[Vitreoretinal secondary procedures following elective macular surgery]

Area of Science:

• Ophthalmology
• Retinal Surgery

Background:

• Macular surgery, including pars-plana vitrectomy (PPV), is performed for conditions like macular pucker and macular hole.
• Reoperations are sometimes necessary to address suboptimal surgical results.

Purpose of the Study:

• To investigate the spectrum and rate of reoperations following macular surgery.
• To evaluate the incidence of repeat vitrectomies and postoperative retinal detachment.

Main Methods:

• Retrospective analysis of 353 eyes undergoing macular surgery (macular pucker or macular hole) between 1995 and 2001.
• All secondary surgical procedures, excluding cataract surgery, were recorded.
• Preoperative circular peripheral cryoretinopexy was performed in all cases prior to pars-plana vitrectomy.

Main Results:

• A second vitrectomy (reoperation) was required in 9.3% of cases due to unsatisfactory macular findings.
• Repeat vitrectomies were performed in 7.8% of macular pucker cases and 11.8% of macular hole cases.
• The rate of postoperative rhegmatogenous retinal detachment was 2.0%, and endophthalmitis occurred in 0.6% of cases.

Conclusions:

• Approximately 9.3% of patients needed a second pars-plana vitrectomy after initial macular surgery.
• The observed 2.0% rate of postoperative retinal detachment is notably lower than reported in other studies.
• Preoperative circular peripheral cryoretinopexy may offer a prophylactic benefit in reducing the risk of postoperative retinal detachment.