Abstract
Purpose :
Subretinal fluid may be drained by a variety of methods. We aimed to evaluate the effect of different methods of subretinal fluid drainage on final surgical success in a cohort of patients undergoing vitrectomy and vitrectomy with scleral buckling for retinal detachment repair.
Methods :
A retrospective cohort study was conducted. At a single institution, patients with retinal detachment who underwent pars plana vitrectomy (PPV) or pars plana vitrectomy with scleral buckling (PPV/SB) were identified. Details about the surgical pathology (extent of detachment, number of breaks), preoperative vision, procedures performed, subretinal drainage method employed (i.e. perfluorocarbon liquid (PFO), retinotomy, drainage through retinal break), final postoperative vision, prevalence of redetachment and prevalence of postoperative proliferative vitreoretinopathy (PVR) were recorded. Fisher's exact test and student's t-test were conducted between groups of subretinal drainage method to identify significant differences in outcomes.
Results :
Three hundred and twenty cases of retinal detachment surgery were identified, 96 cases utilizing PPV alone, and 224 utilizing PPV/SB. Two hundred and fifty-three cases utilized PFO and 67 utilized either posterior retinotomy or drainage through a break. In all, 4 cases utilized a posterior retinotomy. Thirty-one (12%) cases in which PFO was used experienced redetachment, whereas 7 (10%) cases in which retinotomy or drainage through a break was utilized experienced redetachement (p=0.83). Thirty-seven (15%) cases using PFO, and seven (10%) cases using retinotomy or drainage through a break developed PVR (p=0.43). Average final vision (in logMAR) in the PFO group was 0.56, and in the non-PFO group was 0.58 (p=0.35). Improvement in vision postoperatively compared to preoperative vision was 0.45 in the PFO group versus 0.18 in the non-PFO group. While possibly clinically significant, this was not statistically significant (p=0.1). There were insufficient number of cases to stratify the non-PFO group further.
Conclusions :
The method of subretinal fluid drainage did not appear to have an effect on the final success of retinal redetachment surgery, nor did it have a significant effect on the development of PVR or final visual acuity. There may be a clinically significant advantage of PFO in terms of postoperative visual acuity improvement.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.