J Korean Ophthalmol Soc.  2015 Jun;56(6):900-905. 10.3341/jkos.2015.56.6.900.

Outcomes of Relaxing Retinectomy in Patients with Proliferative Vitreoretinopathy

• Choi SC
• Cho HJ
• Lee DW
• Cho SW
• Lee TG
• Kim CG
• Kim JW
• Kim HS

• KMID: 2339155
• DOI: http://doi.org/10.3341/jkos.2015.56.6.900

Abstract

PURPOSE
To report the outcomes of relaxing retinectomy for retinal detachment in patients with proliferative vitreoretinopathy (PVR).
METHODS
Sixty-four cases of relaxing retinectomy for PVR with a minimum follow-up of 6 months were retrospectively reviewed. The outcomes included achievement of complete retinal reattachment, PVR recurrence, the mean number of additional operations, visual acuity and incidence of postoperative complications. We analyzed the influence of intraoperative factors including lens status, retinectomy extent, additional scleral buckling, and tamponade agent on primary retinal reattachment.
RESULTS
Complete retinal reattachment was achieved in 47 eyes (74.3%) without an additional surgery. PVR recurred in 19 eyes (29.7%) and an additional operation was performed in 17 eyes (26.6%). Fifty-seven (89.1%) eyes showed complete retinal reattachment and 40 eyes (62.5%) had visual acuity of 0.02 or more at the final follow-up visit. Hypotony was the major complication and developed in 10 eyes (15.6%). Eyes undergoing smaller (< 180degrees) retinectomy or silicone oil tamponade had higher primary anatomical success rates than larger (> or = 180degrees) retinectomy or gas tamponade (p = 0.043 and 0.013, respectively).
CONCLUSIONS
Relaxing retinectomy is a useful technique for retinal detachment with PVR, but risk of recurrent proliferation or hypotony should be considered.

Keyword

Hypotony; PVR; RD; Relaxing; Retinectomy

MeSH Terms

Follow-Up Studies
Humans
Incidence
Postoperative Complications
Recurrence
Retinal Detachment
Retinaldehyde
Retrospective Studies
Scleral Buckling
Silicone Oils
Visual Acuity
Vitreoretinopathy, Proliferative*
Retinaldehyde
Silicone Oils

Figure

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  Figure 1. Consecutive fundus photos of a 25 year old male patient undergoing 5 repeated operations. (A) Total retinal detachment with extensive subretinal proliferation before surgery. (B) Re-attached retina 2 weeks after 360° relaxing retinectomy (the second operation). (C) Initiation of reproliferation at retinectomy margin 3 weeks after second operation. (D) Preretinal reproliferation 2 weeks after fourth operation. (E) Matured preretinal membrane 4 weeks after fourth operation. (F) Remained tough fibrous ring surrounding the retinectomy site after fifth operation.

Reference

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