360-degree retinectomy for severe ocular rupture.

OBJECTIVE: To investigate the effect of 360-degree retinectomy for severe ocular rupture and evaluate the related factors associated with prognosis.

METHODS: A retrospective analysis was performed on 28 consecutive patients, 18 men and 10 women, with severe ocular rupture admitted to the Chinese PLA General Hospital between January 1999 and January 2002. The patients' ages ranged from 16 to 58 years, mean 29.5 years. All operations were performed by the first author. All patients underwent standard 3-port pars plana vitrectomy with scleral encircling buckle, endophotocoagulation, and tamponaded with silicone oil. Lensectomy were performed on 15 eyes. 360-degree retinotomy and retinectomy were performed at anterior equator on 16 eyes, and posterior equator on 12 eyes.

RESULTS: During operation, all patients were confirmed to have vitreous hemorrhage and retinal detachment, in which hemorrhagic ciliary body detachment was found in 9 eyes, suprachoroidal hemorrhage in 12 eyes, retinal twisting like flower stalk in 11 eyes, and retinal incarceration in 17 eyes. Postoperative follow-up was conducted in 26 cases, ranged from 6 months to 46 months. Retinal reattachment achieved in 20 eyes (76.9%), in which three patients' retina was reattached after revitrectomy. The silicone oil was removed at the fourth month in 8 eyes postoperatively. Corrected visual acuity of 0.02 or more was in 14 eyes (70.0%) among the 20 patients with reattached retina. Visual acuity of 0.05 or more was in 7 eyes (35.0å), and 0.1 or more was in 3 eyes. The best visual acuity was 0.3 in 1 eye.

CONCLUSIONS: Retinectomy may improve the prognosis of severe ocular rupture and save the visual function of some patients.