Treatment Of Non-Inferior Rhegmatogenous Retinal Detachment (RRD) With 23-Gauge PPV Combined Filtered Air Tamponade

Purpose To investigate outcomes of non-inferior rhegmatogenous retinal detachment(RRD)using 23-gauge PPV with filtered air as the vitreous cavity tamponade.Discuss the factors of retinal reattachment after PPV with filtered air tamponade in non-inferior RRD.Methods This prospective case series involved 55 eyes of the patients who underwent 23-gauge pars plana vitrctomy which performed preretinal proliferative membranes and vitreous cortex removal,photocoagulation around the breaks with 3-5 lines,and with filtered air tamponade,between August 2017 and November 2018.Thereinto,25 eyes for male,30 eyes for female,and 34 eyes for the right,21 eyes for the left.Their ages vary from 19 to 76 years old(55.3±11.5,average),the mean follow-up time was 10.85±4.96 months(2-28 months).Results After 2 months of the PPV with filtered air vitreous tamponade,49 eyes’retina reattached,the rate of reattachment is 89.09%.In 2-6 weeks,6 eyes were re-detached,and performed silicone oil tamponade,1 of them suffered iatrogenic break caused by photocoagulation.One eye was secondary to pre-macular membrane in 1.5 months.The BCVA(logMAR)after PPV with filtered air tamponade(0.40±0.31)is significant better than preoperative eyes(1.29±1.05)(t=6.146,P=0.000).The IOP(mmHg)after PPV with filtered air tamponade(14.86±4.32)is significant higher than preoperative eyes(11.85±3.30)(t=-4.390,P=0.000),2 eyes suffered intraocular hypertension,then returned to normal after drops using.12 of 53 eyes with crystalline lens suffered cataract.The rate of reattachment vary in the number of the breaks(χ2=9.269,P=0.010).Laterality of eye(χ2=0.035,P=0.852),age(χ2=1.393,P=0.498),duration(χ2=4.376,P=0.094),phakic/pseudophakic eye(P=0.702),extent of detachment(χ2=2.582,P=0.275),class of PVR(χ2=0.395,P=0.821),size of break(χ2=1.541,P=0,0.673),clock of break(χ2=1.258,P=0.533)and macular on/off(χ2=0.008,P=0.930)are insignificant with reattachment rate.Binary logistic regression analysis indicates laterality of eye(P=0.455),age(P=0.420),duration(P=0.182),extent of detachment(P=0.749),class of PVR(P=0.928),size of break(P=0.093),clock of break(P=0.309)and macular on/off(P=0.580)are insignificant with reattachment rate.The number of the breaks is significant with reattachment rate(P=0.044).Conclusions Pars plana vitrectomy and gas tamponade(air excusively)is a optional treatment of non-inferior rhegmatogenous retinal detachment(RRD),within better success rate and security.