Objective / Purpose:

To evaluate the effectiveness of 23 gauge pars plana vitrectomy (PPV) without scleral buckle (SB) for management of rhegmatogenous retinal detachment (RRD) even with lower breaks.

Methods:

The study included 26 patients with total or subtotal RRD without proliferative vitreoretinopathy (PVR) or with PVR grade A, B or C1. All the patients underwent 23 gauge PPV without SB, shaving of the vitreous base with internal tamponade using either Sulfur Hexafluoride (SF6) 25% or silicone oil. The silicone oil was removed after 1-5 months.

Results:

25 (96.2%) of 26 patients achieved anatomical success defined as complete retinal reattachment. Only 1 patient developed lower localized retinal detachment peripheral to the laser barrage and did not need further interference. Postoperative visual acuity ranged from counting fingers 1.5 meters to 20/22. Intraoperative complications included iatrogenic breaks, lens touch, escape of perfluorocarbon liquid under the retina, suprachoroidal infusion cannula, posterior capsular tear during combined phacoemulsification and PPV. Postoperative complications included corneal edema, early postoperative ocular hypotony or hypertension, cataract.

Conclusion:

23 gauge PPV without SB when combined with proper shaving of the vitreous base is an effective technique for management of RRD even with inferior breaks.