The surgical approach was undertaken according to RRD characteristics, patient demographics, and clinical parameters. Notably, SB was used in young phakic patients without PVD, high myopic patients (axial length > 29 mm), and RRD associated with either anterior or inferior retinal tears.
All patients underwent the same surgical technique that included the following steps: 1) 360° conjunctival peritomy and isolation of the four rectus muscles, 2) circumferential buckle placement, 3) retinal breaks localization (if possible) with indirect ophthalmoscopy and scleral marking with a diathermy probe 4) Cryotherapy to induce a chorioretinal scar 5) 20% Sulfur-hexafluoride (SF6) intravitreal injection (0.4 ccs) previous subretinal fluid drainage that was performed at the surgeon’s discretion.
PPV was preferred over SB in pseudophakic patients or those with media opacity and posterior breaks that precluded the SB approach. All patients underwent a three-port 23-gauge core, and peripheral PPV performed using a noncontact wide viewing system (Constellation Vision System, Alcon Laboratories, Inc., Fort Worth, TX, USA), followed by endolaser photocoagulation using a curved probe that was performed around the retinal tears and circumferentially (360°). Perfluorocarbon liquid was used to flatten the retina during the procedure. Finally, patients received only 20% SF6 as intraocular tamponade. Phacoemulsification and IOL implantation were performed in phakic patients, whether media opacity or lens bulging did not allow the surgeon to perform surgical maneuvers such as vitreous base shaving adequately. The inner limiting membrane (ILM) peeling was randomly performed in the macula-off RRD group and the macula-on RRD “pending foveal detachment” subgroup.
Due to the lack of macular involvement, ILM peeling was avoided in the macula-on “properly so-called" subgroup. All surgeries were performed by an expert surgeon (R.F.)
All patients underwent the same surgical technique that included the following steps: 1) 360° conjunctival peritomy and isolation of the four rectus muscles, 2) circumferential buckle placement, 3) retinal breaks localization (if possible) with indirect ophthalmoscopy and scleral marking with a diathermy probe 4) Cryotherapy to induce a chorioretinal scar 5) 20% Sulfur-hexafluoride (SF6) intravitreal injection (0.4 ccs) previous subretinal fluid drainage that was performed at the surgeon’s discretion.
PPV was preferred over SB in pseudophakic patients or those with media opacity and posterior breaks that precluded the SB approach. All patients underwent a three-port 23-gauge core, and peripheral PPV performed using a noncontact wide viewing system (Constellation Vision System, Alcon Laboratories, Inc., Fort Worth, TX, USA), followed by endolaser photocoagulation using a curved probe that was performed around the retinal tears and circumferentially (360°). Perfluorocarbon liquid was used to flatten the retina during the procedure. Finally, patients received only 20% SF6 as intraocular tamponade. Phacoemulsification and IOL implantation were performed in phakic patients, whether media opacity or lens bulging did not allow the surgeon to perform surgical maneuvers such as vitreous base shaving adequately. The inner limiting membrane (ILM) peeling was randomly performed in the macula-off RRD group and the macula-on RRD “pending foveal detachment” subgroup.
Due to the lack of macular involvement, ILM peeling was avoided in the macula-on “properly so-called" subgroup. All surgeries were performed by an expert surgeon (R.F.)
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