Purpose: To compare the anatomical and functional outcomes of 23-gauge pars plana vitrectomy (PPV) with Densiron-68 tamponade and 360 degrees endolaser versus 20-gauge PPV with encircling scleral buckling (ESB) and an SF6 gas tamponade for the repair of primary pseudophakic retinal detachment with inferior retinal breaks. Methods: Prospective, randomized, comparative, interventional study. Eighty-two eyes of 82 consecutive patients were randomly assigned to 1 of the 2 treatment groups: 23-gauge PPV/Densiron-68 (44 eyes, 54%) or 20-gauge PPV/ESB/SF6 (20%) (38 eyes, 46%). The inclusion criterion was the presence of primary pseudophakic retinal detachment with at least 1 retinal break between the 4- and 8-o'clock positions. The study protocol involved a minimum of 7 visits: baseline, day of surgery, 1 week, and 1, 3, 6, and 9 months postoperation. Densiron-68 removal was performed within 12 weeks of the initial surgery. Two surgical procedures were required in the Densiron group to remove the oil. Results: After the primary procedure, the retina was reattached in 90% (40 of 44) of cases in the 23-gauge PPV/Densiron group and in 92% (35 of 38) of cases in the 20-gauge PPV/ESB/SF6 group (P=0.2, Fisher's exact test). After resolution of redetachments, final anatomical success rate rose to 97% (43 of 44) in the 23-gauge PPV/Densiron group and 94% (36 of 38) in the 20-gauge PPV/SB/SF6 group (P=0.32, Fisher's exact test). Mean final best-corrected visual acuity (logarithm of the minimum angle of resolution) was 0.40 in the 23-gauge PPV/Densiron group and 0.48 in the 20-gauge PPV/ESB/SF6 group (P=0.31, t-test). Operative time was significantly less in the 23-gauge PPV/Densiron group (P=0.002, t-test). No statistically significant difference in the complication rate between the two groups was recorded. Conclusion: Twenty-three-gauge PPV combined with Densiron-68 and 360 degrees endolaser and 20-gauge PPV combined with ESB/SF6 seemed to have similar efficacy in the repair of primary pseudophakic retinal detachment. Supplementary scleral buckling can be avoided using a Densiron-68 tamponade for retinal detachment with inferior retinal breaks. RETINA 31: 686-691, 2011
TWENTY-THREE-GAUGE PARS PLANA VITRECTOMY, DENSIRON-68, AND 360 degrees ENDOLASER VERSUS COMBINED 20-GAUGE PARS PLANA VITRECTOMY, SCLERAL BUCKLE, AND SF6 FOR PSEUDOPHAKIC RETINAL DETACHMENT WITH INFERIOR RETINAL BREAKS / Romano, Mario; Angi, Martina; Valldeperas, Xavier; Costagliola, Ciro; Vinciguerra, Paolo. - In: RETINA. - ISSN 0275-004X. - 31:4(2011), pp. 686-691. [10.1097/IAE.0b013e3181f0d249]
TWENTY-THREE-GAUGE PARS PLANA VITRECTOMY, DENSIRON-68, AND 360 degrees ENDOLASER VERSUS COMBINED 20-GAUGE PARS PLANA VITRECTOMY, SCLERAL BUCKLE, AND SF6 FOR PSEUDOPHAKIC RETINAL DETACHMENT WITH INFERIOR RETINAL BREAKS
ROMANO, MARIO;Costagliola Ciro;
2011
Abstract
Purpose: To compare the anatomical and functional outcomes of 23-gauge pars plana vitrectomy (PPV) with Densiron-68 tamponade and 360 degrees endolaser versus 20-gauge PPV with encircling scleral buckling (ESB) and an SF6 gas tamponade for the repair of primary pseudophakic retinal detachment with inferior retinal breaks. Methods: Prospective, randomized, comparative, interventional study. Eighty-two eyes of 82 consecutive patients were randomly assigned to 1 of the 2 treatment groups: 23-gauge PPV/Densiron-68 (44 eyes, 54%) or 20-gauge PPV/ESB/SF6 (20%) (38 eyes, 46%). The inclusion criterion was the presence of primary pseudophakic retinal detachment with at least 1 retinal break between the 4- and 8-o'clock positions. The study protocol involved a minimum of 7 visits: baseline, day of surgery, 1 week, and 1, 3, 6, and 9 months postoperation. Densiron-68 removal was performed within 12 weeks of the initial surgery. Two surgical procedures were required in the Densiron group to remove the oil. Results: After the primary procedure, the retina was reattached in 90% (40 of 44) of cases in the 23-gauge PPV/Densiron group and in 92% (35 of 38) of cases in the 20-gauge PPV/ESB/SF6 group (P=0.2, Fisher's exact test). After resolution of redetachments, final anatomical success rate rose to 97% (43 of 44) in the 23-gauge PPV/Densiron group and 94% (36 of 38) in the 20-gauge PPV/SB/SF6 group (P=0.32, Fisher's exact test). Mean final best-corrected visual acuity (logarithm of the minimum angle of resolution) was 0.40 in the 23-gauge PPV/Densiron group and 0.48 in the 20-gauge PPV/ESB/SF6 group (P=0.31, t-test). Operative time was significantly less in the 23-gauge PPV/Densiron group (P=0.002, t-test). No statistically significant difference in the complication rate between the two groups was recorded. Conclusion: Twenty-three-gauge PPV combined with Densiron-68 and 360 degrees endolaser and 20-gauge PPV combined with ESB/SF6 seemed to have similar efficacy in the repair of primary pseudophakic retinal detachment. Supplementary scleral buckling can be avoided using a Densiron-68 tamponade for retinal detachment with inferior retinal breaks. RETINA 31: 686-691, 2011I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
