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Mark W. Johnson, Eric W. Schneider, Ryan L. Geraets; Minimalist Pars Plana Vitrectomy for Repair of Primary Rhegmatogenous Retinal Detachment. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2129.
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To evaluate the anatomical and functional outcomes of minimalist pars plana vitrectomy (PPV), defined as PPV without adjuvant scleral buckling, prophylactic 360° endolaser photocoagulation, or perfluorocarbon (PFC) liquid use, for the treatment of uncomplicated primary rhegmatogenous retinal detachment (RRD).
Retrospective interventional case series of consecutive patients undergoing minimalist vitrectomy for RRD by a single surgeon over a 10 year period.
Of 177 patients undergoing PPV for RRD, 93 patients were identified as having an uncomplicated detachment and a minimum follow-up of 6 months (mean, 31 months; range, 6-103 months). Primary anatomic success, defined as retinal reattachment following a single operation, was achieved in 95.7% (89/93) of eyes. Final anatomic success, defined as retinal attachment at final follow-up without regard to additional procedures, was achieved in 98.9% (92/93). Final best-corrected visual acuity of ≤ LogMAR 0.4 (Snellen 0.4) and ≤ LogMAR 1.0 (Snellen 0.1) was achieved in 82.8% and 89.2% of eyes in the cohort, respectively. Postoperative proliferative vitreoretinopathy (PVR) developed in 3.2% of eyes and visually significant epiretinal membrane was seen in 2.2%. No new retinal breaks were observed postoperatively in the absence of clinically-evident PVR.
Adjuvant scleral buckling, prophylactic 360° endolaser photocoagulation, and PFC liquid use are not necessary to achieve a high primary anatomical success rate in the treatment of uncomplicated primary RRD with PPV. In the absence of observable PVR, postoperative vitreous base contraction does not appear to be a clinically relevant phenomenon.
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