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Valved versus nonvalved cannula small-gauge pars plana vitrectomy for repair of retinal detachments with Grade C proliferative vitreoretinopathy

Authors Oellers P, Stinnett S, Hahn P

Received 23 January 2016

Accepted for publication 7 April 2016

Published 30 May 2016 Volume 2016:10 Pages 1001—1006


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Dr Scott Fraser

Patrick Oellers, Sandra Stinnett, Paul Hahn

Duke Eye Center, Duke University School of Medicine, Durham, NC, USA

Purpose: Valved cannulas are a recent addition to small-gauge pars plana vitrectomy (PPV) and provide stable intraocular fluidics. The goal of this study was to compare outcomes and postoperative complication rates of valved vs nonvalved cannula small-gauge PPV for repair of retinal detachments (RDs) complicated by Grade C proliferative vitreoretinopathy (PVR).
Methods: A retrospective chart review of 364 consecutive eyes with either valved or nonvalved cannula PPV for RD repair was performed. The primary outcomes were single surgery and final anatomic success and change in best-corrected visual acuity for repair of RDs complicated by Grade C PVR.
Results: We identified 36 eyes in the valved group and 31 eyes in the nonvalved group with Grade C PVR RD. The single surgery success was 83% vs 77% (P=0.555) and the final anatomic success was 94% vs 87% (P=0.404) in the valved vs nonvalved eyes, respectively. The mean final visual acuity gain was −0.36 logarithm of the minimum angle of resolution (logMAR; approximate Early Treatment Diabetes Retinopathy Study [ETDRS] score =17 letters) in valved eyes vs −0.33 logMAR (approximate ETDRS score =16 letters) in nonvalved eyes (P=0.81). Postoperative complication rates including postoperative day 1 hypotony, hypertony, and anterior chamber fibrin formation; postoperative retention of intraocular or subretinal perfluorocarbon liquid; and subsequent epiretinal membrane peel were not statistically different between groups.
Conclusion: Valved cannula PPV yields equivalent visual acuity and anatomic outcomes without increased postoperative complication rates compared to traditional nonvalved cannula PPV for Grade C PVR-associated RD repair.

Keywords: 23 gauge, 25 gauge, PVR, RD, chronic, single surgery success, final anatomic success

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