A 23- or 25-gauge three-port PPV was performed using the Alcon Constellation system (Alcon Laboratories, Inc., Fort Worth, TX, USA). After central and peripheral vitreous removal, 360° vitreous base shaving was performed up to ora serrata with scleral indentation. Vitreous traction at the retinal tears was released. A complete fluid-air exchange was performed, and subretinal fluid (SRF) was aspirated through a flute needle. If the retina was highly elevated with extensive area involved, perfluorodecalin was used to flatten the retina first. Most patients underwent endophotocoagulation to achieve retinopexy. However, if the retina breaks were in the peripheral area, transscleral cryopexy was applied. A gentle pressure was maintained on the sclerotomy with a cotton-tip applicator for at least 2 min until the incision site was definitely closed. The IOP was controlled to around 24 mmHg, slightly higher than the normal level, thus avoiding postoperative hemorrhage. All patients were instructed to maintain a proper head positioning to enable the air to tamponade the retinal breaks for 1 week. They were also asked to have restricted activities for 1 month and visited the operating surgeon’s clinic at 1 week, 2 weeks, 1 month, and then bimonthly for at least 12 months. During the follow-up, all patients were interviewed about their own assessments of daily physical activity which were classified as inactive (less than light labor), active (light or moderate labor), or very active (heavy labor) [19 (link)]. Restricted activity was defined as being refrained from active or very active physical activity and avoiding frequent and sudden head movement. Anatomical success was defined as the complete disappearance of SRF and flattening of the entire circumference of the retinal breaks.
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