Two-Port Dry Vitrectomy for Rhegmatogenous Retinal Detachment: a pilot study

Objective To evaluate the safety and efficacy of a new surgical technique for the management of primary rhegmatogenous retinal detachment (RRD), consisting of localized PPV near to the retinal break(s), without infusion line, associated with a drainage of subretinal fluid and cryoretinopexy. Methods Multicentric prospective study conducted at the University Hospital of Cagliari and IRCCS Fondazione Policlinico Universitario A. Gemelli, Roma. 20 eyes affected by RRD with the causative retinal break(s) in the superior meridians were enrolled between February 2022 and June 2022. Patients with cataract ≥ 3, aphakia, significant posterior capsule opacification, giant retinal tears, retinal dialysis, history of trauma and PVR ≥ C2 were excluded. All eyes underwent a two-port 25-gauge PPV with localized removal of the vitreous surrounding retinal break(s), followed by 20% SF6 injection and cryopexy. The surgical time was recorded for each procedure. Best corrected visual acuity (BCVA) was measured at baseline and postoperative 6-month. Results Primary anatomic success at 6 months was achieved by 85% of patients. No complications occurred, excepted for three (15%) retinal re-detachments. The average surgical time was 8.61 ± 2.16 minutes. Overall, the difference between pre- and last postoperative mean BCVA was statistically significant. (p 0.02) Conclusions Two-port dry PPV demonstrated safety and efficacy for the treatment of RRD, reaching 85% of anatomical success rate. Although further studies are necessary to confirm the efficacy and long-term benefit of this treatment, we believe that this surgical technique could be considered a valid and safe alternative for the management of primary RRD.