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Published on: September 13, 2016
Two-port dry vitrectomy for rhegmatogenous retinal detachment: a pilot study
Enrico Peiretti1, Tomaso Caporossi2,3, Filippo Tatti4
1Eye Clinic, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy. enripei@hotmail.com.
Objective:
To evaluate the safety and efficacy of a new surgical technique for the management of primary rhegmatogenous retinal detachment (RRD), consisting of localized PPV near the retinal break(s), without infusion line, associated with a drainage of subretinal fluid and cryoretinopexy.
Methods:
Multicentric prospective study conducted at the University Hospital of Cagliari and IRCCS Fondazione Policlinico Universitario A. Gemelli, Roma. Twenty eyes affected by RRD with the causative retinal break(s) in the superior meridians were enrolled between February 2022 and June 2022. Patients with cataract ≥3, aphakia, significant posterior capsule opacification, giant retinal tears, retinal dialysis, history of trauma and PVR ≥C2 were excluded. All eyes underwent a two-port 25-gauge PPV with localized removal of the vitreous surrounding retinal break(s), followed by 20% SF6 injection and cryopexy. The surgical time was recorded for each procedure. Best-corrected visual acuity (BCVA) was measured at baseline and postoperative 6 months.
Results:
Primary anatomic success at 6 months was achieved by 85% of patients. No complications occurred, except for three (15%) retinal re-detachments. The average surgical time was 8.61 ± 2.16 min. Overall, the difference between pre- and last postoperative mean BCVA was statistically significant (p = 0.02).
Conclusions:
Two-port dry PPV demonstrated safety and efficacy for the treatment of RRD, reaching an 85% of anatomical success rate. Although further studies are necessary to confirm the efficacy and long-term benefit of this treatment, we believe that this surgical technique could be considered a valid and safe alternative for the management of primary RRD.
Insights
A new surgical technique for primary rhegmatogenous retinal detachment (RRD) using localized pars plana vitrectomy (PPV) without infusion achieved 85% anatomical success. This safe and effective RRD treatment shows promise as an alternative surgical option.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Retinal Surgery
Background:
- Rhegmatogenous retinal detachment (RRD) is a sight-threatening condition requiring prompt surgical intervention.
- Traditional surgical methods for RRD can be associated with specific complications and varying success rates.
Purpose of the Study:
- To evaluate the safety and efficacy of a novel two-port, no-infusion pars plana vitrectomy (PPV) technique for primary RRD.
- To assess the anatomical success rate and visual acuity outcomes of this minimally invasive approach.
Main Methods:
- A prospective, multicentric study involving 20 eyes with primary RRD.
- The technique involved localized PPV, subretinal fluid drainage, and cryoretinopexy, followed by 20% SF6 gas injection.
- Exclusion criteria included significant cataracts, aphakia, giant retinal tears, and advanced proliferative vitreoretinopathy (PVR).
Main Results:
- 85% of patients achieved primary anatomical success at 6 months post-surgery.
- The average surgical time was 8.61 minutes.
- A statistically significant improvement in best-corrected visual acuity (BCVA) was observed postoperatively (p=0.02).
Conclusions:
- The two-port dry PPV technique is safe and effective for primary RRD management.
- This approach offers an 85% anatomical success rate.
- It represents a potentially valid and safe alternative surgical option for RRD treatment, warranting further investigation for long-term benefits.
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