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D. Mostafavi, N. Bhagat, R. Grigorian, M. Zarbin; 360° Retinectomy/Retinotomy for the Treatment of Traumatic Retinal Detachments. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3167.
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To review the anatomical and functional outcomes of eyes that underwent 360° retinectomy/retinotomy for traumatic retinal detachments (RDs) with proliferative vitreoretinopathy.
Retrospective review of patients who underwent pars plana vitrectomy (PPV) and 360° retinectomy/retinotomy between 1995 and 2006 by two surgeons for traumatic RDs. Anatomic success was defined as complete attachment of the retina or attachment posterior to the scleral buckle, if present.
23 patients (16 male/7 female) were identified. Of the 23 eyes, nine had a recurrent retinal detachment after 360° retinectomy/retinotomy procedure. Repeat vitrectomy was performed in 6 of these 9 eyes, 5 of which were anatomically successful. Overall, 19 of the 23 eyes (83%) had anatomic success after repeat vitrectomy. An average of 1.3 PPVs were performed on all 23 patients. All patients underwent silicone oil tamponade. Eighteen patients had also undergone ruptured globe repair prior to 360° retinectomy/retinotomy. Preoperative visual acuity ranged from light perception to counting fingers. Postoperative visual acuity ranged from no light perception to 20/100. Four patients were unable to have their visual acuity assessed pre- and postoperatively due to a mental disability . Final visual outcomes, compared to preoperative measures, improved in 9 (47%) eyes, worsened in 4 (21%) eyes (3 of which due to phthisis), and stayed the same in 6 (32%) eyes.
The final anatomic results of our series are comparable to those in the reported literature and indicate that vitrectomy with 360° retinectomy can be beneficial in the management of complex retinal detachments caused by trauma. Our study showed that 39% of patients had an improvement of final visual acuity. To our knowledge, this is the largest reported analysis of trauma patients who have undergone 360° retinectomy/retinotomy.
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