25-Gauge sutureless vitrectomy with oblique sclerotomies for the management of retinal detachment in pseudophakic and phakic eyes

PURPOSE. To evaluate the anatomic and functional outcomes of 25-gauge sutureless vitrectomy in primary treatment of noncomplex retinal detachments (RD) in pseudophakic and phakic eyes. METHODS. In this interventional clinical case series, 23 pseudophakic and 13 phakic eyes with total RDs with proliferative vitreoretinopathy grade A/B underwent primary 25-gauge sutureless vitrectomy with oblique sclerotomies and gas endotamponade. Eyes with minimum follow-up of 6 months were evaluated. Main outcome measures were single surgery and final reattachment rates, complications, and changes in visual acuity (VA). RESULTS. Mean duration of visual loss was 14.65 +/- 12.57 and 22.46 +/- 18.95 days in pseudophakic and phakic eyes, respectively. Eighteen (78.26%) pseudophakic eyes and 12 (92.30%) phakic eyes had macular detachment. In all eyes, 25-gauge sutureless vitrectomy was completed without complication. Mean follow-up period was 11.00 +/- 6.63 months. Single surgery and final retinal attachment rates were 91.30% and 95.65% in pseudophakic eyes and 61.53% and 84.61% in phakic eyes, respectively (p=0.073, p=0.539). In both groups, mean VA increased significantly at postoperative month 1 (p<0.05) and at the last visit (p<0.001). Transient hypotony was detected in 2 pseudophakic and 3 phakic eyes with spontaneous resolution. Two (15.38%) phakic eyes had cataractous changes. CONCLUSIONS. In this study, 25-gauge sutureless vitrectomy resulted in higher single surgery and final anatomic success rates in primary treatment of noncomplex RDs in pseudophakic versus phakic eyes, with commensurate increase in VA. (Eur J Ophthalmol 2009; 19: 853-60)