Results of different strategies to manage complicated retinal re-detachment
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RETINAL DISORDERS
Results of different strategies to manage complicated retinal re-detachment Spyridon Dimopoulos 1 & Antony William 2 & Bogomil Voykov 1 & Karl Ulrich Bartz-Schmidt 1 & Focke Ziemssen 1 & Martin Alexander Leitritz 1,3 Received: 27 April 2020 / Revised: 29 August 2020 / Accepted: 5 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Complicated retinal re-detachment with inferior proliferative vitreoretinopathy (PVR) remains a challenge. This study’s aim was to compare vitrectomy with conventional silicon oil (CSO) combined with an encircling band (EB) and vitrectomy with heavy silicon oil (HSO) alone to treat retinal re-detachment through inferior PVR, where standard procedures have already failed. Methods A retrospective analysis was done on patients with inferior complex re-detachment with secondary PVR after primary surgery, who received pars plana vitrectomy (PPV) with CSO combined with EB (group 1) or PPV alone with HSO (group 2) between December 2006 and August 2017. The primary endpoint was retinal reattachment, and the secondary endpoint was visual acuity (VA) change and complications in both groups. Results This study included 119 eyes. Total single surgery anatomical success (SSAS) was 64%, with 80% (52/65) achieved in group 1 and 44.5% (24/54) in group 2 (p < 0.0001). The total final anatomical success (FAS) rate was 79% (94/119). In group 1, FAS was 91% (59/65) compared with 65% (35/54) in group 2 (p = 0.003). The pretreatment VA of group 1 had a median of 1.4 logMAR (95% CI 0.3–1.8), and group 2 showed a median of 1.4 logMAR (95% CI 0.2–1.8). The post-treatment decrease in group 1 was a median equal to − 0.6 versus − 0.1 for group 2 (p = 0.0001). Serious complications were similar in both groups. Conclusion For complicated retinal re-detachment through inferior PVR, the combination of PPV with EB may lead to better anatomical (SSAS, FAS) and functional success compared with PPV alone with HSO. Keywords Retinal detachment . Silicone oil . Encircling band . Proliferative vitreoretinopathy
Introduction
* Spyridon Dimopoulos [email protected] 1
Centre for Ophthalmology, University Eye Hospital, Eberhard-Karls University of Tuebingen, Elfriede-Aulhorn-Str 7, 72076 Tübingen, Germany
2
Schwarzwaldaugenklinik, Schramberg, Germany
3
Section for Experimental Ophthalmic Surgery and Refractive Surgery, Centre for Ophthalmology, University Eye Hospital, Tuebingen, Germany
Although vitreoretinal surgical techniques have improved in recent years, the rate of proliferative vitreoretinopathy (PVR) has not particularly decreased. Re-detachment through PVR remains the most serious complication after the successful treatment of a retinal detachment (RD) [1, 2]. At the end of a vitrectomy procedure, it is impossible to fill the vitreous cavity completely with gas or conventional silicone oil (CSO) (oil has a lighter-than-water density). This leads to a concentration of PVR-stimulating factors in the aqueous subsilicone compartment, c
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