Frequency of persistent sub-macular fluid after pars plana vitrectomy with gas in macula-off rhegmatogenous retinal detachment.
Abstract
BACKGROUND: Rhegmatogenous Retinal Detachment (RRD) is a sight-threatening disease. Scleral Buckling (SB) and Pars Plana Vitrectomy (PPV) are the mainstays of treatment for RRD. The choice of surgical procedure depends on duration and nature of RRD, patient’s age, the location of break and status of the crystalline lens. Incomplete functional recovery is observed in some patients in terms of best corrected visual acuity as compared to clinically attached retina viewed by slit-lamp biomicroscopy. The reasons for this discrepancy was not well known before the invent of optical coherence tomography (OCT). Among many causes, one important cause is Persistent Sub-Macular Fluid (PSMF). Persistent sub-retinal fluid (PSRF) may be a source of vision loss following repair of rhegmatogenous retinal detachment (RRD). As PSMF has a benign course, this study will help in better patient’s reassurance regarding visual recovery.
OBJECTIVE: The objective of this study is to see the frequency of persistent sub-macular fluid following PPV with gas in patients of macula-off RRD. Study Design was prospective interventional. Place & duration of the study was Department of Ophthalmology, Mayo Hospital Lahore, from 11-09-2016 to 10- 01-2017 respectively.
MATERIALS & METHODS: Twenty patients of macula-off RRD full filling the inclusion and exclusion criteria were selected. 23G PPV with isovolumetric C3F8 gas tamponade was performed in all cases by a single surgeon. OCT was performed one month postoperatively in all cases. Those who did not show PSMF were categorized in group A, while those who showed PSMF were categorized in group B. Repeat OCT was done on 2nd, 3rd and 4th months postoperatively for group B only.
RESULTS: The mean age of cases was 48. 60 ± 11.14 years. There were 12(60%) male and 8(40%) female cases. The right eye was operated in 11(55%) cases while 9(45%) cases had left eye operated. Only 2(10%) developed sub-macular fluid at 1st and 2nd month of procedure that was settled at 3rd months.
CONCLUSION: The persistent subclinical submacular fluid was eventually to be resolved with no effect on the anatomical outcome.
KEYWORDS: Persistent Sub-macular Fluid, Pars Plana Vitrectomy, Optical Coherence Tomography.