Retinal Displacement Following Direct and Indirect Fluid Exchange in Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment
Fatemeh Abdi1 *, Mohammad Mirzakhan- KordeAmiri1 , Amin Zand2
- Eye Research Center, The five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
- Department of Ophthalmology, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran.
Abstract: This study aimed to compare the occurrence and characteristics of retinal displacement following direct perfluorocarbon liquid (PFCL)-silicone oil (SO) exchange versus indirect PFCL for air and air for SO exchange methods during pars plana vitrectomy (PPV) in patients with rhegmatogenous retinal detachment (RRD).
Methods: A retrospective comparative case series study was conducted on 58 eyes with recent RRD, undergoing standard three-port PPV with SO tamponade. Fluid exchange was performed using either direct or indirect methods. Postoperatively, a comprehensive ophthalmic examination and fundus autofluorescence (FAF) imaging were conducted at one month. The presence, amount, and location of retinal displacement were assessed based on FAF imaging and compared between the direct and indirect fluid exchange groups.
Results: FAF imaging at one month revealed retinal displacement in 41.4% of eyes in the direct group and 62.0% in the indirect group, with no statistical difference between them (P = 0.537). However, the mean displacement was significantly higher in the indirect group (282.61 ± 110.83 µm) compared to the direct group (220.33 ± 39.67 µm, P = 0.04). The location of displacement (inferior or superior) did not differ significantly between the groups (P = 0.093).
Conclusion: While the occurrence and location of postoperative retinal displacement did not significantly differ between direct and indirect fluid exchange methods during PPV for RRD, eyes treated with the direct method exhibited lower mean displacement compared to the indirect method. These findings suggest the potential benefits of the direct exchange approach in minimizing retinal displacement following surgery.
