Eye Disorders and Treatment

Biography

Biography: Hudson Nakamura

Abstract

Background & Objective: Pseudophakic and aphakic retinal detachments are associated with a lower percentage of successful primary repairs with standard scleral buckling surgery than phakic retinal detachments. The objective of this study was to determine whether a combined scleral buckle and vitrectomy as a primary procedure offers any advantage over conventional scleral buckling in primary pseudophakic and aphakic retinal detachments without proliferative vitreoretinopathy. Materials & Methods: This was a prospective, non-randomized clinical study. Ninety-four consecutive pseudophakic and aphakic retinal detachments were included in the study. All patients were operated upon by the same surgeon. Each patient underwent a combined scleral buckle and pars plana vitrectomy with perfluorocarbon injection and air-fluid exchange. Each patient was followed by the operating surgeon for a minimum of 6 months. Patients were followed with respect to anatomic reattachment, visual acuity improvement and surgical complications. Results: All eyes were anatomically reattached after a single operation. All demonstrated an increase in their visual acuity and there were no complications attributable to the vitrectomy procedure. Conclusions: We conclude that such a combined approach to primary pseudophakic and aphakic retinal detachments offers significant benefits to scleral buckling alone. We believe that the improved success rate is a function of vitrectomy contributing to both an improved peripheral visibility, resulting in fewer missed peripheral breaks and a lower likelihood of proliferative vitreoretinopathy. We recommend this combined surgical approach for all primary pseudophakic and aphakic retinal detachments.