Session Title: Vitreoretinal Surgery II
Session Date/Time: Thursday 26/09/2013 | 14:30-16:00
Paper Time: 15:42
Venue: Hall 3 (Level 0)
First Author: C.Gupta INDIA
Co Author(s): C. Shroff D. Shroff P. Gupta G. Bhatia
To assess the anatomical and visual outcome after intravitreal gas injection for persistent or recurrent retinal detachment (RD) and risk factors for failure.
Retrospective, interventional case study conducted at a tertiary care centre
A retrospective analysis of 58 eyes with persistent or recurrent RD from January 2000 to July 2012 who underwent gas ( SF6 or C3F8) injection with intraoperative or postoperative retinopexy (usually within a week) was done. Patients were divided into four groups : Persistent RD post scleral buckle ( 29 eyes) , recurrent RD post scleral buckle (15 eyes), post vitrectomy RD (9 eyes), post silicon oil removal RD (5 eyes). Patients with redetachment with large breaks ,multiple breaks, vitreous haze and presence of PVR were excluded. Minimum follow up of 3 months was mandatory. Visual acuity, IOP and retinal status at baseline, 6 weeks, 3 months, 1 year and last follow up were analyzed.
Anatomical success (complete reattachment at 3 months) was achieved in 50 eyes (86.2%). 8 eyes ( 13.8%) who failed to reattach with this procedure underwent vitrectomy/ revitrectomy with gas/ oil tamponade. No significant difference was found in the anatomical outcome among the 4 groups. Mean logMAR postoperative visual acuity at 3 months was 0.507, significantly better than the preoperative visual acuity of 0.937 ( p< 0.01). Risk factors for failure were; high myopia (> -16D)- 2 eyes, choroidal coloboma – 1 eye, no definite break- 2 eyes, presence of choroidal detachment – 2 eyes and onset of PVR – 1 eye. 1 eye (1.8%) who had a successful reattachment had a late redetachment 5 years after gas injection. No other complication was recorded in the postoperative period.
Intravitreal gas injection seems to be a safe and relatively non invasive alternative to vitrectomy/ revitrectomy for persistent or recurrent retinal detachment with good anatomical and visual outcomes. A thorough preoperative assessment and correct case selection improves the success rate.