Schrader W. F., Besch K.

Universitätsaugenklinik, Würzburg

Background: Optimal therapy for pseudophakic retinal detachment is currently under debate. In Europe, the multicenter SPR study tries to examine the possible benefit of Pars plana vitrectomy (PPV) as compared to a buckling procedure. We reinvestigated our charts of all patients who had primary surgery for retinal detachment in pseudophakic eyes during the last 4 years (before we joined the SPR Study) and compared the results of both treatment options.
Patients: We excluded 531 eyes with traction retinal detachments, traumatic detachment or with surgery after a primary procedure elsewhere. We included 485 eyes, that had primary surgery for retinal detachment during a period between October 1st, 1995 and October 1st, 1999. Among these, 90 had cataract surgery before. 36 of these eyes received a buckle alone and 54 eyes had PPV ± encircling band.
Results: In pseudophakic eyes, retinal detachment was observed 2,5 years (median) after cataract surgery. A primary anatomic success was achieved in 32 of 36 eyes (88,9%) after a buckling procedure and in 50 of 54 eyes (92,6%) with PPV. We observed postoperative PVR twice as often after a buckle than after PPV ( 19,4% versus 9,3%). A final anatomic success (a completely attached retina) was noted 16 months postoperatively in 31 of 36 cases (86,1%) after a buckle alone and in 53 of 54 cases (98,2%) after PPV.
Conclusions: According to our results, PPV ± encircling band should be the first choice for the treatment of pseudophakic retinal detachment, because we observed ahoigher success rate and a lower rate of secondary PVR, as compared to a buckling procedure.

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