Program list

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

PPV AND ILM PEELING WITHOUT SCLERAL BUCKLING FOR RD GRADE C PVR
Jean-Paul Berrod*, K. Naoun, J.C. Badet, I Hubert
Department of ophthalmology, Hôpital Central - C.O 34 - 54035 NANCY - France

Purpose: To report the anatomic and visual results of primary pars plana vitrectomy (P.P.V.) and ILM peeling without scleral buckle to repair primary rhegmatogenous retinal detachment (R.D.) complicated with C grade PVR.
Methods: Non randomized prospective comparative clinical trial including 45 consecutive eyes with 6 months follow up. Patients underwent P.P.V., epiretinal membrane and ILM peeling. Than we performed retinal reattachment with fluid-gas exchange and transcleral cryopexy or endolaser of the breaks under control of wide angle viewing system. Air SF6 gas mixture was used in 15 eyes, C2F6 in 18 eyes, C3F8 in 8 eyes and silicon oil in 4 eyes.
Results: preoperatively : 21/45 (47 %) eyes were phakic and 24 eyes pseudophakic. Maculae were detached in 42 eyes (92 %) mean extent of R.D. was 3,5. Macular ILM peeling was possible in 34 eyes (76 %) Postoperatively : retinae were reattached with on operation in 31 eyes (69 %). Only 3 retines were not reattached with subsequent surgery. At the end of the study silicone oil was present in 11 eyes. The median preoperative visual acuity rose postoperatively from 2/100 to 16/100.
Conclusion: Primary P.P.V. with macular ILM peeling and fluid-gas exchange is an effective method to repair retinal detachment complicated with C grade PVR.