Purpose: To evaluate surgical techniques and treatment outcomes of rhegmatogenous retinal detachment (RRD) and proliferative vitreoretinopathy (PVR) in case of spreading of pars plana vitrectomy, a microincision vitrectomy surgery (MIVS), wide-angle viewing systems, and high-speed cutter.
Subjects and methods: We compared preoperative factors, surgical procedures, and surgical outcomes in patients with RRD or PVR (grade C or higher) that developed during long-term follow-up between group A (1249 eyes of 1218 patients who underwent initial surgery during the 3-year period from April 2014) and group B (1056 eyes of 1011 patients who underwent initial surgery during the 3-year period from April 2008).
Results: Pars plana vitrectomy (PPV) was performed significantly more frequently for RRD in group A than in group B, whereas no significant difference in surgical procedures for PVR was found. PPV was performed significantly more frequently in group A than in group B for pseudophakia, high myopia, atrophic holes, detachment in one quadrant with a single tear, multiple tears, and inferior flap tears. Scleral buckling was commonly selected in both groups for familial exudative vitreoretinopathy, RRD with atopic dermatitis, and atrophic holes. The initial retinal reattachment rate of PPV for RRD was significantly higher in group A than in group B. No difference was noted in PVR. No differences in the final retinal reattachment rate in the RRD and PVR were noted between the two groups.
Conclusions: Our results suggested that for RRD, the introduction of MIVS, wide-angle viewing systems, and high-speed cutters resulted in PPV being more commonly selected for the initial surgery for RRD. The initial reattachment rate of PPV for RRD was improved. Final retinal reattachment rates were similar between RRD and PVR.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 124: 776-782, 2020.