Management of Inferior Breaks in Pseudophakic Rhegmatogenous Retinal Detachment With Pars Plana Vitrectomy and Air

Abstract

To determine the role of pars plana vitrectomy without scleral buckling and air as a tamponade with 24 hours of prone positioning in the management of inferior breaks in primary pseudophakic rhegmatogenous retinal detachment. Methods: Prospective, noncomparative, interventional case series. Fifteen consecutive eyes (15 patients) with primary pseudophakic rhegmatogenous retinal detachment with causative breaks located between the 4-o'clock and 8-o'clock positions underwent pars plana vitrectomy with air tamponade. The prone position was maintained for 24 hours. Anatomic and functional results are presented. Results: The anatomic reattachment rate was 93.3% after 1 procedure and 100% at the 6-month visit. Mean preoperative best-corrected visual acuity was 20/60 (range, 20/400 to 20/25) and mean postoperative bestcorrected visual acuity was 20/30 (range, 20/100 to 20/20). In 1 case the retina redetached at the second week because of an undetected break. Postoperative epiretinal membrane was observed in 1 case. Conclusion: Pars plana vitrectomy and air tamponade with only 24 hours of prone positioning postoperatively is effective in the management of primary pseudophakic rhegmatogenous retinal detachment with causative breaks between the 4-o'clock and 8-o'clock positions.

25-Gauge pars plana vitrectomy combined with air tamponade for primary rhegmatogenous retinal detachment

“…Two cases (5.4%) re-detached because of development of new breaks. In line with previous studies, 10 , 17 , 21 , 22 our data suggest that PPV with air tamponade can attain satisfactory outcomes for patients with primary RRD, even those with inferior breaks.…”

25-Gauge pars plana vitrectomy combined with air tamponade for primary rhegmatogenous retinal detachment

“…Two cases (5.4%) re-detached because of development of new breaks. In line with previous studies, 10 , 17 , 21 , 22 our data suggest that PPV with air tamponade can attain satisfactory outcomes for patients with primary RRD, even those with inferior breaks.…”

Pars plana vitrectomy for the repair of primary, inferior rhegmatogenous retinal detachment associated to inferior breaks. A comparison of a 25-gauge versus a 20-gauge system

“…The success rate obtained with the high-speed 20-G system is also in line with the results reported for standard 20-G PPV for RRDs involving the inferior quadrants [6, 9–12]. …”

The cause of redetachment after vitrectomy with air tamponade for a cohort of 1715 patients with retinal detachment: an analysis of retinal breaks reopening

“…Our study demonstrated that the single-operation success rate of PPV with air tamponade for the 1715 patients with RRDs was 92.0%, which is in tandem with previous studies where the primary reattachment rate varies from 79.0% to 100.0% [1,[4][5][6][7][8][9][10][11][12][13][14]. We analyzed the failure causes and described their distribution.…”

“…Therefore, instead of emphasizing the prone positioning, restricted activities should also be considered a critical factor. In agreement with previous findings, [13][14][15]. This series study demonstrated that facedown position did not influence the development of a chorioretinal adhesion in the treated retinal tears.…”

25-Gauge pars plana vitrectomy combined with air tamponade for primary rhegmatogenous retinal detachment

“…Two cases (5.4%) re-detached because of development of new breaks. In line with previous studies, 10 , 17 , 21 , 22 our data suggest that PPV with air tamponade can attain satisfactory outcomes for patients with primary RRD, even those with inferior breaks.…”

Pars plana vitrectomy for the repair of primary, inferior rhegmatogenous retinal detachment associated to inferior breaks. A comparison of a 25-gauge versus a 20-gauge system

“…The success rate obtained with the high-speed 20-G system is also in line with the results reported for standard 20-G PPV for RRDs involving the inferior quadrants [6, 9–12]. …”

The cause of redetachment after vitrectomy with air tamponade for a cohort of 1715 patients with retinal detachment: an analysis of retinal breaks reopening

“…Our study demonstrated that the single-operation success rate of PPV with air tamponade for the 1715 patients with RRDs was 92.0%, which is in tandem with previous studies where the primary reattachment rate varies from 79.0% to 100.0% [1,[4][5][6][7][8][9][10][11][12][13][14]. We analyzed the failure causes and described their distribution.…”

“…Therefore, instead of emphasizing the prone positioning, restricted activities should also be considered a critical factor. In agreement with previous findings, [13][14][15]. This series study demonstrated that facedown position did not influence the development of a chorioretinal adhesion in the treated retinal tears.…”

25-Gauge pars plana vitrectomy combined with air tamponade for primary rhegmatogenous retinal detachment

“…Two cases (5.4%) re-detached because of development of new breaks. In line with previous studies, 10 , 17 , 21 , 22 our data suggest that PPV with air tamponade can attain satisfactory outcomes for patients with primary RRD, even those with inferior breaks.…”

Pars plana vitrectomy for the repair of primary, inferior rhegmatogenous retinal detachment associated to inferior breaks. A comparison of a 25-gauge versus a 20-gauge system

“…The success rate obtained with the high-speed 20-G system is also in line with the results reported for standard 20-G PPV for RRDs involving the inferior quadrants [6, 9–12]. …”

The cause of redetachment after vitrectomy with air tamponade for a cohort of 1715 patients with retinal detachment: an analysis of retinal breaks reopening

“…Our study demonstrated that the single-operation success rate of PPV with air tamponade for the 1715 patients with RRDs was 92.0%, which is in tandem with previous studies where the primary reattachment rate varies from 79.0% to 100.0% [1,[4][5][6][7][8][9][10][11][12][13][14]. We analyzed the failure causes and described their distribution.…”

“…Therefore, instead of emphasizing the prone positioning, restricted activities should also be considered a critical factor. In agreement with previous findings, [13][14][15]. This series study demonstrated that facedown position did not influence the development of a chorioretinal adhesion in the treated retinal tears.…”