Comparative evaluation of outcomes of drainage techniques in vitrectomy for rhegmatogenous retinal detachment

Purpose To compare the anatomical and functional outcomes of drainage through posterior retinotomy (PR) versus perfluorocarbon liquid (PFCL)-assisted drainage in vitreoretinal surgery (VRSx) for rhegmatogenous retinal detachment (RRD) and to study intra-operative and post-operative complications. Methods This was a prospective randomized study of 52 cases who underwent VRSx for RRD. Group-1 underwent PFCL-assisted drainage through preexisting break while group-2 had PR to drain subretinal fluid. Cases were evaluated for retinal reattachment rates, visual outcomes, optical coherence tomography (OCT) parameters, and postoperative metamorphopsia. The patients were followed up for minimum period of 3-months. Results Two groups were comparable in terms of demographic and preoperative parameters. Both groups had single surgery success rate of 100% by the end of follow-up. Final best-corrected visual acuity in group-1 was 0.61 ± 0.33 and 0.61 ± 0.32 in group-2 (p=0.77). OCT parameters (foveal contour, retinal layers, central macular thickness, and epiretinal membrane formation) were similar between the two groups. Subjective metamorphopsia was present in 30.77% (8/26) patients in group-1 and 69.23% (18/26) patients in group-2.(p=0.034) One eye had retained subretinal PFCL away from the macula in group-1. Conclusion Anatomical and functional outcomes were similar in vitrectomy using PFCL-assisted drainage versus PR drainage. Postoperative metamorphopsia was lesser in patients who underwent PFCL-assisted drainage through the pre-existing break.