PARS PLANA VITRECTOMY RESULTS IN PROLIFERATIVE VITREORETINOPATHIES

Abstract

Objective : To evaluate the clinical features, surgical treatment results and complications of patients who underwent pars plana vitrectomy for proliferative vitreoretinopathy(PVR) in our clinic. Methods : Forty-eight eyes of 47 patients who underwent pars plana vitrectomy for PVR were included in the study. 29 (61.7%) of the cases were male and 18 (38.2%) were female. Routine ophthalmologic examination was performed to all patients. All operations were performed by the same surgeon. Results : Forty-eight eyes of 47 patients with various levels of PVR underwent pars plana vitrectomy. 29 eyes (60.41%) underwent once pars plana vitrectomy, 18 eyes (37.5%) underwent 2 times pars plana vitrectomy and 1 eye (2.08%) underwent 3 times pars plana vitrectomy. In the postoperative period, the patients were followed up between 2 months and 16 months (mean 6.6 months). At the end of the follow-up period, our anatomic success rate was 81.25% and total retinal attachment was achieved in 39 eyes. Retinal detachment was observed in 4 eyes (8.33%) anterior of scleral buckling, while posterior pole was attached. In 5 eyes (10.41%) retinal attachment could not be achieved and 3 of these eyes (6.25%) developed phthisis. Conclusions : Vitreretinal surgery can provide anatomical and functional success in eyes with rhegmatogenous retinal detachment and PVR. This success rate has increased especially in recent years with the use of gas and silicone oil as intraocular tamponade, intraoperative use of perfluorocarbon fluids, introduction of wide angle vision systems and advances in surgical techniques. PROLIFERATIF VITREORETINOPATILERDE PARS PLANA VITREKTOMI SONUCLARIMIZ OZET Amac : Klinigimizde PVR nedeniyle pars plana vitrektomi uyguladigimiz olgularin klinik ozelliklerini, cerrahi tedavi sonuclarini ve karsilasilan komplikasyonlari degerlendirmek. Gerec ve Yontem : Proliferatif vitreoretinopati sebebiyle pars plana vitrektomi cerrahisi uygulanan 47 olgunun 48 gozu calisma kapsamina alinmistir. Olgularin 29’u (%61.7) erkek, 18’i (%38.2) kadindi. Calismaya aldigimiz olgulara rutin oftalmolojik muayeneler uygulandi. 32 (%68) olguya genel anestezi, 15 (%32) olguya da lokal anestezi altinda pars plana vitrektomi cerrahisi uygulandi. Tum operasyonlar ayni cerrah tarafindan yapildi. Bulgular : Cesitli duzeylerde PVR’i olan 47 olgunun 48 gozune pars plana vitrektomi cerrahisi uygulandi. 29 goze (%60.41) 1 kez pars plana vitrektomi, 18 goze (%37.5) 2 kez pars plana vitrektomi ve 1 goze (%2.08) de 3 kez pars plana vitrektomi cerrahisi uygulandi. Postoperatif donemde olgular 2 ay ile 16 ay arasinda takip edildiler (ortalama 6.6 ay). Takip surelerinin sonunda elde edilen anatomik basari oranimiz %81.25 olup, 39 gozde total retinal yatisma saglanmistir. 4 gozde (%8.33) skleral cokertme onunde retina dekoleyken, arka kutup yatisik olarak izlenmistir. 5 gozde (%10.41) ise retinal yatisma saglanamamis ve bu gozlerden 3 tanesinde (%6.25) ftizis gelismistir. Sonuc : Regmatojen retina dekolmani ve PVR’ si olan gozlerde vitreretinal cerrahi ile anatomik ve fonksiyonel basari saglanabilmektedir. Ozellikle son yillarda intraokuler tamponad olarak gaz ve silikon yaginin kullanilmasi, perflorokarbon sivilarinin intraoperatif kullanilmasi, genis acili gorus sistemlerinin devreye sokulmasi ve cerrahi tekniklerdeki gelismelerle bu basari orani artis gostermistir. Anahtar kelimeler : Pars Plana Vitrektomi, Proliferatif Vitreoretinopati, Retina Dekolmani