Anatomical and Functional Results Following 23-Gauge Primary Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment: Superior versus Inferior Breaks

Purpose. In this retrospective study, we evaluated the anatomical and functional outcomes of patients with rhegmatogenous retinal detachment primarily treated with pars plana vitrectomy in regard to the location of the breaks. Methods. 160 eyes were enrolled in this study, divided into two groups based on break location: the superior break group (115 eyes) and the inferior break group (45 eyes). The main endpoint of our study was the anatomical success at 3 months following surgery. Results. Primary retinal reattachment was achieved in 96.5% of patients in group A and in 93.3% in group B (no statistically significant difference, OR 1.98, 95% CI: 0.4, 7.7). Mean BCVA change and intraoperative complication rate were also not statistically significantly different between the two groups (p>0.05, OR: 1.0, 95% CI: 0.9, 1.01, resp.). Statistical analyses showed that macula status, age, and preoperative BCVA had a significant effect on mean BCVA change (p=0.0001, p=0.005, and p=0.001, resp.). Conclusion. This study supports that acceptable reattachment rates can be achieved using PPV for uncomplicated RRD irrespective of the breaks location and inferior breaks do not constitute an independent risk factor for worse anatomical or functional outcome

The macular buckling procedure in the treatment of retinal detachment in highly myopic eyes with macular hole and posterior staphyloma - Mean follow-up of 15 years

Purpose: To evaluate the long-term anatomical and functional results of the macular buckling procedure in myopic macular hole with retinal detachment and posterior staphyloma. Methods: Twenty-five consecutive highly myopic eyes with retinal detachment, macular hole, and posterior staphyloma, which were operated between February 1983 and April 1992, were retrospectively studied. The last examination was in June 2002. Follow-up of the 25 patients ranged from 10 years to 19 years (mean, 15 years). Macular buckling with an episcleral sponge was the initial and only procedure. In all operated eyes, anchoring of the sponge was away from the posterior pole. Best-corrected visual acuity was evaluated before and after surgery. The axial length of the eyeball was also measured by A-scan ultrasonography before treatment. Results: Twenty-two of 25 eyes were successfully treated with a single procedure. In the remaining three eyes, retinal reattachment was obtained after a second buckling operation, which was considered necessary due to loosing of the sponge fixation sutures in two cases and the location of the hole beside the buckle in one case. The mean overall visual acuity was improved after treatment. Conclusions: The macular buckling procedure with anchoring of the sponge away from the posterior segment provided efficient scleral indentation of long duration for closure of the macular hole and retinal reattachment