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V. Chaturvedi, K. A. Rezaei; Pars Plana Vitrectomy With Scleral Depressed Vitreous Shaving, 360 Degree Peripheral Endolaser, and 14% C3F8 Gas for Primary Repair of Rhegmatogenous Retinal Detachment. Invest. Ophthalmol. Vis. Sci. 2010;51(13):6065.
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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.
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.
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.
PPV with scleral depressed vitreous shaving, 360 degree peripheral endolaser, and 14% C3F8 leads to successful anatomical reattachment with significant visual improvement.
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