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Pseudophakic retinal detachment: treatment by vitrectomy and scleral buckling. Pilot study
Authors:Pournaras C J  Donati G  Sekkat L  Kapetanios A D
Affiliation:H?pitaux Universitaires de Genève. constantin.pournaras@hcuge.ch
Abstract:
INTRODUCTION: Localization of retinal tears generating a pseudophakic retinal detachment (RD) is not always possible; subsequently, segmental indentation by external compression often causes a residual RD. Vitrectomy enables a detailed view of the peripheral part of the retina and better detection of small size retinal breaks. Our pilot survey report anatomic and functional results of a surgical treatment of pseudophakic RD, associating vitrectomy and scleral buckling. MATERIAL AND METHODS: Twenty three consecutive pseudophakic eyes showing an RD were operated on with scleral buckling, vitrectomy, internal subretinal fluid drainage, endolaser and fluid-air exchange by SF(6) 20%. Preoperative findings, intraoperative and postoperative complications, and final results were analyzed. RESULTS: The retina was successfully reattached with a single operation in 21 eyes (92%). One eye presented a recurrence of RD due to a preexisting retinal tear. PVR was observed in one case with the recurrence of the RD. In both cases, a second operation achieved the retinal reattachment. After surgery, visual acuity improved on an average of 3 lines. The most frequently occurring complication was a transitory hypertony in 6 cases (26%). CONCLUSION: Surgical treatment of the pseudophakic RD, combining vitrectomy and scleral buckling shows very good anatomic and functional results; it seems to offer the advantage of a better localization of peripheral retina tears, which enables a recovery with a lower recurrence rate than by extra-ocular surgery only.
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