Subretinal fluid drainage via original retinal breaks for rhegmatogenous retinal detachment

Abstract

Objective: To evaluate the outcome of vitrectomy using only original retinal breaks for subretinal fluid (SRF) drainage during the repair of primary rhegmatogenous retinal detachment (RRD).

Design: A retrospective consecutive interventional case series.

Participants: A consecutive series of 112 eyes of 112 patients.

Methods: Patients underwent 23-gauge vitrectomy without the use of posterior retinotomy and perfluorocarbon liquids for uncomplicated primary RRD at Osaka City University Hospital between September 2007 and March 2011. Exclusion criteria included eyes with giant retinal tears, grade C2 or worse proliferative vitreoretinopathy (PVR), ocular trauma, and the presence of other vitreoretinal diseases.

Results: Single-operation success rate was 92.9%, whereas final anatomical success rate was 100%. Median visual acuity improved significantly from the preoperative logMAR of 0.51 ± 0.78 to the postoperative logMAR of 0.03 ± 0.26 (p < 0.01). No significant differences were observed for the single-operation success rate between the 62 eyes (95.2%) in which some SRF remained at the end of the operation and the rest of the 50 eyes (90.0%, p = 1.000) in which the SRF had been completely aspirated. Complications included transient intraocular pressure rise (12 eyes, 10.7%), epiretinal membrane (5 eyes, 4.5%), and PVR (1 eye, 0.9%). Ocular hypotony and endophthalmitis were not observed.

Conclusions: Uncomplicated primary RRD can be successfully repaired by performing vitrectomy using only the original retinal breaks for SRF drainage. In addition, successful outcomes are not dependent on achieving complete reattachment of the retina throughout the fundus.