Pars Plana Vitrectomy for Retinal Detachments Associated with Chorioretinal Coloboma

2009 
Purpose: To evaluate the anatomical and functional outcomes of surgical management of retinal detachments associated with choroidal colobomas Methods: In this retrospective study, 31 eyes of 31 patients with coloboma-related retinal detachments enrolled. All the eyes underwent standard three-port pars plana vitrectomy with internal tamponade with nonheavy silicon oil in 24 (77.4%) or 20% sulfur hexafluoride (SF6) in 7 (22.6%) eyes. Endolaser photocoagulation at the borders of the coloboma was performed in all cases to isolate the colobomatous area. Encircling band was placed in 12 (38.7%) eyes based on surgeon’s intraoperative judgment. Intraoperative lensectomy was performed in 16 (51.6%) eyes. Results: Mean (±SD) preoperative visual acuity (VA) was 2.41 (±0.73), which showed a statistically significant improvement to 1.78 (±0.93), postoperatively (P<0.001). Placement of encircling band significantly increased the chance of postoperative intraocular pressure (IOP) elevation (P=0.027). Retinal reattachment was ultimately achieved in 29 patients (93.5%) after an average of 1.32 operations per patient. Intractable glaucoma, retinal redetachment, band keratopathy, corneal decompensation and macular hole formation were the complications observed. Conclusion: Using vitrectomy techniques with intraoperative silicon oil or SF6 tamponade and endolaser photocoagulation at the borders of the coloboma is highly successful in anatomical retinal reattachment accompanied by significant visual improvement.
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