Distribution of iatrogenic retinal breaks in macular hole surgery

R. N. Sjaarda, B. M. Glaser, J. T. Thompson, R. P. Murphy, A. Hanham

Research output: Contribution to journalArticle

Abstract

Background: Intraoperative peripheral iatrogenic retinal breaks can be a serious complication of vitreous surgery. This study was undertaken to determine whether vitreous surgical techniques used for macular hole surgery were associated with a different incidence or distribution of retinal breaks. Methods: The authors prospectively evaluated a series of 181 consecutive eyes undergoing macular hole surgery. Contemporaneous reporting of intraoperative and postoperative retinal breaks and postoperative retinal detachments was performed. Comparison was made to historic controls of two case series of patients undergoing vitreous surgery for other indications. Results: Of 181 eyes, 10 (5.5%) had 15 intraoperative retinal breaks. Of the 15 breaks, 3 (20%) were in the quadrant near the surgeon's right-hand sclerotomy, 9 (60%) were in the two inferior quadrants, and 11 (73%) were in the two temporal quadrants. By comparison to previously reported case series, tears in our series were less likely to be near the right-hand sclerotomy (P = 0.00055) and more likely to occur in the two inferior retinal quadrants (P = 0.00015) and two temporal retinal quadrants (P = 0.0042). Two patients (1.1%) of 181 had postoperative retinal detachments. Conclusions: Patients undergoing vitreous surgery for macular hole have a similar incidence but different location of iatrogenic retinal breaks when compared with patients undergoing pars plana vitrectomy for other indications. These breaks are not distributed near sclerotomy sites and tend to be in the inferior and temporal retina. This establishes the need for greater intraoperative surveillance in these areas.

Original languageEnglish (US)
Pages (from-to)1387-1392
Number of pages6
JournalOphthalmology
Volume102
Issue number9
StatePublished - 1995
Externally publishedYes

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Retinal Perforations
Retinal Detachment
Hand
Temazepam
Vitrectomy
Incidence
Tears
Retina

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Sjaarda, R. N., Glaser, B. M., Thompson, J. T., Murphy, R. P., & Hanham, A. (1995). Distribution of iatrogenic retinal breaks in macular hole surgery. Ophthalmology, 102(9), 1387-1392.

Distribution of iatrogenic retinal breaks in macular hole surgery. / Sjaarda, R. N.; Glaser, B. M.; Thompson, J. T.; Murphy, R. P.; Hanham, A.

In: Ophthalmology, Vol. 102, No. 9, 1995, p. 1387-1392.

Research output: Contribution to journalArticle

Sjaarda, RN, Glaser, BM, Thompson, JT, Murphy, RP & Hanham, A 1995, 'Distribution of iatrogenic retinal breaks in macular hole surgery', Ophthalmology, vol. 102, no. 9, pp. 1387-1392.
Sjaarda RN, Glaser BM, Thompson JT, Murphy RP, Hanham A. Distribution of iatrogenic retinal breaks in macular hole surgery. Ophthalmology. 1995;102(9):1387-1392.
Sjaarda, R. N. ; Glaser, B. M. ; Thompson, J. T. ; Murphy, R. P. ; Hanham, A. / Distribution of iatrogenic retinal breaks in macular hole surgery. In: Ophthalmology. 1995 ; Vol. 102, No. 9. pp. 1387-1392.
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