Document Detail

Risk factors for iatrogenic retinal breaks induced by separation of posterior hyaloid face during 23-gauge pars plana vitrectomy.
MedLine Citation:
PMID:  23449510     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To describe the incidence and features of intraoperative retinal breaks caused by induction of posterior hyaloid face (PHF) separation during 23-gauge pars plana vitrectomy (PPV).
METHODS: A prospective, consecutive, single surgeon, observational study of patients undergoing 23-gauge transconjunctival sutureless vitrectomy for macular pathology or floaters, was carried out between 2009 and 2011 at Calderdale Royal Hospital, UK. PHF separations were categorised as either suction induced or requiring membrane blue (DORC Limited) with suction (adherent). The outcome measure was dichotomised into retinal break or tear and no retinal break or tear. Forced entry and parsimonious multiple logistic regression analyses were conducted, using statistical software, to test for significance of association of the set of recorded factors and covariates with the dichotomised outcome measure.
RESULTS: Data were collected and analysed from 137 patients. The incidence of iatrogenic retinal breaks associated with PHF separation during 23-gauge PPV was 18.2%. Under both forced entry and parsimonious multiple logistic regression models, the odds of a retinal break or tear reduce by about 3-4% for each increasing year of age. Findings also showed some substantive association in the forced entry model, with the odds of a retinal break or tear for adherent cases being around 3.8 times those for suction-only cases.
CONCLUSIONS: Mechanical detachment of the PHF represents an important risk factor in the formation of retinal breaks. Particular care should be taken to examine intraoperatively for iatrogenic breaks in order to prevent missed breaks and subsequent rhegmatogenous retinal detachments.
R Rahman; C D Murray; J Stephenson
Publication Detail:
Type:  Journal Article     Date:  2013-03-01
Journal Detail:
Title:  Eye (London, England)     Volume:  27     ISSN:  1476-5454     ISO Abbreviation:  Eye (Lond)     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-05-09     Completed Date:  2013-11-18     Revised Date:  2014-05-07    
Medline Journal Info:
Nlm Unique ID:  8703986     Medline TA:  Eye (Lond)     Country:  England    
Other Details:
Languages:  eng     Pagination:  652-6     Citation Subset:  IM    
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MeSH Terms
Age Distribution
Aged, 80 and over
Epiretinal Membrane / surgery*
Great Britain / epidemiology
Iatrogenic Disease* / epidemiology
Intraoperative Complications*
Logistic Models
Middle Aged
Prospective Studies
Retinal Perforations / epidemiology,  etiology*
Risk Factors
Vitrectomy / adverse effects*,  methods

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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