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Master Thesis

Étude comparative de la vitrectomie transconjonctivale sans suture 23 gauge versus 20 gauge dans la chirurgie du décollement de rétine

Abstract : Objective: To compare the safety and efficacy of 20- and 23-gauge pars plana vitrectomy (PPV) for the management of primary rhegmatogenous retinal detachment (RD) with proliferation vitreoretinopathy (PVR) grade B or less. Methods: This comparative nested case-control study included 35 consecutive 23-gauge transconjunctival PPV cases matched with 35 cases of 20-gauge PPV (from a prospective cohort of 1150 patients) for the baseline visual acuity (VA), axial length, lens and macular status, the location and number of breaks, and PVR grade. All patients had complete PPV, cryotherapy, fluid-gas exchange, and a minimum follow-up of 6 months. The exclusion criteria were eyes with previous vitreoretinal surgery, combined vitrectomy and cataract surgery, RD secondary to trauma or macular hole, diabetic retinopathy, aphakic eyes, giant tears, or posteriorly located breaks precluding treatment using transconjunctival cryotherapy. Results: Baseline examination disclosed pseudophakia in 77.1%, 2.7±2.2 retinal breaks / eye, attached macula in 37.1%, and PVR grade B in 24.3% of the cases. The mean operative time and intraoperative complication rate (11.4%) were similar in both groups. The single reattachment rate and the final anatomical success rate were similar in both groups, 77% and 97%, respectively. Mean preoperative VA of 1.2 ± 0.9 logMAR improved similarly in both groups to 0.4±0.4 at the 6-month visit. A final vision of 20/40 or better was achieved in 61.4% of the eyes. Conclusion: Twenty-three-gauge PPV provides anatomical and visual results similar to the 20-G technique for the management of uncomplicated rhegmatogenous RD.
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Master Thesis
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  • HAL Id : dumas-00626530, version 1

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Magali Albrieux. Étude comparative de la vitrectomie transconjonctivale sans suture 23 gauge versus 20 gauge dans la chirurgie du décollement de rétine. Médecine humaine et pathologie. 2010. ⟨dumas-00626530⟩

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