Two-staged surgery as an alternative to buckle–vitrectomy for rhegmatogenous retinal detachment complicated by choroidal detachment

Abstract

Aim To evaluate the outcome and safety profile of short-term perfluorocarbon liquids (PFCL) tamponade in comparison with buckle-vitrectomy in case of rhegmatogenous retinal detachment (RRD) associated with choroidal detachment (CD). Methods Records of patients who underwent surgery for RRD/CD from January 2016 to July 2019 were reviewed retrospectively. The patients were allocated into two groups-group 1 patients underwent bucklevitrectomy, while those in group 2 underwent a twostaged vitrectomy with short-term (5 days) PFCL tamponade. Results The study included 33 eyes (33 patients) with mean age of 50.3 ± 17.2 years. Group 1 included 15 patients, while group 2 included 18. The pre-operative characteristics were similar in both the groups. The mean pre-operative intraocular pressure in group 1 and 2 was 9.1 ± 4.0 and 8.6 ± 5.2 mmHg, respectively (p = 0.755). Retinal re-attachment after single surgery was achieved in 10 (66.7%) and 14 eyes (77.8%), respectively. All the eyes achieved retinal reattachment after repeat surgery in both the groups (1.40 vs 1.39 surgeries, p = 0.963). Post-surgery visual improvement was seen in 13 (86.7%) and 17 eyes (94.4%), respectively (p = 0.579). Final visual acuity of C 6/60 was obtained in 7 (46.7%) and 9 eyes (50.0%), respectively (p [ 0.999). None of the patients needed retinectomy during repeat surgery. None of the patients experienced exaggerated inflammation or intractable raised IOP spike which could not be controlled with medications. Conclusion Surgical outcomes were similar in both the groups. No clinically apparent toxicity was seen with post-operative short-term PFCL tamponade. Two-staged surgery is a good alternative to bucklevitrectomy for eyes with RRD associated with CD.

Clinical features, management, and outcomes of expulsive choroidal hemorrhage during cataract surgery: 13-year experience of a tertiary eye center

“…10,12 Staged surgery involving the initial temporary tamponade with PFCL followed by a strict supine positioning of the patient for 5 days and subsequent replacement of the PFCL with silicon oil in a second stage surgery have been proven to be beneficial in the management of choroidal detachment associated with retinal detachment. 32 In this series, 3 of the 6 patients who underwent drainage of the SCH underwent the staged surgery where pars plana vitrectomy, drainage of the SCH, and PFCL tamponade was performed in the first stage. This was followed by a strict supine positioning of the patient for 5 days and subsequent replacement of the PFCL with silicon oil after 5 days.…”

Retinal detachment in eyes treated with Aurolab aqueous drainage implant for refractory glaucoma - Incidence and outcomes

“…Two-staged surgery has been previously reported by the authors to be a good alternative to buckle– vitrectomy for eyes with RRD associated with CD and helps in the complete evacuation of residual blood clots by pushing the blood clots posteroanteriorly. [ 16 ] Mechanical stress on posterior ciliary arteries by choroidal effusion is proposed to be a major contributing factor in the development of SCH. [ 3 ] Waterhouse et al .…”

Combined Rhegmatogenous Retinal and Choroidal Detachment

“…vitrectomy (PPV), pars plana lensectomy (PPL), and perfluorocarbon liquid (PFCL) tamponade. [15][16][17][18] This systematic review aims to summarize demographics and associated risk factors for RRD-CD, the utility of adjuvant corticosteroids, and surgical interventions and outcomes. We aimed to answer the following specific questions-What are the demographics and baseline ocular characteristics of eyes with RRD-CD?…”

“…1,2,4,12–15 Various surgical approaches have been used including scleral buckle (SB), pars plana vitrectomy (PPV), pars plana lensectomy (PPL), and perfluorocarbon liquid (PFCL) tamponade. 15–18…”