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[Surgery of retinal detachment without giant tears, macular hole or advanced proliferative vitreoretinopathy]
Purpose:
To evaluate surgical results in usual detachment cases.
Material And Methods:
This retrospective study covered 704 non-referred cases treated by the same surgeon. A follow-up duration of at least 6 months was obtained for all the successful cases.
Results:
In 617 cases (87.6%) permanent reattachment was obtained with the first operation. The two main causes of initial failure were new or non-sealed breaks in 39 cases, 9 of them treated without a buckle, and postoperative PVR in 36 cases. After repeat surgery 48 additional cases were reattached, finally 665 cases (94.5%) were successfully treated. In all, postoperative PVR occurred in 39 cases, 22 of these were reoperated on, successfully for 16; thus PVR caused 23 of the 39 terminal failures. In 13 other failed cases there were no obvious unsealed break or severe postoperative PVR. A final visual acuity of 20/40 or more was attained in 443 cases.
Conclusion:
PVR although infrequent (5.5%), was the main cause of failure. In 13 cases the reason for non reattachment remained uncertain, these failures may have involved an excessive vitreous traction and perhaps in this situation a vitrectomy with a wide angle viewing system might have been helpful.