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Thais S. Mendes, Andre M. Gomes, Helcio V. Passos, Andre Baptistella; Evaluation of Retinectomy in the Treatment of Severe Retinal Detachment. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5787.
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To evaluate the postoperative results and efficacy of retinectomy in the treatment of severe retinal detachment.
The study involved 38 patients with severe rhegmatogenous retinal detachment (RRD) with proliferative vitreoretinopathy (PVR). A standard 23 gauge, three-port pars plana vitrectomy was performed and the extension of retinectomy was decided during the surgery (from 180 to 360 degrees). The patients were examined with Best Corrected Visual Acuity, indirect ophthalmoscopy, fundus photography and tonometry during a 24-month follow-up. The groups were divided into Group 1: vitrectomy with retinectomy and Group 2: vitrectomy without retinectomy (control group). Reoperation rate, number of procedures, hipotony and recurrent retinal detachment were evaluated. Statistical analysis was performed by Exact Fisher’s test for both groups.
The mean preoperative visual acuity was > 1.3 logMAR for both groups. The postoperative visual acuity improved and ranged from 1.3 logMAR to 0.7 logMAR in both groups (p<0.63). The preoperative intraocular pressure was 10,2 and postoperative was 11,6. Hipotony was found in 15,8%, no statistical difference between group 1 and 2. The reoperation rate after the first procedure was 100% in the control group and 33% in the retinectomy group (p<0,001). 31,5% of the patients were submitted to 3 or 4 procedures in group 2. The final retinal reattachment rate after 24 months of follow up was 100% in the group 1 and 88,2% in the group 2.
Retinectomy can be an effective surgical procedure for the treatment of severe retinal detachment with PVR and it may increases the reattachment rate and decreases number of procedures.
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