Ozen Osmanbasoglu, Hülya Güngel, Sevil Karaman, Isýl Pasaoglu, Dilek Alp, Hakan Eren (Istanbul, Turkey)

Advantages:

To assess anatomic and functional outcomes of pars plana vitrectomy (PPV) for rhegmatogeneous retinal detachment (RD) in highly myopic patients.

Methods:

21 patients’ data with high myopia that underwent PPV (twelve with 23 G, nine with 20 G) during May 2006-May 2010 were evaluated. Groups were defined according to the recurrence of retinal detachment. The presence of preoperative posterior vitreous detachment (PVD), addition of scleral buckling (SB) prior to or during the vitrectomy and posterior localization of vitreous base edge were compared among groups. Anatomic and functional success rates were investigated.

Effectiveness / Safety:

Mean age was 48,7±13,2 years (23-82). Mean follow up time was 20.9±16.4 (6-58). Seven patients had SB (2 with pneumatic retinopexy) prior to and 6 patients had SB during the PPV operation. The difference between preoperative and postoperative visual acuity was statistically significant (p: 0.00) (2.38 ± 0.9 /1.22±1.05 LogMAR Unit respectively) there was a mean of -1.07 (±1.27) LogMar Unit increase obtained in all group. Retinal redetachment was seen in 8 patients. Retinal attachment was achieved in all patients after the following surgeries. Eleven patients had no posterior vitreous detachment prior to surgery. In 17 patients the posterior edge of the vitreous base was localized. There was no statistically significant difference between the presence of preoperative PVD and localization of posterior vitreous base edge in between groups (p>0.05). Addition of SB prior to or during the surgery was not found to be effective on retinal detachment recurrence rate or visual acuity gaining.

Take home message:

In highly myopic patients, pars plana vitrectomy with complete peeling of posterior hyaloid, causes functional and anatomical achievement.