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¹S.B. Beyoğlu Göz Eğitim ve Araştırma Hastanesi, İstanbul, Uzm. Dr.
²S.B. Beyoğlu Göz Eğitim ve Araştırma Hastanesi, İstanbul, Asist. Dr.
³S.B. Beyoğlu Göz Eğitim ve Araştırma Hastanesi, İstanbul, Doç. Dr.
⁴S.B. Beyoğlu Göz Eğitim ve Araştırma Hastanesi, İstanbul, Klinik Şefi, Prof. Dr. Purpose: To evaluate outcomes of combined encircling band and pars plana vitrectomy (PPV) in cases of pseudophakic retinal detachment.
Materials and Methods: This study included 34 eyes of 34 patients (6 female, 28 male; mean age: 57) with pseudophakic retinal detachment and proliferative vitreoretinopathy (PVR) at different stages that underwent combined encircling band and PPV. Silicon oil (n=29) or C₃F₈ (n=5) was used as an intravitreal tamponade. Visual acuity, anatomic status, and complications were reviewed retrospectively from the patients’ records.
Results: The mean follow-up was 9 months (3-14 months). Retinal detachment developed after phacoemulsification (n=29), extracapsular lens extraction (n=2), phacoemulsification, anterior vitrectomy and posterior capsulorhexis (n=2), and clear lens extraction (n=1). Fourteen eyes had posterior capsule perforation during phacoemulsification, and another eye developed retinal detachment 6 weeks after Nd:YAG laser capsulotomy. Preoperatively, retinal tear existed in one quadrant in 15 eyes and in multiple quadrants in 11 eyes. Tears confined to the vitreous base at the extreme peripheral retina were detected during surgery. Visual acuity improved in 27 eyes and remained the same in 7 eyes. There was a negative correlation between PVR grade and visual acuity gain (rho: -0.98, P=0.005). Silicon oil extraction was performed in 8 eyes after 9 months (mean). No recurrence was observed in these eyes but reoperation was needed in another 3 eyes with silicon oil. Topical glaucoma medication was started in 11 eyes with elevated intraocular pressures, and cyclophotoablation was performed in 2 eyes that were refractory to medical treatment. Severe corneal edema was noted in 3 eyes, and band keratopathy developed in 2 pediatric patients.
Conclusions: Retinal detachment may develop in eyes with posterior capsule rupture during cataract surgery. PVR can also develop in those eyes. Combined encircling band, PPV, and internal tamponade may yield higher rates of anatomic and visual success. Keywords : Pseudophakic retinal detachment, pars plana vitrectomy, proliferative vitreoretinopathy, encircling band