Thomas Beuste1, Olivier Rebollo2, Eric Parrat3, SÉbastien Guigou4, Pierre-Yves Mérité4, Franck Meyer4, HervÉ Rouhette5, Umberto Lorenzi6, Vincent Soler7,8,9, Anne-Laure Le Piffer10, FrÉdÉric Matonti11,12, Eric Denion1,13. 1. Department of Ophthalmology, CHU de Caen, Cote de Nacre, Caen, France. 2. Centre d'ophtalmologie du Lez, Montferrier sur Lez, France. 3. Centre Ophtalmologique-Jarry, Baie-Mahault, France. 4. AixVision-MGM, Aix en Provence, France. 5. Department of Ophthalmology, Centre ophtalmologique de Mougins, Mougins, France. 6. Department of Ophthalmology, CHU Pointe-à-Pitre Abymes, Guadeloupe, France. 7. Hôpital Pierre-Paul Riquet, CHU Toulouse, Toulouse Cedex, France. 8. Université Toulouse III-Paul Sabatier, Faculté de Médecine Toulouse-Rangueil, Toulouse Cedex, France. 9. INSERM-Université Paul Sabatier U1056-UDEAR, CHU Toulouse, Toulouse, France. 10. Department of Ophthalmology, CH La Rochelle, La Rochelle, France. 11. AP-HM, Hopital Nord, Marseille, France. 12. Institut de Neurosciences de la Timone, Marseille, France; and. 13. Centre Ophtalmologique du Pays des Olonnes (COPO), Olonne-sur-Mer, France.
Abstract
PURPOSE: To evaluate the different mechanisms of retinal detachment recurrence after retinectomy for rhegmatogenous retinal detachment (RD) complicated by proliferative vitreoretinopathy (PVR) and to study its outcome and prognosis. METHODS: Retrospective, multicenter study conducted between January 2009 and November 2016. Retrospective review of 56 patients with recurrent RD (RRD) after a first relaxing retinectomy. RESULTS: The secondary retinal attachment rate was 58.9% (33/56 cases). The various mechanisms of RRD were mainly related to PVR (52/56 cases: 93%). This PVR was anterior in 10 cases (21%), posterior in 31 cases (60%), and combined anterior and posterior in 11 cases (21%). The RRD mechanism was not PVR in 4 of the 56 cases. Some of the RRD mechanisms were specific to retinectomy: fibrosis of the edge of the retinectomy (26 cases: 46.4%), beyond-the-edge proliferation (8 cases: 14.3%), and severe inferior retinal folding (2 cases: 3.6%). In the 2 cases of severe inferior retinal folding, the retina could not be reattached. The anatomical outcome and the mechanism of RRD (anterior PVR, posterior PVR, or combined anterior and posterior PVR) were not correlated (P = 0.12). Visual acuity was significantly better only in patients with complete secondary success, that is, having an attached retina after silicone oil removal: mean preoperative visual acuity was 2.01 logarithm of the minimum angle of resolution versus 1.01 logarithm of the minimum angle of resolution postoperatively (P = 0.019). CONCLUSION: Proliferative vitreoretinopathy caused most of the recurrences, and the anatomical outcome did not depend on the type of PVR involved. Only complete secondary success (attached retina after silicone oil removal) was accompanied by visual acuity improvement.
PURPOSE: To evaluate the different mechanisms of retinal detachment recurrence after retinectomy for rhegmatogenous retinal detachment (RD) complicated by proliferative vitreoretinopathy (PVR) and to study its outcome and prognosis. METHODS: Retrospective, multicenter study conducted between January 2009 and November 2016. Retrospective review of 56 patients with recurrent RD (RRD) after a first relaxing retinectomy. RESULTS: The secondary retinal attachment rate was 58.9% (33/56 cases). The various mechanisms of RRD were mainly related to PVR (52/56 cases: 93%). This PVR was anterior in 10 cases (21%), posterior in 31 cases (60%), and combined anterior and posterior in 11 cases (21%). The RRD mechanism was not PVR in 4 of the 56 cases. Some of the RRD mechanisms were specific to retinectomy: fibrosis of the edge of the retinectomy (26 cases: 46.4%), beyond-the-edge proliferation (8 cases: 14.3%), and severe inferior retinal folding (2 cases: 3.6%). In the 2 cases of severe inferior retinal folding, the retina could not be reattached. The anatomical outcome and the mechanism of RRD (anterior PVR, posterior PVR, or combined anterior and posterior PVR) were not correlated (P = 0.12). Visual acuity was significantly better only in patients with complete secondary success, that is, having an attached retina after silicone oil removal: mean preoperative visual acuity was 2.01 logarithm of the minimum angle of resolution versus 1.01 logarithm of the minimum angle of resolution postoperatively (P = 0.019). CONCLUSION:Proliferative vitreoretinopathy caused most of the recurrences, and the anatomical outcome did not depend on the type of PVR involved. Only complete secondary success (attached retina after silicone oil removal) was accompanied by visual acuity improvement.
Authors: Luca Mautone; Simon Dulz; Christos Skevas; Maximilian Schultheiss; Martin Stephan Spitzer Journal: J Ophthalmol Date: 2022-03-31 Impact factor: 1.909