Relaxing retinotomies and retinectomies in the management of retinal detachment with severe proliferative vitreoretinopathy (PVR)

Figures & data

Table 1 Baseline patients and ocular characteristics (n = 38)

Mean age, SD (range), years 56.6 ± 13.5 (58)

Sex, number (%)

Male 20 (52.6)

Female 18 (47.4)

Best-corrected visual acuity, number (%)

Hand motions 3 (8)

Light perception 35 (92)

Lens status, number (%)

Phakic 20 (52.6)

Aphakic 3 (8)

Pseudophakic 15 (39.4)

RD, quadrants, number (%)

≤three quadrants 5 (13.2)

Four quadrants 33 (86.8)

Retinal breaks, number (%)

One 10 (26.3)

≥two 24 (63.2)

Missing 4 (10.5)

PVR classification (grade C), number (%)

Anterior (CA≥12, type 4 and 5) 26 (68.4)

Posterior (CP 6–12, type 1 and 2 ± type 3) 18 (47)

Missing 4 (10.5)

Prior operations, number (%)

Scleral buckling (SB) 10 (26.3)

Vitrectomy + SB 13 (34.2)

Cataract extraction 18 (47.4)

Mean (SD) 1.42 (1.32)

Abbreviation: SD, standard deviation.

Table 2 Intraoperative data (n = 38)

Procedures in addition to vitrectomy, number (%)

Scleral buckling procedure 15 (39.5)

Scleral buckle revision 5 (13.2)

Lensectomy 20 (52.6)

Relaxing retinotomy (RR), number (%) 38 (100)

Anterior to or on the scleral buckle 16 (42)

Posterior to the scleral buckle 22 (58)

RR size, mean (SD, range) 241° (±62.8, 240)

≥180° 28 (73.7%)

<180° 10 (26.3%)

Retinectomy, number (%) 2 (5.2%)

Intraocular tamponade, number (%)

Sulfur hexafluoride 3 (7.9)

Perfluoropropane 10 (26.3)

Silicone oil 25 (65.8)

Intraoperative complications, number (%)

Iatrogenic retinal breaks 9 (23.7)

Intraoperative hemorrhage 10 (26.3)

Abbreviation: SD, standard deviation.

Table 3 Anatomical and functional outcome in relation to the extent of relaxing retinotomy

		RR ≥ 180° n = 28	RR < 180° n = 10	Total	Chi-square
					X^2	P-value
PVR	Anterior PVR (CA≥12) n = 26	26 (92.85)	0 (0)	26 (68.42)	32.98	<0.001*
	Other PVR n = 12	2 (7.14)	10 (100)	12 (31.57)
RRD	RRD	5 (17.85)	2 (20)	7 (18.42)	0.022	0.882
	No RRD	23 (82.14)	8 (80)	31 (81.57)
BCVA	Improved BCVA	17 (73.91)	6 (26.08)	23 (100)	0.002	0.968
	Not improved BCVA	11 (78.94)	4 (21.05)	15 (100)
Iatrogenic retinal breaks	Iatrogenic retinal breaks	7 (25)	2 (20)	9 (23.7)	0.013	0.9092
	No iatrogenic retinal breaks	21 (75)	8 (80)	29 (76.3)
Intraoperative hemorrhage	Intraoperative hemorrhage	8 (28.57)	2 (20)	10 (26.3)	0.012	0.912
	No intraoperative hemorrhage	20 (71.42)	8 (80)	28 (73.7)

Abbreviations: PVR, proliferative vitreoretinopathy; CA, anterior grade C proliferative vitreoretinopathy; RRD, recurrent retinal detachment; BCVA, best corrected visual acuity; RR, relaxing retinotomy.

Table 5 Anatomical and functional outcomes in relation to the type of intraocular tamponade

		Siliconized eyes n = 25	Gas-filled eyes n = 13	Total	Chi-square
					X^2	P-value
RRD	RRD (n = 7)	3 (11.53)(12)	4 (33.33)(30.76)	7 (18.42)	0.950	0.3296
	No RRD (n = 31)	22 (88.46)(88)	9 (66.66)(69.23)	31 (81.57)
IOP	Hypotony (n = 5)	4 (16)	1 (7.69)	5 (13)	0.045	0.8314
	Normal IOP (n = 33)	21 (84)	12 (92.31)	33 (87)

Abbreviations: RRD, recurrent retinal detachment; IOP, intraocular pressure.

Table 4 Anatomic and visual outcomes at six months (n = 38)

Retinal attachment, number (%) 29 (76.3)

Postoperative BCVA, number (%)

Improved 23 (60.5)

Stable 7 (18.5)

Worse 8 (21.5)

Postoperative complications, number (%)

Recurrent retinal detachment 7 (18.42)

Hypotony 5 (13)

Epimacular membranes 3 (8)

Abbreviation: BCVA, best corrected visual acuity.