Vitrectomy combined with air tamponade in the management of rhegmatogenous retinal detachment following previous vitreoretinal surgery

• Main Authors: Yu-Hong Cheng, Meng Ji, Yun Qi, An-Ming Xie, Hua Wang, Si-Wei Liu
• Format: Article
• Language: English
• Published: Press of International Journal of Ophthalmology (IJO PRESS) 2021-02-01
• Series: Guoji Yanke Zazhi
• Subjects: rhegmatogenous retinal detachment; superior retinal break; previous vitreoretinal surgery; pars plana vitrectomy; air tamponade
• Online Access: http://ies.ijo.cn/cn_publish/2021/2/202102035.pdf

AIM: To observe the efficacy and safety of pars plana vitrectomy(PPV)combined with air tamponade in the treatment of rhegmatogenous retinal detachment(RRD), which caused by superior break(s)following previous vitreoretinal surgery.METHODS: Retrospective analysis of the inpatients in our hospital from November 2017 to October 2019. Patients with RRD caused by superior break(s)who had underwent previous vitreoretinal surgeries and the proliferative vitreoretinopathy less than PVR-C1 were enrolled. For treatment, patients underwent PPV combined with air tamponade. During the operation, the residual vitreous cortex was fully removed, and the subretinal fluid was aspirated from retinal break(s)as much as possible. Make sure the subretinal fluid around the hole was fully drained. Then firmly laser spots were accomplished to seal the retinal break(s). Finally, filtered air was left in the vitreous cavity as tamponade agent. The patients were informed to keep a prone position for 24h postoperation. The primary outcomes were primary and final success rates, best corrected visual acuity(BCVA), and the secondary outcomes were rate of postoperative cataract surgery and high intraocular pressure.RESULTS: Totally 31 patients(31 eyes)with follow-up time more than 6mo were included. The range of retinal detachment was 6.7±3.8h, and the number of retinal breaks was 1.2±0.7. There are 23 eyes(74%)with macular detachment and 18 eyes(58%)with intraocular lens. 6 eyes(19%)were treated with phacoemulsification and intraocular lens implantation together. The rate of primary retinal reattachment in enrolled patients was 87%(27/31), and the final reattachment rate was 100%(31/31). At the 6mo of postoperatively, the BCVA(LogMAR)increased from 2.17±1.27 to 0.53±0.25(P<0.001). Furthermore, 5 eyes(16%)developed transient ocular hypertension.CONCLUSION: PPV with air tamponade can achieve a high success reattachment rate in the management of RRD following previous vitreoretinal surgery. It has the advantages of short postoperative prone time and fewer complications.