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D.M. Berinstein, Z.K. Segal, R.A. Garfinkel, M.H. Osman, R.J. Sanders; Treatment Outcomes of Inferior Retinal Detachments with Associated Inferior Retinal Breaks . Invest. Ophthalmol. Vis. Sci. 2004;45(13):5264.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To report the surgical outcomes of primary inferior rhegmatogenous retinal detachment with associated inferior retinal breaks. Methods:Retrospective, comparative, consecutive series from multiple surgeons at a single institution. Inclusion criteria included uncomplicated, primary retinal detachment with inferior retinal breaks located between 4:00 to 8:00 clock hours. All patients either had scleral buckling surgery; primary pars plana vitrectomy, or combined scleral buckle and vitrectomy. Exclusion criteria included proliferative vitreoretinopathy, traumatic retinal dialysis, post–equatorial retinal breaks, or other concomitant ocular diseases such as uveitis, diabetic retinopathy, or advanced glaucoma. The outcomes measured were retinal reattachment, final visual acuity, and associated complications. Results:Thirty patients were identified as having an inferior retinal detachment with associated inferior retinal breaks. Retinal reattachment was achieved in 26 of 30 eyes (87%). Sixteen patients underwent scleral buckling surgery, 5 had primary vitrectomy, and 9 underwent combined scleral buckle and vitrectomy. In the scleral buckling group, 15 of 16 eyes were successfully reattached on a single operation; 3 of 5 eyes undergoing primary vitrectomy had successfully reattached, and eyes undergoing combined vitrectomy and scleral buckle, retinal reattachment was achieved in 8 of 9 eyes. The best–corrected visual acuity achieved in eyes presenting with the macula attached was 20/30. For eyes with macula–off at presentation, the final vision achieved was 20/220. The most common cause for retinal redetachment for all groups was proliferative vitreoretinopathy. Conclusions:Inferior rhegmatogenous retinal detachment with associated inferior retinal breaks presents less commonly than other types of rhegmatogenous retinal detachment. Repair of inferior retinal detachment can be achieved using different surgical approaches and techniques. Overall, patients achieve favorable anatomic results, and visual outcomes when the macula is attached at initial presentation.
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