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N. Liu, W. Fan, J. Xu, K. Ma, Z. Hou, N. Weng; Incidence of Iatrogenic Peripheral Retinal Breaks Complicating Pars Plana Vitrectomy in Patients With Vitreous Hemorrhage. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5732.
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To determine the incidence of iatrogenic peripheral retinal breaks occurred during pars plana vitrectomy in patients with vitreous hemorrhage.
Consecutive vitrectomies performed on eyes with vitreous hemorrhage but without preexisting retinal detachments at Beijing Tongren Eye Center between 2002 and 2005 were retrospectively reviewed. Cases with iatrogenic peripheral retinal breaks were recorded and analyzed. Minimum follow up was 3 months for all cases. The study was conducted in compliance with the "Declaration of Helsinki".
A total of 364 consecutive vitrectomies were included in the study. Vitreous hemorrhage in this group were mainly due to proliferative diabetic retinopathy (PDR) (190 eyes) and branch retinal vein occlusion (BRVO) (98 eyes). Of the 364 eyes, 28 eyes had 45 iatrogenic peripheral retinal breaks detected with an average incidence of 7.7%. Forty-two of the 45 peripheral breaks (93%) occurred around the sclerotomy sites and the quadrant of predominant hand was involved most commonly (53%). Iatrogenic peripheral retinal breaks were most common in cases with BRVO (13.3%) and less common in cases with PDR (3.7%).
Despite improvements in instrumentation and surgical techniques, iatrogenic peripheral retinal breaks continue to be an important complication of pars plana vitrectomy in patients with vitreous hemorrhage. This complication is mainly sclerotomy-related and is more common in cases with BRVO than in cases with PDR.
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