Skip to main content
PMC home page
The British Journal of Ophthalmology logoLink to The British Journal of Ophthalmology
. 1993 Apr;77(4):199–203. doi: 10.1136/bjo.77.4.199

Pars plana vitrectomy for the treatment of rhegmatogenous retinal detachment uncomplicated by advanced proliferative vitreoretinopathy.

D S Gartry 1, A H Chignell 1, W A Franks 1, D Wong 1
PMCID: PMC504480  PMID: 8494853

Abstract

A consecutive series of 114 eyes (112 patients) undergoing pars plana vitrectomy for rhegmatogenous retinal detachment not complicated by severe proliferative vitreoretinopathy is presented (follow up 1 to 4 years; mean 19 months). The indications for vitrectomy fell into two main groups: (1) where the retinal view was poor and vitrectomy was required to clear media opacities to allow identification of retinal breaks (n = 62); and (2) where technically difficult breaks existed and vitrectomy with internal tamponade was used to relieve vitreoretinal traction and facilitate retinal break closure (n = 44). In some of these cases the need for scleral buckling was eliminated. A smaller third group (n = 8) existed where the position of the break(s) was uncertain in the presence of an adequate view. The success rate with one procedure was 74% and with further surgery retinal reattachment was achieved in 92%. At 6 months after further surgery, beyond which interval no new failures were encountered, best corrected visual acuity was improved in 92 eyes (81%), unchanged in 14(12%), and worse in eight (7%). We conclude that pars plana vitrectomy is an effective method for treatment of selected cases of rhegmatogenous retinal detachment not complicated by proliferative vitreoretinopathy.

Full text

PDF
202

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Billington B. M., Chignell A. H. Treatment of rhegmatogenous retinal detachment uncomplicated by massive periretinal proliferation by pars plana vitrectomy. Trans Ophthalmol Soc U K. 1985;104(Pt 2):120–122. [PubMed] [Google Scholar]
  2. Billington B. M., Leaver P. K. Vitrectomy and fluid/silicone-oil exchange for giant retinal tears: results at 18 months. Graefes Arch Clin Exp Ophthalmol. 1986;224(1):7–10. doi: 10.1007/BF02144123. [DOI] [PubMed] [Google Scholar]
  3. Campochiaro P. A., Glaser B. M. Platelet-derived growth factor is chemotactic for human retinal pigment epithelial cells. Arch Ophthalmol. 1985 Apr;103(4):576–579. doi: 10.1001/archopht.1985.01050040118034. [DOI] [PubMed] [Google Scholar]
  4. Campochiaro P. A., Jerdan J. A., Glaser B. M. Serum contains chemoattractants for human retinal pigment epithelial cells. Arch Ophthalmol. 1984 Dec;102(12):1830–1833. doi: 10.1001/archopht.1984.01040031488029. [DOI] [PubMed] [Google Scholar]
  5. Chignell A. H., Fison L. G., Davies E. W., Hartley R. E., Gundry M. F. Failure in retinal detachment surgery. Br J Ophthalmol. 1973 Aug;57(8):525–530. doi: 10.1136/bjo.57.8.525. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Cousins S., Boniuk I., Okun E., Johnston G. P., Arribas N. P., Escoffery R. F., Burgess D. B., Grand M. G., Olk R. J., Schoch L. H. Pseudophakic retinal detachments in the presence of various IOL types. Ophthalmology. 1986 Sep;93(9):1198–1208. doi: 10.1016/s0161-6420(86)33596-6. [DOI] [PubMed] [Google Scholar]
  7. Escoffery R. F., Olk R. J., Grand M. G., Boniuk I. Vitrectomy without scleral buckling for primary rhegmatogenous retinal detachment. Am J Ophthalmol. 1985 Mar 15;99(3):275–281. doi: 10.1016/0002-9394(85)90356-3. [DOI] [PubMed] [Google Scholar]
  8. Fison P. N., Chignell A. H. Diplopia after retinal detachment surgery. Br J Ophthalmol. 1987 Jul;71(7):521–525. doi: 10.1136/bjo.71.7.521. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Gilbert C., McLeod D. D-ACE surgical sequence for selected bullous retinal detachments. Br J Ophthalmol. 1985 Oct;69(10):733–736. doi: 10.1136/bjo.69.10.733. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Goel R., Crewdson J., Chignell A. H. Astigmatism following retinal detachment surgery. Br J Ophthalmol. 1983 May;67(5):327–329. doi: 10.1136/bjo.67.5.327. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Gonvers M., Machemer R. A new approach to treating retinal detachment with macular hole. Am J Ophthalmol. 1982 Oct;94(4):468–472. doi: 10.1016/0002-9394(82)90240-9. [DOI] [PubMed] [Google Scholar]
  12. Lean J. S., Leaver P. K., Cooling R. J., McLeod D. Management of complex retinal detachments by vitrectomy and fluid/silicone exchange. Trans Ophthalmol Soc U K. 1982 Apr;102(Pt 1):203–205. [PubMed] [Google Scholar]
  13. Lincoff H., Gieser R. Finding the retinal hole. Arch Ophthalmol. 1971 May;85(5):565–569. doi: 10.1001/archopht.1971.00990050567007. [DOI] [PubMed] [Google Scholar]
  14. Machemer R., Aaberg T. M., Freeman H. M., Irvine A. R., Lean J. S., Michels R. M. An updated classification of retinal detachment with proliferative vitreoretinopathy. Am J Ophthalmol. 1991 Aug 15;112(2):159–165. doi: 10.1016/s0002-9394(14)76695-4. [DOI] [PubMed] [Google Scholar]
  15. Machemer R. Massive periretinal proliferation: a logical approach to therapy. Trans Am Ophthalmol Soc. 1977;75:556–586. [PMC free article] [PubMed] [Google Scholar]
  16. McHugh D., Wong D., Chignell A., Leaver P., Cooling R. Pseudophakic retinal detachment. Graefes Arch Clin Exp Ophthalmol. 1991;229(6):521–525. doi: 10.1007/BF00203314. [DOI] [PubMed] [Google Scholar]
  17. Mets M. B., Wendell M. E., Gieser R. G. Ocular deviation after retinal detachment surgery. Am J Ophthalmol. 1985 Jun 15;99(6):667–672. doi: 10.1016/s0002-9394(14)76033-7. [DOI] [PubMed] [Google Scholar]
  18. Rosen P. H., Wong H. C., McLeod D. Indentation microsurgery: internal searching for retinal breaks. Eye (Lond) 1989;3(Pt 3):277–281. doi: 10.1038/eye.1989.38. [DOI] [PubMed] [Google Scholar]
  19. Rubin M. L. The induction of refractive errors by retinal detachment surgery. Trans Am Ophthalmol Soc. 1975;73:452–490. [PMC free article] [PubMed] [Google Scholar]
  20. Stanford M. R., Chignell A. H. Surgical treatment of superior bullous rhegmatogenous retinal detachments. Br J Ophthalmol. 1985 Oct;69(10):729–732. doi: 10.1136/bjo.69.10.729. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Sternberg P., Jr, Machemer R. Results of conventional vitreous surgery for proliferative vitreoretinopathy. Am J Ophthalmol. 1985 Jul 15;100(1):141–146. doi: 10.1016/s0002-9394(14)74996-7. [DOI] [PubMed] [Google Scholar]
  22. Wong D., Billington B. M., Chignell A. H. Pars plana vitrectomy for retinal detachment with unseen retinal holes. Graefes Arch Clin Exp Ophthalmol. 1987;225(4):269–271. doi: 10.1007/BF02150146. [DOI] [PubMed] [Google Scholar]
  23. Wong D., Chignell A. H., Inglesby D. V., Little B. C., Franks W. The treatment of bullous rhegmatogenous retinal detachment. Graefes Arch Clin Exp Ophthalmol. 1992;230(3):218–220. doi: 10.1007/BF00176291. [DOI] [PubMed] [Google Scholar]
  24. de Bustros S., Thompson J. T., Michels R. G., Enger C., Rice T. A., Glaser B. M. Nuclear sclerosis after vitrectomy for idiopathic epiretinal membranes. Am J Ophthalmol. 1988 Feb 15;105(2):160–164. doi: 10.1016/0002-9394(88)90180-8. [DOI] [PubMed] [Google Scholar]

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Publishing Group

RESOURCES