Primary 25-gauge sutureless vitrectomy with oblique sclerotomies in pseudophakic retinal detachment

Retina. 2008 Oct;28(8):1068-74. doi: 10.1097/IAE.0b013e318176de6f.

Abstract

Purpose: To evaluate the anatomic and functional outcomes of 25-gauge sutureless vitrectomy in primary treatment of noncomplex pseudophakic rhegmatogenous retinal detachments (RRD).

Methods: Prospective interventional institutional case series. Twenty-two eyes with pseudophakic RRD with proliferative vitreoretinopathy grade A or B underwent primary 25-gauge vitrectomy with oblique sclerotomies and gas endotamponade. Eyes with minimum follow-up of 6 months were evaluated. Main outcome measures were reattachment rate with single surgery, reoperation, complication rates, and changes in visual acuity (VA).

Results: Mean duration of visual loss was 14.68 +/- 12.87 days. Seventeen (77.27%) eyes had macular detachment. In all eyes 25-gauge sutureless vitrectomy was completed without complications. The mean follow-up period was 10.40 +/- 5.77 months. Retinal attachment was achieved in 21 (95.45%) eyes with single surgery and in all (100%) eyes with second vitrectomy. Mean preoperative VA of 1.61 +/- 1.18 improved to 0.50 +/- 0.53 at the last visit (P < 0.001). Transient hypotony was detected in 2 (9.09%) eyes with spontaneous resolution. No other postoperative complication was observed.

Conclusions: Twenty-five-gauge sutureless vitrectomy with oblique sclerotomies in primary treatment of noncomplex pseudophakic RRDs resulted in reattachment in 95.45% with single surgery, and in 100% with reoperation in one eye, accompanied by an increase in visual acuity in 86% of eyes.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Humans
  • Intraocular Pressure
  • Male
  • Middle Aged
  • Ocular Hypotension / etiology
  • Ocular Hypotension / physiopathology
  • Postoperative Period
  • Prospective Studies
  • Pseudophakia / complications
  • Pseudophakia / surgery*
  • Reoperation
  • Retinal Detachment / complications
  • Retinal Detachment / surgery*
  • Retinal Perforations / complications
  • Retinal Perforations / surgery*
  • Sclera / surgery*
  • Treatment Outcome
  • Visual Acuity
  • Vitrectomy / adverse effects
  • Vitrectomy / methods*
  • Vitreoretinopathy, Proliferative / complications