Primary Pars Plana Vitrectomy With 360-Degree Endolaser Photocoagulation for Pseudophakic Rhegmatogenous Retinal Detachment

Yong Jun Yun; Jung Yeul Kim

doi:10.3341/jkos.2009.50.9.1348

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Yun and Kim: Primary Pars Plana Vitrectomy With 360-Degree Endolaser Photocoagulation for Pseudophakic Rhegmatogenous Retinal Detachment

Original Article

J Korean Ophthalmol Soc 2009;50(9):1348-1352.

Published online: 7 September 2009

DOI: https://doi.org/10.3341/jkos.2009.50.9.1348

Primary Pars Plana Vitrectomy With 360-Degree Endolaser Photocoagulation for Pseudophakic Rhegmatogenous Retinal Detachment

Yong Jun Yun, MD¹, Jung Yeul Kim, MD^1,²

¹Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea

²Research Institude for Medical Sciences, Chungnam National University College of Medicine, Daejeon, Korea

Address reprint requests to Jung Yeul Kim, MD Depart of Ophthalmology, Chungnam National University Hospital #640 Daesa-dong, Jung-gu, Daejeon 301-721, Korea Tel: 82-42-280-8433, Fax: 82-42-255-3745, E-mail: kimjy@cnu.ac.kr

Received 29 March 2009 Accepted 16 June 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report the results of primary pars plana vitrectomy with 360-degree endolaser photocoagulation for pseudophakic rhegmatogenous retinal detachment.

Methods

We retrospectively reviewed the medical records of 35 eyes of 35 patients who hadundergone vitrectomy without scleral bucking as a primary operation for pseudophakic rhegmatogenous retinal detachment with a followup period of more than 12 months. We also analyzed the anatomical success rate and the patients’ final visual acuities. In all patients, endolaser photocoagulation was applied to the retinal tears, as well as to 360-degrees of the peripheral retina, using a curved illuminating endolaser probe intraoperatively.

Results

The mean patient age was 61 years, and the mean followup period was 20 months. The mean preoperative visual acuity (logMAR) was 1.06, while the mean postoperative visual acuity (logMAR) was 0.23. Twenty-four (69%) of the 35 patients showed macular detachment, and 34 (97%) of the 35 eyes experienced retinal reattachment and visual improvement after a single operation. Complications included epiretinal membrane (6%) and cystoid macular edema (3%).

Conclusions

Primary pars plana vitrectomy with 360-degree endolaser photocoagulation, instead of sclera buckling, seemsto be an effective method in managing pseudophakic rhegmatogenous retinal detachment.

Keywords: 360 degrees endolaser, Pseudophakic, Retinal detachment, Vitrectomy

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Figure 1.

Scattergram of preoperative vs. final postoperative visual acuity of 35 eyes (35 patients).

Table 1.

Preoperative characteristics of 35 eyes (35 patients) undergoing primary pars plana vitrectomy with 360-degree endolaser photocoagulation

Mean age (range)	61 (32∼73)
Sex (male : female)	19 : 16
Mean number of break± SD (range)	1.47±0.90 (0∼3)
Macula (on : off)	11 : 24
Type of break
Horseshoe tear	11 (32%)
Round hole	20 (57%)
None observed	4 (11%)
Location of break
Anterior to equator	26 (74%)
Posterior to equator	5 (14%)
Superior half	24 (69%)
Inferior half	7 (20%)
Extent of detachment
≤ 2 quadrant	20 (57%)
≥ 3 quadrant	15 (43%)

Table 2.

Preoperative and postoperative visual acuity of patients undergoing primary pars plana vitrectomy with 360 degrees endolaser photocoagulation (logMAR)

	Total	Macular on	Macular off	p-value^∗
Preoperative VA	1.06±0.63	0.42±0.22	1.36±0.52	0.002
Postoperative VA	0.23±0.16	0.14±0.06	0.27±0.18	0.062

Mean± SD (Standard deviation); VA=visual acuity;

^∗ independent t-test.

Table 3.

Postoperative complications after primary pars plana vitrectomy with 360-degree endolaser photocoagulation

Type	No. of Eyes
Recurrent retinal detachment	1 (3%)
Epiretinal membrane	2 (6%)
Cystoid macular edema	1 (3%)
IOL dislocation	0 (0%)
Persistent IOP increase	0 (0%)
Endophthalmitis	0 (0%)

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