Comparison of Refractive Changes Following Pseudophakic Vitrectomy with or without Gas Tamponade

Abstract

To compare refractive changes following 23-gauge (G) vitrectomy with or without gas tamponade in pseudophakic eyes. This retrospective study included patients with neodymium: yttrium-aluminum-garnet (Nd: YAG) laser capsulotomy, who underwent 23 G pars plana vitrectomy (PPV) between February 2015 and March 2019. Indications for surgery included; rhegmatogenous retinal detachment in Group 1 and epiretinal membrane or vitreous hemorrhage (VH) in Group 2. Gas tamponade 12% perflouropropane (C3F8) was used in Group 1 whereas no tamponade was used in Group 2. The minimum follow-up was 24 months for both groups. A total of 47 patients were recruited (Group 1, n=27 and Group 2, n=20). The visual acuity improvement was statistically significant in both groups (p<0.001). A statistically significant myopic shift was observed in both groups [-0.40±0.54 diopter (D) (P=0.001) in Group 1; -0.17±0.29 D (P=0.017) in Group 2]. In addition, a myopic shift greater than 1 D was observed in 2 eyes (7.4%) in Group 1. The significant hyperopic shift was detected in 3 eyes (11.1%) in Group 1 and 5 eyes (25%) in Group 2. Surgically induced astigmatism was similar between groups [0.46±0.25 D in Group 1 and 0.54±0.26 D in Group 2, (P=0.314)]. Postoperative complications included VH (n=1/27) and macular hole (n=1/27) in Group 1. The clinically significant myopic shift may occur following 23 G vitrectomy in pseudophakic eyes. Eyes with gas tamponade are more prone to myopic shift, possibly due to anterior movement of the intraocular lens. Therefore, targeting slight residual hyperopia (+0.50 D) might be suggested in patients with gas tamponade.

Conjunctival, Scleral and Corneal Complications in Vitreoretinal Surgery

“…Vitrektomi işleminin kendiside psödofakik bireylerde 0,15 ile 0,85 arasında miyopik şifte neden olabilmektedir. Çoğu zaman bu durum geçici olmakta veya zamanla azalmaktadır 27,28. Ayrıca işlem sırasında uygulanan skleral koterizasyon veya sütür kullanımı cerrahi sonrası erken dönemde geçici silindirik değerlerde değişime yol açabilmektedir ve cerrahi sonrası 4-6 ay gibi bir dönemde cerrahi öncesi değerlere dönmektedir.…”