Pars Plana Vitrectomy without Long-Acting Gas Tamponade for Primary Rhegmatogenous Retinal Detachment

Abstract

Purpose: To report the anatomical and visual results of primary pars plana vitrectomy (PPV) without long-acting gas tamponade to repair primary rhegmatogenous retinal detachments (RRDs). Methods: Twenty-seven consecutive patients (27 eyes) with peripheral retinal tears and new RRDs were treated according to the surgical protocol. Patients underwent PPV with fluid-air exchange and endolaser treatment to repair the RRD. Neither long-acting gas nor silicone oil tamponade was combined with PPV. All patients were followed from 6 to 26 months with an average follow-up of 11 months. Reattachment of the retina and visual outcome were compared to the results of previously published studies. Results: Reattachment was achieved in 24 of 27 eyes (89%) with a single operation, and in all 27 (100%) eyes, the retina was ultimately reattached with subsequent operations. The median initial visual acuity was 0.4, and the median final visual acuity was 1.0. Conclusions: Primary PPV with fluid-air exchange alone and laser treatment is a safe, effective method for the repair of primary retinal detachments. The anatomical reattachment rate and the visual acuity obtained with this technique appear to be at least as good as those reported in the literature for primary PPV combined with long-acting gas tamponade.

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.…”

“…In previous years, air tamponade has been more widely used than ever before for the limited access to expansile gas in China. According to previous reports, the single-operation success rate of PPV with air tamponade for RRDs varied from 79.0% to 100% [1,[4][5][6][7][8][9][10][11][12][13][14]. New or missed retinal breaks, reopening of original tears and PVR are the main causes of failure [1,6,7,[10][11][12][13][14][15][16][17].…”

“…According to previous reports, the single-operation success rate of PPV with air tamponade for RRDs varied from 79.0% to 100% [1,[4][5][6][7][8][9][10][11][12][13][14]. New or missed retinal breaks, reopening of original tears and PVR are the main causes of failure [1,6,7,[10][11][12][13][14][15][16][17]. The conditions of new or missed retinal breaks and PVR have been extensively investigated in previous studies [1,6,7,12,17].…”

Exclusive Use of Air as Gas Tamponade in Rhegmatogenous Retinal Detachment

“…In selected RRD cases where air was used as gas tamponade, noninferior results to long-acting gas have been reported [5, 7–10]. To the best of our knowledge, the current study is the first report of exclusive use of air as gas tamponade in vitrectomy for RRD.…”

Sutureless 25-Gauge Vitrectomy for Rhegmatogenous Retinal Detachment Caused by Superior Breaks Using Air Tamponade

“…In a study by Hotta et al, 25 which evaluated air tamponade with 20-gauge vitrectomy for primary RRD, the authors achieved a final visual acuity of greater than or equal to 0.4 for 96% of the included cases, primary reattachment of 89% of the included cases, and final reattachment of 100% of the included cases. However, it should be stressed here that the authors performed lensectomy in 78% of the cases.…”