Successful surgical outcomes after 23-, 25- and 27-gauge vitrectomy without scleral encircling for giant retinal tear
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CLINICAL INVESTIGATION
Successful surgical outcomes after 23‑, 25‑ and 27‑gauge vitrectomy without scleral encircling for giant retinal tear Hiroshi Kunikata1,2 · Naoko Aizawa1 · Risa Sato1 · Koji M. Nishiguchi3 · Toshiaki Abe4 · Toru Nakazawa1,2,3,5 Received: 17 January 2020 / Accepted: 1 June 2020 © Japanese Ophthalmological Society 2020
Abstract Purpose Retinal detachment due to giant retinal tears (GRTs), tears larger than 90°, is rare and difficult to treat. Here, we show and compare surgical results of 23-, 25- and 27-gauge (G) micro-incision vitrectomy surgery (MIVS) for GRT. Study design Retrospective and interventional case series. Methods Retrospective review of 41 eyes of 38 patients with GRT who underwent MIVS. Surgical outcomes after MIVS, including reattachment rates and postoperative complications, were compared between instrument gauges. All patients were followed for at least 6 months postoperatively. Results MIVS with 23G, 25G and 27G instruments was performed in 7, 19 and 15 eyes, respectively. Silicone oil (SO) was used in 34 of 41 eyes (83%) with a mean removal time of 43.8 days after first surgery. Best-corrected visual acuity (BCVA) was recovered or maintained in 39 eyes (95%). Reattachment was attained after initial surgery in 38 of 41 eyes (93%) (23G: 6/7 [86%]; 25G: 17/19 [89%]; 27G: 15/15 [100%]). Final reattachment was eventually achieved in all eyes (two eyes needed support from scleral encircling). Postoperative complications occurred in 16 eyes (39%) (23G: 3/7 [43%]; 25G: 8/19 [42%]; 27G: 5/15 [33%]), including macular pucker, cystoid macular edema, macular hole, subretinal perfluorocarbon liquid, retinal folds, vitreous hemorrhage and redetachment. There were no significant differences between the three groups in rate of high myopia, GRT size, operation time, phacovitrectomy rate, SO usage rate, initial reattachment rate, final reattachment rate, preoperative BCVA, final BCVA or rate of postoperative complications. Conclusion Despite occasional postoperative complications, primary MIVS, regardless of gauge size, appears to be a safe and feasible option for GRT surgery. Keywords Rhegmatogenous retinal detachment · Giant retinal tears · Microperimetry · Scleral buckling · Proliferative vitreoretinopathy
Corresponding Author: Hiroshi Kunikata * Hiroshi Kunikata [email protected] 1
Department of Ophthalmology, Tohoku University Graduate School of Medicine, 1‑1 Seiryo‑machi, Aoba‑ku, Sendai 980‑8574, Japan
2
Department of Retinal Disease Control, Tohoku University Graduate School of Medicine, Sendai, Japan
3
Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
4
Division of Clinical Cell Therapy, United Centers for Advanced Research and Translational Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
5
Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Sendai, Japan
Introduction Repairing retinal detachment caused by gia
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