Pars Plana Vitrectomy Alone for the Management of Pseudophakic Rhegmatogenous Retinal Detachment with Only Inferior Breaks

Purpose To report the surgical results of primary pseudophakic rhegmatogenous retinal detachment (RRD) with only inferior retinal breaks (IRBs) repaired by pars plana vitrectomy (PPV) alone and complete drainage of subretinal fluid. Design Prospective, interventional cohort study. Participants A total of 147 consecutive pseudophakic eyes of 147 patients with primary RRD with causative inferior breaks. Methods All eyes underwent PPV alone and complete drainage of subretinal fluid, with air, 20% sulfur hexafluoride (SF 6 ), or 12% perfluoropropane (C 3 F 8 ) as tamponade and with no face-down position in the postoperative period. Main Outcome Measures Postoperative primary and final anatomic outcome, visual acuity, and complications. Results The patient population consisted of 44 women (30%) and 103 men (70%) with a mean age of 60.8±12.9 years. The mean follow-up period was 24.9±19.4 months. The mean number of quadrants affected was 2.4 (range, 1–4). A single break was present in 90 cases (61.2%), and 2 to 4 breaks were present in 57 cases (38.8%). The macula was found to be detached in 118 cases (80.3%) and attached in 29 cases (19.7%) intraoperatively. Of 152 breaks located between 5 and 7 clock-hours, 124 breaks (81.6%) were located outside the limits of the gas bubble on the first or third day postoperatively. Initial reattachment was achieved in 139 cases (94.5%; 95% confidence interval, 89.5–97.6). Final reattachment was achieved in 147 cases (100%). Two cases (1.3%) redetached because of new or missed retinal breaks. Six cases (4.1%) redetached because of incomplete retinal adhesion of the treated break(s). Mean preoperative best-corrected visual acuity (BCVA) was 1.11±0.59 logarithm of the minimum angle of resolution (logMAR). The mean final postoperative BCVA was 0.42±0.33 logMAR. Conclusions Pars plana vitrectomy alone with complete drainage of subretinal fluid achieves a high reattachment rate in the management of primary pseudophakic RRD due to IRBs.