Abstract
Purpose::
Traditionally, in eyes with rhegmatogenous retinal detachment (RRD) a vitreous separation (PVD) posterior to the tear is described. Based on their experience with hundreds of RRD eyes undergoing vitrectomy, the authors aimed at clarifying whether this is indeed the typical configuration of the vitreoretinal interface.Materials and
Methods::
A prospective study on 36 eyes undergoing vitrectomy for RRD. All eyes were phakic and had no history of trauma. Each eye underwent preoperative ultrasonography and intraoperative marking of the vitreous using triamcinolone acetonide.
Results::
The patient was a male in 45% of the cases; the average age was 57 (27-80) years; 61% of eyes had an average 4 D myopia. The average detachment involved 2.3 quadrants, the macula was off in 61%. The vitreous showed the typical configuration (PVD posterior to the tear) in 33% of eyes; in 31% a combination of PVD and vitreoschisis was present; in 36% only a vitreoschisis was found but no PVD. The primary success rate of vitrectomy was 95% with 83% of eyes showing an average of 3.5 lines improvement in vision. The remaining eyes developed cataract interfering with the visual acuity.
Conclusions::
The intraoperative findings in this prospective study confirmed that the typical "PVD posterior to the tear" characterization of the vitreoretinal interface in eyes with PPD is true in only a minority of eyes. In most eyes the traction force leading to retinal detachment comes from a more complex anatomical configuration. Vitrectomy showed a high success rate in these phakic eyes with PPD.
Keywords: vitreoretinal surgery • retina • pathology: human