Outcomes of 25-Gauge Vitrectomy With Relaxing Retinectomy for Retinal Detachment Secondary to Proliferative Vitreoretinopathy

Abstract

The aim of this study is to evaluate visual and anatomic outcomes of 25-gauge vitrectomy with relaxing retinectomies for complex retinal detachment (RD) secondary to proliferative vitreoretinopathy (PVR). A single-center, retrospective case series of 44 patients who had undergone a 25-gauge vitrectomy with a relaxing retinectomy for the treatment of combined RD and PVR was performed. Pre-operative characteristics, intraoperative techniques, and outcomes were analyzed. The rates of attachment, complications, and visual acuity were analyzed. Institutional Review Board/Ethics Committee approval was obtained and the described research adhered to the tenets of the Declaration of Helsinki. At the final follow-up, 27 eyes (61%) had attachment after one surgery, 41 eyes (93%) ultimately had attached retinas, 3 eyes (7%) had hypotony, 3 eyes had become phthisical (7%), and 24 eyes (56%) had improved visual acuity. After stratifying by visual outcomes, 20/400 or better BCVA was not associated with age (p=0.66), RD etiology (p=0.61), pre-operative hypotony (p=0.60), nor size of retinectomy (p=0.48). Patients achieving 20/400 vision or better were statistically more likely to be pseudophakic (p=0.024) and have silicone oil removal (p<0.0001). The use of 25-gauge vitrectomy and relaxing retinectomy provides a high rate of reattachment and improved visual acuity.