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Anatomic and Functional Outcomes after Pars Plana Vitrectomy for Giant Retinal Tear-Related Retinal Detachment: The
Peter Kiraly1, Tsveta Ivanova2, Evita E Christou2
1Manchester Royal Eye Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom; Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom; Nuffield Laboratory of Ophthalmology, University of Oxford, Oxford, United Kingdom.
Primary pars plana vitrectomy (PPV) for giant retinal tear-related rhegmatogenous retinal detachment (GRT-RRD) shows high success rates. Gas tamponade may offer better visual outcomes than silicone oil, particularly in macula-on cases.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Giant Retinal Tear Treatment
Background:
- Giant retinal tear-related rhegmatogenous retinal detachment (GRT-RRD) is a severe condition requiring prompt surgical intervention.
- Pars plana vitrectomy (PPV) is a primary surgical approach for GRT-RRD.
Purpose of the Study:
- To assess the anatomic and functional results of primary PPV in patients with GRT-RRD.
- To compare the outcomes of gas versus silicone oil tamponade in these patients.
Main Methods:
- A retrospective, single-center cohort study included 110 eyes undergoing primary PPV for GRT-RRD.
- Propensity score matching was used to control for confounding factors.
- Single surgery anatomical success (SSAS) and final best-corrected visual acuity (BCVA) were the primary outcome measures.
Main Results:
- High rates of SSAS (88.2%) and final anatomic success (FAS) (96.3%) were achieved.
- Male sex was associated with higher odds of SSAS, while proliferative vitreoretinopathy (PVR) grade C was associated with lower odds.
- Silicone oil trended toward worse final BCVA compared to gas in the overall cohort and was significantly worse in macula-on eyes.
Conclusions:
- Primary PPV is highly effective for GRT-RRD, with C2F6 being the most common gas tamponade.
- Anatomical success rates were similar between gas and silicone oil groups.
- Gas tamponade showed a trend towards better visual outcomes, especially in macula-on detachments.
