Pars-plana vitrectomy alone vs vitrectomy with scleral buckling for primary rhegmatogenous pseudophakic retinal detachment

Stangos, Alexandros N.; Petropoulos, Ioannis K.; Brozou, Catherine G.; Kapetanios, Anastasios D.; Whatham, Andrew; Pournaras, Constantin J.

doi:10.1016/j.ajo.2004.06.086

« Previous Next »American Journal of Ophthalmology
Volume 138, Issue 6 , Pages 952-958, December 2004

Pars-plana vitrectomy alone vs vitrectomy with scleral buckling for primary rhegmatogenous pseudophakic retinal detachment

Alexandros N. Stangos, MD
- Division of Ophthalmology, Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland.
Ioannis K. Petropoulos, MD
- Division of Ophthalmology, Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland.
Catherine G. Brozou, MD
- Division of Ophthalmology, Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland.
Anastasios D. Kapetanios, MD
- Division of Ophthalmology, Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland.
Andrew Whatham, DPHIL
- Division of Ophthalmology, Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland.
Constantin J. Pournaras, MD
- Division of Ophthalmology, Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland.
- Inquiries to Constantin J. Pournaras, MD, Division of Ophthalmology, Department of Clinical Neurosciences, University Hospitals of Geneva, 22 Rue Alcide-Jentzer, 1211, Geneva, Switzerland; fax: + 41 22 3828421

Accepted 29 June 2004. published online 21 October 2004.

Purpose

To compare primary pars-plana vitrectomy (PPV) alone vs vitrectomy with an encircling scleral buckling procedure for the treatment of primary rhegmatogenous pseudophakic retinal detachment (PsRD).

Design

Prospective, nonrandomized, comparative study.

Methods

All 71 eyes of 68 consecutive patients with PsRD presented to our service between 1998 and 2002 were offered either vitrectomy alone (group-A) or vitrectomy in combination with encircling scleral buckling procedure (group-B). Preoperative and postoperative patient characteristics were recorded in detail. Main outcome measures were reattachment with a single surgery, visual acuity, and reattachment surgery-related complications.

Results

Retina reattachment with a single surgery was achieved in 97.78% in group A and 92.31% in group B. Visual acuity improved by 3 or more lines in 60% in group A and 69% in group B. Mean postoperative refractive error change (spherical) was −0.05 diopters in group A and −1.43 diopters in group B. Postoperative intraocular pressure on long-term follow-up was elevated in 4.44% (group A) and 34.61% (group B). Average follow-up was 12.45 months (±5.23 SD) ranging from 9 to 40 months. We detected additional breaks intraoperatively in 54.9% of cases (both groups).