Encircling band, laser retinopexy and lens removal as standard procedure in complicated retinal detachment shows a good clinical outcome

Acta Ophthalmol. 2011 Nov;89(7):629-33. doi: 10.1111/j.1755-3768.2009.01763.x. Epub 2010 Feb 12.

Abstract

Purpose: To evaluate vitrectomy in conjunction with the use of perfluorocarbon, cerclage, laser retinopexy, lens removal and silicone oil as surgical treatment of proliferative vitreoretinopathy associated with retinal detachment.

Methods: Sixty-two eyes of 62 patients were treated for complicated retinal detachment following failed prior scleral buckling. Outcome measures were; retinal reattachment rate 6 months after silicone oil removal, status of the retina, visual acuity (VA), duration of silicone tamponade and frequency of reoperations.

Results: The final reattachment rate was 95%. Reoperations had to be performed in 25% of patients. Eighty-one per cent of these patients received one and 19% two or more operations following silicone oil implantation. The mean time to reoperation was 1.8 ± 1.4 months. Silicone oil was removed after 5.6 ± 4.1 months following the last vitreoretinal procedure in 90%, respectively, 95% with attached retina. Five per cent experienced retinal detachment after silicone oil removal. At the end of follow-up, the mean VA was 0.13 ± 0.26 Snellen. Seventy per cent of patients achieved a vision of 20/200 or better (mean 0.25 ± 0.27).

Conclusion: Our study demonstrates good final outcomes when a rigorous surgical approach was used. Furthermore, this standard procedure reduces the need for reoperations and consequently improves the functional outcome.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Endotamponade
  • Female
  • Follow-Up Studies
  • Humans
  • Laser Therapy*
  • Lens, Crystalline / surgery*
  • Male
  • Middle Aged
  • Retinal Detachment / complications
  • Retinal Detachment / physiopathology
  • Retinal Detachment / surgery*
  • Retrospective Studies
  • Scleral Buckling*
  • Silicone Oils / administration & dosage
  • Treatment Outcome
  • Visual Acuity / physiology
  • Vitrectomy*
  • Vitreoretinopathy, Proliferative / complications
  • Vitreoretinopathy, Proliferative / physiopathology
  • Vitreoretinopathy, Proliferative / surgery*

Substances

  • Silicone Oils