However, the differences in surgical outcomes of using MIVS to treat RRD with PVD between young patients and elderly patients aged >70 years remain unclear. Data from the UK’s National Ophthalmology Database have been evaluated to determine the results of PPV for RRD in patients with a mean age above 60 years. Therefore, ophthalmic surgeons should select appropriate RRD treatments for their elderly patients only after considering this RRD mechanism.
The main mechanism for RRD in elderly people is thought to be the vitreous remaining attached to the retina during PVD progression, resulting in a horseshoe retina tear. The PPV has evolved to micro-incision vitrectomy surgery (MIVS), which involves smaller, sutureless sclerotomy wounds that result in a comfortable procedure without serious postoperative complications. reported that vitrectomy is effective for improving visual function even in individuals aged ≥85 years. Although a previous study evaluated SB versus PPV for RRD, a recent comprehensive study found that patients age 65 years and older had the greatest overall PPV treatment rates. Scleral buckling (SB) and PPV are common RRD treatments. Longer life expectancies likely contribute to rising myopia rates, the growing popularity of cataract surgery and the increasing number of elderly patients suffering from RRD. However, a recent study reported that RRD surgery not only improved the visual acuity and quality of life of elderly patients aged >70 years but also was cost effective despite the relatively shorter life expectancies of the participants. Therefore, in clinical practice, elderly people often decline the surgery in view of their relatively few remaining years of life. Most significantly, patients of advanced age often have inferior functional results (i.e., best-corrected visual acuity ), compared to that of younger patients after this operation. Partial-thickness retinal folds related to postoperative metamorphopsia are common after PPV for RRD repair. The RRD post-surgery vision-related quality of life also is significantly impaired in these patients.
The estimated costs of pars plana vitrectomy (PPV) surgery to treat RRD are high ($7,940 USD in America). The annual incidence of RRD is low, ranging from 6.3 to 17.9 per 100,000 individuals in the global population. This may primarily be attributed to the occasional need for multiple surgeries and the fact patients need to adhere to specific postoperative positional restrictions. However, most developing countries with limited medical resources do not prioritise RRD treatment. Posterior vitreous detachment (PVD) caused by senile vitreous liquefaction is the main mechanism for RRD in elderly patients. Rhegmatogenous retinal detachment (RRD) can lead to blindness without appropriate and timely treatment. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: All relevant data are within the manuscript and its Supporting Information files.įunding: The authors received no specific funding for this work.Ĭompeting interests: The authors have declared that no competing interests exist. Received: SeptemAccepted: DecemPublished: January 6, 2021Ĭopyright: © 2021 Yamashita et al.
PLoS ONE 16(1):Įditor: Michael Mimouni, University of Toronto, CANADA (2021) Micro-incision vitrectomy surgery for primary rhegmatogenous retinal detachments with posterior vitreous detachments in elderly patients: Preoperative characteristics and surgical outcomes. Citation: Yamashita K, Sakakura S, Ofuji Y, Sato M, Nagamoto T, Kubono H, et al.
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