Multiple subretinal fluid blebs after pars plana vitrectomy for rhegmatogenous retinal detachment repair

• Published in: Graefe's archive for clinical and experimental ophthalmology Vol. 257; no. 5; pp. 921 - 929
• Main Authors: Otsuka, Yuki, Oishi, Akio, Suda, Kenji, Tsujikawa, Akitaka, Kurakazu, Toshiaki
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-05-2019; Springer Nature B.V
• Subjects: Acuity; Cryotherapy; Eye; Medicine; Medicine & Public Health; Ophthalmology; Patients; Retina; Retinal Disorders; Risk factors; Surgery; Wound drainage; Pars plana vitrectomy; Multiple subretinal fluid blebs; Rhegmatogenous retinal detachment; 27-gauge
• ISSN: 0721-832X; 1435-702X
• DOI: 10.1007/s00417-018-04231-9

Purpose
To investigate the incidence of and clinical risk factors for multiple subretinal fluid (SRF) blebs after pars plana vitrectomy (PPV).
Methods
This study examined patients who underwent PPV (25- or 27-gauge) to repair a primary rhegmatogenous retinal detachment (RRD). Clinical characteristics, including age, sex, axial length, symptom duration, and postoperative best-corrected visual acuity (BCVA), were compared between eyes with and without multiple SRF blebs. Intentional drainage retinotomy and cryotherapy use were also performed. Main outcome measures were the effect of these parameters on multiple SRF bleb incidence 1 month after surgery.
Results
A total of 108 eyes of 106 patients (76 men and 32 women; mean age = 58.9 ± 9.0 years) were included. Multiple SRF blebs were observed in 8 eyes (7.4%). Logistic regression analysis showed that creation of intentional drainage retinotomy and 27-gauge PPV are risk factors for the development of multiple SRF blebs. The number and size of blebs spontaneously decreased over time, and SRF had completely resolved in 5 eyes (62.5%) 1 year after surgery.
Conclusion
Multiple SRF blebs developed even after small gauge vitrectomy. The SRF did not affect postoperative BCVA and gradually absorbed without treatment.