Abstract
Purpose :
To evaluate anatomical success rate and visual outcomes of pars plana vitrectomy (PPV) without postoperative head positioning for primary rhegmatogenous retinal detachment (RRD) repair.
Methods :
A retrospective chart review of subjects undergoing PPV with or without phacoemulsification for primary non-complex RRD with gas tamponade between January 2015 to January 2017 was performed. Phakic patients who have not had combined PPV and phacoemulsification were positioned after surgery, and therefore were excluded from the study. Patients with silicone oil tamponade, proliferative vitreoretinopathy and less than 3 months follow up were also excluded. The primary outcome was initial anatomical success rate. Secondary outcome measures were changes in best corrected visual acuity (BCVA) and final reattachment rate.
Results :
Of the 108 cases identified, 53 eyes from 53 patients were included in this study. The mean age of the study patients was 65 ± 7 years, 68% of patients were males. The mean follow up duration was 223 ± 137 days. PPV alone was performed in 53% of cases while the remaining patients had combined PPV and phacoemulsification. Retinal detachment involved more than 1 quadrant in 35 (66%) cases, and involved the macula in 16 (30%) eyes. A single retinal break was found in 21 (40%) eyes, and 24 (45%) eyes had 2 to 4 retinal breaks. Twenty eight percent of breaks were located inferiorly between 5 to 7 clock hours. Primary and final anatomical success was achieved in 87% and 98% of cases, respectively. The most common cause of redetachment was proliferative vitreoretinopathy. The mean baseline BCVA improved from 1.1 ± 1.0 logarithm of the minimum angle of resolution (logMAR) to 0.6 ± 0.7 logMAR after retinal reattachment (P=0.001).
Conclusions :
PPV with or without phacoemulsification for primary RRD is associated with good visual and anatomical outcomes without restricted postoperative positioning. Postoperative positioning is troublesome to most patients and may not be necessary for all patients with RRD to achieve anatomical success. Further studies are required to validate these findings.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.