Sutureless 25-Gauge Vitrectomy for Rhegmatogenous Retinal Detachment Caused by Superior Breaks Using Air Tamponade

This study was aimed to evaluate the efficacy and safety of 25-gauge sutureless vitrectomy in repairing primary rhegmatogenous retinal detachment (RRD) with air tamponade.

This is a prospective, clinic-based, case series.

Twenty consecutive eyes of 20 patients with primary RRD caused by superior breaks of less than a month underwent transconjunctival sutureless 25-gauge vitrectomy with intraocular air tamponade. Patients who had a follow-up of less than 6 months were excluded. Outcome measures included best corrected visual acuity (BCVA), reattachment rate by a single procedure, final reattachment rate by additional procedures, and complications.

The mean follow-up was 10 months (range, 6-15 months). The proportion of eyes with BCVA of between 20/200 and 20/70 increased significantly from 15% at baseline to 65% on day 14 (P = 0.024). At final follow-up, 15%, 60%, and 25% had BCVA worse than 20/200, between 20/200 and 20/70, and better than 20/70, respectively. The mean BCVA was significantly better than baseline (logMAR, 1.4) by day 14 (logMAR, 0.87). The reattachment rate by a single procedure was 70%, and the final success rate was 100% after 1 additional procedure. The primary success rate increased to 77.8% after excluding 2 eyes with proliferative vitreoretinopathy grade C1. High myopia and large retinal break were 2 other conditions associated with failed primary reattachment. No postoperative complication was observed.

Selected eyes with primary RRD may gain the benefit of early visual recovery when treated with 25-gauge vitrectomy and air tamponade.