Use of 25-Gauge Vitrectomy in the Management of Primary Rhegmatogenous Retinal Detachment

In Brief Purpose: To evaluate the anatomical and functional results of 25-gauge transconjuctival vitrectomy in the management of primary rhegmatogenous retinal detachment (RRD). Methods: A retrospective, noncomparative interventional case series including 131 consecutive patients who underwent 25-gauge transconjunctival vitrectomy for primary RRD repair was performed. Data concerning pre- and postoperative visual acuity and intraocular pressure (IOP), lens status, macular status, location of primary break, surgical time, postoperative inflammation, peri- and postoperative complications, and number of sutured sites were collected. Main outcome measures were anatomical success rate, postoperative visual acuity and IOP, and peri- and postoperative complications. Results: The success rate at 3 months was 92.4%. The visual acuity improved from 20/50 (range, 20/16 to light perception) to 20/32 (range, 20/200 to 20/16). Ten patients (7.6%) redetached after a mean follow-up time of 38 days (range, 21–53 days) because of the presence of proliferative vitreoretinopathy in 7 eyes (9.2%) or a new retinal tear in 3 eyes (3.9%). A lowered IOP between 6 mmHg and 10 mmHg (mean, 7.8 mmHg) was observed in 11 patients (8.4%). None had frank hypotony. None of the patients had choroidal detachment or endophthalmitis. Conclusion: Good case selection was shown to ensure good outcomes with 25-gauge transconjuctival vitrectomy in the management of primary RRD. Twenty-five-gauge vitrectomy, cryo/laser, and gas/oil tamponade were performed in 131 patients with primary rhegmatogenous retinal detachment. A total of 92.4% of the patients had the retina successfully reattached at the first operation. Their vision improved from 20/50 to 20/32. No endophthalmitis or choroidal detachment was encountered. In conclusion, 25-gauge vitrectomy is a safe and effective technique for the management of primary retinal detachment.