23-gauge sutureless vitreo-retinal surgery for superior rhegmatogenous retinal detachment

ABSTRACT

To determine the results of 23-gauge sutureless vitreo-retinal surgery for superior/supero-temporal rhegmatogenous retinal detachment [RRD]. Study Design: Quasi experimental study. LRBT, Free Base Eye Hospital, Karachi, from January 2010 to December 2011. Adult patients who underwent 23-gauge sutureless vitreo-retinal surgery along with use of Perfluoropropane [C[3]F[8]] gas as internal tamponading agent for fresh [upto 3 weeks] superior/supero-temporal RRD was reviewed. Major outcome measures were anatomical success, best corrected visual acuity [BCVA] with Log Mar and complications during and after surgery. Postoperative follow-up was done on 1st day and at 1st, 4th, 8th and finally at 12th week. Sixty eyes of 60 patients, age between 30 - 60 years including 37 [61.67%] males and 23 [38.33%] females having superior or superatemporal RRD underwent 23-guage sutureless vitreo-retinal surgery with the use of perfluoropropane [C[3] F[8]] gas as internal temponade at the end of procedure. Anatomical success rate was 81.66% [49 out of 60 eyes]] with first surgery and raised to 90% [54 cases] with second surgery. Log Mar BCVA significantly improved from mean baseline 0.93 to 0.49 with mean difference of 0.43 [p < 0.001], 95% confidence interval. Postoperative complications were sub-conjunctival haemorrhage in 11 eyes [18.33%], wound leak in 7 eyes [11.66%], anterior chamber became shallow in 6 eyes [10%], cataract developed in 5 eyes [8.33%], re-retinal detachment in 4 eyes [6.66%], ocular hypotony and sterile inflammatory reaction in 3 eyes [5%] each, while iatrogenic breaks developed in 2 eyes [3.33%]. The 23-gauge sutureless vitreo-retinal surgery for superior rhegmatogenous retinal detachment achieved high anatomical success and significant visual improvement. Sub-conjunctival haemorrhage was the most frequent procedural complication