Endoilluminator-assisted scleral buckling and vitrectomy in the treatment of primary rhegmatogenous retinal detachment

Session Details

Session Title: Free Paper Session 1: Vitreoretinal Surgery I

Session Date/Time: Thursday 07/09/2017 | 09:00-10:30

Paper Time: 09:06

Venue: Room 111

First Author: : T.Imshenetskaya BELARUS

Co Author(s): :    V. Yarmak   V. Markevich                          

Abstract Details

Purpose:

To evaluate the efficiency and the safety of surgical treatment of primary rhegmatogenous retinal detachment (RRD) with 23 G vitrectomy plus encircling band and endoilluminator-assisted scleral buckling (EASB). There are many surgical methods commonly used for repair of primary rhegmatogenous retinal detachment including pars plana vitrectomy (PPV) with or without gas or silicone oil tamponade, pneumoretinocerglage, scleral buckling, including endoilluminator-assisted scleral buckling or a combination of these procedures.

Setting:

Belarusian medical academy of postgraduate education

Methods:

Sixty two eyes of 62 patients (41 males and 21 females) with primary RRD complicated by proliferative vitreoretinopathy ≤C. All patients were divided into two groups: 49 eyes were with “macula-off” RRD (79 %) and 13 eyes were with “macula-on” RRD (21 %) were evaluated during 2-year period (2015-2016). Baseline characteristics including age, etiological diagnosis, duration of detachment, preoperative visual acuity (VA), lens status and PVR grade were recorded. All patients underwent 23G vitrectomy plus encircling band and endoilluminator-assisted scleral buckling after retinal tear visualization in 36 patients (58 %). Successful break determination was followed by standard scleral buckling under surgical microscope with a non-contact wide angle viewing system. Endotamponade was performed in 92.7% patients: 49.7% by gas (SF6), 26.4% by silicon oil. Patients were assessed for anatomical retinal attachment and VA change at 1st day, 1 and 4 weeks, 3 months and 3 monthly there after till 2 years.

Results:

At least one intraoperative break could be localized in 36 of 62 (58 %) eyes. Median age of these patients was 48 years (range: 17-74). 41 eyes (66.1%) were phakic, 21 (33.9%) were pseudophakic. Good final visual prognosis was significantly associated with initial visual acuity ≥ 20/200 and “macula-on” retinal detachment. Anatomical success (attachment of retina) was achieved in 83.1% eyes with EASB and in 85.6% eyes with cerclage and 23G vitrectomy. All eyes remained attached at the end of 2 years. Significant improvement in mean visual acuity (VA) was achieved at the end of follow-up in 92.4% cases.

Conclusions:

Vitrectomy plus equatorial cerclage and endoilluminator-assisted scleral buckling can be considered an effective surgical method in primary rhegmatogenous retinal detachment (RRD) cases.

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