Program list

SYMPOSIUM: STRATEGIES
SECTION: To prevent complicated stages of PVR
Moderators: William Mieler, Francesco Boscia
Tuesday, September 16th, 2003 ; 8:20 - 9:50

PARS PLANA VITRECTOMY WITHOUT SCLERAL BUCKLE FOR COMPLICATED RD WITH STAGE B PVR
J.P Berrod*, J.C Badet, K. Naoun, I. Hubert
Nancy, France

Purpose : To report the anatomic and visual results of primary pars plana vitrectomy (P.P.V) without scleral buckling to repair primary rhegmatogenous retinal detachment (R.D.) complicated with B grade PVR.
Methods : Nonrandomized prospective comparative clinical trial including 145 consecutive eyes with 6 months follow up. Patients underwent P.P.V., retinal reattachment with fluid-gas exchange and transcleral cryopexy of the breaks and peripheral retina under control of wide angle viewing system.
Results : preoperatively : 90/145 (61 %) eyes were phakic and 55 eyes pseudophakic. Among the phakic patients, maculae were detached in 80 eyes (89 %) mean extend of R.D. was 2,9. Among the pseudophakic patients, maculae were detached in 46 eyes (84%) mean extent of R.D. was 2,7 quadrants. Postoperatively : retinae were reattached with on operation in 81 eyes (90 %) of the phakic eyes and in 50 (89 %) of the pseudophakic eyes. Only 2 retinae were not reattached with subsequent surgery. The median preoperative visual acuity rose postoperatively from 20/200 to 15/40 in phakic eyes and to 20/40 in pseudophakic eyes. Refractive error measurement obtained was - 2 diopters in phakic patients related to nuclear sclerosis present in all the phakic eyes and - 0,5 diopter in pseudophakic.
Conclusion : Primary P.P.V. with fluid-gas exchange and cryopexy is a very effective method to repair retinal detachment complicated with B grade PVR whatever the status of the lens but carries a high risk of nuclear sclerosis in phakic eyes.