Vitrectomy with air tamponade for surgical repair of rhegmatogenous retinal detachment by eye position guided fluid-air exchange

Cheng, Yannan; Wang, Hua; Li, Bo; Ji, Meng; Shi, Qiang; Qi, Yun; Hu, Yuwen; Xie, An-Ming; Pei, Cheng

doi:10.18240/ijo.2020.09.13

Cited by 13 publications

(12 citation statements)

References 24 publications

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“…In accordance with previous observations, we found that using PFCL and performing a drainage retinotomy are not always necessary and they should be reserved for more complicated RRD cases [ 37 , 38 , 50 ]. We believe that complete drainage of subretinal fluid is not necessary except for patients who undergo SiO tamponade, to avoid the risk of PVR formation and recurrence of RRD due to incomplete filling of the vitreous chamber by SiO [ 51 ].…”

Section: Discussionsupporting

confidence: 92%

“…Recent studies have shown the safety and efficacy of PPV for the repair of uncomplicated RRD without the use of PFCL, with both gas [ 21 , 36 ] and air [ 37 , 38 ] tamponade. These studies also confirmed that anatomical retinal reattachment after PPV can be successfully achieved without complete drainage of subretinal fluid in the same way as observed in pneumatic retinopexy [ 39 ] and in scleral buckling [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have shown the safety and efficacy of PPV for the repair of uncomplicated RRD without the use of PFCL, with both gas [21,36] and air [37,38] tamponade.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy and Safety of Vitrectomy without Using Perfluorocarbon Liquids and Drainage Retinotomy Associated with Postoperative Positioning Based on Residual Subretinal Fluid for Rhegmatogenous Retinal Detachment

Chelazzi

Azzolini

Bellina

et al. 2021

Journal of Ophthalmology

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Medical records of 75 eyes from 75 consecutive patients with uncomplicated rhegmatogenous retinal detachment (RRD) who underwent pars plana vitrectomy (PPV) were analyzed. Inclusion criteria were patients with RRD who underwent primary 23- or 25-gauge PPV with air, gas, or SiO tamponade and performed by a single surgeon, no use of perfluorocarbon liquids (PFCL) and drainage retinotomy, and follow-up ≥ six months. Exclusion criteria were patients who underwent previous vitreoretinal surgery, proliferative vitreoretinopathy (PVR) more than grade B, giant tears, and encircling band associated with PPV. The main endpoint was the anatomical retinal reattachment rate after a single surgical procedure. Secondary endpoints were best-corrected visual acuity (BCVA), postoperative retinal displacement, and intraoperative and/or postoperative complications. Primary anatomical success was achieved in 97.3% of cases using this modified surgical procedure. Retinal slippage occurred only in 28.2% of patients and it was not observed in all cases of macula-on RRD. The mean logMAR of the BCVA significantly improved in 92% of patients and no intraoperative complications were observed. The results suggest that complete subretinal liquid drainage is not mandatory for all RRD cases treated with PPV and that using PFCL and performing a drainage retinotomy are not essential in eyes with primary RRD and PVR less than grade B. Postoperative positioning after PPV for uncomplicated RRD based on the presence or absence of residual subretinal fluid at the end of surgery could limit the occurrence of postoperative retinal displacement, while promoting patient compliance.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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Efficacy and Safety of Vitrectomy without Using Perfluorocarbon Liquids and Drainage Retinotomy Associated with Postoperative Positioning Based on Residual Subretinal Fluid for Rhegmatogenous Retinal Detachment

Chelazzi

Azzolini

Bellina

et al. 2021

Journal of Ophthalmology

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“…Another method for the drainage of SRF involves the use of original breaks; however, complete resolution of SRF through the original retinal breaks may be challenging. Several reports have indicated that residual SRF was present in 54.1%–55.4% of cases after drainage from original breaks, 6,25 and this residual SRF did not significantly influence the primary success rate. 6,25,26 Mimouni et al 27 reported that there were significantly fewer cases with residual SRF and outer retinal layer irregularity after drainage retinotomy than that after drainage through the original breaks, but the change in BCVA and the final BCVA was not significantly associated with residual SRF.…”

Section: Discussionmentioning

confidence: 89%

Drainage Retinotomy Is a Risk Factor for Surgical Failure After Pars Plana Vitrectomy in Patients With Primary Uncomplicated Rhegmatogenous Retinal Detachment

Ohara

Yuasa

Harada

et al. 2022

Retina

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Purpose: To identify risk factors for recurrent retinal detachment after uncomplicated pars plana vitrectomy in patients with primary rhegmatogenous retinal detachment (RRD).Methods: This single-center retrospective study included patients with primary RRD who underwent 23-gauge and 25-gauge pars plana vitrectomy at Hiroshima University Hospital between January 2016 and May 2021. All patients had $3 months of follow-up. Patients were excluded if they had preoperative proliferative vitreoretinopathy worse than Grade C1; giant retinal tears; tractional, exudative, or traumatic retinal detachment; or the use of perfluorocarbon liquid. Factors that influenced RRD treatment outcome and postoperative complications were evaluated.Results: We analyzed 519 eyes of 509 patients who underwent pars plana vitrectomy for primary RRD. The primary and final success rates were 93.8% and 99.8%, respectively. Drainage retinotomy was a risk factor for surgical failure in both multivariate analysis (odds ratio 2.36, 95% confidence interval 1.08-5.15, P = 0.0314) and a propensity scorematching analysis (odds ratio 3.20, 95% confidence interval 1.14-9.04, P = 0.0277). Postoperative epiretinal membrane was associated with drainage retinotomy in multivariate analysis (odds ratio 1.93, 95% confidence interval 1.04-3.57, P = 0.0358). Conclusion:The avoidance of drainage retinotomy during small-gauge pars plana vitrectomy in patients with RRD may lead to better surgical success and less frequent epiretinal membrane formation.

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“…While we continue to refine our choice and use of current technology, future developments in retinal surgery have already been reported and will surely influence future decisions. Such new developments include endolaser cerclage (Chaturvedi et al 2014;Falkner-Radner et al 2015), standard core and peripheral PPV with air tamponade (Cheng et al 2020), local dry vitrectomy combined with segmental scleral SB (Fei et al 2020), glue-assisted retinopexy in PPV without tamponade (Tyagi & Basu 2019) and localized PPV with air tamponade (Zhang et al 2017;Bonfiglio et al 2018). et al 2010;Lee et al 2014;Mohamed et al 2016;Schmidt et al 2019).…”

Section: Discussionmentioning

confidence: 99%

Retinal surgery quality indicators for uncomplicated primary rhegmatogenous retinal detachment without a national registry

Carlsson

Fricke

Dahlberg

et al. 2022

Acta Ophthalmologica

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Purpose: The objective of this study was to evaluate the possibility of analysing quality indicators for uncomplicated primary rhegmatogenous retinal detachment in a hospital department of ophthalmology without the support of a national registry or need to collect data from referring ophthalmological centres. Methods: In 2014, we operated 231 consecutive eyes with uncomplicated retinal detachment. Our quality indicators were primary anatomical success, final anatomical success and postoperative endophthalmitis. We reviewed medical records in our university surgical department retrospectively and compared them with medical records from the regional hospitals that had referred most of the operated patients and done their own postoperative examination. Our hypothesis was that any retinal re-detachment and/or serious postoperative complication would be reported back. Results:The medical records at the surgical department revealed primary anatomic success for 91.3% of eyes and final anatomical success of 99.6%. The data from the regional hospitals confirmed that our hypothesis was correct. All patients with adverse outcomes were referred back for reoperation. Patients who were not referred again had an attached retina and showed no signs of endophthalmitis. Conclusion: Our hypothesis that data in the surgical department's medical records would closely reflect those in referring hospitals was borne out. This supports, under current conditions, an effective strategy for analysing chosen quality indicators without relying on a national registry or reviewing records from regional hospitals.

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Vitrectomy with air tamponade for surgical repair of rhegmatogenous retinal detachment by eye position guided fluid-air exchange

Cited by 13 publications

References 24 publications

Efficacy and Safety of Vitrectomy without Using Perfluorocarbon Liquids and Drainage Retinotomy Associated with Postoperative Positioning Based on Residual Subretinal Fluid for Rhegmatogenous Retinal Detachment

Efficacy and Safety of Vitrectomy without Using Perfluorocarbon Liquids and Drainage Retinotomy Associated with Postoperative Positioning Based on Residual Subretinal Fluid for Rhegmatogenous Retinal Detachment

Drainage Retinotomy Is a Risk Factor for Surgical Failure After Pars Plana Vitrectomy in Patients With Primary Uncomplicated Rhegmatogenous Retinal Detachment

Retinal surgery quality indicators for uncomplicated primary rhegmatogenous retinal detachment without a national registry

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