BACKGROUND: Rhegmatogenous retinal detachment (RRD) is a vision-threatening condition that requires prompt surgical intervention. With advancements in surgical techniques and equipment, pars plana vitrectomy (PPV) has become increasingly popular for the management of RRD. This, in turn, requires beginner vitreoretinal surgeons to be able to manage RRD early in their training. INTRODUCTION: Comparison of the results and complication rates of a 25-gauge (25 g) PPV with gas tamponade for RRD between experienced and inexperienced surgeons. METHODS: This is a retrospective comparative consecutive case series study of patients with uncomplicated RRD treated with 25 g PPV with gas tamponade. Patients were divided into two groups: in the experienced surgeon group (ESG), the procedure was performed by an experienced vitreoretinal surgeon, in the inexperienced surgeon group (ISG), it was performed by two inexperienced surgeons. Anatomical and functional results and complication rates were compared between the two groups. RESULTS: A total of 216 eyes were included in the study. In the ESG (106 eyes), the single operation success rate was 94.3%, and the final success rate was 100%. In the ISG (110 eyes), the single operation success rate was 93.6%, and the final success rate was 100%. The difference in single surgery success rate between groups was not statistically significant (P = 0.828). The mean postoperative BCVA improvement was 0.348 decimal in the ESG and 0.405 decimal in the ISG (P = 0.234). The difference in complication rates between groups was not significant. CONCLUSIONS: A 25 g PPV with gas tamponade for the treatment of RRD yields excellent anatomical results and improvement in best-corrected visual acuity (BCVA). With good technique and the use of modern vitrectomy machines and instruments, some inexperienced surgeons can achieve a high single-surgery success rate, suggesting a short learning curve. The complication rate is comparable between experienced and inexperienced surgeons.

• Klíčová slova
• Gas tamponade, Inexperienced surgeon, Pars plana vitrectomy, Rhegmatogenous retinal detachment,
• Publikační typ
• časopisecké články MeSH

PURPOSE: To compare the effect of different types of intraocular tamponade and different types of postoperative positioning on the closure of idiopathic macular hole (IMH). METHODS: Prospective randomized clinical trial enrolling 104 eyes of 100 patients (age, 57-87 years) undergoing MH surgery. All patients were operated on by an experienced surgeon using 25-gauge pars plana vitrectomy (PPV) and internal limiting membrane (ILM) peeling. Patients were randomized according to the type of intraocular tamponade and postoperative positioning into the following four groups: SF6 + nonsupine reading position (n = 26) (group 1), air + nonsupine reading position (n = 25) (group 2), air + prone position (n = 26) (group 3), or SF6 + prone position (n = 27) (group 4). The follow-up period was 6 months. RESULTS: MH closure was achieved in 87 eyes (83.7 %) in the overall sample after the first surgery, with closure rates of 100%, 56%, 84.6%, and 92.6% in groups 1, 2, 3, and 4, respectively. The group 2 was significantly less successful compared to the other three groups (p < 0.05). MH of sizes ≤400 µm was closed in 97.2% of cases after the first surgery, with no significant differences between groups (p = 0.219). MH with sizes over 400 µm was closed in 70.9% of cases after the first surgery, with both groups with air tamponade being significantly less successful than group 1. The nonsupine reading position was subjected to a better subjective evaluation in terms of postoperative comfort and quality of sleep, with no differences between air and SF6 tamponade tolerance. CONCLUSION: PPV with ILM peeling, intraocular tamponade, and positioning remains the basic surgical approach in the treatment of IMH. For MH ≤ 400 µm, a high closure rate can be achieved by combining air tamponade and nonsupine reading position. For macular holes >400 µm, the greatest anatomical success can be achieved by using the SF6 tamponade in combination with the nonsupine reading position.

• Publikační typ
• časopisecké články MeSH