RESULTS OF VITRECTOMY IN RHEGMATOGENOUS R ETINAL-DETACHMENT AND DENSEVITREOUS OPACITIES

Background In-some cases of rhegmatogenous retinal detachment dense vi treous opacities can delay the diagnosis and prevent a scleral bucklin g procedure. In these cases a primary vitrectomy is neccessary. These results of vitrectomy are of current interest, because intra-and posto perative complications are comparable to the group of patients with re tinal detachment and clear media, in which primary vitrectomy is discu ssed today as an alternative method. Patients and Methods After redeta chment and trauma were excluded, we reviewed the charts of 40 patients (40 eyes), who underwent vitrectomy and gas endotamponade for rhegmat ogenous retinal detachment and dense vitreous opacities. In 31 cases v itreous hemorrhage and in 9 cases other dense non inflammatory vitreou s opacities were present. Intraoperatively detected PVR (1), giant tea r (1) and retinal holes located at the posterior pole (1) were exclude d. The remaining 37 eyes were examined retrospectively. The median fol low-up time was 12 months. Results In 32 of 37 eyes the retina was rea ttached after the first vitrectomy (86,5%). In 5 eyes a redetachment o ccurred, in 3 of them caused by PVR. After revitrectomy successful rea ttachment could be achieved in all cases. As intraoperative complicati ons iatrogenic retinal break formation could be observed in 3 cases an d lens-touch in 1 case. Postoperatively secondary tears in attached re tina developed in 2 cases, in 1 case an arterial branch occlusion and in 1 case a Macular-Pucker. During the follow-up period a cataract dev eloped in 12 of the 21 phacic patients. Conclusions The reattachment r ate of primary vitrectomy in eyes with retinal detachment and associat ed dense vitreous opacities is slightly lower compared to the rate of scleral buckling procedures in cases of retinal detachment with clear media. Comparable good or even better results may be expected for prim ary vitrectomy in cases of retinal detachment without vitreous opaciti es. Since the risk of intra-and post operative complications in our gr oup of patients is small it is promising also for primary vitrectomy i n cases with good view on the fundus.