Abstract
Objective: To observe the characteristics and evaluate the efficacy and safety of the chronic total rhegmatogenous retinal detachment (RRD) treatment by the 23-gauge pars plana vitrectomy (PPV) in young adults and to analyze the related factors.Methods: A retrospective chart review was performed for the young adults who underwent the 23-gauge PPV for the chronic total RRD at the Tianjin Medical University General Hospital from 2011 to 2018. A total of 54 eyes of 48 patients were included in this study. The preoperative vision ranged from 2.00 to 1.00. The mean duration of RRD was 9 ± 0.6 months with a range from 4 to 18 months. The proliferative vitreoretinopathy (PVR) grade D1 and grade D2 was diagnosed in 48 eyes and 6 eyes, respectively. About 37 eyes were filled with C3F8 and 17 eyes were filled with silicone oil tamponade. The follow-up ranged from 9 to 78 months with a mean of 23 ± 2.2 months.Results: The postoperative visual acuity increased in all the eyes at the final observation. The retinal attachment was achieved in 49 eyes (90.7%) in the primary PPV. Five eyes (9.3%) with the failed retinal attachment finally achieved the attachment after the second procedure. The postoperative complications mainly included temporary intraocular pressure (IOP) elevation, hyphema, and retinal redetachment.Conclusion: Chronic total RRD can be treated via the 23-gauge PPV with a great anatomical and visual prognosis in the young adult. The successful treatment of the chronic total RRD in young adults is mainly associated with the complete dissection of the severe vitreoretinopathy, especially for the epiretinal membrane at the retinal breaks and degenerations and the subretinal proliferation during surgery.
Highlights
Rhegmatogenous retinal detachment (RRD), which often causes difficult recovery of the retinal function due to the delayed retinal reattachment by a surgical procedure, is one of the most common reasons for severely decreased vision in young adults
It has been reported that the incidence of RRD in the young adults is different from RRD in the adults; it is ∼0.38– 0.69 per 100,000 individuals in the children and 7.98–12.4 per 100,000 individuals in the adults [2, 7]
The selection of surgical procedures according to the vitreoretinopathy is important for the final outcomes in the chronic total RRD in the young adults
Summary
Rhegmatogenous retinal detachment (RRD), which often causes difficult recovery of the retinal function due to the delayed retinal reattachment by a surgical procedure, is one of the most common reasons for severely decreased vision in young adults. RRD has multiple etiologies in young adults [1]. Chronic total RRD is one of the most refractory retinal detachments with poor outcomes in young adults. A scleral buckling procedure and pars plana vitrectomy (PPV), are typically used to treat RRD in young adults. The selection of surgical procedures according to the vitreoretinopathy is important for the final outcomes in the chronic total RRD in the young adults. The purpose of choosing an optimal approach to treating the chronic total RRD in young adults is to provide the patients with an individualized management conceptual design according to the etiology and severity of the proliferative vitreoretinopathy (PVR)
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