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23-gauge transconjunctival sutureless vitrectomy versus 20-gauge vitrectomy with scleral buckling in pseudophakic rhegmatogenous retinal detachment

Session Details

Session Title: Vitreoretinal Surgery III

Session Date/Time: Friday 12/09/2014 | 08:00-10:00

Paper Time: 08:08

Venue: Boulevard E

First Author: : R.Singh INDIA

Co Author(s): :    R. Samanta   M.R. Dogra   A. Gupta        

Abstract Details

Purpose:

The aim of our study was to compare the outcomes of 23-gauge TSV alone with SF6 tamponade and 20-gauge PPV with SB (240 band) and SF6 tamponade in repair of pseudophakic rhegmatogenous retinal detachments (RRDs).

Setting:

A tertiary care referral eye center

Methods:

This randomised prospective study included total 30 eyes of 30 patients (15 in each group). Inclusion criteria for both the group included pseudophakic RRD patients older than 40 years with PVR less than grade C . We performed this comparative study by randomly distributing pseudophakic RRD patients into group A (23-gauge TSV/SF6) & group B (20-gauge PPV/SB/SF6) and prospectively followed them for 3 months. Primary outcome of the study was to compare anatomical success rate between 23 gauge TSV /SF6 tamponade (group A) and 20 gauge PPV/SB/SF6 tamponade (group B) at the end of 3 months. Secondary outcome measures included postoperative BCVA at 3 months, intraoperative complications and post operative complications.

Results:

The single surgery anatomical attachment rate was 86.7% in group A and 93.3% in group B (the difference is not statistically significant). The final attachment rate found was 100% in both the groups.There is no statistically significant difference in final visual outcome in between the two groups.There were two re-detachments in group A. Both had inferior re-RD with inferior breaks. There was one re-detachment in group B which was not associated with inferior break. The occurrence of intra-operative complications was identical in both the groups. Both the groups had one case of intra-operative limited shallow choroidal detachment. Only one patient in group A (23-gauge TSV) required suturing of one of the scleral ports. None of the patients in either group had hypotony or endophthlmtis in the post-operative period.

Conclusions:

Our prospective randomized comparative study in repair of pseudophakic rhegmatogenous retinal detachments could not find any statistically significant difference in anatomical and visual outcome between 23-gauge TSV/SF6 tamponade and 20-gauge PPV/SB/SF6 tamponade. Both the groups had identical intra-operative complications. However, in cases of RDs with inferior breaks, 23-gauge TSV/SF6 tamponade without SB had lower single surgery success rate as compared to 20-gauge PPV/SB/SF6 tamponade

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