Congree of 7th Mediterretina Club, İstanbul, Türkiye, 17 - 20 Nisan 2014, ss.61
7th MEDITEяRETINA CLUB International Meeting - April
17-20 2014 İstanbul
O -48
Peripheral Vitrectomy Under Air in Rhegmatogenous
Retinal Detachment
T Altan, K T Özbilen, R H
Babayev
İstanbul Eye Hospital
Purpose:
To evaluate the results of pars plana vitrectomy with peripheral vitreous
shaving under air in eyes with rhegmatogenous retinal detachment (RRD).
Patients and Methods: Fourty two eyes of 42 consecutive patients with RRD
were in-cluded in the study. All patients underwent 23G pars plana vitrectomy.
Phakic patients underwent phacoemulsification and intraocular lens implantation
at the same setting if they are in the presbyopic age, or they have a high
refractive error. Following central vitrectomy and removal of anterior hyaloid
perfluorodecaline was injected if there was Grade C PVR, if the detachment was
bullous, or if the macula was completely detached. Following heavy
perfluorocarbon liquid injection vitrectomy was performed up to the vitreous
base. Anteri-or subretinal fluid was drained via existing holes and
perfluorodecaline was removed with fluid-air exchange. Subretinal fluid was
drained from posterior drainage retinotomy under air in surgeries without
perfluorodecaline use. Vitreous base shaving was made under air in all eyes up
to just anterior to ora serrata.
Results: Fifteen woman and 27 man was included in the study.
Twelve of 19 phakic eyes underwent phacoemulsification and lens implantation at
the same setting. Patients were followed for 6.5±4 months. Only 5 eyes had
Grade C PVR. Perfluorodecaline was used in 13 (31%) eyes peroperatively.
Silicone oil was used as tamponade in 19 eyes, and C3F8 gas was used in the
remaining 23 eyes. Redetachment was developed in 4 (9.5%) eyes. Redetachment
was due to anterior PVR in 2 cases and was related to drainage retinotomy in
the other 2 cases. Complete reattachment was obtained in 3 of these cases and
shallow detachment anterior to the equator persisted in the other case after
repeat surgeries. Acci-dental peripheral holes was created in 2 eyes
peroperatively. Increased IOP was detected in 5 eyes, and fibrin reaction
developed in 3 eyes postoperatively.
Conclusion:
Vitreous base shaving under air in eyes with retinal detachment is a safe and
effective method. It has a high success and low complication rate. Scleral
indentation is not necessary during surgery. It also decreases the need for
heavy perfluorocarbon fluid use and the disadvantages due to its use.
Abstract book page:61