Purchase this article with an account.
C. Shiina, Y. Takizawa, M. Kiyokawa, T. Sakuma, N. Hatano, M. Suami, H. Nakajima, A. Mizota, M. Tanaka; Factors Affecting The Successful Reattachment Of Rhegmatogenous Retinal Detachments Performed By Young Vitreoretinal Fellows . Invest. Ophthalmol. Vis. Sci. 2006;47(13):1440.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To determine the factors affecting the rate of reattachment of rhegmatogenous retinal detachments (RRDs) performed by inexperienced fellows in our vitreoretinal program. The pre– and intraoperative factors which made it necessary for additional operations were investigated.
The medical records of 620 eyes with different types of RRD that had surgery during the past five years were reviewed. The choice of SB or VTX was determined by the senior surgeon based on the location, number, and size of the retinal tears. RRD that were deeper, larger, and eyes with multiple tears were treated by VTX. The pre– and intraoperative factors associated with failure following the first operations, the type of additional procedures, and the final reattachment rate was investigated.
Among the 620 eyes, 344 eyes had SB and 276 eyes had VTX as the first surgery. Sixty of the 344 eyes (17.4%) in the SB group required re–operations. A higher percentage of eyes that had drainage of subretinal fluid or had retinal tears located in lower quadrants required additional surgery, e.g., VTX or relocation of the buckle. The final reattachment rate was 99.0%. In contrast, 25 of the 276 eyes (9.3%) in the VTX group needed a second operation. There was no statistical relationship between the success rate and re–operative conditions, however, analysis revealed that the main cause of a re–detachment was new retinal tears near each port. The final success rate was 97% in the VTX group.
Senior surgeons assisting fellows performing SB should pay special attention to eyes which need drainage and eyes with breaks located in the lower quadrants. For VTX, sufficient removal of gel and careful fundus examination especially near each port at the end of operation appears to be important.
This PDF is available to Subscribers Only