gms | German Medical Science

Introduction: Retinal detachment is the most common retinological emergency. If untreated, a retinal detachment proceeds in the majority of cases and leads to functional impairment or blindness. Adjacent to buckel surgery, pars plana vitrectomy is the most preferred method for treating retinal detachment in Germany.

In the following we present our results of a 20-gauge pars plana vitrectomy with subretinal fluid endodrainage as a treatment of simple and complex retinal detachment.

Methods: To drain the subretinal fluid, a flexible silicon Tip aspirator is pushed gently under the retina through the preexisting tear or a new created drainage foramen and a fluid-air exchange is fullfilled. Perfluordecalines are not required. Lasercoagulation retinopexie is performed under air respectively under siliconoil. 202 patients (75 females, 127 males), mean age 68 years (± 17,4) received a 20 G vitrectomy with subretinal endodrainage. 143 eyes had a rhegmatogenous retinal detachment (34 with full thickness macular hole). 59 eyes showed a proliferative vitreoretinopathy ° B or C (29,2%). 16 patients were pretreated elsewhere. Only 42 eyes were pseudophacic. Overall, 161 eyes had a detached macula preoperatively (79,7%).

Results: The primary reattachment rate was 100% at discharge from hospital. However 9 patients had a re-detachment (4,5%), which was treated successfully with a second vitrectomy.

The mean best corrected visual acuity in logMAR improved from 1.3 to 1.2 by discharge from the hospital. After an average time of 15 weeks the best corrected visual acuity was logMAR 0.8 and after 24 weeks logMAR 0.6.

Conclusion: 20-gauge pars plana vitrectomy with subretinal fluid endodrainage is a valuable surgical procedure to reattach simple and also complex retinal detachments. Also it improves the best corrected visual acuity significantly. Perfluorodecalines are generally not required