AI Article Synopsis
- - A study assessed the risk factors for peripheral retinal breaks occurring during pars plana vitrectomy, analyzing data from 404 surgeries that did not have preexisting retinal issues.
- - Out of the surgeries, 32 eyes developed 55 iatrogenic peripheral retinal breaks, with the highest incidence found in patients with branch retinal vein occlusion (BRVO) and the majority around the surgical entry points.
- - The findings suggest that retinal breaks are mostly related to the sclerotomy and that detecting breaks during surgery leads to better outcomes for retinal reattachment compared to those found after surgery.
Article Abstract
Objective: To assess the risk factors and prognosis of peripheral retinal breaks complicating pars plana vitrectomy.
Methods: Retrospective observational case series. Four hundred and four consecutive vitrectomies performed on eyes without preexisting retinal breaks or retinal detachments were retrospectively reviewed. Cases with peripheral retinal breaks found during or after the vitrectomy were recorded and analyzed.
Results: Of the 404 vitrectomies, 32 eyes had 55 iatrogenic peripheral retinal breaks with an average incidence of 7.9%. Peripheral retinal breaks were most common in cases with branch retinal vein occlusion (BRVO) (13.3%) and less common in proliferative diabetic retinopathy (PDR) (3.7%) (chi2 =9.18, P<0.01). Of the 55 breaks, 51 (92.7%) occurred around the sclerotomy sites, and 29 (52.7%) in the quadrant corresponding to the predominant hand of the surgeon. Cases with breaks detected during surgery had a better outcome of retinal reattachment as compared with cases identified postoperatively.
Conclusions: Peripheral retinal breaks complicating pars plana vitrectomy is mainly sclerotomy-related and is more common in cases with BRVO than in cases with PDR. Early detection during surgery tends to have a better outcome.
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