Pars plana vitrectomy combined with scleral buckle versus pars plana vitrectomy for giant retinal tear

Gutiérrez, Mario; Rodríguez, José Luis Martín; Cruz, Diego Zamora-de La; Pimentel, Mariana A. Flores; Jiménez-Corona, Aída; Novak, Linda C.; Hidalgo, Rene Cano; Graue, Federico

doi:10.1002/14651858.cd012646.pub2

Cited by 12 publications

(11 citation statements)

References 63 publications

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“…In our sample, redetachment occurred in 53% of cases that presented with PVR, which is similar to other reports. [6][7][8] Eyes without PVR had better final visual outcomes than eyes with PVR. 1 The role of the encircling buckle in GRT management is controversial.…”

Section: Discussionmentioning

confidence: 99%

“…PVR occurs when a large area of the retinal pigment epithelium is exposed. 8 The incidence of advanced PVR (grade C1 or greater) in cases with a GRT is variable. In 2 prospective studies, 2,13 the incidence of PVR was over 30%.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, the indentation of the buckle could eventually induce intraoperative slippage of the posterior flap of the tear, redundant retinal folds, and fish mouthing. 8 In a prospective series of 212 cases, Scott et al 2 found that those managed without an encircling band had a higher risk for redetachment. This association was statistically significant in the univariate analysis only.…”

Section: Discussionmentioning

confidence: 99%

“…2,[5][6][7] Nevertheless, the role of other vitrectomy adjuncts, such as scleral buckling, lensectomy, a 360-degree laser barrier, and the type of endotamponade, remains under debate, and the available evidence on this topic is limited. [8][9][10][11] We report the surgical outcomes and the impact of several preoperative factors and surgical adjuncts on the retinal reattachment rate in a large series of GRT-RRD cases treated at a single center in Chile over the past 2 decades.…”

Section: Introductionmentioning

confidence: 99%

“…2,5–7 Nevertheless, the role of other vitrectomy adjuncts, such as scleral buckling, lensectomy, a 360-degree laser barrier, and the type of endotamponade, remains under debate, and the available evidence on this topic is limited. 8–11…”

Section: Introductionmentioning

confidence: 99%

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Retinal Detachment Associated With Giant Retinal Tears: Surgical Management and Outcomes in the Past 2 Decades

Varela

Morales

Díaz

et al. 2023

Journal of VitreoRetinal Diseases

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Purpose: To describe the surgical outcomes of rhegmatogenous retinal detachments (RRDs) associated with giant retinal tears (GRTs) and define factors associated with primary anatomic failure. Methods: This retrospective consecutive study comprised primary GRT-RRD surgeries between 1999 and 2021 at a single institution. Exclusion criteria were a follow-up of less than 3 months and incomplete surgical data. Results: The series included 69 eyes (64 patients). Single-surgery anatomic success (SSAS) was achieved in 75% and final anatomic success (FAS) in 90%. The mean logMAR visual acuity improved from 1.5 ± 1.1 to 0.6 ± 0.9. Preoperative factors significantly associated with redetachment were proliferative vitreoretinopathy (PVR) (odds ratio [OR], 6.2; P < .01), hypotony (OR, 13.6; P < .01), and a 180-degree or larger GRT (OR, 3.3; P = .04). All cases were treated with pars plana vitrectomy (PPV) and perfluoro-N-octane (PFCL). Perfluoropropane (C3F8) was used in 59% and silicone oil in 41%; the redetachment rate was significantly lower in gas cases (15% vs 39%) ( P = .02). An encircling band, placed in 84% eyes, had a tendency to reduce redetachment (22% vs 36%) ( P = .32). Lensectomy was performed in 61% of phakic eyes, with no effect on redetachment (20% vs 21%) ( P = .92). On multivariate analysis, PVR and hypotony were significantly associated with redetachment. Conclusions: PPV with PFCL achieved high SSAS and FAS rates. PVR and hypotony were the main preoperative factors associated with anatomic failure. In cases without PVR, C3F8 tamponade significantly increased SSAS. Encircling scleral buckling showed a nonsignificant tendency toward an increase in SSAS. Lensectomy had no effect on SSAS.

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