Abstract
AbstractThe goal of surgery for PVR is to reattach the retina by identifying all retinal breaks and relieving all significant vitreoretinal traction. Vitrectomy ,membrane peeling and gas or silicone oil tamponade are required in most cases. Firstly, a meticulous pars plana vitrectomy and shaving of the vitreous base is performed. This is followed by a 360‐degree, scleral‐depressed peripheral retinal examination using a wide‐field viewing system to identify and then diathermize all the retinal breaks. The important goal of PVR surgery is complete membrane peeling to relieve all tangential retinal traction, thus allowing the retina to conform to the RPE/choroid. ILM peeling at the macula is also part of the treatment to prevent pucker formation or redetachment of the macula. In cases where there is persistent traction despite complete membrane peeling a sufficiently large relaxing retinotomy must be performed to relieve the persistant retinal traction. The retina is then temporarily flattened under air ,or perfluorocabon. Next, all of the retinal breaks and edges of any retinotomies are treated confluently with laser. The intraocular gas or silicone oil are typically used to provide extended long term endoretinal tamponade.
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