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Observational Study
. 2020 May;40(5):943-950.
doi: 10.1097/IAE.0000000000002482.

POSTERIORLY INSERTED VITREOUS BASE: Preoperative Characteristics, Intraoperative Findings, and Outcomes After Vitrectomy

Elliott H Sohn  1   2 , Austin Strohbehn  3 , Tomasz Stryjewski  4 , Katarzyna Brodowska  4 , Miles J Flamme-Wiese  2 , Robert F Mullins  1   2 , Dean Eliott  4
Affiliations
Observational Study

POSTERIORLY INSERTED VITREOUS BASE: Preoperative Characteristics, Intraoperative Findings, and Outcomes After Vitrectomy

Elliott H Sohn et al. Retina. 2020 May.

Abstract

Purpose: To determine the preoperative characteristics, intraoperative and postoperative complications, and outcomes of eyes with posteriorly inserted vitreous base.

Methods: In this retrospective, observational, consecutive case series at 2 academic centers, 37 patients were studied who had posteriorly inserted vitreous base noted during vitrectomy. Posteriorly inserted vitreous base was defined as the insertion of the posterior hyaloid membrane being located posterior to the vortex veins. Fifteen eyes were analyzed in a histopathologic study of donor eyes to determine the average distance of the ora serrata from the vortex veins as this distance is uncertain.

Results: Posteriorly inserted vitreous base was identified during vitrectomy in 31 eyes with rhegmatogenous retinal detachment (84%), 4 with macular hole (11%), 1 with vitreous hemorrhage, and 1 with epiretinal membrane. Adjunctive buckle was used in 24%; 54% had 360° laser. Average number of tears seen preoperatively in those with rhegmatogenous retinal detachment was 3.1. Thirty percent had new breaks identified intraoperatively. Forty-one percent had lattice degeneration; new breaks were found in 40% of eyes with lattice. Thirteen percent of rhegmatogenous retinal detachments developed proliferative vitreoretinopathy. Average distance from the ora serrata to the vortex veins was 7.6 mm.

Conclusion: Any eye undergoing vitrectomy may have posteriorly inserted vitreous base, but those with a high number of retinal breaks and lattice near the equator may be at highest risk. Redetachment and proliferative vitreoretinopathy still occur despite knowledge of the disorder and adjuvant treatments.

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Conflict of interest statement

Conflict of interest: No conflicting relationship exists for any author

Figures

Figure 1.
Figure 1.
Eye diagrams showing normal and posteriorly inserted vitreous base anatomy. Left depicts normal vitreous base insertion 2–3 mm posterior to the ora serrata. Right depicts a vitreous base that is inserted posteriorly, over 6 mm posterior to the ora serrata.
See this image and copyright information in PMC

Comment in

  • Correspondence.
    Shukla D. Shukla D. Retina. 2020 Nov;40(11):e68. doi: 10.1097/IAE.0000000000002957. Retina. 2020. PMID: 33086371 No abstract available.
  • Reply.
    Sohn EH, Mullins RF, Eliott D. Sohn EH, et al. Retina. 2020 Nov;40(11):e68-e69. doi: 10.1097/IAE.0000000000002958. Retina. 2020. PMID: 33086372 No abstract available.

References

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