Minimally invasive surgery-endoscopic retinal detachment repair in patients with media opacities

Evaluate the use of an ophthalmic endoscope in patients with a retinal detachment and anterior media opacity.

A retrospective interventional case series. Search of a comprehensive database of retinal detachment patients with pre-operatively impaired anterior segments such that lens extraction, a keratoprosthesis, or extensive anterior segment manipulation was required for adequate repair. Pars plana vitrectomy was carried out with an endoscope without manipulation of the anterior segment. Characteristics of the detachment were recorded, as were complications/subsequent surgeries, pre-operative, 3-month post-operative, and final follow-up visual acuities.

Before surgery, five patients had a gas-induced cataract after a failed pneumatic retinopexy; one patient had a Reis-Buckler's dystrophy and corneal ulcer; three patients had synechiae around iris-fixed lenses. One patient had proliferative vitreoretinopathy. The median pre-operative vision was hand motion (20/30 to light perception). The median final visual acuity was 20/30 (20/20-20/200). Two patients required a subsequent lens extraction, one patient had a recurrent detachment.

In appropriate retinal detachment patients, endoscopy can be safe and effective, while limiting the scope of the surgical intervention.