Outcomes of Primary Rhegmatogenous Retinal Detachment Repair in Eyes With Preoperative Grade B or C Proliferative Vitreoretinopathy

Overview

Journal J Vitreoretin Dis

Publisher Sage Publications

Date 2023 Apr 3

PMID 37008548

Authors

Travis J Peck

Matthew R Starr

Yoshihiro Yonekawa

M Ali Khan

Anthony Obeid

Edwin H Ryan

Claire Ryan

Michael Ammar

Luv G Patel

Nora J Forbes

Antonio Capone Jr

Geoffrey G Emerson

Daniel P Joseph

Dean Eliott

Carl D Regillo

Jason Hsu

Omesh P Gupta

Ajay E Kuriyan

Affiliations

Soon will be listed here.

Abstract

Purpose: This work evaluates the anatomic and functional outcomes of primary rhegmatogenous retinal detachments (RRDs) with preoperative grade B and C proliferative vitreoretinopathy (PVR) vs eyes without PVR.

Methods: As a multi-institutional, interventional, retrospective study of all patients undergoing primary RRD surgical procedures from January 1, 2015, through December 31, 2015, this study evaluated the visual acuity (VA) outcomes and single-surgery anatomic success rates (SSAS) of patients with primary grade B and C PVR at the time of RRD repair.

Results: A total of 2486 eyes underwent primary RD surgery during the study period, of which 153 eyes (6.2%) had documented preoperative PVR grade B or C. Eyes without PVR had better SSAS compared with eyes with grade B or C PVR (87% vs 83% vs 75%, respectively, < .0001). Eyes without PVR also had better final mean (SD) logMAR VA (0.35 [0.47]; 20/45 Snellen equivalent) than eyes with PVR of grade B (0.50 [0.56]; 20/63 Snellen equivalent) or grade C ( < .0001). In only eyes with preoperative PVR, there were no significant differences in final VA or SSAS on multivariate analysis based on surgical approach or use of retinectomy or membrane peeling alone in the intraoperative management of PVR.

Conclusions: Eyes with primary preoperative grade B and C PVR appear to have significantly worse VA outcomes and lower surgical success rates. Surgical approach and management of PVR membranes did not appear to affect VA or success rates, indicating that preoperative PVR severity may dictate these outcomes.

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References

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

Di Lauro S, Kadhim M, Charteris D, Pastor J . Classifications for Proliferative Vitreoretinopathy (PVR): An Analysis of Their Use in Publications over the Last 15 Years. J Ophthalmol. 2016; 2016:7807596. PMC: 4939352. DOI: 10.1155/2016/7807596. View

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

Joseph D, Ryan E, Ryan C, Forbes N, Wagley S, Yonekawa Y . Primary Retinal Detachment Outcomes Study: Pseudophakic Retinal Detachment Outcomes: Primary Retinal Detachment Outcomes Study Report Number 3. Ophthalmology. 2020; 127(11):1507-1514. DOI: 10.1016/j.ophtha.2020.05.005. View

Sebag J . Shaken not stirred. Ophthalmology. 2001; 108(7):1177-8. DOI: 10.1016/s0161-6420(01)00621-2. View

Wang J, Ryan E, Ryan C, Kakulavarapu S, Mardis P, Rodriguez M . FACTORS ASSOCIATED WITH THE USE OF 360-DEGREE LASER RETINOPEXY DURING PRIMARY VITRECTOMY WITH OR WITHOUT SCLERAL BUCKLE FOR RHEGMATOGENOUS RETINAL DETACHMENT AND IMPACT ON SURGICAL OUTCOMES (PRO STUDY REPORT NUMBER 4). Retina. 2019; 40(11):2070-2076. DOI: 10.1097/IAE.0000000000002728. View

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

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

Ryan E, Joseph D, Ryan C, Forbes N, Yonekawa Y, Mittra R . Primary Retinal Detachment Outcomes Study: Methodology and Overall Outcomes-Primary Retinal Detachment Outcomes Study Report Number 1. Ophthalmol Retina. 2020; 4(8):814-822. DOI: 10.1016/j.oret.2020.02.014. View

10.

Chang S, Coleman D, Lincoff H, Wilcox Jr L, Braunstein R, Maisel J . Perfluoropropane gas in the management of proliferative vitreoretinopathy. Am J Ophthalmol. 1984; 98(2):180-8. DOI: 10.1016/0002-9394(87)90353-9. View

11.

Starr M, Obeid A, Ryan E, Ryan C, Ammar M, Patel L . RETINAL DETACHMENT WITH INFERIOR RETINAL BREAKS: Primary Vitrectomy Versus Vitrectomy With Scleral Buckle (PRO Study Report No. 9). Retina. 2021; 41(3):525-530. DOI: 10.1097/IAE.0000000000002917. View

12.

Adelman R, Parnes A, Michalewska Z, Ducournau D . Clinical variables associated with failure of retinal detachment repair: the European vitreo-retinal society retinal detachment study report number 4. Ophthalmology. 2014; 121(9):1715-9. DOI: 10.1016/j.ophtha.2014.03.012. View

13.

Ryan S . The pathophysiology of proliferative vitreoretinopathy in its management. Am J Ophthalmol. 1985; 100(1):188-93. DOI: 10.1016/s0002-9394(14)75004-4. View

14.

Lean J, Stern W, IRVINE A, Azen S . Classification of proliferative vitreoretinopathy used in the silicone study. The Silicone Study Group. Ophthalmology. 1989; 96(6):765-71. DOI: 10.1016/s0161-6420(89)32821-1. View

15.

Stopa M, Kociecki J . Anatomy and function of the macula in patients after retinectomy for retinal detachment complicated by proliferative vitreoretinopathy. Eur J Ophthalmol. 2010; 21(4):468-72. DOI: 10.5301/EJO.2010.6069. View

16.

Rachal W, Burton T . Changing concepts of failures after retinal detachment surgery. Arch Ophthalmol. 1979; 97(3):480-3. DOI: 10.1001/archopht.1979.01020010230008. View

17.

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

18.

Pastor J, Rojas J, Pastor-Idoate S, Di Lauro S, Gonzalez-Buendia L, Delgado-Tirado S . Proliferative vitreoretinopathy: A new concept of disease pathogenesis and practical consequences. Prog Retin Eye Res. 2015; 51:125-55. DOI: 10.1016/j.preteyeres.2015.07.005. 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