Pseudophakic retinal detachment: a pilot study of vitrectomy and scleral buckling

Introduction: Localization of retinal tears generating a pseudophakic retinal detachment (RD) is not always possible; subsequently, segmental indentation by external compression often causes a residual RD, Vitrectomy enables a detailed view of the peripheral part of the retina and better detection of small size retinal breaks. Our pilot survey report anatomic and functional results of a surgical treatment of pseudophakic RD, associating vitrectomy and scleral buckling. Material and Methods: Twenty three consecutive pseudophakic eyes showing an RD were operated on with scleral buckling, vitrectomy, internal subretinal fluid drainage, endolaser and fluid-air exchange by SF6 20%. Preoperative findings, intraoperative and postoperative complications, and final results were analyzed. Results: The retina was successfully reattached with a single operation in 21 eyes(92%). One eye presented a recurrence of RD due to a preexisting retinal tear. PVR was observed in one case with the recurrence of the RD. In both cases, a second operation achieved the retinal reattachment. After surgery, visual acuity improved on an average of 3 lines. The most frequently occurring complication was a transitory hypertony in 6 cases (26%). Conclusion: Surgical treatment of the pseudophakic RD, combining vitrectomy and scleral buckling shows very good anatomic and functional results; it seems to offer the advantage of a better localization of peripheral retina tears, which enables a recovery with a lower recurrence rate than by extra-ocular surgery only.