Management of inferior breaks in pseudophakic rhegmatogenous retinal detachment with pars plana vitrectomy and air

Objective: To determine the role of pars plana vitrectomy without scleral buckling and air as a tamponade with 24 hours of prone positioning in the management of inferior breaks in primary pseudophakic rhegmatogenous retinal detachment. Methods: Prospective, noncomparative, interventional case series. Fifteen consecutive eyes (15 patients) with primary pseudophakic rhegmatogenous retinal detachment with causative breaks located between the 4-o'clock and 8-o'clock positions underwent pars plana vitrectomy with air tamponade. The prone position was maintained for 24 hours. Anatomic and functional results are presented. Results: The anatomic reattachment rate was 93.3% after 1 procedure and 100% at the 6-month visit. Mean preoperative best-corrected visual acuity was 20/60 (range, 20/400 to 20/25) and mean postoperative best-corrected visual acuity was 20/30 (range, 20/100 to 20/20). In 1 case the retina redetached at the second week because of an undetected break. Postoperative epiretinal membrane was observed in 1 case. Conclusion: Pars plana vitrectomy and air tamponade with only 24 hours of prone positioning postoperatively is effective in the management of primary pseudophakic rhegmatogenous retinal detachment with causative breaks between the 4-o'clock and 8-o'clock positions. ©2005 American Medical Association. All rights reserved.