Abstract
Purpose :
Conventional Pars Plana Vitrectomy( PPV) for Rhegmatogenous Retinal Detachments (RRD) involves use of silicone oil or gas tamponades. These agents have complications like secondary glaucoma, corneal and lens changes and need for post operative positioning. This study describe the long term outcomes of a new surgical technique utilizing fibrin glue as temporary tamponade that obviates the need for oil or gas after PPV in cases of RRD
Methods :
25 eyes with RRD were assessed. Complete PPV was done in all cases followed by fluid–air exchange, laser photocoagulation around the breaks and application of 0.1 to 0.2ml of fibrin glue. No long-acting gas or silicone oil was used subsequently for tamponade . No postoperative positioning was prescribed. Primary outcome measure was defined as successful anatomical retinal reattachment. Secondary outcome measures were postoperative improvement in best corrected visual acuity (BCVA) and complications. Only patients with more than 6 months of follow up were included
Results :
The median age was 58 (range: 36-61) years and median duration of symptoms was 18 (range: 7- 60) days . There were 15 eyes with inferior ,7 superior and 3 total RDs. Successful reattachment was achieved in 19 out of 25 (76%) cases and was maintained at 6 months of follow-up. The median BCVA improved from 20/100 preoperatively to 20/80 at 1-week and 20/50 at 1-month postoperatively. Fibrin glue was noted to spontaneously resorb by 2 weeks in all cases. None of the eyes had any elevated intra-ocular pressures or unexpected inflammation . Two eyes developed cystoid macular edema at the end of 1 month visit which resolved with the use of topical nepafenac eye drops. Median follow up was 14 months (range 15-24 months).
Conclusions :
Fibrin glue plug can safely tamponade retinal breaks until the effect of laser retinopexy becomes permanent. Thus GuARD is a promising technique for the treatment of simple uncomplicated RRDs and allows early visual recovery while avoiding the problems of gas or oil tamponade
This is a 2020 ARVO Annual Meeting abstract.