PRIMARY 25-GAUGE SUTURELESS VITRECTOMY WITH OBLIQUE SCLEROTOMIES IN PSEUDOPHAKIC RETINAL DETACHMENT

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In Brief Purpose: To evaluate the anatomic and functional outcomes of 25-gauge sutureless vitrectomy in primary treatment of noncomplex pseudophakic rhegmatogenous retinal detachments (RRD). Methods: Prospective interventional institutional case series. Twenty-two eyes with pseudophakic RRD with proliferative vitreoretinopathy grade A or B underwent primary 25-gauge vitrectomy with oblique sclerotomies and gas endotamponade. Eyes with minimum follow-up of 6 months were evaluated. Main outcome measures were reattachment rate with single surgery, reoperation, complication rates, and changes in visual acuity (VA). Results: Mean duration of visual loss was 14.68 ± 12.87 days. Seventeen (77.27%) eyes had macular detachment. In all eyes 25-gauge sutureless vitrectomy was completed without complications. The mean follow-up period was 10.40 ± 5.77 months. Retinal attachment was achieved in 21 (95.45%) eyes with single surgery and in all (100%) eyes with second vitrectomy. Mean preoperative VA of 1.61 ± 1.18 improved to 0.50 ± 0.53 at the last visit (P < 0.001). Transient hypotony was detected in 2 (9.09%) eyes with spontaneous resolution. No other postoperative complication was observed. Conclusions: Twenty-five-gauge sutureless vitrectomy with oblique sclerotomies in primary treatment of noncomplex pseudophakic RRDs resulted in reattachment in 95.45% with single surgery, and in 100% with reoperation in one eye, accompanied by an increase in visual acuity in 86% of eyes. In this study, 25-gauge sutureless vitrectomy was found to be effective and safe in the management of noncomplex pseudophakic rhegmatogenous retinal detachment with a single surgery success rate of 95% and final success rate of 100%. Postoperatively, visual acuity of 20/40 or better was achieved in 50% of eyes postoperatively.