Illes Kovacs*, Gyorgy Salacz Hungary

Purpose:

To evaluate the effects of relaxing peripheral retinotomy performed during retinal detachment surgery in cases of severe anterior proliferative vitreoretinopathy (PVR).

Method:

Twenty eyes of twenty patients (age av: 56.75 years) of complicated retinal detachment underwent pars plana vitrectomy with relaxing retinotomy (mainly 180 degrees) due to PVR at our Department between Aug. 2001 and Febr. 2003. Mean follow up: 19 weeks (12 week-26 months). In 8 eyes total retinal detachment, in 12 eyes lower partial retinal detachment was observed preoperatively, 15 of them previously underwent pars plana vitrectomy. In 11 eyes anterior PVR was preoperatively diagnosed, in 9 eyes retinal shrinkage at the lower part of the retina was observed during the operation. The operative technique included vitrectomy, retinotomy, intraocular tamponade (gas or silicone oil) and laser treatment.

Results:

The retina reattached in 18 cases, small residual detachment remained in 2 cases. Redetachment occured in 5 eyes, retina was reattached in 4 eyes by second operation. Mean visual acuity improved from 0.04 to 0.1. Intraoperative complication was: intense bleeding from retinotomy (1), main postoperative complications were epimacular proliferation (3), cataract (1), and increased intraocular pressure (2).

Conclusion:

In severe PVR cases relaxing retinotomy is a safe and effective surgical method improving anatomical and functional results of complicated retinal detachment cases.