Abstract
Purpose
To evaluate the visual outcome, primary anatomic success, and cataract progression of phakic eyes of patients aged younger than 50 years treated for rhegmatogenous retinal detachment (RRD) with primary pars plana vitrectomy (PPV).
Methods
This was a retrospective, observational, cross-sectional study. The data from 53 RRD patients undergoing PPV were analyzed. The time course changes in best-corrected visual acuity (BCVA) and cataract formation were examined.
Results
The 53 patients had a mean age of 37.8 years. Forty-eight eyes (90.6 %) achieved anatomic success after the primary surgery. The BCVA improved significantly after surgery (mean ± SD −0.091 ± 0.146) when compared with the baseline (mean ± SD 0.214 ± 0.597; P = 0.0001). No patient aged younger than 40 years (mean 32.5 years; range 17–39) developed significant lens opacity or received cataract surgery within the first 3 years. Of the patients aged older than 40 years (mean 43.8 years; range 40–49), 22 % developed significant lens opacity and received cataract surgery within the first 3 years. A significant difference was found in cataract progression between the two groups within the first 3 years (P = 0.0217), but not over the entire follow-up period (P = 0.1679).
Conclusions
We found that lens-sparing PPV for RRD in patients aged younger than 50 years had a reasonable success rate, although cataract progression was evident during the follow-up period in patients aged older than 40 years.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Afrashi F, Akkin C, Egrilmez S, Erakgun T, Mentes J. Anatomic outcome of scleral buckling surgery in primary rhegmatogenous retinal detachment. Int Ophthalmol. 2005;26:77–81.
Heimann H, Bartz-Schmidt KU, Bornfeld N, Weiss C, Hilgers RD, Foerster MH, et al. Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment: a prospective randomized multicenter clinical study. Ophthalmology. 2007;114:2142–54.
Miki D, Hida T, Hotta K, Shinoda K, Hirakata A. Comparison of scleral buckling and vitrectomy for retinal detachment resulting from flap tears in superior quadrants. Jpn J Ophthalmol. 2001;45:187–91.
Savastano A, Savastano MC, Barca F, Petrarchini F, Mariotti C, Rizzo S. Combining cataract surgery with 25-gauge high-speed pars plana vitrectomy: results from a retrospective study. Ophthalmology. 2014;121:299–304.
Azad RV, Chanana B, Sharma YR, Vohra R. Primary vitrectomy versus conventional retinal detachment surgery in phakic rhegmatogenous retinal detachment. Acta Ophthalmol Scan. 2007;85:540–5.
Silva PS, Diala PA, Hamam RN, Arrigg PG, Shah ST, Murtha TL. Visual outcomes from pars plana vitrectomy, phacoemulsification, and intraocular lens implantation in patients with diabetes. Retina. 2014;34:1960–8.
Peyman GA, Huamonte F, Goldberg MF. Management of cataract in patients undergoing vitrectomy. Am J Ophthalmol. 1975;80:30–6.
Blodi BA, Paluska SA. Cataract after vitrectomy in young patients. Ophthalmology. 1997;104:1092–5.
Hsuan JD, Brown NA, Bron AJ, Patel CK, Rosen PH. Posterior subcapsular and nuclear cataract after vitrectomy. J Cataract Refract Surg. 2001;27:437–44.
Holekamp NM, Shui Y-B, Beebe DC. Vitrectomy surgery increases oxygen exposure to the lens: a possible mechanism for nuclear cataract formation. Am J Ophthalmol. 2005;139:302–30.
Blankenship GW, Machemer R. Long-term diabetic vitrectomy results: report of 10 year follow-up. Ophthalmology. 1985;92:503–6.
Oshima Y, Emi K, Motokura M, Yamanishi S. Survey of surgical indications and results of primary pars plana vitrectomy for rhegmatogenous retinal detachments. Jpn J Ophthalmol. 1999;43:120–6.
Melberg NS, Thomas MA. Nuclear sclerotic cataract after vitrectomy in patients younger than 50 years of age. Ophthalmology. 1995;102:1466–71.
Sakamoto T, Miyazaki M, Hisatomi T, Nakamura T, Ueno A, Itaya K, et al. Triamcinolone-assisted pars plana vitrectomy improves the surgical procedures and decreases the postoperative blood–ocular barrier breakdown. Graefes Arch Clin Exp Ophthalmol. 2002;240:423–9.
Thelen U, Amler S, Osada N, Gerding H. Success rates of retinal buckling surgery: relationship to refractive error and lens status: results from a large German case series. Ophthalmology. 2010;117:785–90.
Heimann H, Bornfeld N, Friedrichs W, Helbig H, Kellner U, Korra A, et al. Primary vitrectomy without scleral buckling for rhegmatogenous retinal detachment. Graefes Arch Clin Exp Ophthalmol. 1996;234:561–8.
Bartz-Schmidt KU, Kirchhof B, Heimann K. Primary vitrectomy for pseudophakic retinal detachment. Br J Ophthalmol. 1996;80:346–9.
Stangos AN, Petropoulos IK, Brozou CG, Kapetanios AD, Whatham A, Pournaras CJ. Pars-plana vitrectomy alone vs vitrectomy with scleral buckling for primary rhegmatogenous pseudophakic retinal detachment. Am J Ophthalmol. 2004;138:952–8.
Adelman RA, Parnes AJ, Ducournau D. Strategy for the management of uncomplicated retinal detachments: the European vitreo-retinal society retinal detachment study report 1. Ophthalmology. 2013;120:1804–8.
Caiado RR, Magalhães O Jr, Badaró E, Maia A, Novais EA, Stefanini FR, et al. Effect of lens status in the surgical success of 23-gauge primary vitrectomy for the management of rhegmatogenous retinal detachment. Retina. 2015;35:326–33.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of interest
Y. Hosoda, None; S. Kuriyama, None; H. Hattori, None; H. Hayashi, None; M. Matsumoto, None.
About this article
Cite this article
Hosoda, Y., Kuriyama, S., Hattori, H. et al. Outcome of primary vitrectomy in phakic patients aged younger than 50 years with rhegmatogenous retinal detachments. Jpn J Ophthalmol 60, 395–400 (2016). https://doi.org/10.1007/s10384-016-0463-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10384-016-0463-z