The Outcomes of Primary Retinal Detachment Surgery with 23-gauge Vitrectomy in Patients without Severe Proliferative Vitreoretinopathy: A Single Surgeon Case Series

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.

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Anatomic and Visual Outcomes Following Surgical Repair of Retinoschisis-Related Retinal Detachments

Journal of VitreoRetinal Diseases ◽

10.1177/2474126418801263 ◽

2018 ◽

Vol 3 (1) ◽

pp. 6-9 ◽

Cited By ~ 1

Author(s):

Maxwell S. Stem ◽

Bruce R. Garretson ◽

Bozho Todorich ◽

Jade Price ◽

Adam J. Weiner ◽

...

Keyword(s):

Retinal Detachment ◽

Success Rate ◽

Proliferative Vitreoretinopathy ◽

Surgical Repair ◽

Case Series ◽

Scleral Buckle ◽

Entire Cohort ◽

Initial Surgery ◽

The Mean ◽

Anatomic Success

Purpose: The purpose of this article is to report the characteristics of patients with retinoschisis-related retinal detachments and to summarize their clinical outcomes after surgical repair. Methods: A single-center interventional case series of 37 eyes from 35 patients who underwent surgery to repair a retinoschisis-related retinal detachment between January 1, 2009 and January 1, 2017 was conducted. Results: The mean ± SD age at the time of the first retinal detachment repair was 63 ± 13 years. As the initial surgery, scleral buckle was performed in 14 eyes, scleral buckle + vitrectomy in 14 eyes, and vitrectomy in 9 eyes. The single-operation success rate for the entire cohort was 65% (24/37), and the final anatomic success rate was 97% (36/37). Among eyes requiring more than 1 surgery, 46% (6/13) developed proliferative vitreoretinopathy. Best-corrected visual acuity improved or remained stable after 1 year of follow-up in the majority (n = 27, 73%) of eyes. The mean (SD) number of surgeries required to achieve the final anatomic and visual result was 1.8 (1.2) for all eyes (range, 1-5 surgeries). Conclusion: The single-surgery success rate for retinoschisis-related retinal detachments was lower than that reported for typical rhegmatogenous retinal detachments, and the incidence of proliferative vitreoretinopathy was higher. When counseling patients with retinoschisis-related retinal detachments, it is important to caution them that they may require more than 1 surgery to achieve anatomic success.

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Postoperative Macular Proliferative Vitreoretinopathy: A Case Series and Literature Review

Case Reports in Ophthalmology ◽

10.1159/000512285 ◽

2021 ◽

pp. 464-472

Author(s):

Samer Khateb ◽

Hamzah Aweidah ◽

Michael Halpert ◽

Tareq Jaouni

Keyword(s):

Retinal Detachment ◽

Proliferative Vitreoretinopathy ◽

Medical Center ◽

Primary Repair ◽

Rapid Development ◽

Case Series ◽

Macular Function ◽

Department Of Ophthalmology ◽

Hebrew University ◽

Detachment Time

Premacular membranes developing following pars plana vitrectomy (PPV) can cause significant anatomical and functional deficits to the macula. Recent reports showed that postoperative premacular membranes are a localized presentation of macular proliferative vitreoretinopathy (mPVR). Here, we report retrospectively a case series of 5 patients with severe mPVR which developed following uneventful PPV and were followed up to 32 months in the Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, between October 2016 and February 2020. All patients underwent primary repair of rhegmatogenous retinal detachment (RRD) before mPVR developed. Mean best-corrected visual acuity (BCVA) at presentation was 20/76 Snellen (0.58 LogMAR). Median duration of the retinal detachment time until surgery was 1.5 days (range 1–21 days). Mean interval time from last normal follow-up exam to diagnosis of mPVR was 19 days (range 10–28). BCVA dropped from a mean of 20/38 Snellen (0.28 LogMAR) prior to mPVR development to 20/166 Snellen (0.92 LogMAR) following its development, recovering to 20/57 Snellen (0.45 LogMAR) after peeling of membranes. Mean central macular thickness measured by optical coherence tomography decreased from 711 to 354 μm postsurgery. In conclusion, short-term mPVR is a different entity from macular pucker in terms of rapid development, structural distortion, and visual compromise. Surgical treatment significantly restores macular function and anatomy.

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