Nafis ur Rahman, Nafis Ur Rahman.
Primary Vitrectomy for Uncomplicated Aphakic and Pseudophakic Retinal Detachments.
Pak J Ophthalmol Jan ;16(4):148-53.

A retrospective study of 173 eyes of 173 patients with aphakic and pseudophakic rhegmatogenous retinal detachments who underwent primary vitrectomy during the period January 1997 to January 2000 is reported. The purpose was to evaluate the role of primary vitrectomy in the management of rhegmatogenous aphakic and pseudophakic retinal detachments. All cases selected had uncomplicated rhegmatogenous retinal detachments. There were 119 (68.8%) males and 54 (31.2%) females. Ninety-four (54.3%) eyes were aphakic, while 79 (45.7%) eyes were pseudophakic. Fifteen (8.6%) eyes had anterior chamber lenses, while 64 (36.9%) eyes had posterior chamber lenses. Forty-seven (27.16%) eyes had a combined approach done, i.e. vitrectomy and scleral buckling. One hundred twenty-two (70.5%) patients underwent surgery under general anesthesia, while 51 (29.5%) patients underwent surgery under local anesthesia. Anatomical success was achieved in 144 eyes (83%) after primary surgery. Twenty-nine eyes (17%) required repeat surgery with an overall 92% success rate. Causes of failure were proliferative vitreoretinopahy (PVR), new breaks, and reopened breaks. Visual results depended on the initial visual acuity (V.A.), with 37 eyes (21.4%) having visual acuity between 616 and 6112. All cases with macular detachments retained their preoperative vision. Seventytwo eyes (41.6%) had visual acuity between 6/18 and 6136. No vision-threatening intraoperative complications were encountered. The only significant early postoperative complication was a rise of intraocular pressure following the use of intravitreal sulphur hexafluoride gas (SF6). Primary vitrectomy for pseudophakic and aphakic retinal detachments improves the reattachment rate by allowing a direct controlled attack on the cause of the detachment and release of vitreoretinal traction by an internal approach and at the same time avoiding many intraoperative and postoperative complications of scleral buckling.

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