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Is extreme surgery so extreme?
  1. D Wong
  1. St Paul’s Eye Unit, Royal Liverpool University Hospital, Liverpool L7 8XP, UK; david.wong@medix-uk.com

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    The jury is out

    A t first sight, using retinectomy for treating glaucoma seemed extreme, even when most of the eyes treated were legally blind. More than 20 years ago, Robert Machemer described performing retinotomy to relieve traction in two patients with retinal detachment complicated by proliferative vitreoretinopathy (PVR).1 At the time retinotomy was considered extreme and surgically the last resort. Several years elapsed before small case series began to appear in literature.2–5 By the time that the Silicone Oil Studies Report 5 was published in 1993, retinotomy was firmly established.6 The surprise was not only that gas and oil were equally effective, but that nearly one third of all patients …

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