Author: Piergiacomo Grassi (United Kingdom)
Co-authors: Stephen Winder, Yashin Ramkissoon, Kurt Spiteri-Cornish, Raquel Garcia-Cabrera, Siddharth Subramani, Anand Chawla
Purpose
To report anatomical and functional outcomes of non-primary retinectomy for rhegmatogenous retinal detachment (RRD) with grade C proliferative vitreoretinopathy (PVR-C), and to assess the structural and functional macular changes in eyes with anatomical success.
Setting/Venue
Vitreoretinal Service, Ophthalmology Department, the Royal Hallamshire Hospital, Sheffield, United Kingdom.
Methods
Retrospective single-centre cohort study: one hundred-one consecutive retinectomies of 101 previously vitrectomized eyes (101 patients) affected by RRD with PVR-C between January 2014 and February 2020 were included. The mean postoperative follow-up was 36.18±19.53 months (12-75 months).
Results
Mean preoperative best corrected visual acuity (BCVA) was 1.48 ± 0.71 logMAR. Anatomical success rate was 78.2% after one retinectomy and 83.1% after two retinectomies. Final BCVA ≥ 20/200 was achieved in 29% of cases, 8% gained ≥ 20/80. Final mean postoperative BCVA of successes with oil in situ was 1.68 ± 0.59 compared with 1.07 ± 0.63 logMAR of successes after oil removal (p=0.00005). Post-operative macular Optical Coherence Tomography (OCT) was obtained from 60/84 successes (71%). Normal macular profile was found in 3%, while majority demonstrated exudative maculopathy (51.5%), macular atrophy (22%), tractional maculopathy (21.5%), macular disciform scar (2%). Bivariate linear relationship between final central foveal thickness (CFT) and BCVA was statistically significant (p=0.000013).
Conlusions
Satisfactory anatomical and functional outcome is possible following retinectomy for PVR-C. Positive prognostic factors include removal of oil without re-detachment, normal macular status and lower CFT. Normal macular profile was rarely found (3% of cases), while majority demonstrated exudative maculopathy, macular atrophy, tractional maculopathy. Functional outcome was influenced by macular changes, as final BCVA and CFT correlated.
Financial Disclosure
Financial Disclosures: The authors have no proprietary or commercial interest in any material discussed in this article.
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