Abstract
Purpose
To investigate the incidence of and clinical risk factors for multiple subretinal fluid (SRF) blebs after pars plana vitrectomy (PPV).
Methods
This study examined patients who underwent PPV (25- or 27-gauge) to repair a primary rhegmatogenous retinal detachment (RRD). Clinical characteristics, including age, sex, axial length, symptom duration, and postoperative best-corrected visual acuity (BCVA), were compared between eyes with and without multiple SRF blebs. Intentional drainage retinotomy and cryotherapy use were also performed. Main outcome measures were the effect of these parameters on multiple SRF bleb incidence 1 month after surgery.
Results
A total of 108 eyes of 106 patients (76 men and 32 women; mean age = 58.9 ± 9.0 years) were included. Multiple SRF blebs were observed in 8 eyes (7.4%). Logistic regression analysis showed that creation of intentional drainage retinotomy and 27-gauge PPV are risk factors for the development of multiple SRF blebs. The number and size of blebs spontaneously decreased over time, and SRF had completely resolved in 5 eyes (62.5%) 1 year after surgery.
Conclusion
Multiple SRF blebs developed even after small gauge vitrectomy. The SRF did not affect postoperative BCVA and gradually absorbed without treatment.
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Funding
This study was partly supported by the Ministry of Education, Culture, Sports, Science and Technology (MEXT), Tokyo, Japan.
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Akio Oishi received a grant from Novartis (Basel, Switzerland) and speaker’s honoraria from Alcon (Tokyo, Japan), Bayer (Leverkusen, Germany), and Santen (Osaka, Japan); Akitaka Tsujikawa received grants from Novartis, Santen, Bayer, HOYA (Tokyo, Japan), Kowa (Nagoya, Japan), Pfizer (New York, NY), AMO Japan (Tokyo, Japan), Senju (Osaka, Japan), Wakamoto (Tokyo, Japan), Alcon, Japan Medical Industry Association (Tokyo, Japan), Tomey (Nagoya, Japan), JFC Sales Plan (Tokyo, Japan), and Atsuzawa Prosthesis (Tokyo, Japan) and speaker’s honoraria from Alcon, Bayer, Santen, Novartis, Pfizer, Senju, Nidek (Gamagori, Japan), AMO Japan, Kowa, Chugai (Tokyo, Japan), Sanwa Kagaku (Nagoya, Japan), Kyoto Soyaku (Kyoto, Japan), HOYA, Otsuka (Tokyo, Japan), Daiichi Sankyo (Tokyo, Japan), and Wakamoto; Toshiaki Kurakazu received speaker’s honoraria from Santen, HOYA, Kowa, Pfizer, AMO Japan, Senju, Alcon, Japan Medical Industry Association, and Nidek. The following authors have no financial disclosures: Yuki Otsuka and Kenji Suda.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study protocol was reviewed and approved by the Institutional Review Board and Ethics Committee (IRB/EC) of Hidaka Medical Center (Toyooka Japan). Because of this study’s retrospective nature, the IRB/EC waived the requirement of informed consent.
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Otsuka, Y., Oishi, A., Suda, K. et al. Multiple subretinal fluid blebs after pars plana vitrectomy for rhegmatogenous retinal detachment repair. Graefes Arch Clin Exp Ophthalmol 257, 921–929 (2019). https://doi.org/10.1007/s00417-018-04231-9
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DOI: https://doi.org/10.1007/s00417-018-04231-9