Abstract
BackgroundTo compare anatomical, functional outcomes and complications of high-speed 25-gauge (G) pars plana vitrectomy (PPV) versus 20-G PPV for the management of primary inferior rhegmatogenous retinal detachment (RRD) associated to inferior breaks/holes.MethodsEighty-five eyes from 85 patients with a minimum follow-up of 3 months were retrospectively evaluated. Forty-one patients underwent 25-G and 44 patients underwent 20-G PPV. All patients underwent PPV with fluid-air exchange, sulfur hexafluoride (SF6) 20 % gas tamponade and laser or cryo retinopexy.ResultsThe mean follow-up interval was 6.51(±2.32) and 6.63 (±2.58) months in the 25-G and 20-G groups respectively. Single-operation success rate was 92.7 % for the 25-G group and 81.8 % for the 20-G group (P = 0.24). Post-operative hypotony was observed in no case. Redetachment occurred in 3 eyes operated on with 25-G and in 8 eyes operated on with 20-G system. All retinas were attached at final follow-up. Logarithm of the minimum angle of resolution visual acuity significantly improved from 0.69 ± 0.76 to 0.33 ± 0.37 in the 25-G and from 0.47 ± 0.59 to 0.21 ± 0.28 in the 20-G group (P = 0.0007 and P < 0.0001 respectively).ConclusionsHigh-speed PPV and SF6 gas tamponade using either 25-G or 20-G PPV system, yields similar single operation anatomical success rates for the repair of uncomplicated, primary inferior RRDs associated to inferior breaks.
Highlights
Pars plana vitrectomy (PPV) is gaining popularity for the treatment of primary rhegmatogenous retinal detachment (RRD)
The advent of small-gauge instruments has sensibly implemented the use of pars plana vitrectomy (PPV) for the management of vitreoretinal pathologies because of its potential advantages such as shorter operating times and faster ocular healing in comparison to standard 20-G vitrectomy [1,2,3,4]
We decided to focus our attention on uncomplicated inferior detachments originating from inferior breaks/holes to compare the outcomes of 25-G versus 20-G PPV
Summary
Pars plana vitrectomy (PPV) is gaining popularity for the treatment of primary rhegmatogenous retinal detachment (RRD). High rates of redetachment for inferior detachments treated with standard 20-G PPV have been reported [5]. In a large, prospective randomised controlled trial of standard 20-G PPV and gas to repair RRD, inferior retinal breaks were not identified as a risk factor for anatomical failure [6]. Functional outcomes and complications of high-speed 25-gauge (G) pars plana vitrectomy (PPV) versus 20-G PPV for the management of primary inferior rhegmatogenous retinal detachment (RRD) associated to inferior breaks/holes. Conclusions High-speed PPV and SF6 gas tamponade using either 25-G or 20-G PPV system, yields similar single operation anatomical success rates for the repair of uncomplicated, primary inferior RRDs associated to inferior breaks
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