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Li Wei Heng, Stephen Charn Beng Teoh; Characteristics, Success Rates and Complication Rates of Inferior Primary Rhegmatogenous Retinal Detachments - A Retrospective Case Series. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6159.
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To describe the characteristics, success and complication rates of surgically-repaired inferior primary rhegmatogenous retinal detachments.
A retrospective case series of 36 patients with inferior primary rhegmatogenous retinal detachments (RRD) that were surgically repaired in a period of eighteen months (July 2008 to December 2009) in a single institution.
Of the 36 patients (n=36), 11 patients had the macula attached, 23 had the macula detached, and 2 had the macula-split pre-operatively. 7 patients had proliferative vitreo-retinopathy (PVR) pre-operatively. 33 patients had a single retinal break in the inferior retina, while 3 patients had an inferior retinal break and a concurrent superior retinal break. 12 out of 36 patients (33.3%) had a combined scleral buckle (SB) with trans-pars-plana vitrectomy (TPPV), whereas 9 (25%) had a scleral buckle only and 15 (41.7%) had a trans-pars-plana vitrectomy only. 27 patients (75%) required the use of an intraocular tamponading agent. Of these 27 patients, 7 patients required the use of silicon oil and 20 with intraocular gas. The overall success rate was 91.7% (33/36). The success rate for the patients who underwent scleral buckle only was 88.9%, 86.7% for those with vitrectomy only, and 100% for those with combined scleral buckle and vitrectomy. The overall failure rate was 8% (3/36) with re-detachment within 3 months of the primary retinal detachment surgery. The overall post-operative complication rate was 30% (11/36), 6 had significant cataract formation requiring cataract surgery within 18 months of primary RRD surgery, 1 had epi-retinal membrane formation and 2 developed glaucoma (1 required glaucoma-filtering surgery).
In our case series, a third of the patients underwent a combined scleral buckle-vitrectomy surgery with majority of the patients requiring intraocular tamponade. The overall success rate was 91.7%, of which, those who underwent combined scleral buckle and vitrectomy had the highest success rate. The failure rate was 8%, with significant cataract formation being the most common post-operative complication.
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