Abstract
Purpose: :
To describe the characteristics and outcome of patients who underwent pars plana vitrectomy (PPV) with scleral depressed vitreous shaving, 360 degree peripheral endolaser, and 14% C3F8 gas for rhegmatogenous retinal reattachment (RRD) surgery.
Methods: :
Retrospective review of consecutive patients who underwent primary repair of RRD by PPV with scleral depressed vitreous shaving, 360 degree peripheral endolaser, and 14% C3F8 (by one surgeon, KAR). Patients with previous retinal treatment, proliferative vitreoretinopathy, pathologic myopia, and <3 months follow-up were excluded.
Results: :
From September 2006 to July 2009, 112 eyes of 112 consecutive patients underwent retinal reattachment surgery for new onset RRD. Ninety-one eyes underwent PPV with scleral depressed vitreous shaving, 360 endolaser, and 14% C3F8 were included. Eighteen eyes with pathologic myopia underwent primary scleral buckling with or without PPV and three eyes with insufficient follow-up were excluded. The mean follow-up was 13.7 +/- 9.2 months (range 3-34 months). The mean age was 60.1 +/- 11.3 years (range 35-93 years). Thirty-two eyes were pseudophakic. The mean number of retinal breaks associated with the RRD was 2.2 (range 1-9 breaks). Thirty eyes had RRDs associated with inferior breaks. The mean extent of RRD was 7.3 clock hours (range 1.5-24 clock hours). The macula was detached in 58 eyes (63%). The reattachment rate after one surgical procedure was 95% (86/91) while overall reattachment rate was 100%. Overall mean initial visual acuity (VA) was 20/300 (range 20/20-hand movements) and mean final VA was 20/50 (range 20/20-5/200). In macula off RRDs, the mean initial VA was 5/200 (range 20/60-hand movements) while the mean final VA was 20/40 (range 20/20-5/200). Thirty-eight eyes (66%) with macula off RRDs had final VA of 20/40 or better while 30 eyes (91%) with macula on RRDs had final VA of 20/40 or better.
Conclusions: :
PPV with scleral depressed vitreous shaving, 360 degree peripheral endolaser, and 14% C3F8 leads to successful anatomical reattachment with significant visual improvement.
Keywords: retinal detachment