PPV, Retinectomy, and Silicone Oil Without Scleral Buckle for Recurrent RRD From Proliferative Vitreoretinopathy

Deaner, Jordan D.; Aderman, Christopher M.; Bonafede, Lucas; Regillo, Carl D.

doi:10.3928/23258160-20191031-15

Cited by 10 publications

(14 citation statements)

References 24 publications

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“…The primary anatomical success rate after one surgery was 83% (43/52 eyes) and is considered comparable to current attachment rates in complex RRD surgery cases [ 28 , 29 ]. However, it increased to 96% (50/52) after the second surgery.…”

Section: Discussionsupporting

confidence: 70%

Intravitreal injection associated rhegmatogenous retinal detachment: outcomes of a European analysis

Vounotrypidis

Freissinger

Cereda

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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Purpose As the number of intravitreal injections (IVI) increases annually, this study aimed to assess the anatomical and functional outcomes following rhegmatogenous retinal detachment (RRD) surgery for IVI-associated RRD (IVARD). Methods All non-vitrectomized eyes developing IVARD since 2007 in two European vitreoretinal centers (Department of Ophthalmology, LMU Munich, Germany, and Eye Clinic Luigi Sacco, University of Milan, Milan, Italy) were included. Main outcomes were primary and secondary retinal attachment rate after surgery, rate of proliferative vitreoretinopathy (PVR), and final functional result. Ten years of incidence rates per injection were calculated for one center. Results Fifty-two eyes of 52 patients comprised the study. Primary anatomic success rate was 83% (n = 43) and secondary 96% (n = 50). PVR was observed in all uveitic eyes (n = 3), in eyes with postoperative cystoid macular edema (n = 2), and in 8 of 9 eyes that received the dexamethasone implant (DEX). Age, number of prior injections, duration of symptoms, or time between last IVI and RRD did not show any statistically significant differences with regard to presence of PVR or not. Mean BCVA improved in 28 cases, remained stable in 16 cases, and worsened in 8 cases. The RRD incidence rate was statistically significant higher for DEX and ocriplasmin compared with that for anti-VEGF agents. Conclusion The anatomical result after one surgical intervention seems acceptable, but the final visual outcome remains rather poor, because of the underlying macular disease. In our population, injection with DEX is associated with higher IVARD rate, presence and development of PVR, and recurrent RRD in comparison with anti-VEGF agents.

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Section: Discussionsupporting

confidence: 70%

Intravitreal injection associated rhegmatogenous retinal detachment: outcomes of a European analysis

Vounotrypidis

Freissinger

Cereda

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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“…We found that the single-operation complete retinal reattachment rate was 75% (15/20), the complete retinal reattachment rate was 80% (16/20), and the incomplete retinal reattachment rate was 90% (18/20) for re-vitrectomy for Re-RD in post-vitrectomy eyes. Previous studies have reported that the success rate of resurgery for Re-RD is 60%–95.2% [ 5 , 10 , 13 , 19 – 21 ]. The reasons for the great disparity among previous reports are not only due to differences in population and surgical methods but also because of differences in the definition of anatomical success and follow-up time.…”

Section: Discussionmentioning

confidence: 99%

“…The reasons for the great disparity among previous reports are not only due to differences in population and surgical methods but also because of differences in the definition of anatomical success and follow-up time. For example, the reattachment rate of 82.1% reported by Deaner et al [ 10 ] referred to anatomical reattachment under SO with a single operation after 1 year of follow-up. After SO removal, the complete reattachment rate for a single surgery was 57.1%.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, complications after revitrectomy combined with tamponade were secondary glaucoma in 25% of eyes, complicated cataract in 100% of eyes, SO dependence in 15% of eyes, keratitis in 5% of eyes, and Re-RD in 10% of eyes. In previous reports, the percentage of complicated cataract was 69%–100% [ 8 , 38 ], secondary glaucoma was 30%–60.6% [ 3 , 38 , 45 ], SO-dependent eye was 19.7%–50% [ 10 , 19 , 38 , 46 ], Re-RD was 30.3% [ 38 ], and SO emulsification was 11.7% [ 14 ]. Choudhary et al [ 3 ] found that although IOP increased in 60.6% of patients before SO removal, only 7.5% of patients needed cyclophotocoagulation to reduce the IOP to the normal range after SO removal.…”

Section: Discussionmentioning

confidence: 99%

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Re-vitrectomy for recurrent retinal detachment in post-vitrectomy eyes of rhegmatogenous retinal detachment

Bai

Zheng²,

Zhu

et al. 2022

BMC Ophthalmol

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Background Recurrent retinal detachment (Re-RD) usually affects the prognosis of surgery for rhegmatogenous retinal detachment (RRD). Previous clinical studies of Re-RD were not specific. This study aimed to analyze the clinical characteristics of Re-RD in post-vitrectomy eyes with RRD and surgical outcomes after revitrectomy without combining it with retinectomy or scleral buckling. Methods This is a retrospective case series analyzed the ocular characteristics of 20 recurrent and contralateral eyes, evaluated the significance of the associations between variables before reoperation and the final best-corrected visual acuity (BCVA), and calculated the outcome of revitrectomy. Results Patients with phakic eyes, those undergoing only one surgery, and those with more than one break had better final BCVA. The final BCVA was negatively correlated with the axial length and positively correlated with the preoperative BCVA. Among the 12 eyes with no break detected before surgery, 11 (92%) were found to have a small crevice-like break beside the pigment scar of a large number of original laser spots. The single-operation complete retinal reattachment rate was 75%, the complete retinal reattachment rate was 80%, and the final incomplete retinal reattachment rate was 90%. The BCVA improved from 1.2 ± 0.6LogMAR (0.06 ± 0.25) before surgery to 0.8 ± 0.7LogMAR (0.15 ± 0.2) at the last follow-up. The BCVA of 16 patients with complete retinal reattachment improved from 1.0 ± 0.5LogMAR (0.1 ± 0.3) to 0.6 ± 0.4LogMAR (0.25 ± 0.4). In the contralateral eyes, 15% already had vision-damaging disease, and the incidence of eyesight-threating lesions was 5.9% during follow-up. Conclusions Revitrectomy without retinectomy or scleral buckling can effectively treat Re-RD in post-vitrectomy eyes. In Re-RD patients with no definite retinal break detected preoperatively, the retinal hole usually shows small crevice-like changes alongside a large number of original laser pigment scars.

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“…Although SB can provide additional support in inferior detachments and anterior PVR, some studies suggested that effective retinotomy with proper tamponade during vitrectomy may obviate the requirement of concurrent SB, resulting in less surgical time, cost, and morbidity. 32 33 34 …”

Section: Discussionmentioning

confidence: 99%

Retinotomy and Retinectomy in the Management of Rhegmatogenous Retinal Detachment Associated with Advanced Proliferative Vitreoretinopathy

Falavarjani

Zand

Birjandi

et al. 2022

Journal of Current Ophthalmology

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Purpose: To report the anatomical and functional outcomes of retinotomy and/or retinectomy for the management of rhegmatogenous retinal detachment (RRD) complicated by advanced proliferative vitreoretinopathy (PVR). Methods: In this retrospective study, the charts of patients who underwent pars plana vitrectomy with retinotomy and/or retinectomy for the management of RRD complicated by PVR were reviewed. Primary outcome measures were final best-corrected visual acuity (BCVA) and anatomical reattachment rate. Results: Sixty-one eyes of 61 patients with a mean age of 48.56 ± 15.92 were studied. The mean follow-up time was 21.38 ± 23.08 months. The mean angle of the retinotomy was 171.31° ± 79.15°. Thirty-two (52.5%) of them needed extensive (≥180°) retinotomy. In addition, simultaneous retinectomy was performed in 36.2% of the cases. The BCVA was 2.18 ± 0.63 and 1.85 ± 0.71 logMAR before the surgery and at the last visit, respectively ( P = 0.001). The initial anatomical success was achieved in 45 eyes (73.8%) after retinotomy surgery. Sixteen eyes (26.2%) had recurrent RD and needed reoperation, which was performed 5.60 ± 4.01 months after the initial retinotomy surgery. At the last examination, the retina was attached in all patients. Conclusion: Retinotomy with/without retinectomy is an effective procedure in the majority of patients with RRD associated with advanced PVR; however, additional surgeries are needed in a significant number of eyes to achieve final anatomical success.

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PPV, Retinectomy, and Silicone Oil Without Scleral Buckle for Recurrent RRD From Proliferative Vitreoretinopathy

Cited by 10 publications

References 24 publications

Intravitreal injection associated rhegmatogenous retinal detachment: outcomes of a European analysis

Intravitreal injection associated rhegmatogenous retinal detachment: outcomes of a European analysis

Re-vitrectomy for recurrent retinal detachment in post-vitrectomy eyes of rhegmatogenous retinal detachment

Retinotomy and Retinectomy in the Management of Rhegmatogenous Retinal Detachment Associated with Advanced Proliferative Vitreoretinopathy

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