Frank Becquet Nantes, France


Increases in aqueous flare intensity indicate the breakdown of the ocular blood-aqueous barrier. This condition could partly influence proliferative vitreoretinopathy (PVR) development in rhegmatogenous retinal detachment (RD) because increased proteinaceous flare in the intraocular fluids is probably a stimulus to further cellular proliferation. Thus, changes in aqueous protein concentration in RD at different PVR grades were investigated.


A prospective study of 241 patients presenting unilateral RD (PVR stage 0 to C) was performed. Laser cell-flare meter (LFM) analysis have been realised for each patient the day before, 2 days after and then 30 days after surgical treatment. Surgical treatment consisted in scleral buckling with cryotherapy with/without gas tamponade or vitrectomy. Statistical analyses were made to characterize flare status of each PVR stage. Uni-and multidimensional analyses were used to calculate the one month prognosis (recurrence or not) value of 10 clinical and LFM variables.


The aqueous flare increases significantly with the PVR stages (stage 0: 5 photons/msec to stage C3: 91 photons/msec preoperatively). Multidimensional analyses demonstrated that the following variables to have an independent unfavourable prognosis value were: RD extension, number of cryoapplication, break’ size, important aqueous flare. Statistical analyses also allow giving a specific discriminant value to RD extension and to preoperative important aqueous flare. This enables to enhance the PVR classification.


LFM exam of the anterior chamber has a better predictive value than PVR classification. This clinical classification would be ameliorated, in term of prognosis, with the regular use of the LFM exam. This would lead to a more personalised preoperative medical care and surgical strategy.