Effect of Lens Status in the Surgical Success of 23-Gauge Primary Vitrectomy for the Management of Rhegmatogenous Retinal Detachment

Caiado, Rafael Ramos; Magalhães, Octaviano; Badaró, Emmerson; Maia, André; Novais, Eduardo Amorim; Stefanini, Francisco Rosa; Navarro, Rodrigo; Arévalo, J. Fernando; Wu, Lihteh; Moraes, Nilva Simeren Bueno de; Farah, Michel Eid; Maia, Maurício

doi:10.1097/iae.0000000000000307

Cited by 50 publications

(58 citation statements)

References 29 publications

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“…Retinal redetachment was observed in only 3 phakic and 2 pseudophakic eyes. The overall results obtained in the present study showed better trend in comparison to the study by Caiado et al, where 28–29% redetachment rate was reported for phakic eyes subjected to primary PPV with C 3 F 8 or SO tamponade, although their results are not truly comparable to ours, due to being reported on cases with uncomplicated RRD [10]. We also show that high retinal reattachment rate can be achieved without combining PPV and scleral buckle.…”

Section: Discussioncontrasting

confidence: 54%

“…PPV has several advantages compared to the scleral buckling technique [10]. In phakic eyes, however, access to the vitreous base is technically difficult, making PPV in such cases challenging, possibly being the reason for having higher incidence of redetachment in these patients [11, 12].…”

Section: Introductionmentioning

confidence: 99%

“…In phakic eyes, however, access to the vitreous base is technically difficult, making PPV in such cases challenging, possibly being the reason for having higher incidence of redetachment in these patients [11, 12]. In pseudophakic or aphakic eyes, on the other hand, a direct approach to the vitreous base may facilitate shaving of the vitreous base and also recognition and management of intraoperative vitreoretinal pathology [10]. This is the meaningful reason for many retinal surgeons to prefer a combined surgical technique (PPV with phacoemulsification and intraocular lens (IOL) implantation) [13].…”

Section: Introductionmentioning

confidence: 99%

“…The most often used tamponade for complex RRDs are perfluoropropane gas (C 3 F 8 ) and silicone oil (SO) [22]. SO is frequently used in patients with complex RRDs, when retinectomies are unavoidable, in patients having lost the fellow eye or in patients unable to comply with postoperative head positioning [10]. There are several different reports on the outcomes of surgery and reattachment rates for SO and intraocular gas tamponade in a heterogeneous groups of patients with RRD and the differing surgical approaches.…”

Section: Introductionmentioning

confidence: 99%

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Anatomical success rate of pars plana vitrectomy for treatment of complex rhegmatogenous retinal detachment

et al. 2016

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BackgroundPars plana vitrectomy (PPV) is preferred surgical procedure for the management of complex rhegmatogenous retinal detachment (RRD). The purpose of this study was to evaluate the anatomical results of primary PPV for the treatment of primary complex RRD and to determine the influence of lens status, tamponading agent, preoperative proliferative vitreoretinopathy (PVR) and axial length (AL) of the eye upon the anatomical outcome.MethodsA retrospective consecutive chart analysis was performed on 117 eyes from 117 patients with complex RRD managed with PPV. Fifty-nine eyes were phakic and 58 pseudophakic eyes. All patients had a minimum follow-up period of 12 months. Eyes were classified into groups using independent variables (first classification based upon lens status and tamponade used, second classification based upon lens and PVR status and third classification based upon AL of the eye). The groups were compared for anatomical outcomes (dependent variables) using nonparametric- or, in case of normally distributed data, parametric- statistical tests.ResultsRetinal reattachment rate in phakic eyes was 94.9% compared to 93.1% in pseudophakic, with no statistically significant difference between the two. The overall retinal reattachment rate with single surgery was 94.0%. Final reattachment rate was 97.4%. In case of established PVR ≥ C1, the reattachment rate was not statistically different (92.6%) from eyes with no PVR (91.1%) irrespective of lens status. A statistically significant difference was found between redetachment rates only between phakic eyes with gas tamponade compared to silicon oil (SO) (p = 0.001). Reattachment rate proved to be similar in both AL groups (≤24 mm and > 24 mm).ConclusionsHigh anatomical success rate of primary vitrectomy for complex RRD with either gas or SO tamponade was achieved in phakic as well as pseudophakic eyes irrespective of AL of the eye.

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Section: Discussioncontrasting

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Anatomical success rate of pars plana vitrectomy for treatment of complex rhegmatogenous retinal detachment

et al. 2016

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“…This corroborates the findings of a retrospective study by Caiado et al [30] which assessed the effects of lens status on the success rate of PPV for RD. The success rates of primary PPV with either gas or SO tamponade in pseudophakic eyes with RD was higher than the same procedure performed in phakic eyes.…”

Section: Discussionsupporting

confidence: 81%

Primary Retinal Detachment Surgery: Changes in Treatment and Outcome in an Austrian Tertiary Eye Center

Smretschnig¹,

Falkner-Radler²,

Spörl³

et al. 2017

Ophthalmologica

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Purpose: The surgery of choice for primary retinal detachment (RD) has shifted towards primary vitrectomy (PPV) in recent years. In this study, 2 cohorts of consecutive patients, treated by 8 retinal surgeons within a 7-year time span were compared. Methods: Baseline demographic data, surgical procedure, and outcome of patients with primary RD surgery between January 2007 and December 2008 (group 1, G1) and January 2012 and December 2013 (group 2, G2) were compared. Statistical analysis included univariate comparisons (Wilcoxon rank-sum test and χ² test) and ANCOVA (analysis of covariance) models. Results: The most common primary procedure was scleral buckling (n = 92, 66%) in G1 and PPV (n = 252, 85%) in G2 (p < 0.0001). Primary anatomical success rates were comparable (89%). The percentage of eyes with best corrected visual acuity (BCVA) equal or better than 0.3 logMAR (6/12) at final follow-up was significantly higher in G2 (61%, n = 156) compared to 49% (n = 68) in G1 (p = 0.0223). Conclusions: Within 7 years, a complete trend reversal could be observed shifting the primary surgical approach for RD towards PPV. Primary and final anatomical success rates were comparable, yet the later group experienced a significantly higher gain in BCVA, which approves the change in treatment regimen.

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Facts and Figures About Retinal Detachment Based on a Retinal Detachment Register from North Sweden

Olofsson

2018

Retinal Detachment Surgery and Proliferative Vitreoretinopathy

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Effect of Lens Status in the Surgical Success of 23-Gauge Primary Vitrectomy for the Management of Rhegmatogenous Retinal Detachment

Cited by 50 publications

References 29 publications

Anatomical success rate of pars plana vitrectomy for treatment of complex rhegmatogenous retinal detachment

Anatomical success rate of pars plana vitrectomy for treatment of complex rhegmatogenous retinal detachment

Primary Retinal Detachment Surgery: Changes in Treatment and Outcome in an Austrian Tertiary Eye Center

Facts and Figures About Retinal Detachment Based on a Retinal Detachment Register from North Sweden

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