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[Pseudophakic retinal detachment: how to manage?].

L Benhmidoune1, Y Elkharroubi1, A A Bensemlali1

  • 1Service d'ophtalmologie adulte, hôpital 20-Août-1953, 4, rue Lahcen-El-Arjoune-ex-Dalton, 20360 Casablanca, Maroc.

Journal Francais D'Ophtalmologie
|November 27, 2013
PubMed
Summary

External surgery and vitrectomy offer comparable outcomes for pseudophakic retinal detachment (RD). Both surgical methods achieved similar anatomical success and visual acuity, demonstrating their effectiveness in treating RD without significant proliferative vitreoretinopathy.

Keywords:
Décollement de rétineIndentation scléraleInternal tamponadePseudophakicPseudophaqueRetinal detachmentScleral buckleTamponnement interneVitrectomieVitrectomy

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Area of Science:

  • Ophthalmology
  • Retinal Surgery
  • Surgical Outcomes

Background:

  • Retinal detachment (RD) is a common complication post-cataract surgery, necessitating prompt surgical intervention.
  • External approach with retinopexy and scleral buckling is a gold standard for pseudophakic RD without significant proliferative vitreoretinopathy (PVR).
  • Intraocular surgery is increasingly preferred by many surgeons for pseudophakic RD management.

Purpose of the Study:

  • To compare the anatomical and functional results of external surgery versus vitrectomy for pseudophakic retinal detachment.
  • Evaluate the efficacy of two distinct surgical approaches in restoring retinal attachment and visual function.

Main Methods:

  • A comparative study involving two groups: external surgery (n=24) and vitrectomy with internal tamponade (n=22).
  • Patients with specific exclusions (e.g., recurrences, vitreous hemorrhage, grade C PVR) were included to ensure comparability.
  • Key outcomes measured included initial and final anatomical success rates, final visual acuity, and reasons for surgical failure, with a minimum 12-month follow-up.

Main Results:

  • Initial retinal reattachment rates were similar: 87.5% for external surgery and 86.4% for vitrectomy (P=0.91).
  • Final anatomical success rates after a mean 12-month follow-up were also comparable: 95.84% for external surgery and 95.45% for vitrectomy (P=0.95).
  • Final visual acuity outcomes were identical between groups, with approximately 40% of patients achieving 1/10 to 5/10 vision (P=0.98).

Conclusions:

  • Vitrectomy with internal tamponade yields anatomical and functional results comparable to external surgery for pseudophakic retinal detachment.
  • Both surgical techniques demonstrate high success rates in reattaching the retina and improving visual function.
  • The choice between external surgery and vitrectomy may depend on specific clinical factors and surgeon preference.