Radial Retinotomies with Endodiathermy for Severe Proliferative Vitreoretinopathy: Short-Term Results

Abstract

Purpose. Retinal redetachment of silicone oil-filled eyes continues to be a frustrating condition that typically requires retinectomy. We proposed radial retinotomy as a potentially less invasive surgery. Here, we preliminarily explored its feasibility, efficacy, and safety. Methods. Totally 9 eyes of 9 consecutive patients were included in a prospective noncomparative trial. A series of retinotomies were created by endodiathermy in a radial pattern to relax the foreshortened retina. The eye was refilled with fresh silicone oil. The treated eyes were examined via visual acuity (VA) tests, tonometry, slit-lamp microscopy, and fundus photography during a 6-month observation period. Results. The procedure was completed in an average of 28 minutes from silicone oil removal to fresh silicone oil placement. Fundus photography demonstrated that 7 of the 9 eyes (78%) exhibited retinal reattachment. On average, VA was significantly improved within the first 2 weeks (P = 0.02) and remained stable for the following 6 months. The change in intraocular pressure was not significant (P = 0.76), and no adverse event was observed (0%). Conclusion. Radial retinotomies with endodiathermy were shown to be feasible, effective, and safe in selected cases of inferior contracted retina without vitreous base fibrosis over a 6-month observation period. This trial is registered with NCT02201706.

Endodiathermal Tautening of Floppy or Irregular Iris in Endothelial Keratoplasty (Iridodiathermy)

“…The bipolar endodiathermy probe is a standard part of vitreo-retinal surgical set-ups. 9,10 It is easily available and can be connected to vitrectomy machines, newer phaco machines (in diathermy mode), and even to cautery units. Disposable and reusable autoclavable models in 20, 23, 25, and 27 gauges are available.…”

Intravitreal slow-release dexamethasone alleviates traumatic proliferative vitreoretinopathy by inhibiting persistent inflammation and Müller cell gliosis in rabbits

“…Müller cells can be triggered by various inflammatory cytokines and subsequently release more cytokines and growth factors into the local retinal environment to promote intraretinal glial proliferation and tissue insults [17] . Tremendous advancements in surgical techniques for PVR management have been achieved [18][19] , but persistent inflammation and proliferation compromise surgical outcomes. Additionally, protracted inflammation might cause poor vision and retinal shortening [20][21] , even after surgical intervention for PVR.…”