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D. Panigrahi, B.L. Johnson, R. Kuzumi, Z. Segal, M.K. Barazi, J. Bezek, W.B. Phillips II, D.M. Berinstein, M.A. von Fricken; Pars Plana Vitrectomy for the Treatment of Primary Pseudophakic and Aphakic Inferior Retinal Detachment . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3047.
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Purpose: To evaluate the safety and efficacy of treating rhegmatogenous retinal detachment (RRD) with primarily inferior pathology using pars plana vitrectomy (PPV) as the primary surgical procedure. Methods: Retrospective analysis of a comparative interventional case series. Results: Seventeen eyes of 17 patients underwent PPV with shaving of the vitreous base, air-fluid exchange, and sulfur hexafluoride gas tamponade for RRD with retinal breaks between 4:00 and 8:00 by one surgeon. Retinal breaks were treated with laser indirect ophthalmoscopy (14), endolaser (2), or cryotherapy (1). Fifteen of 17 eyes (88%) were successfully reattached with a single PPV. Five of 6 macula-on detachments were re-attached with PPV resulting in a mean spectacle corrected Snellen visual acuity of 20/25. Ten of 11 eyes with macula-off detachments were re-attached with PPV resulting in a mean spectacle corrected Snellen visual acuity of 20/50. Eight of 11 (73%) of macula-off eyes had an end-point visual acuity of 20/40 or better. Post-operative complications included recurrent retinal detachment (12%), transient ocular hypertension (17%), proliferative vitreoretinopathy (12%), and macular pucker (12%). Conclusions: Pars plana vitrectomy for the treatment of RRD with inferior vitreoretinal pathology may be a safe and effective surgical modality. Outcomes in this pilot study were comparable to those achieved by PPV and/or or scleral buckle for pseudophakic RRD previously reported in the literature. Further evaluation of PPV for pseudophakic inferior RRD is warranted.
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