Anatomical and visual outcome of vitrectomy for giant retinal tear detachment with proliferative vitreoretinopathy: A retrospective, consecutive case series

Main Article Content

Ogugua Ndubuisi Okonkwo Adekunle Olubola Hassan Obinna Onyeaso Toyin Akanbi Rhoda Dein Komolafe

Abstract

Aim: To report the anatomical and visual outcome of giant retinal tear (GRT) associated retinal detachment (RD) with advanced proliferative vitreoretinopathy (PVR) and determine the effect of presenting clinical and surgical variables.


Method: Retrospective, non-comparative, consecutive, interventional case series of vitreoretinal surgeries performed in a private tertiary eye unit. Patient demographics, preoperative, and intra-operative variables were assessed and analyzed.


Inclusion: Eyes which had surgery for previously unoperated GRT RD with PVR and had > 3 months of follow up.


Exclusion: Other primary and secondary forms of RD with no GRT.


Results: Thirty-six eyes of 36 patients were evaluated. Male: female ratio = 5:1. Mean age of 45.53 ± 13.2 years (range 12 - 65 years). Left eye, twenty-three eyes (63.9%). Rate of advanced PVR C and D was 83%, four quadrant (total RD) 55.6%, macula detachment 91.7%, giant tear size was 90 to 180 degree and > 180 degree in 55.6% and 33.3% respectively. Single surgery attachment rate was 41.7% and final attachment after a second surgery was 86.1%. Visual outcome was CF or better in twenty-three eyes (63.9%). Recurrent RD in 58.3% was due to postoperative PVR. Gender, age, laterality, PVR grade, giant tear size, quadrants affected by RD had no impact on anatomical outcome (p> 0.05). Significantly, scleral buckle (SB) use did not reduce rate of recurrent RD and had no significant effect on anatomical outcome (p > 0.05).


Conclusion: GRT RDs have a higher rate of PVR compared to more commonly encountered RRD. When treating GRT RD with advanced PVR, meticulous membrane removal should be accomplished using vital dyes to aid visualization. This will reduce recurrence of postoperative PVR. Pre-, intra- and post-operative factors, including use of a SB did not affect single surgery success. Visual improvement is limited by the occurrence of PVR.

Article Details

How to Cite
OKONKWO, Ogugua Ndubuisi et al. Anatomical and visual outcome of vitrectomy for giant retinal tear detachment with proliferative vitreoretinopathy: A retrospective, consecutive case series. Medical Research Archives, [S.l.], v. 11, n. 3, mar. 2023. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/3666>. Date accessed: 20 apr. 2024. doi: https://doi.org/10.18103/mra.v11i3.3666.
Section
Case Reports

References

1. Shunmugam M, Ang GS, Lois N. Giant retinal tears. Surv Ophthalmol. 2014;59(2):192-216.
2. Hamrick KE, Helgeson MK. Retinal dialysis. Optom Clin. 1992;2(3):93-112.
3. Glaser BM. Treatment of giant retinal tears combined with proliferative vitreoretinopathy. Ophthalmology. 1986;93(9):1193-7.
4. Okonkwo O, Hassan A, Gyasi M, et al. Giant retina tear in an African population: Presentation and fellow eyes. Open J Ophthalmol. 2017;7:129-37.
5. Glaser BM, Carter JB, Kuppermann BD et al. Perfluoro-octane in the treatment of giant retinal tears with proliferative vitreoretinopathy. Ophthalmology. 1991;98(11):1613-21.
6. Placeres Daban J, Artieda García D, Yaluff Portilla S, et al. A novel technique to avoid intraoperative giant tear slippage: the bimanual double aspiration technique. Int J Retina Vitreous. 2021;27;7(1):42.
7. Rodriguez M, Lin J, Townsend JH, et al. Giant retinal tears: clinical features and outcomes of vitreoretinal surgery at a university teaching hospital (2011-2017). Clin Ophthalmol. 2018; 12:2053-2058.
8. Okonkwo ON, Lewis K, Hassan AO, et al. Indications and outcomes of vitrectomy surgery in a series of 1000 black African eyes. BMJ Open Ophthalmol. 2019;4:e000083.
9. Okonkwo ON, Hassan A O, Oderinlo O. Outcome of vitrectomy for advanced proliferative vitreoretinopathy complicating primary rhegmatogenous retinal detachment among Nigerians. Niger J Clin Pract 2020;23:337-42
10. The classification of retinal detachment with proliferative vitreoretinopathy. Ophthalmology. 1983;90:121-5.
11. Gonzalez MA, Flynn HW Jr, Smiddy WE, et al. Surgery for retinal detachment in patients with giant retinal tear: etiologies, management strategies, and outcomes. Ophthalmic Surg Lasers Imaging Retina. 2013;44:232-7.
12. Ong SS, Ahmed I, Gonzales A, et al. Vitrectomy versus Vitrectomy with Scleral Buckling in the Treatment of Giant Retinal Tear Related Retinal Detachments: An International Multicenter Study. Ophthalmol Retina. 2022; S2468-6530(22)00102-6.
13. Taleb EA, Nagpal MP, Mehrotra NS, et al. Giant retinal tear retinal detachment etiologies, surgical outcome, and incidence of recurrent retinal detachment after silicone oil removal. Oman J Ophthalmol. 2020 ;13(3):117-122.
14. Ghasemi Falavarjani K, Alemzadeh SA, Modarres M, et al. Outcome of surgery in patients with giant retinal tear: 10 years experience. Eye (Lond). 2017;31(9):1284-1289.
15. Idrees S, Sridhar J, Kuriyan AE. Proliferative Vitreoretinopathy: A Review. Int Ophthalmol Clin. 2019 ;59(1):221-240.
16. Ambiya V, Rani PK, Narayanan R, et al. Outcomes of Recurrent Retinal Detachment Surgery following Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment. Semin Ophthalmol. 2018;33(5):657-663.
17. Ting DSW, Foo VHX, Tan TE, et al. 25-years Trends and Risk factors related to Surgical Outcomes of Giant Retinal Tear-Rhegmatogenous Retinal Detachments. Sci Rep. 2020;10(1):5474.
18. Hernández F, Alpizar-Alvarez N, Wu L. Chromovitrectomy: an update. J Ophthalmic Vis Res. 2014;9(2):251-9.
19. Papastavrou VT, Chatziralli I, McHugh D. Gas Tamponade for Retinectomy in PVR-Related Retinal Detachments: A Retrospective Study. Ophthalmol Ther. 2017 ;6(1):161-166.
20. Girsang W, Sari DCR, Srigutomo W, et al. Concept and application of relaxing radial retinectomy for retinal detachment with advanced proliferative vitreo-retinopathy. Int J Retina Vitreous. 2020;1;6:46.
21. Israilevich RN, Starr MR, Mahmoudzadeh R, et al. Factors Associated with Good Visual Acuity Outcomes After Retinectomy in Eyes with Proliferative Vitreoretinopathy. Am J Ophthalmol. 2022;S0002-9394(22)00096-4.
22. Hocaoglu M, Karacorlu M, Giray Ersoz M, et al. Retinotomy and retinectomy for anterior inferior proliferative vitreoretinopathy: Can visual outcome be improved? Eur J Ophthalmol. 2021;11206721211012848.
23. Abdullah ME, Moharram HEM, Abdelhalim AS, et al. Evaluation of primary internal limiting membrane peeling in cases with rhegmatogenous retinal detachment. Int J Retina Vitreous. 2020;6:8.
24. Kumar V, Dubey D, Kumawat D, et al. Role of internal limiting membrane peeling in the prevention of epiretinal membrane formation following vitrectomy for retinal detachment: a randomised trial. Br J Ophthalmol. 2020;104(9):1271-1276.
25. Al-Khairi AM, Al-Kahtani E, Kangave D, et al. Prognostic factors associated with outcomes after giant retinal tear management using perfluorocarbon liquids. Eur J Ophthalmol. 2008 ;18(2):270-7.
26. Glaser BM, Carter JB, Kuppermann BD, et al. Perfluoro-octane in the treatment of giant retinal tears with proliferative vitreoretinopathy. Ophthalmology. 1991;98(11):1613-21.
27. Shapiro MJ, Blair MP, Solinski MA, et al. The importance of early diagnosis of Stickler syndrome: Finding opportunities for preventing blindness. Taiwan J Ophthalmol. 2018;8(4):189-195.
28. Qureshi MH, Steel DHW. Retinal detachment following cataract phacoemulsification-a review of the literature. Eye (Lond). 2020;34(4):616-631.
29. McCullagh D, Higham A, Best R. The BElfast Retinal Tear and detachment Score (BERT Score). Eye (Lond). 2021;35(5):1427-1430.
30. Xu D, Uhr J, Patel SN, et al. Sociodemographic Factors Influencing Rhegmatogenous Retinal Detachment Presentation and Outcome. Ophthalmol Retina. 2021;5(4):337-341.
31. Gutierrez M, Rodriguez JL, Zamora-de La Cruz D, Flores Pimentel MA, Jimenez-Corona A, Novak LC, Cano Hidalgo R, Graue F. Pars plana vitrectomy combined with scleral buckle versus pars plana vitrectomy for giant retinal tear. Cochrane Database Syst Rev. 2019;(12):CD012646. DOI: 10.1002/14651858.CD012646.
32. Sung JY, Lee MW, Won YK, et al. Clinical characteristics and prognosis of Total Rhegmatogenous retinal detachment: a matched case-control study. BMC Ophthalmol. 2020;20(1):286.
33. Lee CS, Shaver K, Yun SH, et al. Comparison of the visual outcome between macula-on and macula-off rhegmatogenous retinal detachment based on the duration of macular detachment. BMJ Open Ophthalmol. 2021;6(1):e000615.
34. Greven MA, Leng T, Silva RA, et al. Reductions in final visual acuity occur even within the first 3 days after a macula-off retinal detachment. Br J Ophthalmol. 2019;103(10):1503-1506.
35. Diederen RM, La Heij EC, Kessels AG, et al. Scleral buckling surgery after macula-off retinal detachment: worse visual outcome after more than 6 days. Ophthalmology. 2007;114(4):705-9.