Pars Plana Vitrectomy versus Combined Pars Plana Vitrectomy–Scleral Buckle for Primary Repair of Pseudophakic Retinal Detachment
Poster presented at: Retina Society Annual Meeting, September 2005, San Diego, California, and American Academy of Ophthalmology Annual Meeting, October 2005, Chicago, Illinois.
Received 29 July 2005; accepted 26 May 2006.
Purpose
To evaluate pars plana vitrectomy (PPV) versus a combined PPV and scleral buckle (PPV/SB) for repair of noncomplex, pseudophakic retinal detachment.
One hundred fifty-two eyes of 152 patients followed up for a mean of 10 months. The case series included 68 consecutive patients who underwent PPV and 84 consecutive patients who underwent a PPV/SB for primary repair of primary pseudophakic retinal detachment at Wills Eye Hospital between 2002 and 2004.
Methods
All primary PPV cases were performed by 2 surgeons who perform primary vitrectomy without regard to location of detachment, number and location of break(s), refractive error, or macula status. All primary PPV/SB were performed by a group of surgeons who solely perform PPV/SB on pseudophakic retinal detachments. All eyes underwent a standard 3-port 20-gauge PPV under wide-field viewing and scleral depression. Endolaser photocoagulation was applied either around the retinal tears or 360° to the vitreous base region followed by gas tamponade. Patients with proliferative vitreoretinopathy grade C or worse were excluded from the study.
Main Outcome Measures
(1) Single surgery anatomic success rates, (2) preoperative and postoperative visual acuity, and (3) complications.
Results
The single surgery anatomic success rate in the primary PPV group was 63 of 68 eyes (92.6%; 95% confidence interval [CI], 84%–98%) and in the primary PPV/SB group was 79 of 84 eyes (94.0%; 95% CI, 87%–98%). Both groups obtained 100% final reattachment rate. There was no statistically significant difference between the success rates (P = 0.75, Fisher exact test). The PPV group’s best-corrected postoperative visual acuity demonstrated a +0.10 logarithm of the minimum angle of resolution improvement over the PPV/SB group (P = 0.07). The PPV group had a smaller incidence of postoperative complications (13/68 patients [19.1%] vs. 27/84 patients [32.1%]; P = 0.10, Fisher exact test).
Conclusions
Primary PPV and PPV/SB seem to have similar efficacy in the repair of a matched group of patients with primary noncomplex pseudophakic retinal detachment. There was no statistically significant difference in complication rate between the 2 groups.
Correspondence to Eric D. Weichel, MD, Department of Ophthalmology, Walter Reed Army Medical Center, 6900 Georgia Avenue, Washington, DC 20307.
Manuscript no. 2005-702.
From the Eye Research Institute, Philadelphia, Pennsylvania, and Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania.
The authors have no conflicts of interest related to the article.
The views expressed in this article are those of the authors and do not reflect the official policy of the Department of the Army, Department of Defense, or United States Government.
ABSTRACT