Vitreoretinal surgery was performed by 9 vitreoretinal surgeons at the Kyorin Hospital. The pre- and postoperative findings and the surgical procedures were obtained from medical records. The preoperative factors examined were the age, sex, lens status, best-corrected visual acuity (BCVA), an incidence of high myopia with a refractive error (spherical equivalent) of >−6.0 diopters (D) or an axial length >26.5 mm, the presence of a posterior vitreous detachment, macular detachment, undetected causative retinal breaks, the number of retinal breaks, the locations of the causative retinal breaks (upper or lower quadrants), the size of the RRD (1–4 quadrants), and presence of PVR. The background factors included prior blunt trauma, retinopathy of prematurity, association with familial exudative vitreoretinopathy, and atopic dermatitis. The surgical procedures included pars plana vitrectomy (PPV), scleral buckling (SB) surgery, or a combination of PPV and SB. The postoperative factors included the final rate of retinal reattachment, BCVA at 6 months after the last surgery, and clinical characteristics of the cases that required reoperation.
The final retinal reattachment rate was determined at 6 months after the last surgery, including the removal of silicone oil (SO) tamponade. If the SO was not removed, the eye was assumed to be still detached. We excluded cases of RD with a macular hole, RRD associated with a perforating ocular trauma, and reoperated cases after an initial surgery that was performed at another hospital. The presence of a posterior vitreous detachment was determined by the presence of glial ring floaters or intraoperative findings of the residual posterior vitreous cortex made visible by triamcinolone crystals.
Cataract surgery was performed together with PPV as needed, using the Constellation® Vision System (Alcon laboratories, Fort Worth, TX, USA) for vitreous surgery and the Resight® wide-angle fundus viewing system (Carl Zeiss Meditec, Dublin, CA, USA) for intraoperative observation. The PPV was performed with a 25-gauge (G) or 27G system, and tamponade was performed with air, sulfur hexafluoride (SF6), propane octafluoride (C3F8) gas, or SO as needed. The SB procedure was performed under view by indirect binocular ophthalmoscopy with cryotherapy and local buckling or encircling buckling. Subretinal fluid drainage and air or gas injection were performed as needed. Scleral buckles (#287 silicone tire, #240 silicone band, #506 silicone sponge, #511 silicone sponge, MIRA, Inc., Uxbridge, MA, USA, or LABTICIAN, Oakville, Canada) were used.
The final retinal reattachment rate was determined at 6 months after the last surgery, including the removal of silicone oil (SO) tamponade. If the SO was not removed, the eye was assumed to be still detached. We excluded cases of RD with a macular hole, RRD associated with a perforating ocular trauma, and reoperated cases after an initial surgery that was performed at another hospital. The presence of a posterior vitreous detachment was determined by the presence of glial ring floaters or intraoperative findings of the residual posterior vitreous cortex made visible by triamcinolone crystals.
Cataract surgery was performed together with PPV as needed, using the Constellation® Vision System (Alcon laboratories, Fort Worth, TX, USA) for vitreous surgery and the Resight® wide-angle fundus viewing system (Carl Zeiss Meditec, Dublin, CA, USA) for intraoperative observation. The PPV was performed with a 25-gauge (G) or 27G system, and tamponade was performed with air, sulfur hexafluoride (SF6), propane octafluoride (C3F8) gas, or SO as needed. The SB procedure was performed under view by indirect binocular ophthalmoscopy with cryotherapy and local buckling or encircling buckling. Subretinal fluid drainage and air or gas injection were performed as needed. Scleral buckles (#287 silicone tire, #240 silicone band, #506 silicone sponge, #511 silicone sponge, MIRA, Inc., Uxbridge, MA, USA, or LABTICIAN, Oakville, Canada) were used.
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