Abstract
Abstract: :
Purpose: To describe our experience with two–port vitrectomy, using binocular ophthalmoscopy as visualization system, in management of several vitreo retinal pathologies. Methods: Retrospective, longitudinal, observational and descriptive study. We include patients who had their surgery between the years 1997 to 2002, with two ports vitrectomy technique, in retina service of APEC, México City. Results: We analyzed records of 139 patients. 52% (72/139) were male, average age was 54 years old (range 1–70) and mean follow up of 23.6 months (range: 4–60 months). Diagnosis were tractional Retinal Detachment (RD) due to diabetic retinopathy, rhegmatogenous RD, recurrent RD, RD secondary to penetrating ocular wound with foreign body, epiretinal membrane, tractional RD associated with pars planitis and others. Average baseline Best Corrected Visual Acuity (BCVA) was Count Fingers 2 meters. As tamponade we used silicone oil in 57.5% (80/139), SF6 in 2.9% (4/139) and C3F8 in 5.1% (7/139). A scleral buckling was used in 19.4% (27/139) of patients, lensectomy was necessary in just 3.6% (5/139). Anatomic success with one procedure was obtained in 90.7% (126/139). The most frequent post operative complications were macular fibrosis, papillary atrophy and glaucoma. We had redetachment in 9.3% (13/139) of cases with the first procedure. After the surgery, the BCVA improved compared to baseline in 47% (65/139), maintained the same in 12% (17/139) and 41% (57/139) presented visual loss. Average final BCVA was Count Fingers 2 meters. Conclusions: Two ports vitrectomy assisted by indirect ophthalmoscopy is a technique that can be used on different vitreoretinal pathologies, either as a main or as an adjuvant visualization instrument. It offers advantages versus panoramic lenses (lower cost, availability, less trauma to sclerotomies, less ports and decreased vitrectomy time) and its main disadvantage is a difficult learning curve.
Keywords: retinal detachment • vitreoretinal surgery • clinical (human) or epidemiologic studies: outcomes/complications