[Vitreoretinal secondary procedures following elective macular surgery].

OBJECTIVE

The spectrum of reoperations after macular surgery was investigated retrospectively in a large group of patients. All secondary surgical procedures except for cataract surgery were considered.

METHODS

Between July 1995 and June 2001 353 eyes underwent macular surgery (218 due to macular pucker, 135 due to macular hole) with a pars-plana vitrectomy (PPV), creation of vitreous detachment, membrane peeling and SF(6)/air-instillation. The vitrectomies were performed by 4 different surgeons. In all patients a preoperative circular peripheral cryoretinopexy was performed 3-4 weeks before macular surgery. The follow-up was 20.9 months on average. The number of revitrectomies as well as the postoperative retinal detachment rate were investigated.

RESULTS

In 33 cases (9.3%) a second vitrectomy had to be performed due to an unsatisfying postoperative macular finding: 17/218 (7.8%) after macular pucker surgery with a recurrent pucker and 16/135 (11.8%) after macular hole surgery with persistent or recurrent macular hole. In 7/353 (2.0%) a postoperative rhegmatogenous retinal detachment was observed and in 2/353 (0.6%) a postoperative endophthalmitis had to be treated.

CONCLUSION

In 9.3% of our patients a second PPV due to an unsatisfying macular finding became necessary. The rate of postoperative retinal detachment of 2.0% is considerably lower than in most other studies. Therefore, a possible prophylactic effect of the preoperative circular peripheral cryoretinopexy is suggested to reduce the risk of postoperative retinal detachment.