The comparison of the surgical outcome of 27-gauge pars plana vitrectomy for primary rhegmatogenous retinal detachment between air and SF6 gas tamponade

Tetsumoto, Akira; Imai, Hisanori; Hayashida, Miyeko; Otsuka, Keiko; Matsumiya, Wataru; Miki, Akiko; Nakamura, Makoto

doi:10.1038/s41433-019-0726-2

Cited by 36 publications

(51 citation statements)

References 27 publications

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“…However, GT has several disadvantages including: extended visual rehabilitation, post-operative visual disturbance, restrictions on flying and daily activity and increased cataract formation. 1 As cataract formation is linked to the longevity of gas exposure, 1 –5 air tamponade (AT) may offer reduced cataract formation, quicker rehabilitation and early detection of primary failure prior to proliferative vitreoretinopathy (PVR) formation. Using filtered air as AT following fluid-air-exchange (FAX), minimises potential operational error in GT-related concentration calculations.…”

Section: Introductionmentioning

confidence: 99%

Vitrectomy with air tamponade and cryotherapy for retinal detachment repair without perfluorocarbon use: A UK 12-month prospective case series

Moussa

Mathews

Makhzoum

et al. 2020

European Journal of Ophthalmology

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Introduction: Rhegmatogenous retinal detachment (RRD) is commonly managed by pars plana vitrectomy (PPV). Gas tamponade has significant clinical and quality of life factors that affect the patient. Using shorter acting air tamponade, intuitively leads to surgical concern for higher rate of primary detachment. To circumvent this, surgeons advocate the use of perfluorocarbon to maximise sub-retinal-fluid drainage when using air tamponade and/or avoid using cryotherapy due to longer duration for scar formation relative to laser. These steps are a deviation from traditional technique for otherwise routine primary RRD repair and discourages popularisation of using air tamponade despite the benefits to patients. Method: Prospective 12-month, single centre, single surgeon, consecutive study from January to December 2019. Inclusion criteria was as per based on the pneumatic retinopexy versus vitrectomy for retinal detachment: (i) single retinal break or group of breaks, no larger than 1-clock-hour (30°), in detached retina; (ii) all breaks in detached retina lie above the 8 to 4 o’clock meridian; and (iii) breaks or lattice degeneration in attached retina at any location. We excluded PVR formation and RRD in the inferior 4 o’clock hours. Results: We report primary and final success rate of 96% and 100%, respectively in 23 eyes (22 macular-on and one macular-off) with RRD eyes in a 12-month period. Cryopexy was utilised in 65% patients and in isolation in 23% with no perfluorocarbon use in all eyes. Conclusion: We show cryotherapy can be used safely in AT-RRD without PFCL in RRD fulfilling PIVOT trial criteria with minimal cataract formation and IOP spikes and faster post-operative visual rehabilitation.

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Section: Introductionmentioning

confidence: 99%

Vitrectomy with air tamponade and cryotherapy for retinal detachment repair without perfluorocarbon use: A UK 12-month prospective case series

Moussa

Mathews

Makhzoum

et al. 2020

European Journal of Ophthalmology

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“…In addition, Bell's phenomenon might result in the exposure of breaks to intravitreal fluid and not to gas, especially when the eyes are shut 17 . Tetsumoto et al reported that the gas may act better on the peripheral retina in the supine position than in the prone position 18 . However, standard ophthalmic examinations, such as slit lamp examination, anterior segment optical coherence tomography or ultrasound biomicroscopy, do not reveal whether the tamponade gas closes the breaks when patients are in prone position or when the eyes are shut.…”

mentioning

confidence: 99%

Evaluation of intraocular gas using magnetic resonance imaging after pars plana vitrectomy with gas tamponade for rhegmatogenous retinal detachment

Gozawa

Kanamoto

Ishida

et al. 2020

Sci Rep

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We used magnetic resonance imaging (MRI) to assess how a patient's posture affects intraocular gas changes and whether the postoperative prone position is required after pars plana vitrectomy (ppV) with gas tamponade for rhegmatogenous retinal detachments (RRDs). eight patients with RRDs who underwent ppV combined with cataract surgery with gas tamponade were prospectively included. they underwent MRi examination both in the prone and supine positions. We separated the retina into four parts: superior-posterior, superior-anterior, inferior-posterior, and inferior-anterior. We then calculated the gas contact rate as (the length of the retina contacting the gas in each retinal part) divided by (the length of each retinal part) × 100% in both the prone and supine positions. The mean gas contact rate of the superior-anterior part of the retina was significantly higher (P = 0.006) in the supine position than in the prone position. the mean gas contact rate of the inferior-anterior part of the retina was also significantly higher (P = 0.0004) in the supine position than in the prone position. We believe that if all retinal breaks were located anterior to the equator, the supine position may provide better tamponade gas coverage for the breaks than the prone position. Although potential postoperative complications caused by the supine position require careful attention, our result may shorten the duration of postoperative prone position and may decrease the patients' discomfort after ppV with gas tamponade for RRDs.

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“…Recent series have reported high success rates with air tamponade alone in RRD with inferior breaks, suggesting that tamponade in vitrectomy may not act purely by break closure, but also by a reduction in intraocular fluid currents. [49][50][51] PPV: visual outcomes Typically, visual recovery is closely linked with macular status pre-operatively, but macula-sparing cases can have worse vison postoperatively from macular involvement by displaced SRF intraoperatively, as well as some degree of epiretinal membrane (ERM) formation (35%) and CMO (15%) which can also effect visual recovery and require revision surgery for ERM in up to 15% of cases. 52 The Pneumatic Retinopexy versus Vitrectomy for the Management of Primary RRD Outcomes Randomized Trial (PIVOT) compared outcomes following PnR and PPV for primary RRD, and reported that BCVA had improved by 3 and 61 Early Treatment Diabetic Retinopathy Study (ETDRS) letters at 1 year following PPV for macula-on and macula-off RRD, respectively.…”

Section: Sb: Visual Outcomesmentioning

confidence: 99%

Rhegmatogenous retinal detachment: a review of current practice in diagnosis and management

et al. 2020

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Rhegmatogenous retinal detachment (RRD) is a common condition with an increasing incidence, related to the ageing demographics of many populations and the rising global prevalence of myopia, both well known risk factors. Previously untreatable, RRD now achieves primary surgical success rates of over 80%–90% with complex cases also amenable to treatment. The optimal management for RRD attracts much debate with the main options of pneumatic retinopexy, scleral buckling and vitrectomy all having their proponents based on surgeon experience and preference, case mix and equipment availability. The aim of this review is to provide an overview for the non-retina specialist that will aid and inform their understanding and discussions with patients. We review the incidence and pathogenesis of RRD, present a systematic approach to diagnosis and treatment with special consideration to managing the fellow eye and summarise surgical success and visual recovery following different surgical options.

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The comparison of the surgical outcome of 27-gauge pars plana vitrectomy for primary rhegmatogenous retinal detachment between air and SF6 gas tamponade

Cited by 36 publications

References 27 publications

Vitrectomy with air tamponade and cryotherapy for retinal detachment repair without perfluorocarbon use: A UK 12-month prospective case series

Vitrectomy with air tamponade and cryotherapy for retinal detachment repair without perfluorocarbon use: A UK 12-month prospective case series

Evaluation of intraocular gas using magnetic resonance imaging after pars plana vitrectomy with gas tamponade for rhegmatogenous retinal detachment

Rhegmatogenous retinal detachment: a review of current practice in diagnosis and management

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