Program list

SYMPOSIUM: STRATEGIES
SECTION: To manage complicated cases of PVR
Moderators: Didier Ducournau, Murat Oncel
Tuesday, September 16th, 2003 ;9:50 - 12:00

MANAGEMENT OF INFERIOR RETINAL BREAKS (IRB) DURING PARS PLANA VITRECTOMY (PPV) FOR RHEGMATOGENOUS RETINAL DETACHMENT (RRD) AND PROLIFERATIVE VITREORETINOPATHY (PVR)
F Boscia*, C Furino, L Sborgia, M Reibaldi, N Recchimurzo, C Sborgia
Italy

Purpose: To determine whether it is necessary to support IRB during PPV with a scleral explant (SB).
Methods: We studied prospectively eighty-three eyes undergoing PPV for RRD with IRB/retinectomies (between 4-8 hours) and PVR grade C-D. Twenty cases received SF6 20-30%, fifteen C3F8 14-18%, thirty-three silicone oil, fifteen received a tamponading agent (5 eyes C3F8 14-18% , 4 eyes SF6 20-28%, 6 silicone oil) with an encircling band and/or an inferior SB. Patient were asked to posture face down.
Results: Fifty-seven (83.8%) eyes vitrectomized without SB and thirteen (86,6%) of those vitrectomized with SB were reattached with a single operation after a minimum follow up of three months. Conclusion: It is not necessary to support IRB with SB during PPV for RRD repair in selected cases provided adequate positioning is maintained and tamponading agent is used.
Take-home message: Gas and silicone oil tamponade with appropriate face down posturing support efficiently inferior breaks even without scleral explants during pars plana vitrectomy for rhegmatogenous retinal detachment repair in selected cases.