Safety and efficacy of cryopexy during pars Plana vitrectomy in rhegmatogenous retinal detachment

Abstract

Purpose: To evaluate efficacy and safety of intraoperative cryoretinopexy in cases of rhegmatogenous retinal detachment (RRD).

Methods: In this retrospective, interventional case series, we review the medical records of 85 consecutive cases of RRD treated with pars plana vitrectomy and gas tamponade, without the use of perfluorocarbon liquids. Baseline best-corrected visual acuity, intraocular pressure, number and location of retinal breaks, location and extension of retinal detachment, duration of symptoms, macula status, presence, and grade of proliferative vitreoretinopathy (PVR) were registered. Follow-up visits were at 1 day, 15 days, 1 month and 3 months. Anatomical and functional outcomes and any adverse event were recorded.

Results: Primary anatomical success was obtained in 82/85 patients (96%). During the postoperative period, PVR was observed in 4/85 cases (4.7%), 3 of whom developed recurrence of retinal detachment. 7/85 (8.2%) patients developed ocular hypertension. We built a model of logistic regression including age, sex, lens status, macula status, number of quadrants involved, number of ruptures and duration of symptoms. None of the variables considered was found to be a predictor of postoperative PVR development. Symptom's duration (β = 0.429; 95% CI = 0.009-0.023; P < 0.001) and preoperative BCVA (β = 0.273; 95% CI = 0.034-0.184; P = 0.005) were predictors for final BCVA.

Conclusion: These findings emphasize the safety and efficacy of the use of intraoperative cryotherapy, associated with PPV and gas tamponade, for the management of uncomplicated RRDs.

Keywords: Cryopexy; cryotherapy; pars plana vitrectomy; perfluorocarbon liquids; proliferative vitreoretinopathy; rhegmatogenous retinal detachment.