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V.L. Landolt, A.J. Ruby, G.A. Williams, T.S. Hassan, B.R. Garretson; Scleral Buckle With Pars–plana Vitrectomy vs. Scleral Buckle Alone in Pseudophakic Retinal Detachment . Invest. Ophthalmol. Vis. Sci. 2006;47(13):1447.
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To assess the effectiveness of pars–plana vitrectomy (PPV) with a scleral buckle in the management of pseudophakic rhegmatogenous retinal detachment compared to historical reports of scleral buckle or vitrectomy alone.
This was a retrospective chart review. The charts of all patients undergoing repair of pseudopahakic retinal detachment by PPV with scleral buckle over an eighteen month period were reviewed. Gender, age, type of IOL, distribution and number of retinal breaks, extent of detachment including status of macula, preoperative visual acuity and preoperative IOP were recorded. Length of follow–up, final visual acuity, final IOP, final status of retina and total number of surgical procedures were also recorded. Visual acuity was analyzed by converting Snellen visual acuity to the logarithm of the minimal angle of resolution (logMAR) score, developed by Ferris and associates. Patients who had previously undergone PPV for any reason as well as cases involving proliferative vitreoretinopathy were excluded. Our primary outcome measure was the rate of reattachment with a single operation. Secondary outcomes included final visual acuity and overall success rate as defined by most recent retinal status (attached or detached).
Sixty–five eyes of sixty–three patients met the criteria for further review. Of the 65 eyes, 64 were primarily reattached with a single operation (98%). The one failure was secondary to a new retinal hole and was later successfully reattached with a single additional operation. Three separate patients who were primarily reattached subsequently re–detached secondary to proliferative vitreoretinopathy, one patient was successfully reattached with one operation, one patient required two operations for successful reattachment and the third was lost to follow–up. Two patients developed a macular pucker and were successfully treated with a PPV and membrane peel. The average pre–operative visual acuity was +1.3 logMAR (approximately 20/300) and the average post–operative visual acuity was +0.43 logMAR (approximately 20/60).
Preliminary results indicate that scleral buckle with pars–plana vitrectomy may offer higher primary success rate when compared to historical reports of scleral buckle or vitrectomy alone for the management of pseudophakic rhegmatogenous retinal detachments.
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