Purpose: The aim of this study is to evaluate visual and anatomic outcomes of 25-gauge vitrectomy with relaxing retinectomies for complex retinal detachment (RD) secondary to proliferative vitreoretinopathy (PVR). Methods: A single-center, retrospective case series of 44 patients who had undergone a 25-gauge vitrectomy with a relaxing retinectomy for the treatment of combined RD and PVR was performed. Preoperative characteristics, intraoperative techniques, and outcomes were analyzed. The rates of attachment, complications, and visual acuity were analyzed. Institutional review board/ethics committee approval was obtained, and the described research adhered to the tenets of the Declaration of Helsinki. Results: At the final follow-up, 27 eyes (61%) had attachment after 1 surgery, 41 eyes (93%) ultimately had attached retinas, 3 eyes (7%) had hypotony, 3 eyes had become phthisical (7%), and 24 eyes (56%) had improved visual acuity. After stratifying by visual outcomes, 20/400 or better best-corrected visual acuity was not associated with age ( P = .66), RD etiology ( P = .61), preoperative hypotony ( P = .60), nor size of retinectomy ( P = .48). Patients achieving 20/400 vision or better were statistically more likely to be pseudophakic ( P = .024) and have silicone oil removal ( P < .0001). Conclusion: The use of 25-gauge vitrectomy and relaxing retinectomy provides a high rate of reattachment and improved visual acuity.
Prevention and control of proliferative vitreoretinopathy: primary retinal detachment surgery using silicone oil as a planned two-stage procedure in high-risk cases
