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Induced posterior vitreous detachment during vitrectomy linked to retinal breaks

Am J Ophthalmol. 2009;147(6):1012-1016.

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Induction of posterior vitreous detachment during vitrectomy was shown to significantly increase the incidence of intraoperative and postoperative retinal breaks, a study showed.

"Caution should be exercised after the induction of [posterior vitreous detachment] to identify all retinal breaks so they can be treated," the study authors said.

The retrospective study included 311 eyes of 311 patients who underwent pars plana vitrectomy for the treatment of epiretinal membranes (174 eyes) or macular holes (137 eyes). Data showed the incidence of retinal breaks, the number of eyes that required induced posterior vitreous detachment during vitrectomy and possible risk factors for retinal breaks.

Posterior vitreous detachment was induced in 28 eyes with epiretinal membranes (16%) and 105 eyes with macular holes (76.6%).

The results showed a 6.9% overall incidence of retinal breaks in the eyes with epiretinal membranes and 14.6% in eyes with macular holes.

Intraoperative retinal breaks, postoperative retinal breaks or both were seen in nine of 28 epiretinal membrane eyes that underwent surgery with induced posterior vitreous detachment (32.1%) and in three of 146 eyes that had surgery without induced posterior vitreous detachment (2.1%).

Retinal breaks were seen in 19 of 105 eyes with macular holes that underwent surgery with induced posterior vitreous detachment (12.7%) and in one of 32 eyes with macular holes that underwent surgery without induced posterior vitreous detachment (3.1%), the authors said.