Pars Plana Vitrectomy with External Drainage for Non Exudative Retinal Detachment

Purpose: To describe a surgical technique for retinal detachment (RD) with undetected retinal breaks, which combines pars plana vitrectomy (PPV) and external subretinal fluid (SRF) drainage. Methods: In this retrospective observational study, patients with diagnosis of RD with undetected retinal breaks were enrolled. Standard three-port 25 Gauge (G) core and peripheral PPV was performed. Perfluorocarbon liquid was injected in the vitreous cavity to obtain posterior retinal flattening. Trans scleral 27G needle external drainage was performed approximately at 8 mm from limbus to drain SRF sub-conjunctivally. Prophylactic peripheral endolaser was performed on 360°. Sulfur hexafluoride 20% was used as tamponade. Results: In fourteen out of 15 patients complete SRF drainage was obtained. In only one case SRF did not leak out in the sub-conjunctival space. Neither intraoperative nor postsurgical complications were recorded. Flat retina with no SRF was observed in all sample and no RD relapses were reported at each follow up. Conclusion: External drainage combined to PPV may represent a valid and safe option to drain SRF in RD cases with undetected retinal breaks. The advantages of the technique consisted in absence of retinal pigment epithelium cells dispersion in the vitreous chamber, prompt dry retina, low risk of postoperative retinal folds.