Recurrence after primary vitrectomy for pseudophakic retinal detachment

Introduction: The aim of this study was to evaluate the incidence of pseuclophakic retinal detachment (RD) recurrence after primary vitrectomy. Patients and methods: This was a prospective nonrandomized consecutive case series study, evaluating two series presenting to our clinic with pseuclophakic RD from 1998 to 2004 (103 eyes of 97 patients). The study included 24 consecutive pseudophakic eyes treated with gas vitrectomy surgery with placement of an encircling band from January 1998 to December 2000 (group A) and 79 consecutive pseuclophakic eyes treated with gas vitrectomy surgery with no encircling band from January 2001 to December 2004 (group B). Pre- and postoperative characteristics were analyzed in both groups. In the cases of postoperative RD recurrence, we particularly analyzed the pre- and postoperative risk factors, as well as the anatomic and functional outcome. Results: Visual acuity improved in 74/103 (71.8%) eyes from both groups postoperatively. Recurrence of RD after primary vitrectomy occurred in eight of 103 (7.8%) eyes in both groups. More specifically, two of 24 (8.3%) eyes in group A and six of 79 (7.6%) eyes in group B presented a recurrence after gas vitrectomy with encircling band and gas vitrectomy alone, respectively. Among these eight eyes, four eyes (50%) presented proliferative vitreoretinopathy (PVR) at the time of initial vitrectomy, while all eyes presented PVR at the time of recurrence (one grade B, seven grade Q. These eyes required two additional interventions on average. Five eyes (62.5%) required silicone-oil tamponade for a good anatomic reapplication. Discussion: These results show that recurrence after primary vitrectomy for pseuclophakic RD is most often related to the presence of PVR before or after the first intervention. This series reports a success rate of 91.7% and 92.4%, respectively, for group A and B, thus demonstrating the efficacy of vitrectomy in the treatment of pseuclophakic RD. This study also shows a nonsignificant difference in the recurrence rate among patients treated by gas vitrectomy and those undergoing gas vitrectomy in association with encircling band placement, which raises the question of the usefulness of an additional encircling band in pseuclophakic RD.