Primary vitrectomy for rhegmatogenous retinal detachment in pseudophakic eyes: 20-gauge versus 25-gauge vitrectomy

Autor:	Irmingard M. Neuhann, Peter Szurman, Karl Ulrich Bartz-Schmidt, Sabine Aisenbrey, Ulrike Hagemann, Daniela Süsskind, Ralf-Dieter Hilgers
Rok vydání:	2016
Předmět:	Male Pars plana Microsurgery Intraocular pressure Proliferative vitreoretinopathy medicine.medical_specialty Visual acuity Pseudophakia genetic structures medicine.medical_treatment Visual Acuity Vitrectomy 03 medical and health sciences chemistry.chemical_compound Postoperative Complications 0302 clinical medicine Ophthalmology medicine Humans Prospective Studies 030212 general & internal medicine Prospective cohort study Intraocular Pressure Aged business.industry Retinal Detachment Retinal detachment Retinal General Medicine Middle Aged medicine.disease eye diseases Surgery medicine.anatomical_structure chemistry 030221 ophthalmology & optometry Female medicine.symptom business
Zdroj:	Acta Ophthalmologica. 94:824-828
ISSN:	1755-375X
DOI:	10.1111/aos.13133
Popis:	Purpose To report anatomical and functional outcome of 20-gauge versus 25-gauge primary pars plana vitrectomy for management of complex rhegmatogenous retinal detachment in pseudophakic eyes. Methods Prospective single-centre randomized comparative pilot trial. Fifty patients with retinal detachment (RD) not complicated by proliferative vitreoretinopathy grade B or C, who cannot be treated with a single meridional sponge, were randomized (1:1) from November 2006 to January 2010 to either 20-gauge or 25-gauge vitrectomy as first surgical intervention and followed up over a 12-month period, evaluating change in best-corrected visual acuity, anatomical success and intraocular pressure dysregulation. Results Mean visual acuity improved by 0.88 (SD 0.67) from 1.22 logMAR (SD 0.63) to 0.34 logMAR (SD 0.31) in the 20-gauge group and by 0.53 (SD 0.91) from 0.86 logMAR (SD 0.73) to 0.34 logMAR (SD 0.46) in the 25-gauge group. Final anatomical success rate was 100% and primary success rate was 69% at 6 months of follow-up. In the 20-gauge group, the retina was attached after one single procedure in 18 eyes (72%) and in 21 eyes (84%) of the 25-gauge group. Two patients in the 25-gauge group had hypotony at the first postoperative day which normalized within 6 weeks. Conclusion In our series, transconjunctival sutureless 25-gauge and 20-gauge vitrectomy showed comparable results in pseudophakic RD not suitable for single sponge surgery with respect to visual outcome and retinal reattachment. Postoperative hypotony does not seem to be a significant problem of transconjunctival sutureless vitrectomy.
Databáze:	OpenAIRE
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