[Pars plana vitrectomy for pseudophakic retinal detachment].

Senn Peter, Schmid Martin K, Job Oliver, Hürlimann Anita, Schipper Isaak

Augenklinik Kantonsspital Luzern, Germany.

Klin Monbl Augenheilkd. 2002 Apr;219(4):226-30. doi: 10.1055/s-2002-30651.

BACKGROUND

Pars plana vitrectomy, usually without additional buckling procedures, is the first choice for repair of pseudophakic retinal detachment at the Lucerne Eye Hospital.

PATIENTS AND METHODS

In a retrospective study we analyzed a consecutive series of 129 eyes (122 patients) treated for pseudophakic retinal detachment. All underwent a primary pars plana vitrectomy. 97 % had retrobulbar anaesthesia. SF6 was used in 93 %, Si-oil in 7 %. An additional encircling band was placed in 5 %. Mean age was 65 years (24 - 92, +/- 13). Minimal follow-up was 8 months (8 - 66, median 25).

RESULTS

Mean duration of surgery was 90 minutes (50 - 140, +/- 15). Severe PVR grade C was present in 17 %. Breaks in the inferior part of the retina were found in 52 % - the localisation had no influence on the anatomical or functional outcome. A difference between preoperative and intraoperative findings was noted in 46 % (missed breaks or lattice degenerations etc.). For general medical reasons, Si-oil was not removed in 4 eyes. Complete reattachment after the first operation was achieved in overall 91 % (oil-left eyes were considered as failure); in 95 %, if the oil-left eyes were excluded from the study; in 93 %, if the eyes with encircling band were not counted; in 95 % without encircling-band and oil-left eyes; in 93 % without PVR-C cases; 95 % without encircling-band/oil-left/PVR-C eyes. Median final visual acuity was 1.0, if the macula was not detached preoperatively and 0.8, if the macula was detached. Intraocular pressure problems (> 30 mm Hg < 12 h and/or > 25 mm Hg > 36 h) were noted in 28 %. Prophylactic or therapeutic antiglaucomatous medication was applied in 58 %. 14 % showed a transient fibrin reaction in the anterior segment. Refraction and ocular motility were not influenced by the surgery.

CONCLUSION

Primary vitrectomy for pseudophakic retinal detachment is safe and effective. Transient elevation of the intraocular pressure is a frequent postoperative complication.