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Tailored vitrectomy and laser photocoagulation without scleral buckling for all primary rhegmatogenous retinal detachments.

Johansson, Kristina LU ; Malmsjö, Malin LU and Ghosh, Fredrik LU (2006) In British Journal of Ophthalmology 90(10). p.1286-1291
Abstract
Aim: To investigate the anatomical and functional results and the complications in eyes operated on using vitrectomy without scleral buckling for all forms of rhegmatogenous retinal detachment ( RRD). Methods: All cases of primary RRD at the University Hospital of Lund, Lund, Sweden, treated by one surgeon during a period of 3 years were retrospectively reviewed. In 131 ( 98%) of 134 consecutive cases, a final follow-up record of 3 - 14 months was obtained, and these eyes were included in the study. The surgical protocol was tailored for each case and consisted of vitrectomy, laser photocoagulation and tamponade. Preoperative and intraoperative variables were analyses for risk for redetachment and postoperative proliferative... (More)
Aim: To investigate the anatomical and functional results and the complications in eyes operated on using vitrectomy without scleral buckling for all forms of rhegmatogenous retinal detachment ( RRD). Methods: All cases of primary RRD at the University Hospital of Lund, Lund, Sweden, treated by one surgeon during a period of 3 years were retrospectively reviewed. In 131 ( 98%) of 134 consecutive cases, a final follow-up record of 3 - 14 months was obtained, and these eyes were included in the study. The surgical protocol was tailored for each case and consisted of vitrectomy, laser photocoagulation and tamponade. Preoperative and intraoperative variables were analyses for risk for redetachment and postoperative proliferative vitreoretinopathy ( PVR). Results: Complete reattachment was achieved in 87% of cases ( 114/131) after one operation and in 95% cases after >= 1 operation. A primary detachment of > 1 quadrant was the only significant risk factor for redetachment ( p < 0.05). The most common cause of redetachment was progressive PVR. Significant risk and factors for PVR postoperatively were a poor preoperative visual acuity and a high number of laser effects during surgery ( p < 0.05). The visual acuity for the total number of eyes, macula-off eyes, and pseudophakic as well as phakic eyes, improved significantly. The visual acuity for macula-on eyes did not change significantly. Six patients developed ocular hypertension and another 6 an epiretinal membrane. Three patients reported a visual field defect. Increased lens opacification was seen in 64 of the 94 ( 68%) phakic eyes. Conclusions: The tailored vitrectomy protocol is well suited to all types of RRD. Increased lens opacification in phakic eyes is common, but visual acuity is considerably improved in phakic as well as pseudophakic eyes. PVR development postoperatively is related to the extent of laser treatment, indicating that the protocol may be even further optimised in the future. (Less)
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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
British Journal of Ophthalmology
volume
90
issue
10
pages
1286 - 1291
publisher
BMJ Publishing Group
external identifiers
  • wos:000240525100021
  • scopus:33750309945
  • pmid:16837538
ISSN
1468-2079
DOI
10.1136/bjo.2006.098202
language
English
LU publication?
yes
id
c9a3e016-54e2-4b22-a95c-97b778ac9983 (old id 159022)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16837538&dopt=Abstract
date added to LUP
2016-04-01 16:27:59
date last changed
2020-01-12 19:23:58
@article{c9a3e016-54e2-4b22-a95c-97b778ac9983,
  abstract     = {Aim: To investigate the anatomical and functional results and the complications in eyes operated on using vitrectomy without scleral buckling for all forms of rhegmatogenous retinal detachment ( RRD). Methods: All cases of primary RRD at the University Hospital of Lund, Lund, Sweden, treated by one surgeon during a period of 3 years were retrospectively reviewed. In 131 ( 98%) of 134 consecutive cases, a final follow-up record of 3 - 14 months was obtained, and these eyes were included in the study. The surgical protocol was tailored for each case and consisted of vitrectomy, laser photocoagulation and tamponade. Preoperative and intraoperative variables were analyses for risk for redetachment and postoperative proliferative vitreoretinopathy ( PVR). Results: Complete reattachment was achieved in 87% of cases ( 114/131) after one operation and in 95% cases after &gt;= 1 operation. A primary detachment of &gt; 1 quadrant was the only significant risk factor for redetachment ( p &lt; 0.05). The most common cause of redetachment was progressive PVR. Significant risk and factors for PVR postoperatively were a poor preoperative visual acuity and a high number of laser effects during surgery ( p &lt; 0.05). The visual acuity for the total number of eyes, macula-off eyes, and pseudophakic as well as phakic eyes, improved significantly. The visual acuity for macula-on eyes did not change significantly. Six patients developed ocular hypertension and another 6 an epiretinal membrane. Three patients reported a visual field defect. Increased lens opacification was seen in 64 of the 94 ( 68%) phakic eyes. Conclusions: The tailored vitrectomy protocol is well suited to all types of RRD. Increased lens opacification in phakic eyes is common, but visual acuity is considerably improved in phakic as well as pseudophakic eyes. PVR development postoperatively is related to the extent of laser treatment, indicating that the protocol may be even further optimised in the future.},
  author       = {Johansson, Kristina and Malmsjö, Malin and Ghosh, Fredrik},
  issn         = {1468-2079},
  language     = {eng},
  number       = {10},
  pages        = {1286--1291},
  publisher    = {BMJ Publishing Group},
  series       = {British Journal of Ophthalmology},
  title        = {Tailored vitrectomy and laser photocoagulation without scleral buckling for all primary rhegmatogenous retinal detachments.},
  url          = {http://dx.doi.org/10.1136/bjo.2006.098202},
  doi          = {10.1136/bjo.2006.098202},
  volume       = {90},
  year         = {2006},
}