Comparison between air and gas as tamponade in 25-gauge pars plana vitrectomy for primary superior rhegmatogenous retinal detachment.

BACKGROUND/OBJECTIVES: The aim of this study was to compare surgical outcomes and postoperative characteristics, between eyes that underwent pars plana vitrectomy (PPV) for RRD, with air or different gas agents as tamponade. SUBJECTS/METHODS: The records of 262 patients that underwent PPV for RRD with air or different gas tamponades and a follow-up of at least 6 months were examined. Only cases with superior retinal breaks were included. Demographic, pre-, intra- and postoperative characteristics including rate of recurrence and complications were analysed. RESULTS: 48 patients were treated with air and 214 were treated with gas. No differences were found in success rate between air and gas group at both 3 and 6 months (respectively, 93.8% vs 93.6 and 100% vs 100%, all P values > 0.05). Postoperative best-corrected visual acuity (BCVA) was significantly higher in the air group compared with the gas group 7 days and 1 month postoperatively (respectively, 0.2 ± 0.4 vs 2.6 ± 0.5, P < 0.001 and 0.1 ± 0.4 vs 0.4±0.9, P = 0.04). The occurrence ocular hypertension at 1 month postoperatively was significantly higher in the gas group compared with the air group (15.4 % vs 0%, P < 0.001). At 6 months, the prevalence of epiretinal membrane (ERM) was significantly higher in the gas group compared with air group (4.2% vs 16.8%, P = 0.02). CONCLUSIONS: Air was comparable to gas tamponades in terms of surgical outcome and BCVA at 6 months. In addition, air allowed an earlier visual recovery and resulted in a lower rate of postoperative ocular hypertension and ERM.

Efficacy of 2 Trabecular Micro-Bypass Stents During Phacoemulsification for Mild to Advanced Primary Open-angle Glaucoma Controlled With Topical Hypotensive Medications.

PURPOSE: The purpose of the current study was to evaluate the efficacy and adverse event profile of 2 trabecular micro-bypass stents implanted during standard phacoemulsification cataract surgery in patients with mild to advanced open-angle glaucoma whose intraocular pressure (IOP) was well controlled by topical medications. PATIENTS AND METHODS: This study was a retrospective analysis of patients with mild to advanced chronic open-angle glaucoma who underwent phacoemulsification and implantation of 2 stents. For all patients, preoperative and postoperative characteristics were evaluated, including number of medications and IOP. Postoperative visits were scheduled at 7 days and at months 1, 6, 12, and 24 after surgery. At each visit, IOP and the number of medications were noted. RESULTS: In total, 63 eyes of 41 patients were included in the study. The vast majority of eyes (85.7%) were diagnosed with primary open-angle glaucoma. Preoperative mean IOP at baseline was 16.8±3.0 mm Hg (range, 10 to 24 mm Hg) with a mean of 2.3±0.9 medications. The mean IOP reduction represented a 13% decrease at 1 month (P<0.001), 13% at 6 months (P<0.001), 12% at 1 year (P<0.001), and 10% at 2 years (P<0.001), concomitant with a 23% reduction in the mean number of medications (P<0.001), 35% (P<0.001), 40% (P<0.001), and 40% (P<0.001), respectively, at each scheduled follow-up visit. At 24 months postoperatively, 19 of 23 (83%) patients experienced an IOP decrease compared with the preoperative visit. No severe device-related adverse events were observed. CONCLUSIONS: Patients with mild to advanced glaucoma can benefit from micro-bypass implantation even if their IOP is well controlled with topical hypotensive medications. Expectations for these reductions should be moderate.