Results of retinotomy for retinal detachment with marked proliferative vitreoretinopathy
I. Ia. Novytskyy, R. M. Smal, O. Iu. Plevachuk, Ia. V. Andriiuk
Oculus Eye Clinic; Lviv (Ukraine)
Novytskyy IIa, Smal RM, Plevachuk OIu, Andriiuk IaV. Results of retinotomy for retinal detachment with marked proliferative vitreoretinopathy.
Background: Indications for retinotomy, its procedure and efficacy are still a subject for study and discussions.
Purpose: To examine the efficacy of relaxing circumferential and radial retinotomies for retinal detachment associated with marked proliferative vitreoretinopathy (PVR).
Material and Methods: Twenty-seven patients (27 eyes) with retinal detachment associated with PVR were involved in the study. Eleven eyes (40%) had retinotomy of less than 90°, eight (30%), of 90° to 180°, four (15%), of 180° to 270°, and four (15%), 360° (circumferential retinotomy). Additional radial retinotomy was performed in 5 eyes (19%), and retinotomy combined with choroidectomy, in 2 eyes.
Results: Of the 27 eyes, retinal reattachment was achieved after the first surgery in 20 eyes (74%), after re-surgery in 5 eyes (19%). Anatomical success was achieved after removal of silicone oil in 15 eyes (56%). By the time of analysis, silicone oil was not removed in 12 eyes (44%). Complete retinal re-attachment was achieved in 25 eyes (93%), and partial re-attachment, in 2 eyes (7%).
Conclusion: Retinotomy should be performed in eyes with retinal detachment and contraction. Circumferential and radial retinotomies provide a relatively high rate of anatomical success of surgery.
Keywords: retinal detachment, proliferative vitreoretinopathy, closed vitrectomy, retinotomy, retinal re-attachment
1.Machemer R. [Cutting of the retina: a means of therapy for retinal reattachment]. Klin Monbl Augenheilkd. 1979;175(50):597–601. German.
2.Machemer R, Aaberg TM, Freeman HM, Irvine AR, Lean JS, Michels RM. An updated classification of retinal detachment with proliferative vitreoretinopathy. Am J Ophthalmol. 1991 Aug 15;112(2):159‐165.
3.Khan MA, Brady CJ, Kaiser RS. Clinical management of proliferative vitreoretinopathy: an update. Retina. 2015;35:165–175.
4.Eckardt C, Behrendt S, Zwick A. Results of silicone oil removal from eyes treated with retinectomies. Ger J Ophthalmol. 1992;1(1):2–6.
5.Bovey EH, de Ancos E, Gorivers M. Retinotomies of 180 degrees or more. Retina. 1995;15(5):394–398.
6.Faude F, Lambert A, Wiedemann P. 360 degrees retinectomy in severe anterior PVR and PDR. Int Ophthalmol. 1998;22(2):119–123.
7.Lesnoni G, Billi B, Rossi T, Stirpe M. The use of panoramic viewing system in relaxing retinotomy and retinectomy. Retina. 1997;17(3):186–190.
8.Reinking U, Lucke K, Bopp S, Laqua H. Results after retinotomy and retinectomy in the treatment of complicated retinal detachment. Klin Monbl Augenheilkd. 1990;197(5):382–5.
9.Shalaby KA-G. Relaxing retinotomies and retinectomies in the management of retinal detachment with severe proliferative vitreoretinopathy (PVR). Clin Ophthalmol. September 2010:1107. d
10.Kuhn F. Vitreoretinal Surgery: Strategies and Tactics. Springer International Publishing; 2016. 551 р.
11.Jiang Y, Oh DJ, Messenger W, Lim JI. Outcomes of 25-gauge vitrectomy with relaxing retinectomy for retinal detachment secondary to proliferative vitreoretinopathy. J Vitreoretin Dis. 2019;3(2):69‐75.
12.Tan HS, Mura M, Lesnik Oberstein SY, de Smet MD. Primary Retinectomy in Proliferative Vitreoretinopathy. Am J Ophthalmol. 2010;149(3):447–452.
13.Quiram PA, Gonzales CR, Hu W, et al. Outcomes of Vitrectomy with Inferior Retinectomy in Patients with Recurrent Rhegmatogenous Retinal Detachments and Proliferative Vitreoretinopathy. Ophthalmology. 2006;113(11):2041–2047.
14.Iwahashi-shima C, Sato T, Bando H, Ikeda T, Emi K. Anatomic and functional outcomes of 25-gauge vitrectomy for repair of eyes with rhegmatogenous retinal detachment complicated by proliferative vitreoretinopathy. Clin Ophthalmol. 2013;7:2043–9
15.Adhi MI, Siyal N, Aziz S. Anatomical and functional outcomes of retinectomies in retinal detachments complicated by proliferative vitreoretinopathy. Saudi J Ophthalmol. 2017;31(4):216-223.
16.Scott IU, Flynn HWJ, Murray TG, Feuer WJ. Outcomes of surgery for retinal detachment associated with proliferative vitreoretinopathy using perfluoro-n-octane: a multicenter study. Am J Ophthalmol. 2003;136(3):454–463.
17.Papastavrou VT, Chatziralli I, McHugh D. Gas Tamponade for Retinectomy in PVR-Related Retinal Detachments: A Retrospective Study. Ophthalmol Ther. 2017;6(1):161‐166.
The authors certify that they have no conflicts of interest in the subject matter or materials discussed in this manuscript.