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Elena Gibin, andrea galli, nicholas righetti, michele clerici, ana cristina daniel, francesca gilardoni, massimo vignanelli; Pneumatic retinopexy for primary rhegmatogenous retinal detachment in phakic eyes with single break: our experience.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1068.
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© ARVO (1962-2015); The Authors (2016-present)
To report the results of pneumatic retinopexy (PR) for primary reghmatogenous retinal detachment (RD) in a group of phakic patients in terms of success rate and complications.
Sixty-six phakic eyes (51 males and 15 females), who underwent primary PR for rhegmatogenous RD, were retrospectively evaluated. Mean age at surgery time was 60.2±10.1 years. We only included eyes with one single break located in the superior 8-clock hours. Detachment involved macula in 20 eyes (30.3%), 46 eyes (69.7%) had "macula-on" detachment. All procedures were performed by the same experienced vitreoretinal surgeon. Surgical technique entailed: location and cryotherapy of retinal break, 0.4 ml acqueous extraction through one limbar paracentesis and C3F8 20% injection. Prolonged prone positioning of the head was maintained from 2 to 4 hours to minimize retinal folding risk, followed by steamroller manoeuvre. Mean follow-up time was 153±65 days. Success and failure rate, together with reasons for failure were evaluated.
Anatomical successful outcome of primary PR was obtained in 47 eyes (71%), extended to 95% with additional surgery (pars plana vitrectomy) performed within 1 month from PR. Three eyes (5.0%) required several additional surgeries. 86% of the recurrences occurred 25.1±8.9 days from PR (early failure), while only 14% occurred during residual follow-up. The most common cause of early failure were new/missed retinal breaks (52.6 %). Other reasons for early failure were persistent subretinal fluid (31.6%) or insufficient gas tamponade (15.8%). No difference in outcomes was noticed between macula-on or macula-off detachment. No major intra-surgical complications occurred. Nine eyes (13.6%) required cataract surgery during follow-up.
In conclusion, we believe that PR still maintains a current role as a valid procedure for selected cases of macula on/off primary reghmatogenous retinal detachments. Despite limitations of our study in terms of design and limited follow-up, PR for phakic eyes with single break appears to have good rates of success, manageable complications and low costs.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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