Visual outcome and complications of 25-gauge vitrectomy for rhegmatogenous retinal detachment; 84 consecutive cases.

摘要

PURPOSE: To assess the visual outcome and complications of 25-G transconjunctival sutureless vitrectomy (25G-TSV) for rhegmatogenous retinal detachments. METHODS: Retrospective, consecutive, interventional case series of 84 eyes of 84 consecutive patients with RRD who underwent 25G-TSV. All surgeries were performed by a single surgeon at a single centre. RESULTS: The initial and final reattachment rates were 95.2 and 100%, respectively. The mean visual acuity improved from 0.78 logarithm of the minimum angle of resolution (logMAR) units to 0.17 logMAR units at the final examination (P<0.001). A macula-off RRD was present preoperatively in 45 of the 84 eyes, and 11 of these eyes (24.4%) developed postoperative retinal complications. Of these complications, one eye had an intraoperative choroidal detachment, five developed a postoperative macular pucker, one eye had a postoperative macular hole, and four eyes developed a retinal redetachment. The percentages of eyes developing retinal complications in the macula-on group (2.6%) was significantly lower than that in the macula-off group (P=0.004). An intraocular pressure (IOP)>or=35 mm Hg was detected in five eyes (6.0%) within the first postoperative week. All of these eyes had a macula-off RRD, and none of the eyes with a macula-on RRD had an elevation of the IOP (P=0.04). CONCLUSIONS: Our findings indicate that 25G-TSV is a feasible treatment for RRD and leads to retinal reattachment rates comparable with those following conventional vitrectomy. However, intra- and postoperative retinal complications and postoperative elevation of the IOP can occur especially in eyes with a preoperative macula-off RRD.