Abstract

Objective:To compare the effects of Pars Plana Vitrectomy (PPV) and Scleral Buckling (SB) with reference to Central Corneal Thickness (CCT), Corneal Endothelial-Cell Density (CED), Anterior Chamber Depth (ACD) and Axial Length (AL) in repair of Rhegmatogenous Retinal Detachment (RRD).Methods:This comparative cross sectional analytical study was conducted at Armed Forces Institute of Ophthalmology (AFIO), Rawalpindi from July 2013 to July 2015. A total of 69 eyes of 69 patients which underwent repair of RRD by either PPV or SB were analyzed to compare mean change in CCT, CED, ACD and AL between two groups.Results:Mean age of patients was 56.23±5.22 years. Mean pre-operative CCT, CED, ACD and AL in PPV group was 533.06±13.28µm, 2231.67±164.57Cells/mm2, 3.37±0.18mm and 23.66±0.76mm respectively. Mean post-operative CCT, CED, ACD and AL in PPV group was 534.81±11.83µm, 2037.19±167.83 Cells/mm2, 3.24±0.13mm and 23.88±0.80mm respectively. Change in CED, ACD and AL from pre-operative value after PPV was statistically significant (p<0.001). Mean pre-operative CCT, CED, ACD and AL in SB group was 530.73±12.59 µm, 2161.79±161.96 Cells/mm2, 3.343±0.14mm and 23.67±0.82mm respectively. Mean post-operative CCT, CED, ACD and AL in SB group was 532.76±7.74 µm, 2158.27±156.58 Cells/mm2, 3.24±0.10mmand 25.71±0.86mm respectively. Change in ACD and AL from pre-operative value after SB was statistically significant (p<0.001). Mean change of CED, ACD and AL between two groups was also statistically significant (p<0.001).Conclusion:Rhegmatogenous retinal detachment repair causes ocular changes, with significantly more decrease in corneal endothelial cell density after pars plana vitrectomy, and more increase in anterior chamber depth and axial length after scleral buckling.

Highlights

  • Retinal diseases have an immense impact on vision related quality of life

  • Rhegmatogenous Retinal Detachment (RRD) is an ophthalmic condition related to significant morbidity

  • We observed minimal change in Central Corneal Thickness (CCT) in both Pars Plana Vitrectomy (PPV) and Scleral Buckling (SB) group. This is contrary to the findings by Buettner H et al who found that CCT increases significantly in all eyes after trans pars plana surgery.[7]

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Summary

Introduction

In resources limited countries like Pakistan, provision of primary health care facilities is a challenging task. In such conditions, the financial and socio-economic burden of provision of adequate retinal surgical facilities is a daunting assignment. Pak J Med Sci November - December 2017 Vol 33 No 6 www.pjms.com.pk 1412 modern surgical management of retinal diseases.[1] Rhegmatogenous Retinal Detachment (RRD) is an ophthalmic condition related to significant morbidity. It is detachment of neurosensory retina from retinal pigment epithelium, and is attributed to many risk factors like trauma, male gender and high myopia.[2]

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