Purchase this article with an account.
I. Tsui, H. Schubert; Inferior Retinectomy and Silicone Oil for Repair of Recurrent Retinal Detachments. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5764.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Proliferative vitreoretinopathy (PVR), a major complication of retinal detachments, affects the inferior retina more severely and may lead to recurrent retinal elevations. The purpose of this study is to describe pre-operative characteristics, surgical management with retinectomy and silicone oil, as well as visual and anatomic outcomes.
A retrospective, interventional case series. Review of forty one patients operated on by one surgeon over a 10 year period. Preoperative data were pre-existing risk factors for detachment, prior surgical history, and PVR location. The surgical procedure was >180 degree retinectomy, laser to the retinotomy edge, and silicone oil. Visual acuity, recurrent detachment, and post-operative complications were the main outcome measures.
Average follow-up time was 3.1 years with a range of 6 months to 10.5 years. At initial presentation thirty-one of forty-one patients (76%) had at least one risk factor for retinal detachment. Cataract extraction (49%), high myopia (29%), and lattice degeneration (27%) were the risk factors identified. Average number of prior procedures for retinal attachment surgery was 2.3 +/- 1.0 with a range of 1 to 5 procedures. The majority of detachments were inferior and most (75%) had an inferior break found pre-operatively. Thirty-one patients (76%) had count fingers or worse vision pre-operatively and post-operatively 16 patients (39%) had 20/100 vision or better. Visual acuity was improved in 32 patients (78%), unchanged in 5 patients (11%), and worse in 3 patients (7%). Thirty-six retinas (88%) remained attached throughout the follow-up time. Silicone oil was removed in 25 (61%) patients with an average time interval of 14 +/- 8 months. Post-operative complications included corneal decompensation (22%), glaucoma (13%), and hypotony (11%).
A large inferior retinectomy effectively addresses the proliferations where they most frequently occur: inferiorly, on the retinal surface, and most importantly, underneath it. Silicone oil was beneficial for long term tamponade and reattachment success. Visual results in these chronic retinal detachments were limited mainly by the number of previous surgeries and the overall duration of the disease process.
This PDF is available to Subscribers Only