Goias Eye Bank Foundation, Brazil
Hudson Nakamura is a Medical Specialist in Ophthalmology and specialized in Retina and Vitreous. Completed School of Medicine at the Federal University of Goiás – UFG and residency from the Base Hospital of the Federal District - Brasília - DF. Presently member of American Academy of Ophthalmology, Brazilian Council of Ophthalmology, Canadian Society of Ophthalmology and also the member of most prestigious society ARVO - The Association for Research in Vision and Ophthalmology United States. Currently working as a professor in department of Retina and Vitreous Course of Medical Residency in Ophthalmology at the Bank of Goias Eye Foundation. Is also working as Specialist in vitreoretinal disease Fellowship - University of Toronto Canada, Specialist in Ophthalmology - University of Toronto Canada, Specialist in vitreoretinal disease Fellowship - Brazilian Center for Eye Surgery.
Background & Objective: Pseudophakic and aphakic retinal detachments are associated with a lower percentage of successful primary repairs with standard scleral buckling surgery than phakic retinal detachments. The objective of this study was to determine whether a combined scleral buckle and vitrectomy as a primary procedure offers any advantage over conventional scleral buckling in primary pseudophakic and aphakic retinal detachments without proliferative vitreoretinopathy. Materials & Methods: This was a prospective, non-randomized clinical study. Ninety-four consecutive pseudophakic and aphakic retinal detachments were included in the study. All patients were operated upon by the same surgeon. Each patient underwent a combined scleral buckle and pars plana vitrectomy with perfluorocarbon injection and air-fluid exchange. Each patient was followed by the operating surgeon for a minimum of 6 months. Patients were followed with respect to anatomic reattachment, visual acuity improvement and surgical complications. Results: All eyes were anatomically reattached after a single operation. All demonstrated an increase in their visual acuity and there were no complications attributable to the vitrectomy procedure. Conclusions: We conclude that such a combined approach to primary pseudophakic and aphakic retinal detachments offers significant benefits to scleral buckling alone. We believe that the improved success rate is a function of vitrectomy contributing to both an improved peripheral visibility, resulting in fewer missed peripheral breaks and a lower likelihood of proliferative vitreoretinopathy. We recommend this combined surgical approach for all primary pseudophakic and aphakic retinal detachments.
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