Primary 25-Gauge Airbag Vitrectomy in Pseudophakic Rhegmatogenous Retinal Detachment

Purpose: To evaluate the anatomic and functional outcomes and the rate of complications of a novel pars plana vitrectomy approach (airbag vitrectomy), with 25-gauge vitrectomy performed under air infusion, in the treatment of primary pseudophakic rhegmatogenous retinal detachment (PsRD). Methods: Prospective, noncomparative, interventional case series. One hundred forty-one eyes of 141 consecutive patients with primary PsRD uncomplicated by severe proliferative vitreoretinopathy (grade A or B). All patients underwent primary 25-gauge vitrectomy under continuous infusion of air, laser retinopexy of retinal breaks, and air or gas tamponade. Eyes with minimum follow-up of 6 months were evaluated. The Main Outcome Measures were primary anatomical success rate, defined as retinal reattachment at final follow-up after a single operation without additional surgery, visual outcome and rate of complications. Results: At 6 months the retina was reattached successfully after a single surgery in 98% of eyes (138/141). In 3 eyes (2%) retinal detachment recurred during the follow-up period, caused by proliferative vitreoretinopathy in 2 eyes and by new retinal breaks in 1 eye. After surgery, best corrected visual acuity improved significantly (P<0.001, ANOVA). Mean final visual acuity (SD) was 0.28 (0.34) logarithm of the minimum angle of resolution (logMAR) compared with 0.94 (0.84) logMAR before surgery (P<0.01, Tukey–Kramer test). The most common postoperative complication was transitory hypertony (IOP >21 mmHg), detected in 10 eyes (7%) on postoperative day 1. Conclusions: Primary 25-gauge airbag vitrectomy provides a high anatomic and functional success in eyes with PsRD and is associated with a low rate of complications.