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Rajiv R. Rathod, Jennifer I. Lim; Outcomes of Retinal Detachment Repair with Relaxing Retinectomies in Cases of Severe Proliferative Vitreoretinopathy. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6170.
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Eyes that have developed severe fibrous proliferation or retinal incarceration often have significant retinal foreshortening and present a challenge for surgical repair. Many of these eyes are considered end-stage and are often written-off as irreparable. The purpose of this study is to retrospectively review cases in which retinal detachment surgery was performed in the setting of severe proliferation requiring relaxing retinectomies to achieve anatomic retinal attachment.
A retrospective review of all cases with severe proliferative vireoretinopathy and/or retinal incarceration with retinal detachment that underwent surgical repair by one surgeon over a 40 month period was performed. All cases that required a relaxing retinectomy to achieve retinal reattachment were identified. The surgical techniques and postoperative course and outcomes were reviewed for these cases.
Fifty-six eyes were identified with severe proliferative retinopathy and retinal detachment that underwent surgical repair. Of these, 10 cases required relaxing retinectomies. Seven of these ten eyes showed retinal attachment at follow-up. Vision in these eyes were 20/200 (1 eye), counting fingers (3 eyes), hand motions (3 eyes). Three eyes were complicated by recurrent detachment. Two of these underwent re-operation and achieved anatomically successful attachment. One eye remained chronically detached and maintained light perception vision. Two eyes progressed to no light perception and phthisis bulbi. One eye developed epithelial downgrowth and was treated with 5-FU and remained attached.
Relaxing retinectomies may be required in cases of retinal detachment with severe proliferation to allow complete retinal attachment. Many of these eyes are end-stage and would undoubtedly progress to a degenerative state. By restoring retinal anatomic integrity, a significant portion of these eyes can be maintained and in some cases improved vision, though minimal, can be achieved.
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