Combined 23-Gauge PPV and Scleral Buckle Versus 23-Gauge PPV Alone for Primary Repair of Pseudophakic Rhegmatogenous Retinal Detachment

Ophthalmic Surg Lasers Imaging Retina. 2015 Jul-Aug;46(7):702-7. doi: 10.3928/23258160-20150730-03.

Abstract

Background and objective: This review compares 23-gauge pars plana vitrectomy (PPV) alone versus combined 23-gauge pars plana vitrectomy and scleral buckle (PPV/SB) for primary repair of pseudophakic rhegmatogenous retinal detachment (RRD).

Patients and methods: A retrospective review of 70 eyes that underwent 23-gauge PPV and 43 eyes that received 23-gauge PPV/SB for pseudophakic RRD. Minimum follow-up was 3 months. Outcome measures included anatomical success, visual acuity, and complication rates.

Results: The 23-gauge PPV group achieved primary anatomical success in 58 of 70 cases (83%). Primary success in the PPV/SB group occurred in 36 of 43 cases (84%). Final anatomical success was achieved in all 113 cases (100%). The difference in primary success rates was not statistically significant (P = 1.000, Fisher exact test). Average visual acuity for macula-on RRDs in the PPV group showed a +0.07 logMAR improvement (P = .580) versus a +1.34 improvement (P < .001) in macula-off PPV cases. SB/PPV macula-on cases showed a decrease in logMAR visual acuity by -0.06 (P = .380) while macula-off SB/PPV cases improved by +1.28 (P = .002). There were no significant complications in either group.

Conclusion: Both 23-gauge PPV and PPV/SB are effective procedures for repairing pseudophakic RRD and exhibit similar rates of success.

Publication types

  • Comparative Study

MeSH terms

  • Endotamponade
  • Female
  • Fluorocarbons / administration & dosage
  • Follow-Up Studies
  • Humans
  • Intraocular Pressure / physiology
  • Intraoperative Complications
  • Male
  • Middle Aged
  • Postoperative Complications
  • Pseudophakia / surgery*
  • Retinal Detachment / physiopathology
  • Retinal Detachment / surgery*
  • Retrospective Studies
  • Scleral Buckling / methods*
  • Sulfur Hexafluoride / administration & dosage
  • Visual Acuity / physiology
  • Vitrectomy / methods*

Substances

  • Fluorocarbons
  • perflutren
  • Sulfur Hexafluoride