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P.A. Quiram, C.R. Gonzales, A. Gupta, S.D. Schwartz, M.O. Yoshizumi, A.E. Kreiger; Improved Surgical Outcomes of Inferior Retinectomy With Radical Anterior Base Dissection and Lens Removal in Patients With PVR . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5476.
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Purpose: To determine the anatomical and functional outcomes of patients treated with vitrectomy and inferior retinectomy for recurrent, rhegmatogenous retinal detachment complicated by proliferative vitreoretinopathy (PVR). Methods: Consecutive patients over a 6–year period treated with vitrectomy surgery and inferior retinectomy were studied retrospectively. The primary outcome was anatomic success defined as complete retinal reattachment. Secondary outcomes included change in visual acuity, the mean number of operations required for complete retinal reattachment, number of operations prior to retinectomy, silicone oil tamponade, location and extent of retinectomy, lensectomy, and incidence of glaucoma, keratopathy or other post–operative complications. Results: Of the 56 patients identified (60% male and 40% female), the mean age was 62 years (range 19–87 years). Complete retinal reattachment was achieved in 52/56 (93%) patients with a mean follow–up interval of 25 months (range 6–70 months). Following retinal reattachment, visual acuity was improved or stabilized in 39/56 (70%) patients. The mean number of operations for retinal detachment prior to diagnosis of PVR requiring retinectomy was 1.8 (range 1–5). Patients undergoing radical anterior vitreous base dissection and lensectomy had a higher success rate than those that did not, 74% vs 38%, respectively [p=0.011]. Furthermore, tamponade with silicone oil had a higher success rate than tamponade with gas, 72% vs 18%, respectively [p=0.002]. Silicone oil tamponade was used in 50/56 (89%) patients at the time of inferior retinectomy. By the time of last follow up, 26/56 (46%) patients underwent silicone oil removal. Following silicone oil removal, 1/26 (4%) patients had a recurrent retinal detachment. Of the 56 patients, 9 (16%) had one or more of the following complications including keratopathy requiring penetrating keratoplasty (n= 4), glaucoma requiring aqueous shunt device (n=3) and hypotony (n=3). Conclusions: Inferior retinectomy can be a successful surgical technique for the treatment of PVR–related retinal detachments. In addition, patients that had radical anterior base dissection with lensectomy had a higher success rate than those that did not.
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