<p>Large Retinectomies for Retinal Detachment Complicated by Proliferative Vitreoretinopathy: Anatomical and Functional Outcome of Silicone Oil versus Perfluoropropane Gas</p>

Abstract

Purpose: To assess the anatomic and functional outcomes of eyes undergoing vitrectomy and large retinectomy for the management of retinal detachment (RD) complicated by advanced proliferative vitreoretinopathy (PVR). Methods: A total of 66 eyes of 63 patients with RD complicated by PVR were treated with vitrectomy and 180° or more retinectomy and silicone oil (n=46) or perfluoropropane gas (n=20) were used as intraocular tamponades. Results: Retinal reattachment was achieved in 89.39% (59 eyes) of the cases. The mean follow-up was 33.7 months (range 12-76 months). In gas-filled eyes, the final anatomic success rate was 85% (17 eyes) and in silicone oil-filled eyes was 91.3% (42 eyes) (p=0.46). After the initial retinectomy, the total anatomic success rate was 80.3% (53/66 eyes), 70% in gas-filled eyes (14/20 eyes) and 84.79% in silicone oil-filled eyes (39/46 eyes) (p=0.19). Visual acuity (VA) improved in 37 (56.06%) eyes, remained the same in 19 (28.78%) eyes and became worse in 10 (15.15%) cases. Best corrected VA was ≥20/200 in 22 eyes 33.33%. The final VA was associated with the preoperative VA (r=0.68), the preoperative status of the macula influence significantly the final visual acuity (p<0.0001) and there is statistically significant difference in the final visual acuity between eyes with and without anatomic success (p<0.05). Conclusion: The large circumferential retinectomies can be beneficial in eyes with RD complicated by advanced PVR. No significant difference was found in anatomic success rate, and rate of complications between eyes with silicone oil tamponade and long acting gas undergoing large retinectomy. Regarding the final BCVA, slight difference was found in favor of gas-filled eyes.

The impact of the COVID-19 Pandemic on rhegmatogenous retinal detachment treatment patterns

“…SB provides an advantage in dealing with chronic RRD with a subretinal brand and atrophic breaks [ 43 ], but 11.3% of patients were reported to undergo the secondary procedure to deal with an unattached retina [ 46 ]. PPV is reserved for complicated cases and is often accompanied by retinoctomy and silicone oil tamponade to achieve better outcomes [ 47 , 48 ]. The requirement of multiple follow-ups concerning the persistence of a detached retina, a fear of PVR progression [ 49 ] when the break is located near the subretinal brand, and bad toleration of the SB procedure under local anesthesia may partly account for the changes of treatment towards PPV.…”

The Impact of the Covid-19 Pandemic on Rhegmatogenous Retinal Detachment Treatment Patterns

“…SB provides an advantage in dealing with chronic RRD with a subretinal brand and atrophic breaks[26], but 11.3% of patients were reported to undergo the secondary procedure to deal with an unattached retina [29]. PPV is reserved for complicated cases and is often accompanied by retinoctomy and silicone oil tamponade to achieve better outcomes [30,31]. The requirement of multiple follow-ups concerning the persistence of a detached retina, a fear of PVR progression when the break is located near the subretinal brand, and bad toleration of the SB procedure under local anesthesia may partly account for the changes of treatment towards PPV.…”