Homayoun Tabandeh 1 , Nikolas J S London 2 , David S Boyer 3 , Harry W Flynn 4 Show Affiliations »
Abstract
PURPOSE: To evaluate outcomes of small-gauge pars plana vitrectomy (PPV) for the treatment of rhegmatogenous retinal detachment (RD) without scleral-depressed shaving of the vitreous base. METHODS: Retrospective, consecutive case series. Surgical technique included small-gauge PPV (25G, 23G, 25G+ or 27G) and wide-angle vitrectomy viewing system in all cases. No cases were excluded based on the level of complexity of RD. Outcome measures were retinal reattachment rates and Snellen visual acuity (best-corrected visual activity [BCVA]). RESULTS: 312 eyes of 301 patients, mean age 60.8 years, and mean follow-up 23.1 months. Baseline characteristics included macula-off RD in 207 (66%) eyes, psudophakia in 124 (40%) eyes, high myopia in 74 (24%) eyes and giant retinal tear in 14 (5%) eyes. The retina was reattached with one procedure in 296 (95%) eyes. Final retinal reattachment was achieved in 310 (99%) eyes. The BCVA at baseline was >20/40 in 76 (24%) eyes, 20/50-20/100 in 48 (15%) eyes, 20/200-20/400 in 46 (15%) eyes and <20/400 in 142 (46%) eyes. At the last follow-up, the BCVA was >20/40 in 168 (54%) eyes, 20/50-20/100 in 60 (19%) eyes, 20/200-20/400 in 49 (16%) eyes and <20/400 in 35 (11%) eyes. The mean change in logMAR equivalent was -0.12 for the macula-on group and -1.13 for the macula-off group (p<0.0001). CONCLUSION: Small-gauge PPV without scleral-depressed vitreous base shaving can be associated with good anatomical and visual outcomes. Case selection based on the complexity of RD may not be required when considering small-gauge PPV. © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
PURPOSE: To evaluate outcomes of small-gauge pars plana vitrectomy (PPV) for the treatment of rhegmatogenous retinal detachment (RD) without scleral-depressed shaving of the vitreous base. METHODS: Retrospective, consecutive case series. Surgical technique included small-gauge PPV (25G, 23G, 25G+ or 27G) and wide-angle vitrectomy viewing system in all cases. No cases were excluded based on the level of complexity of RD. Outcome measures were retinal reattachment rates and Snellen visual acuity (best-corrected visual activity [BCVA ]). RESULTS: 312 eyes of 301 patients , mean age 60.8 years, and mean follow-up 23.1 months. Baseline characteristics included macula-off RD in 207 (66%) eyes, psudophakia in 124 (40%) eyes, high myopia in 74 (24%) eyes and giant retinal tear in 14 (5%) eyes. The retina was reattached with one procedure in 296 (95%) eyes. Final retinal reattachment was achieved in 310 (99%) eyes. The BCVA at baseline was >20/40 in 76 (24%) eyes, 20/50-20/100 in 48 (15%) eyes, 20/200-20/400 in 46 (15%) eyes and <20/400 in 142 (46%) eyes. At the last follow-up, the BCVA was >20/40 in 168 (54%) eyes, 20/50-20/100 in 60 (19%) eyes, 20/200-20/400 in 49 (16%) eyes and <20/400 in 35 (11%) eyes. The mean change in logMAR equivalent was -0.12 for the macula-on group and -1.13 for the macula-off group (p<0.0001). CONCLUSION: Small-gauge PPV without scleral-depressed vitreous base shaving can be associated with good anatomical and visual outcomes. Case selection based on the complexity of RD may not be required when considering small-gauge PPV. © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Entities: Chemical
Disease
Species
Keywords:
23 25 and 27 gauge vitrectomy; microincision small gauge pars plana vitrectomy; retinal detachment; scleral depression; vitreous shave
Mesh： See more »
Year: 2019
PMID： 30770355 DOI： 10.1136/bjophthalmol-2018-313626
Source DB: PubMed Journal: Br J Ophthalmol ISSN： 0007-1161 Impact factor: 4.638