Pars plana vitrectomy with and without triamcinolone acetonide assistance in pseudophakic retinal detachment complicated with proliferative vitreoretinopathy

Jpn J Ophthalmol. 2010 Jul;54(4):331-7. doi: 10.1007/s10384-010-0807-z. Epub 2010 Aug 11.

Abstract

Purpose: To evaluate the anatomical and functional outcomes of pars plana vitrectomy (PPV) in pseudophakic retinal detachment (RD) complicated with proliferative vitreoretinopathy (PVR) without previous scleral buckling (SB) or vitrectomy, both with and without triamcinolone acetonide (TA) assistance.

Methods: In this retrospective, interventional, comparative case series, 72 pseudophakic eyes with RD with PVR grade C1 or greater underwent PPV either with (group 1, n = 40) or without (group 2, n = 32) TA assistance. Eyes with a minimum of 6 months of follow-up were evaluated. Main outcome measures were reattachment, redetachment, complication rate, and changes in visual acuity (VA).

Results: The mean follow-up period was 14.57 +/- 8.55 months. Single-surgery and final reattachment rates were 87.50% and 95% in group 1, and 78.12 % and 96.87% in group 2, (P = 0.349, P = 1.000). Redetachment rates were 12.50% in group 1 and 21.87% group 2 (P = 0.349). In both groups the mean VA increased significantly in postoperative week 1 and in all control visits (P< 0.001) with no difference in complication rate (P > 0.05).

Conclusions: In this study PPV with TA assistance resulted in a lower, albeit statistically insignificant, redetachment rate in the treatment of RD complicated with PVR compared to PPV without TA assistance in eyes without previous SB or PPV. Visual acuity improved in 72% of eyes in both groups. Intraoperative and postoperative complication rates were also similar.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Epiretinal Membrane / diagnosis
  • Epiretinal Membrane / surgery
  • Female
  • Fluorocarbons / administration & dosage
  • Follow-Up Studies
  • Glucocorticoids*
  • Humans
  • Intraoperative Complications
  • Laser Coagulation
  • Male
  • Middle Aged
  • Postoperative Complications
  • Pseudophakia / etiology
  • Pseudophakia / surgery*
  • Recurrence
  • Retinal Detachment / etiology
  • Retinal Detachment / surgery*
  • Retrospective Studies
  • Silicone Oils / administration & dosage
  • Triamcinolone Acetonide*
  • Visual Acuity / physiology
  • Vitrectomy / methods*
  • Vitreoretinopathy, Proliferative / complications*
  • Vitreous Body / pathology

Substances

  • Fluorocarbons
  • Glucocorticoids
  • Silicone Oils
  • perfluorooctane
  • perflutren
  • Triamcinolone Acetonide