A possible strategic role of air during pars plana vitrectomy for macula-involving rhegmatogenous retinal detachment
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ORIGINAL PAPER
A possible strategic role of air during pars plana vitrectomy for macula-involving rhegmatogenous retinal detachment Rino Frisina . Irene Gius . Giuseppe Frascogna . Tobia Pizzolon . Angelo Greggio . Luigi Tozzi . Edoardo Midena
Received: 17 May 2020 / Accepted: 4 September 2020 Ó Springer Nature B.V. 2020
Abstract Aim To evaluate the advantages and safety of vitrectomy under air for treating macula-involving rhegmatogenous retinal detachment (RRD). Methods Consecutive patients with macula-involving RRD who underwent vitrectomy under air were recruited. Demographic and clinical data were: age, gender, eye, lens status, best corrected visual acuity (BCVA) in logarithm of the minimum angle of resolution (logMAR), axial length, intraocular pressure (IOP). RRD parameters were: RRD extent, retinal breaks number. Surgical data were: cataract surgery, tamponade used. Postoperative parameters were: BCVA, IOP at first, third, sixth month, recurrent RD, incidence of retinal folds, subretinal fluid (SRF) persistence, macular displacement. Results Seventy-one eyes (71 patients) were recruited. Cataract surgery was performed in 32 of 45 phakic patients. The tamponade used was: sulfur hexafluoride 18% (41), silicon oil (SO) (26), highdensity SO (4). BCVA improved significantly from
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10792-020-01591-2) contains supplementary material, which is available to authorized users. R. Frisina (&) I. Gius G. Frascogna T. Pizzolon A. Greggio L. Tozzi E. Midena Department of Ophthalmology, University of Padova, via Giustiniani n. 2, 35128 Padua, Italy e-mail: [email protected]
baseline (1.2 ± 0.4 logMAR) to the last control (0.8 ± 0.7 logMAR) (P = 0.03285). Recurrent RD incidence was 14.1%. Postoperative complications were: retinal folds (2), SRF persistence (3), macular displacement (2). Conclusion Vitrectomy under air is a safe alternative technique for treating macula-involving RRD. Vitrectomy under air allows surgeon to remove accurately the vitreous from the peripheral retina and facilitates the removal of SRF reducing the complications related to its postoperative persistence. Keywords Air Macula-involving rhegmatogenous retinal detachment Retinal fold Subretinal fluid Vitrectomy Vitreous cutter port
Introduction Pars plana vitrectomy (PPV) has been greatly developed significantly in the last few years, and the evolution of the instruments has made it less and less invasive and traumatic, widening the indications and increasing the demand. However, PPV approach for the treatment of macula-involving rhegmatogenous retinal detachment (RRD) is not yet standardized, leaving open different ways of performing it. Which maneuvers are better to perform remains debatable and, often, the surgical management depends on surgeon’s experience. The anatomical success of the
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retinal re-attachment may be not sufficient to give an adequate visua
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