[Vitrectomy in the treatment of simple retinal detachment].

PURPOSE

To report the indications and results of vitrectomy in the treatment of uncomplicated retinal detachment.

METHODS

This retrospective study covered 103 vitrectomies that were carried out during an 8-year period for the treatment of rhegmatogenous retinal detachment without severe proliferative vitreoretinopathy, macular hole, or giant tear. Mean follow-up time was 20.3 months.

RESULTS

The indications for vitrectomy were vitreal opacities in 32 cases, unseen or uncertain retinal breaks despite a good retinal view in 9 cases, a difficult arrangement of breaks in 34 cases, severe vitreal traction in 15 cases, and iatrogenic intraocular bleeding in 13 cases, 6 of them referred. In all, retinal breaks were uncertain or invisible in 49 cases. A buckle was used in 83 cases and an internal tamponade in 93. After vitrectomy, the retina was reattached in 76 cases, and after further surgery in 88 (85.4%). With vitrectomy, we were able to confirm or to detect all breaks in 36 cases. Of the 13 intraoperatively unseen breaks, 10 were responsible for vitrectomy failure. Late recurrence after more than 6 months was observed in 5 cases (4.9%). Secondary cataract was observed in 22 (66.6%) of the 33 phakic cases that had been operated on successfully and without complication.

CONCLUSION

Our results indicate that vitrectomy is a useful procedure in the management of certain cases of uncomplicated rhegmatogenous retinal detachment. However, secondary cataract is a problem, and the risk of late recurrence needs further evaluation.