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Yi Jiang, Jennifer I Lim; Outcomes of 25-gauge vitrectomy with relaxing retinectomy for retinal detachment secondary to proliferative vitreoretinopathy.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4150.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the outcomes and complications of 25-gauge vitrectomy with relaxing retinectomy (RR) for retinal detachment secondary to proliferative vitreoretinopathy (PVR).
A retrospective review was performed on all operations for a single surgeon from July 2007 to July 2016. All eyes with retinal detachments secondary to PVR were included. In addition to basic demographic data, etiology of PVR, indication for surgery, number of previous surgeries, surgical procedure, surgical tamponade and retinectomy extent were noted. Primary outcome measures included visual acuity, prescence or abscence of hypotony (intraocular pressure of 5 mmHg or less), primary/final anatomic success rate, and all complications . Patients with < 6 months of follow up or concurrent scleral buckling during surgery were excluded.
We included 44 eyes from 43 patients (24 males and 19 females with an average age of 49.9 years (8-91)) with a mean follow up time of 30.1 months (6-70). 33/44 eyes (75.0%) had > 1 year follow up. The retinal detachment involved the macula in 42/44 eyes (95.5%). There was a mean of 1.84 prior operations (0-6) in eyes undergoing retinectomy. Perfluorocarbon was used in 42/44 (95.5%) eyes; tamponade consisted of silicone oil in 42/44 (95.5%) eyes versus 20% SF6 or 16% C3F8 gas in 2/44 eyes (4.5%). Mean clock hours of RR were 6.35 (1-12). End anatomic success was acheived in 40/43 eyes (93.0%) (20 eyes (46.5%) attached after silicone oil removal, 20 eyes (46.5%) attached under oil). There were 2 eyes (4.7%) that never acheived anatomic attachment and 1 eye (2.3%) detached under oil. 14 eyes (31.8%) had re-detachments at an average of 150.6 days (29-316). 13 patients (29.5%) had hypotony pre-operatively and only 1 eye (2.3%) had hypotony postoperatively. Three eyes (6.8%) were phthisical at the final visit.
Our results show a final reattachment rate of 93.0%, which compares favorably to other gauge vitrectomy studies. The relatively low rate of hypotony and failed repair at the final visit may justify the use of 25 gauge vitrectomy with relaxing retinectomy for severe PVR related retinal detachments, including eyes with multiple previous operations.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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