Primary 25-Gauge Airbag-Vitrectomy in Pseudophakic Rhegmatogenous Retinal Detachment

Abstract

Purpose: To evaluate the anatomic and functional outcomes and the rate of complications of primary 25-gauge airbag-vitrectomy in the treatment of pseudophakic rhegmatogenous retinal detachment (PsRD) uncomplicated by severe proliferative vitreoretinopathy.

Methods: In this prospective, nonrandomized, surgical technique study, 141 eyes of 141 consecutive patients with PsRD with proliferative vitreoretinopathy grade A or B underwent primary 25-gauge airbag vitrectomy, consisting in pars plana vitrectomy performed under continuous infusion of air, and air or gas endotamponade. Eyes with minimum follow-up of 6 months were evaluated. The preoperative and postoperative characteristics were analyzed. Main outcome measures were primary anatomical success rate, defined as retinal reattachment at final follow-up after a single operation without additional surgery, visual outcome at the last follow-up visit, and rate of complications.

Results: At six months the retina was reattached successfully after a single surgery in 98% of eyes (138/141). Recurrence of retinal detachment occurred in 3 eyes (2%) during the follow-up period, caused by proliferative vitreoretinopathy in 2 eyes and by new retinal breaks in 1 eye. After treatment, BCVA improved significantly (P < 0.000, ANOVA). Mean final visual acuity (SD) was 0.28 (0.34) logarithm of the minimum angle of resolution (logMAR) compared with 0.94 (0.84) logMAR before surgery (P < 0.001, Tukey-Kramer test). The most common postoperative complication was hypotony, detected in 4 eyes (3%) on postoperative day 1.

Conclusions: Primary 25 gauge airbag vitrectomy provides a high anatomic success rate in eyes with PsRD and is associated with a low rate of complications.

Keywords: 762 vitreoretinal surgery • 697 retinal detachment