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Combined scleral buckle and pars plana vitrectomy as a primary procedure for pseudophakic retinal detachments.

AbstractBACKGROUND AND OBJECTIVE:
Pseudophakic and aphakic retinal detachments are associated with a lower percentage of successful primary repair with standard scleral buckling surgery, than phakic retinal detachments. The objective of this study was to determine whether a combined scleral buckle and vitrectomy, as a primary procedure, offers any advantage over conventional scleral buckling in primary pseudophakic and aphakic retinal detachments, without proliferative vitreoretinopathy.
MATERIALS AND METHODS:
This was a prospective, non-randomized clinical study. Ninety-four consecutive pseudophakic and aphakic retinal detachments were included in the study. All patients were operated upon by the same surgeon. Each patient underwent a combined scleral buckle and pars plana vitrectomy with perfluorocarbon injection and air-fluid exchange. Each patient was followed by the operating surgeon for a minimum of 6 months. Patients were followed with respect to anatomic reattachment, visual acuity improvement, and surgical complications.
RESULTS:
All eyes were anatomically reattached after a single operation. All demonstrated an increase in their visual acuity, and there were no complications attributable to the vitrectomy procedure.
CONCLUSIONS:
We conclude that such a combined approach to primary pseudophakic and aphakic retinal detachments offers significant benefits to scleral buckling alone. We believe that the improved success rate is a function of vitrectomy contributing to both an improved peripheral visibility, resulting in fewer missed peripheral breaks, and a lower likelihood of proliferative vitreoretinopathy. We recommend this combined surgical approach for all primary pseudophakic and aphakic retinal detachments.
AuthorsR G Devenyi, H de Carvalho Nakamura
JournalOphthalmic surgery and lasers (Ophthalmic Surg Lasers) 1999 Sep-Oct Vol. 30 Issue 8 Pg. 615-8 ISSN: 1082-3069 [Print] United States
PMID10507563 (Publication Type: Clinical Trial, Journal Article)
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Pseudophakia (surgery)
  • Retinal Detachment (surgery)
  • Scleral Buckling
  • Treatment Outcome
  • Vitrectomy

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