J Korean Ophthalmol Soc.  2016 Oct;57(10):1613-1618. 10.3341/jkos.2016.57.10.1613.

Prognostic Factors of Anatomical Success in Microincisional Vitrectomy for Rhegmatogenous Retinal Detachment

Affiliations
  • 1Department of Ophthalmology, Pusan National University College of Medicine, Busan, Korea. oph97@naver.com
  • 2Medical Research Institute, Pusan National University Hospital, Busan, Korea.
  • 3Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.

Abstract

PURPOSE
To determine the prognostic factors of primary anatomical success after microincisional vitrectomy for rhegmatogenous retinal detachment (RRD).
METHODS
The medical records of 206 eyes treated with microincisional vitrectomy for RRD from 2009 to 2014 were retrospectively reviewed. The preoperative factors (best corrected visual acuity, break sites, number of breaks, break size, extent of retinal detachment, high myopia, lens status) and intraoperative factors (combined cataract surgery, vitrectomy machine, tamponade, sclerotomy size) were investigated to determine correlations with primary anatomical success.
RESULTS
Of the 206 eyes, 198 eyes (96.1%) were reattached after primary vitrectomy; 46 eyes of 48 eyes with inferior breaks (95.8%, p = 1.000), 42 eyes of 44 pseudophakic eyes (95.5%, p = 1.000), 84 eyes of 89 eyes with multiple breaks (95.4%, p = 0.296). All 39 eyes using air tamponade (100%, p = 0.224) were reattached and there was no significant correlation with primary anatomical success. Conversely, 44 eyes of 49 eyes with high myopia (89.8%) were reattached after primary surgery, which was lower than non-high myopic eyes (98.1%, p = 0.028). Multivariate logistic regression showed that high myopia was an independent factor for primary reattachment failure (odds ratio = 5.795, 95% confidence interval = 1.332-25.208, p = 0.019).
CONCLUSIONS
Microincisional vitrectomy for RRD showed a high reattachment rate regardless of break site and number, lens status, or tamponade type. However, primary reattachment failure was relatively common in high myopia patients, thus, meticulous care is required.

Keyword

Pars plana vitrectomy; Prognosis; Rhegmatogenous retinal detachment

MeSH Terms

Cataract
Humans
Logistic Models
Medical Records
Myopia
Prognosis
Retinal Detachment*
Retinaldehyde*
Retrospective Studies
Visual Acuity
Vitrectomy*
Retinaldehyde

Cited by  1 articles

Subretinal Fluid Drainage through Original Breaks without Perfluorocarbon Liquid for Rhegmatogenous Retinal Detachment
Jong Heon Kim, Kyoo Won Lee, Hyun Gu Kang
J Korean Ophthalmol Soc. 2019;60(9):859-866.    doi: 10.3341/jkos.2019.60.9.859.


Reference

References

1. Woon WH, Burdon MA, Green WT, Chignell AH. Comparison of pars plana vitrectomy and scleral buckling for uncomplicated abdominal retinal detachment. Curr Opin Ophthalmol. 1995; 6:76–9.
2. Bartz-Schmidt KU, Kirchhof B, Heimann K. Primary vitrectomy for pseudophakic retinal detachment. Br J Ophthalmol. 1996; 80:346–9.
Article
3. Newman DK, Burton RL. Primary vitrectomy for pseudophakic and aphakic retinal detachments. Eye (Lond). 1999; 13(Pt 5):635–9.
Article
4. Wickham L, Connor M, Aylward GW. Vitrectomy and gas for abdominal break retinal detachments: are the results comparable to abdominal, gas, and scleral buckle? Br J Opthalmol. 2004; 88:1376–9.
5. Gartry DS, Chignell AH, Franks WA, Wong D. Pars plana abdominal for the treatment of rhegmatogenous retinal detachment uncomplicated by advanced proliferative vitreoretinopathy. Br J Ophthalmol. 1993; 77:199–203.
6. Brazitikos PD, Androudi S, Christen WG, Stangos NT. Primary pars plana vitrectomy versus scleral buckle surgery for the abdominal of pseudophakic retinal detachment: a randomized clinical trial. Retina. 2005; 25:957–64.
7. Park HJ, Seo MS. Clinical analysis according to treatment methods in simple retinal detachment. J Korean Ophthalmol Soc. 2001; 42:1277–83.
8. Sharma YR, Karunanithi S, Azad RV, et al. Functional and anatomic outcome of scleral buckling versus primary vitrectomy in abdominal retinal detachment. Acta Ophthalmol Scand. 2005; 83:293–7.
9. Koh TH, Choi MJ, Cho SW, et al. Scleral buckling and primary abdominal in simple rhegmatogenous retinal detachment. J Korean Ophthalmol Soc. 2010; 51:366–71.
10. Martínez-Castillo VJ, García-Arumí J, Boixadera A. Pars plana abdominal alone for the management of pseudophakic abdominal retinal detachment with only inferior breaks. Ophthalmology. 2016; 123:1563–9.
11. Schneider EW, Geraets RL, Johnson MW. Pars plana vitrectomy without adjuvant procedures for repair of primary rhegmatogenous retinal detachment. Retina. 2012; 32:213–9.
Article
12. Park SW, Kwon HJ, Kim HY, et al. Comparison of scleral buckling and vitrectomy using wide angle viewing system for abdominal retinal detachment in patients older than 35 years. BMC Ophthalmol. 2015; 15:121.
Article
13. Zhou C, Qiu Q, Zheng Z. Air versus gas tamponade in abdominal retinal detachment with inferior breaks after 23-gauge pars plana vitrectomy: a prospective, randomized comparative interventional study. Retina. 2015; 35:886–91.
14. Sinawat S, Ratanapakorn T, Sanguansak T, et al. Air vs perfluoropropane gas in pneumatic retinopexy: a randomized non-inferiority trial. Arch Ophthalmol. 2010; 128:1243–7.
15. Tan HS, Oberstein SY, Mura M, Bijl HM. Air versus gas abdominal in retinal detachment surgery. Br J Ophthalmol. 2013; 97:80–2.
16. Sharma A, Grigoropoulos V, Williamson TH. Management of abdominal rhegmatogenous retinal detachment with inferior breaks. Br J Ophthalmol. 2004; 88:1372–5.
17. Heimann H, Bornfeld N, Friedrichs W, et al. Primary vitrectomy without scleral buckling for rhegmatogenous retinal detachment. Graefes Arch Clin Exp Ophthalmol. 1996; 234:561–8.
Article
18. Eckardt C. Transconjunctival sutureless 23-gauge vitrectomy. Retina. 2005; 25:208–11.
Article
19. Nam Y, Chung H, Lee JY, et al. Comparison of 25- and 23-gauge sutureless microincision vitrectomy surgery in the treatment of various vitreoretinal diseases. Eye (Lond). 2010; 24:869–74.
Article
20. Miller DM, Riemann CD, Foster RE, Petersen MR. Primary repair of retinal detachment with 25-gauge pars plana vitrectomy. Retina. 2008; 28:931–6.
Article
21. Lee YH, Park JH, Sagong M, Chang WH. Surgical outcomes of transconjunctival 25-gauge plus pars plana vitrectomy for abdominal retinal detachment. J Korean Opthalmol Soc. 2015; 56:351–6.
22. Park SW, Kwon HJ, Shin MK, et al. Impact of age on scleral abdominal surgery for rhegmatogenous retinal detachment. J Korean Ophthalmol 2017. [In press].
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