities and macular diseases, and in cases with more complex vitreoretinal pathologies[8,9,10,11,12,13,14]
Summary
Rhegmatogenous retinal detachment (RRD) is a serious, vision-threatening condition which affects approximately 1 out of 10.000 people every year. The development of RRD is caused by formation of a retinal break followed by accumulation of intraocular fluid in the subretinal space. Current intervention methods used are scleral buckling, pneumatic retinopexy and pars plana vitrectomy (PPV), the latter being performed either as a sole procedure or combined with scleral buckling[3,4,5]. Treatment in often individualized based on surgeon experience and preferences, number and location of retinal breaks, amount of subretinal fluid, state of the macula, presence of proliferative vitreoretinopathy (PVR), condition of the lens, state of the vitreous body and overall condition of the patient. The development of sutureless vitrectomy methods was a significant milestone in the vitreoretinal surgery. Such techniques offer benefits of a mini-invasive procedure with a higher post-operative comfort and faster recovery. Anatomical and functional results of 25-gauge PPV for RRD are evaluated
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