rss
Br J Ophthalmol 2009;93:1228-1233 doi:10.1136/bjo.2008.140988
  • Original Article
  • Clinical science

Retinotomy and silicone oil for detachments complicated by anterior inferior proliferative vitreoretinopathy

  1. I Tsui1,
  2. H D Schubert2
  1. 1
    Jules Stein Eye Institute, University of California, Los Angeles, California, USA
  2. 2
    Edward S Harkness Eye Institute, Columbia University, New York, USA
  1. Correspondence to Dr I Tsui, Jules Stein Eye Institute, University of California, Los Angeles, 100 Stein Plaza, Los Angeles, CA 90095, USA; itsui{at}jsei.ucla.edu
  • Accepted 24 April 2009
  • Published Online First 7 May 2009

Abstract

Aim: To describe a subset of patients with recurrent retinal detachments caused by anterior intraretinal and subretinal proliferative vitreoretinopathy (PVR), which required greater than 180° retinotomy and silicone oil tamponade.

Methods: Interventional case series. Forty-one patients underwent >180° retinotomy, anterior retinectomy, removal of subretinal membranes, laser to the retinotomy edge and silicone oil tamponade. Risk factors for detachment, prior surgical history and PVR location were examined. Main outcomes included change in visual acuity, recurrent detachment and postoperative complications.

Results: Cataract extraction (49%), high myopia (29%) and lattice degeneration (27%) were preoperative risk factors. The average number of prior procedures for retinal attachment was 2.3 (SD 0.9). The majority of detachments were inferior and related to anterior intraretinal and subretinal PVR. Twenty-four patients (59%) saw 20/200 or better. Eleven patients (27%) had poor vision (<20/400) at the end of follow-up. Thirty-seven retinas (90%) remained attached. Increased rates of postoperative corneal decompensation (p<0.0001) and silicone oil in the anterior chamber (p<0.0001) were statistically significant markers of poor visual outcome.

Conclusions: Patients with complex PVR requiring a large retinotomy often had similar presurgical conditions. A large inferior retinotomy effectively addressed proliferations where they most frequently occur, and silicone oil was beneficial.

Footnotes

  • Competing interests None.

  • Provenance and Peer review Not commissioned; externally peer reviewed.

  • Ethics approval Ethics approval was provided by Institutional Review Board of Columbia University (IRB-AAAC1164).

Relevant Article

  • At a glance:At a glance Br J Ophthalmol 2009;93:idoi:10.1136/bjo.2009.169433

This Article

  1. Abstract
  2. Full text
  3. PDF
  4. All versions of this article:
    1. bjo.2008.140988v1
    2. 93/9/1228 most recent

Responses

  1. Submit a response
  2. No responses published

Register for free content

The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.