Large Inferior Retinectomies for Proliferative Vitreoretinopathy in Silicone Oil-filled Eyes

Overview

Journal Int J Retina Vitreous

Publisher Biomed Central

Date 2022 Oct 1

PMID 36183118

Authors

Gabriel Castilho Sandoval Barbosa

Allan Gomes da Silva

Guilherme Daher Goncalves Monteiro Dos Reis

Frederico Hackbart Bermudes

Carolina Maria Barbosa Lemos

Rafael Garcia

Thiago Jose Muniz Machado Mazzeo

Cleide Guimaraes Machado

Andre Marcelo Vieira Gomes

Affiliations

Soon will be listed here.

Abstract

Background: To describe the anatomical and functional outcomes and late complications in patients who developed inferior proliferative vitreoretinopathy (PVR) in silicone oil-filled eyes and who required reoperation with large inferior retinectomy.

Methods: This is a single-center, retrospective, interventional case series analysis. The study involved 18 individuals with tractional retinal re-detachment due to PVR development inferiorly in eyes who had undergone prior pars plana vitrectomy and silicone oil as a tamponade. All patients included in the study underwent secondary surgery with large inferior retinectomy (from 120° to 270°) and silicone oil filling.

Results: The mean follow-up period was 44.0 ± 31.5 (± SD) months (range: 4 to 96 months. The anatomical success, defined as the complete reattachment of the retina until the last follow-up, was observed in 88.9% of the cases. The postoperative visual acuity ranged from 20/100 to hand motion at 60 cm. Only two cases (11.1%) did not achieve anatomical success at the last follow-up due to recurrent PVR and retinal re-detachment (one including hypotony). All of the patients were pseudophakic. The PVR grade, as well as the presence of PVR prior to primary surgery, showed no statistical correlation with BCVA, the extent of retinectomies, and final macular status. There was a statistically significant correlation between "Final BCVA" and "Initial BCVA" (r = 0.654) and between "Final BCVA" and "Extent of Retinectomy" (r = 0.615).

Conclusions: Reoperation in eyes filled with silicone oil may be required when PVR is developed. Secondary surgery in these cases with large inferior retinectomy and silicone oil implantation may reach good anatomical success with low rates of late complications, besides improving visual acuity. A better BCVA at the time of re-RD diagnosis and cases of retinectomies with greater extensions showed a positive correlation with better functional outcomes. Trial registration Research Ethics Committee of the Suel Abujamra Institute reviewed and approved this study protocol (approval number, 5.404.961).

Citing Articles

Outcomes after giant peripheral retinotomy and anterior flap retinectomy for rhegmatogenous retinal detachments with advanced proliferative vitreoretinopathy using small gauge vitrectomy.

Agarwal A, Kumar Menia N, Markan A, Sallam A, Habib A, Mansour A Indian J Ophthalmol. 2024; 72(12):1772-1779.

PMID: 38622862 PMC: 11727936. DOI: 10.4103/IJO.IJO_2840_23.

References

Kolomeyer A, Grigorian R, Mostafavi D, Bhagat N, Zarbin M . 360° retinectomy for the treatment of complex retinal detachment. Retina. 2010; 31(2):266-74. DOI: 10.1097/IAE.0b013e3181eef2c7. View

De Silva D, Kwan A, Bunce C, Bainbridge J . Predicting visual outcome following retinectomy for retinal detachment. Br J Ophthalmol. 2008; 92(7):954-8. DOI: 10.1136/bjo.2007.131540. View

Lewis H, Burke J, Abrams G, AABERG T . Perisilicone proliferation after vitrectomy for proliferative vitreoretinopathy. Ophthalmology. 1988; 95(5):583-91. DOI: 10.1016/s0161-6420(88)33136-2. View

Han D, Lewis M, Kuhn E, Abrams G, Mieler W, Williams G . Relaxing retinotomies and retinectomies. Surgical results and predictors of visual outcome. Arch Ophthalmol. 1990; 108(5):694-7. DOI: 10.1001/archopht.1990.01070070080039. View

Blumenkranz M, Azen S, Aaberg T, Boone D, Lewis H, Radtke N . Relaxing retinotomy with silicone oil or long-acting gas in eyes with severe proliferative vitreoretinopathy. Silicone Study Report 5. The Silicone Study Group. Am J Ophthalmol. 1993; 116(5):557-64. DOI: 10.1016/s0002-9394(14)73196-4. View

MACHEMER R, AABERG T, Freeman H, IRVINE A, Lean J, Michels R . An updated classification of retinal detachment with proliferative vitreoretinopathy. Am J Ophthalmol. 1991; 112(2):159-65. DOI: 10.1016/s0002-9394(14)76695-4. View

. Vitrectomy with silicone oil or perfluoropropane gas in eyes with severe proliferative vitreoretinopathy: results of a randomized clinical trial. Silicone Study Report 2. Arch Ophthalmol. 1992; 110(6):780-92. DOI: 10.1001/archopht.1992.01080180052028. View

Bovey E, De Ancos E, Gonvers M . Retinotomies of 180 degrees or more. Retina. 1995; 15(5):394-8. View

Quiram P, Gonzales C, Hu W, Gupta A, Yoshizumi M, Kreiger A . Outcomes of vitrectomy with inferior retinectomy in patients with recurrent rhegmatogenous retinal detachments and proliferative vitreoretinopathy. Ophthalmology. 2006; 113(11):2041-7. DOI: 10.1016/j.ophtha.2006.05.039. View

10.

Nagasaki H, Shinagawa K, Mochizuki M . Risk factors for proliferative vitreoretinopathy. Prog Retin Eye Res. 1998; 17(1):77-98. DOI: 10.1016/s1350-9462(97)00007-4. View

11.

Charteris D, Sethi C, Lewis G, Fisher S . Proliferative vitreoretinopathy-developments in adjunctive treatment and retinal pathology. Eye (Lond). 2002; 16(4):369-74. DOI: 10.1038/sj.eye.6700194. View

12.

. The classification of retinal detachment with proliferative vitreoretinopathy. Ophthalmology. 1983; 90(2):121-5. DOI: 10.1016/s0161-6420(83)34588-7. View

13.

Tseng J, Barile G, Schiff W, Akar Y, Vidne-Hay O, Chang S . Influence of relaxing retinotomy on surgical outcomes in proliferative vitreoretinopathy. Am J Ophthalmol. 2005; 140(4):628-36. DOI: 10.1016/j.ajo.2005.04.021. View

14.

Charteris D . Proliferative vitreoretinopathy: revised concepts of pathogenesis and adjunctive treatment. Eye (Lond). 2019; 34(2):241-245. PMC: 7002479. DOI: 10.1038/s41433-019-0699-1. View

15.

Choudhary M, Choudhary M, Saeed M, Ali A . Removal of silicone oil: prognostic factors and incidence of retinal redetachment. Retina. 2012; 32(10):2034-8. DOI: 10.1097/IAE.0b013e3182562045. View

16.

Grigoropoulos V, Benson S, Bunce C, Charteris D . Functional outcome and prognostic factors in 304 eyes managed by retinectomy. Graefes Arch Clin Exp Ophthalmol. 2006; 245(5):641-9. DOI: 10.1007/s00417-006-0479-z. View

17.

Pastor J, Rodriguez de la Rua E, Martin F . Proliferative vitreoretinopathy: risk factors and pathobiology. Prog Retin Eye Res. 2002; 21(1):127-44. DOI: 10.1016/s1350-9462(01)00023-4. View

18.

Coffee R, Jiang L, Rahman S . Proliferative vitreoretinopathy: advances in surgical management. Int Ophthalmol Clin. 2014; 54(2):91-109. DOI: 10.1097/IIO.0000000000000023. View

19.

Mendes T, Vieira Gomes A, Rocha B, Passos Junior H, Abujamra S . Evaluation of retinectomy in the treatment of severe proliferative vitreoretinopathy. Int J Retina Vitreous. 2016; 1:17. PMC: 5088467. DOI: 10.1186/s40942-015-0018-3. View

20.

Lewis H, AABERG T, Abrams G . Causes of failure after initial vitreoretinal surgery for severe proliferative vitreoretinopathy. Am J Ophthalmol. 1991; 111(1):8-14. DOI: 10.1016/s0002-9394(14)76889-8. View