Influence Of Intraocular Tamponade On Unintentional Retinal Displacement After Standard Vitrectomy For Reghmatogenous Retinal Detachment

Abstract

Purpose: : To investigate the relation between type of intraocular tamponade and unintentional retinal displacement (URD) after standard vitrectomy.

Methods: : Twenty-three eyes of 23 consecutive patients affected by rhegmatogenous retinal detachment (RRD) underwent three-port pars plana vitrectomy (TPPV) with gas (perfluoropropane) or silicone oil tamponade, according to specific clinical conditions. All patients underwent complete ocular examination, including fundus autofluorescence (FAF) (Topcon TRC-50DX), spatial and quantitative assessment of fixation (Nidek MP-1 microperimetry) before surgery and on 7-day, 1-month, 3-month and 6-month post-operatory visits.

Results: : URD was noted on FAF in 12 of the 23 eyes (52.2%). Retinal displacement rate was greater in gas-injected eyes (10/14, 71.4%) compared with eyes with silicone oil (2/9, 22.2%) (Fisher’s exact test, p=0.036). Retina shifted downward in all gas-injected eyes and upward in all eyes with silicone oil. Preoperative and follow-up macular function assessment was reliably performed only in macula-on cases (7). In this subgroup a fixation shift was noted on the first post-operative visit, with a maximum value on the 7-day post-operative examination and decreasing throughout the follow-up examinations.

Conclusions: : In eyes with RRD treated with vitrectomy and gas or silicone oil injection, URD may occur despite successful retinal reattachment. The type of intraocular tamponade seems to influence retinal dislocation rate and direction.

Keywords: retinal detachment • vitreoretinal surgery • vitreous substitutes