This article is more than 5 years old. Information may no longer be current.
Tamponade not necessary for successful PPV
Click Here to Manage Email Alerts
RIO GRANDE, Puerto Rico — Pseudophakic rhegmatogenous retinal detachment can be repaired with pars plana vitrectomy alone, without a tamponade agent in the postoperative period, said one surgeon speaking here.
Vicente Martinez-Castillo, MD, described a prospective study of 60 eyes of 60 patients who underwent PPV. The inclusion criterion was primary pseudophakic rhegamatogenous retinal detachment; all patients had a follow-up period of at least 1 year. Patients ranged in age from 39 to 85 years old, 70% were male, and 35 were myopic. Posterior chamber IOLs had been implanted in 56 patients and an anterior chamber IOL had been implanted in one patient. The average time between cataract extraction and retinal detachment was 34 months, Dr. Martinez-Castillo said during the Masters of the American Society of Retina Specialists meeting.
“The key is to perform the vitrectomy with perfluorocarbon liquid and use a transscleral diode laser,” he said. At the end of the procedure, the vitreous cavity was filled with balanced salt solution, he said.
The initial reattachment rate was 98.3%, with a final reattachment rate of 100%. No patient developed PVR in the postop period, he said.
“Until the gas is absorbed or the oil removed, surgeons don’t know for sure if the retina is reattached,” he said.
When performing a PPV for RRD, “it’s possible to have a sealed choroid adhesion intraoperatively,” he said. Using perfluorocarbon “obviates the need for [silicone] oil,” he said.
Surgeons should inject the perfluorocarbon liquid, ensuring maximum drainage of the subretinal fluid, should ensure the entire retinal break is attached to the retinal pigment epithelium and retinopexy should be done with a diode laser.