Alireza Ramezani, Mohammad H Dehghan, Ahmad Rostami, Hamid Ahmadieh, Morteza Entezari, Masoud Soheilian, Mohsen Azarmina, Siamak Moradian, Mehdi Yaseri (Tehran, Iran)

Advantages:

In the management of rhegmatogeneous retinal detachment (RD) accompanying chorioretinal coloboma, difficulty in locating the retinal breaks, their posterior location, and inability to create adequate chorioretinal adhesions around the coloboma by cryo or laser, make vitrectomy a more preferable technique compared to scleral buckling.

Methods:

Vitrectomies were performed in a standard fashion employing a three-port 20-gauge pars-plana approach. Encircling band (No. 240) placement and pars-plana lensectomy (including lens capsule removal) were performed in association with vitrectomy in 92% and 90.9%, respectively. Intraocular lens removal was performed in two eyes. All eyes underwent intraoperative laser therapy around the colobomatous area and retinal breaks followed by air/fluid exchange. Intraocular tamponade included 20% sulphur hexafluoride (SF6) and silicone oil.

Effectiveness / Safety:

In a retrospective interventional case series, 28 eyes of 28 patients (including 18 male subjects) who had undergone surgery for retinal detachment associated with retinal colobomas were evaluated. Primary surgery included vitrectomy in 25 (89.3%) and scleral buckling in 3 (10.7%) eyes. The internal tamponade used in eyes undergoing vitrectomy was silicone oil in 23 (92%) eyes and SF6 in 2 (8%) eyes. Mean follow-up was 40±SD months. The mean number of operations per eye was 1.57±0.74 and the retina remained attached in 26 eyes (92.9%) at final follow-up. Mean preoperative visual acuity was 2.33±0.55 (range, 1.15-2.9) logMAR that significantly improved to 1.72±0.9 (range, 0.09-3.1) logMAR postoperatively.