Overall, complete vitrectomy with SOI resulted in significantly better anatomical outcomes and significantly less need for additional surgery as compared with PPV. In addition, in the posttraumatic subgroup, statistically better visual outcomes were noted in group 2 than in group 1.
Management of posteriorly dislocated crystalline lens has traditionally been performed with a standard 20-gauge vitrectomy system. The latest surgical platforms integrate multiple devices into single systems and feature advanced fluidics, vitreous cutting technology, and intraocular pressure control along with continued improvements in small-gauge instrumentation and wide-angle viewing systems. This allows truly robust removal of core vitreous and outstanding control of the surgical field on par with its 20-gauge predecessor, resulting in an expanded spectrum of complex vitreoretinal maneuvers feasible with 23- or 25-gauge systems. Posteriorly dislocated crystalline lens/intraocular lens is one such indication which can be safely and effectively managed by a 23- or 25-gauge vitrectomy system alone or combined with the 20-gauge fragmatome/forceps with lesser complications and early recovery.
Aim: To study the functional and anatomic outcomes of retinectomy of 180° or more in eyes with rhegmatogenous retinal detachment (RD) with advanced proliferative vitreoretinopathy (PVR) Grade D.
Materials and methods:A retrospective analysis of 51 eyes that underwent pars-plana vitrectomy (PPV) with 180° or more of retinectomy for RD with PVR Grade D was done. Main outcome measures included retinal reattachment, visual outcomes and complications at a follow-up of 12 months. Separate analysis for these parameters was also carried out for subgroup of one-eyed patients.Results: Overall retinal reattachment was achieved in 86.3% cases with mean improvement in BCVA of 0.59 ± 0.91 (statistically highly significant) at final follow-up. In subgroup of one-eyed patients (n = 11), retinal reattachment was achieved in 81.8% eyes with mean improvement of 0.52 ± 0.62 (significant) and 45.4% patients gained ambulatory vision. Main complications included recurrent PVR, optic atrophy, secondary glaucoma and hypotony.Conclusion: Retinectomies of 180° or more can help alleviate intractable traction in eyes with advanced PVR to achieve significant anatomical and functional improvement. This approach was found to be particularly valuable in one-eyed patients in order to achieve ambulatory vision.
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