Results of pars plana vitrectomy with inferior retinotomy in inferior rhegmatogenous retinal detachments with inferior retinal breaks and proliferative vitreoretinopathy grades B or C

Author: Ricardo Machado Soares (Portugal)

Co-authors: Joana Da Silva Fernandes, Catarina Cunha Ferreira, Sofia Cunha Teixeira, Filipe Sousa Neves, Paula Sepúlveda, Miguel Bilhoto

Purpose

To report the surgical outcomes of pars plana vitrectomy (PPV) with inferior retinotomy without the need for scleral buckling in primary inferior rhegmatogenous retinal detachment (RRD) with inferior retinal breaks and Proliferative vitreoretinopathy (PVR) grades B or C.

Setting/Venue

Department of Ophthalmology - Centro Hospitalar de Vila Nova de Gaia e Espinho

Methods

A retrospective, consecutive series, single-center study of patients that underwent PPV with inferior retinotomy for primary inferior RRD with inferior retinal breaks (4:00 to 8:00 clock hours) and PVR grades B or C. Data was obtained from patients’ medical records from October 2014 to November 2020. The primary outcomes of the study were retinal reattachment and visual acuity improvement. Data collected before and after surgery was compared between groups using chi-square analysis and paired samples t-test. The resulting p-values significance level was set at p=0.05.

Results

Thirty-two patients (32 eyes) met the inclusion criteria. PVR in stage B was present in 19 patients and stage C in 13 patients. Macula-off RRD was diagnosed in 25 patients while the other 7 patients had RRD with the macula attached. Regarding primary outcomes, 31 out of 32 (97%) patients achieved retinal reattachment with no differences between PVR groups (p=0.406). The best-corrected visual acuity (BCVA) improved significantly in eyes with macula-off RRD at presentation (p<0.001). Although macula-attached RRD eyes had higher final BCVA, its improvement was not statistically significant (p=0.370). Besides one retinal redetachment, no other significant complications were reported after surgery.

Conlusions

Inferior retinal breaks are associated with surgical failure following PPV for inferior RRD repair, especially if advanced PVR is present. Our results suggest that, in these less common and more challenging cases, PPV with an inferior retinotomy is associated with very favorable anatomic and visual outcomes.

Financial Disclosure

None