25-gauge vitrectomy and gas for the management of rhegmatogenous retinal detachment

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2019 Feb;163(1):80-84. doi: 10.5507/bp.2018.034. Epub 2018 Jun 21.

Abstract

Aims: To evaluate the anatomical and functional results in patients with rhegmatogenous retinal detachment (RRD) who underwent 25-gauge pars plana vitrectomy (PPV) with gas tamponade.

Materials and methods: A retrospective evaluation of 126 eyes of 126 patients (79 men, 47 women) with RRD who underwent 25-gauge PPV with gas tamponade (13% C3F8 in 87 eyes, 20% SF6 in 39 eyes). 113 patients (89.7%), were operated on under local anaesthesia, 13 patients (10.3%) under general anaesthesia. Macula was detached in 85 eyes (67.5%). 53 eyes had pseudophakic RRD, 73 eyes were phakic. Anatomical success of the primary intervention, change in best corrected visual acuity (BCVA) and incidence of complications were assessed. An average follow-up period is 7.2 months (6-15).

Results: With single operation, retinal attachment was achieved in 125 eyes (99.2%); the final anatomical success was 100%. The initial mean BCVA was 0.89 logMar (2.00 to 0.00); at the end of the follow-up period, it improved to 0.23logMAR (1.00 to -0.10), P < 0,0001. During the first post-intervention day, hypotony of the eye below 10 mmHg was observed in 1 patient (0.8%); on the contrary, intraocular pressure was temporarily increased to 25 mmHg and more in 36 patients (28.6%).

Conclusion: The surgical treatment of RRD using 25-gauge PPV with expansive gas tamponade renders excellent anatomical results and improvement in BCVA. The incidence of complications and necessity of sclerotomy suturing are low.

Keywords: 25-gauge; gas; oblique; retinal detachment; rhegmatogenous; transconjunctival; vitrectomy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Humans
  • Intraocular Pressure / physiology*
  • Male
  • Middle Aged
  • Postoperative Complications
  • Retinal Detachment / physiopathology
  • Retinal Detachment / rehabilitation
  • Retinal Detachment / surgery*
  • Retrospective Studies
  • Treatment Outcome
  • Visual Acuity / physiology*
  • Vitrectomy / instrumentation
  • Vitrectomy / methods