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Digital archive of theses discussed at the University of Pisa

 

Thesis etd-10112022-225609


Thesis type
Tesi di specializzazione (4 anni)
Author
SINISI, FABRIZIO
URN
etd-10112022-225609
Thesis title
Routine use of air tamponade in pars plana vitrectomy for primary rhegmatogenous retinal detachment in young adults: shall we reconsider vitrectomy thresholds in the small gauge transconjunctival era?
Department
PATOLOGIA CHIRURGICA, MEDICA, MOLECOLARE E DELL'AREA CRITICA
Course of study
OFTALMOLOGIA
Supervisors
relatore Prof. Figus, Michele
correlatore Dott. Bali, Ernesto
Keywords
  • air tamponade
  • laser photocoagulation
  • pars plana vitrectomy
  • retinal detachment
  • vitreoretinal surgery
Graduation session start date
03/11/2022
Availability
Withheld
Release date
03/11/2025
Summary
The objective of this study was to evaluate and compare the efficacy and safety of air vs SF6 20% tamponade after 23- or 25-gauge pars plana vitrectomy (PPV) for primary rhegmatogenous retinal detachment in young adults and to analyze the related risk factors.
Among 383 patients who underwent the 23- or 25-gauge PPV with SF6 20% or Air tamponade for primary rhegmatogenous retinal detachment at Chirec ophthalmology service from 2014 to 2022, a total of 56 eyes of 55 patients aged between 21 and 50 years at the time of the fist surgery was included in this study.
The main outcome measure was the rate of an anatomically attached retina without the presence of any tamponade agent for at least 3 months postoperatively. Subgroup analysis was made taking in account breaks location, detachment extension, type of tamponade used and phakic status. Type and number of complications were reported as well.
Preoperative characteristics were similar between the two groups. Overall success rate in treating RRD with PPV in cases involving superior, inferior, and multiple breaks is 83,4% with air tamponade and 85% with SF6 20% tamponade.
Our study shows that the encouraging results for RRD treated with air tamponade are extendable also to the young adults subgroup.
While scleral buckling remains a mainstay of retinal detachment surgery especially in children, the evolution in the pars plana vitrectomy technique extended its versatility with a low rate of complications, less post-operative discomfort, and good visual recovery.
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