25-gauge vitrectomy and gas for the management of rhegmatogenous retinal detachment

Abstract

Aims. To evaluate the anatomical and functional results in patients with rhegmatogenous retinal detachment (RRD) who underwent 25-gauge pars plana vitrectomy (PPV) with gas tamponade. Materials and Methods. A retrospective evaluation of 126 eyes of 126 patients (79 men, 47 women) with RRD who underwent 25-gauge PPV with gas tamponade (13% C3F8 in 87 eyes, 20% SF6 in 39 eyes). 113 patients (89.7%), were operated on under local anaesthesia, 13 patients (10.3%) under general anaesthesia. Macula was detached in 85 eyes (67.5%). 53 eyes had pseudophakic RRD, 73 eyes were phakic. Anatomical success of the primary intervention, change in best corrected visual acuity (BCVA) and incidence of complications were assessed. An average follow-up period is 7.2 months (6-15). Results. With single operation, retinal attachment was achieved in 125 eyes (99.2%); the final anatomical success was 100%. The initial mean BCVA was 0.89 logMar (2.00 to 0.00); at the end of the follow-up period, it improved to 0.23logMAR (1.00 to -0.10), P < 0,0001. During the first post-intervention day, hypotony of the eye below 10 mmHg was observed in 1 patient (0.8%); on the contrary, intraocular pressure was temporarily increased to 25 mmHg and more in 36 patients (28.6%). Conclusion. The surgical treatment of RRD using 25-gauge PPV with expansive gas tamponade renders excellent anatomical results and improvement in BCVA. The incidence of complications and necessity of sclerotomy suturing are low.

Surgical Treatment of Idiopathic Macular Hole Using Different Types of Tamponades and Different Postoperative Positioning Regimens

“…After PPV with gas tamponade, up to 35.6% of patients may have IOP above 30 mm Hg [ 38 ]. In a previous study of our research group, 28.5% of patients with detached retina and treated with PPV and gas tamponade had IOP ≥ 25 mmHg on the first postoperative day group of patients [ 39 ]. In contrast, eyes with air tamponade have shown the lowest risk of IOP elevation (cumulative risk of 11.5% for IOP elevation ≥ 30 mmHg after 48 hours) [ 40 ].…”

25-gauge vitrectomy with gas tamponade for rhegmatogenous retinal detachment: experienced vs. inexperienced surgeons

“…All patients underwent a three-port 25g PPV, using the oblique cannula insertion technique described previously [6], using a Constellation ® vitrectomy machine (Alcon, Fort Worth, TX, USA), with an Ultravit ® vitrectomy probe with a cutting rate of 5000 cuts/min. Valved cannulas were used in all patients starting in August 2016.…”

“…Rhegmatogenous retinal detachment (RRD) is a vision-threatening condition that requires prompt surgical intervention. Several surgical techniques for the treatment of RRD have been developed with scleral buckling, pneumatic retinopexy, and pars plana vitrectomy (PPV) being currently used [1][2][3][4][5][6].…”

25-gauge vitrectomy with gas tamponade for rhegmatogenous retinal detachment: experienced vs. inexperienced surgeons

“…All patients underwent a three-port 25 g PPV, using the oblique cannula insertion technique described previously [6], using a Constellation® vitrectomy machine (Alcon, Fort Worth, TX, USA), with an Ultravit® vitrectomy probe with a cutting rate of 5000 cuts/min. Valved cannulas were used in all patients starting in August 2016.…”