Black Sea Journal of Health Science

Yazarlar: Sami YILMAZ, Ayşegül MAVİ YILDIZ, Mehmet Emin ASLANCI, Remzi AVCI

Konular:Cerrahi

DOI:10.19127/bshealthscience.902131

Anahtar Kelimeler:Pars plana vitrectomy,Myopic shift,Induced astigmatism,Pseudophakic eyes,Gas tamponade

Özet: To compare refractive changes following 23-gauge (G) vitrectomy with or without gas tamponade in pseudophakic eyes. This retrospective study included patients with neodymium: yttrium-aluminum-garnet (Nd: YAG) laser capsulotomy, who underwent 23 G pars plana vitrectomy (PPV) between February 2015 and March 2019. Indications for surgery included; rhegmatogenous retinal detachment in Group 1 and epiretinal membrane or vitreous hemorrhage (VH) in Group 2. Gas tamponade 12% perflouropropane (C3F8) was used in Group 1 whereas no tamponade was used in Group 2. The minimum follow-up was 24 months for both groups. A total of 47 patients were recruited (Group 1, n=27 and Group 2, n=20). The visual acuity improvement was statistically significant in both groups (p<0.001). A statistically significant myopic shift was observed in both groups [-0.40±0.54 diopter (D) (P=0.001) in Group 1; -0.17±0.29 D (P=0.017) in Group 2]. In addition, a myopic shift greater than 1 D was observed in 2 eyes (7.4%) in Group 1. The significant hyperopic shift was detected in 3 eyes (11.1%) in Group 1 and 5 eyes (25%) in Group 2. Surgically induced astigmatism was similar between groups [0.46±0.25 D in Group 1 and 0.54±0.26 D in Group 2, (P=0.314)]. Postoperative complications included VH (n=1/27) and macular hole (n=1/27) in Group 1. The clinically significant myopic shift may occur following 23 G vitrectomy in pseudophakic eyes. Eyes with gas tamponade are more prone to myopic shift, possibly due to anterior movement of the intraocular lens. Therefore, targeting slight residual hyperopia (+0.50 D) might be suggested in patients with gas tamponade.

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