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Entry-site-related retinal detachment after pars plana vitrectomy
Article first published online: 24 APR 2007
DOI: 10.1111/j.1600-0420.2007.00930.x
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How to Cite
Wimpissinger, B. and Binder, S. (2007), Entry-site-related retinal detachment after pars plana vitrectomy. Acta Ophthalmologica Scandinavica, 85: 782–785. doi: 10.1111/j.1600-0420.2007.00930.x
Publication History
- Issue published online: 18 OCT 2007
- Article first published online: 24 APR 2007
- Received on October 25th, 2006 Accepted on February 18th, 2007.
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Keywords:
- entry site;
- pars plana vitrectomy;
- retinal detachment;
- sclerotomy
Abstract.
Purpose: Today, pars plana vitrectomy represents a standard surgical procedure for a number of retinal diseases that were previously considered inoperable. The aim of the present study is to investigate the entry site of pars plana vitrectomy as a possible source of retinal detachment.
Methods: We reviewed retrospectively all cases of uncomplicated pars plana vitectomies because of macular hole, macular pucker and diabetic macular oedema performed in our department between 1 January 2001 and 7 July 2004.
Results: Over 3.5 years, 244 pars plana vitrectomies because of macular disease were performed. Sclerotomy-related retinal detachment was observed in 11 (4.5%) cases. These retinal detachments occurred at a mean of 37 (2–100) days after surgery. They appeared within the first 4 weeks in 55% of the cases.
Conclusion: Iatrogenic retinal breaks and detachment continue to be a severe complication of pars plana vitrectomy, despite improvements in instrumentation and surgical techniques. A 4.5% incidence of sclerotomy-related retinal detachment after simple vitrectomy calls for action. Current approaches to reduce this complication – such as circular peripheral cryoretinopexy, scleral buckling or 360° laser treatment – are invasive. We recommend extended vitreous base cleaning with scleral indentation and examination of the entry sites, performed with a three-mirror lens or via careful indirect ophthalmoscopy into the periphery, 4 weeks after surgery.