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TWENTY-THREE–GAUGE PARS PLANA VITRECTOMY, DENSIRON-68, AND 360° ENDOLASER VERSUS COMBINED 20-GAUGE PARS PLANA VITRECTOMY, SCLERAL BUCKLE, AND SF6 FOR PSEUDOPHAKIC RETINAL DETACHMENT WITH INFERIOR RETINAL BREAKS

Romano, Mario R MD, PhD*†; Angi, Martina MD; Valldeperas, Xavier MD‡§; Costagliola, Ciro MD; Vinciguerra, Paolo MD*

doi: 10.1097/IAE.0b013e3181f0d249
Original Study
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Purpose: To compare the anatomical and functional outcomes of 23-gauge pars plana vitrectomy (PPV) with Densiron-68 tamponade and 360° endolaser versus 20-gauge PPV with encircling scleral buckling (ESB) and an SF6 gas tamponade for the repair of primary pseudophakic retinal detachment with inferior retinal breaks.

Methods: Prospective, randomized, comparative, interventional study. Eighty-two eyes of 82 consecutive patients were randomly assigned to 1 of the 2 treatment groups: 23-gauge PPV/Densiron-68 (44 eyes, 54%) or 20-gauge PPV/ESB/SF6 (20%) (38 eyes, 46%). The inclusion criterion was the presence of primary pseudophakic retinal detachment with at least 1 retinal break between the 4- and 8-o'clock positions. The study protocol involved a minimum of 7 visits: baseline, day of surgery, 1 week, and 1, 3, 6, and 9 months postoperation. Densiron-68 removal was performed within 12 weeks of the initial surgery. Two surgical procedures were required in the Densiron group to remove the oil.

Results: After the primary procedure, the retina was reattached in 90% (40 of 44) of cases in the 23-gauge PPV/Densiron group and in 92% (35 of 38) of cases in the 20-gauge PPV/ESB/SF6 group (P = 0.2, Fisher's exact test). After resolution of redetachments, final anatomical success rate rose to 97% (43 of 44) in the 23-gauge PPV/Densiron group and 94% (36 of 38) in the 20-gauge PPV/SB/SF6 group (P = 0.32, Fisher's exact test). Mean final best-corrected visual acuity (logarithm of the minimum angle of resolution) was 0.40 in the 23-gauge PPV/Densiron group and 0.48 in the 20-gauge PPV/ESB/SF6 group (P = 0.31, t-test). Operative time was significantly less in the 23-gauge PPV/Densiron group (P = 0.002, t-test). No statistically significant difference in the complication rate between the two groups was recorded.

Conclusion: Twenty-three-gauge PPV combined with Densiron-68 and 360° endolaser and 20-gauge PPV combined with ESB/SF6 seemed to have similar efficacy in the repair of primary pseudophakic retinal detachment. Supplementary scleral buckling can be avoided using a Densiron-68 tamponade for retinal detachment with inferior retinal breaks.

This randomized comparative study showed encouraging results using 23-gauge pars plana vitrectomy combined with Densiron-68 for pseudophakic retinal detachment with inferior retinal breaks. Supplementary scleral buckling can be avoided using a Densiron-68 tamponade for inferior retinal breaks.

From the *Department of Ophthalmology, Istituto Clinico Humanitas, Rozzano, Milan, Italy; †Department of Ophthalmology, University of Molise, Campobasso, Italy; ‡Department of Ophthalmology, Campus Bio-Medico University of Roma, Roma, Italy; and §Department of Ophthalmology, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.

The authors have no conflicts of interest to disclose.

Reprint requests: Mario R. Romano, MD, PhD, Department of Ophthalmology, University of Molise, Via F. De Sanctis, 86100, Campobasso, Italy; e-mail: romanomario@email.it

© The Ophthalmic Communications Society, Inc.