Abstract
Purpose :
To investigate the prevalence of vitreous cortex remnants (VCR) and the utility of VCR removal using a diamond-dusted membrane scrapers (DDMS) on visual and anatomic outcomes after pars plana vitrectomy (PPV) for primary rhegmatogenous retinal detachment (RRD) repair.
Methods :
We evaluated the prevalence of VCR in eyes that underwent PPV for primary RRD between July 2014 and February 2021. The presence or absence of VCR on the retinal surface extending from the macula to outside the vascular arcade was identified during PPV using triamcinolone acetonide. The VCR outside the vascular arcade was completely removed using a DDMS under a wide-viewing system. In some cases, the VCR at the fovea was also removed, though not always systematically assessed. Preoperative factors and outcomes were compared between eyes with VCR removed intraoperatively to those without VCR.
Results :
VCR was present and removed (VCR+) in 86 (46%) eyes and absent (VCR-) in 101 (54%) eyes. Patients with VCR were significantly older than those without (P=0.006). The preoperative BCVA (logarithm of the minimum angle of resolution) tended to be worse in VCR+ (1.23±0.92 [Snellen equivalent, 20/340]) than in VCR- (1.03±0.89 [20/214]), however, the difference was not statistically significant (P=0.095). There were no between-group differences in postoperative BCVA (VCR+ 0.44±0.54 [20/55]; VCR- 0.42±0.50 [20/53]; P=0.38) or visual improvement (+0.79±0.91, VCR+; +0.61±0.81, VCR-; P=0.31). SSAS was also comparable between the groups (90%, VCR+; 91%, VCR-; P=0.573). The incidence of postoperative PVR (9%, VCR+; 6%, VCR-; P=0.554) and postoperative ERM (28%, VCR+; 29%, VCR-; P=0.97) were comparable between the groups during mean follow-up period of 28.2 months.
Conclusions :
Nearly half of the patients with RRD had VCR, which was more likely to occur in older patients. VCR removal resulted in favorable functional and anatomical outcomes comparable to those in eyes without any VCR in patients with RRD.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.