LONG-TERM RESULTS OF TOTAL RETINECTOMY IN CASES WITH ADVANCED PROLIFERATIVE VITREORETINOPATHY.

PURPOSE: To evaluate the long-term results of total retinectomy in patients with rhegmatogenous retinal detachment and severe proliferative vitreoretinopathy.

METHODS: Seven eyes of 7 patients had pars plana vitrectomy, with or without pars plana lensectomy, and total retinectomy, with or without silicone oil tamponade, for the management of rhegmatogenous retinal detachment and proliferative vitreoretinopathy (Grade D1-3) after previous complex vitreoretinal surgery procedures. Visual acuity, intraocular pressure, details of previous operations, and development of complications were evaluated retrospectively.

RESULTS: Five eyes had a history of penetrating eye trauma, one had persistent fetal vasculature, and one had Coats disease. Patients were all male, with a mean age of 15 ± 11 years (range, 2-31). The mean follow-up was 49.7 ± 50.2 months (range, 12-132). In 3 eyes (42%), enucleation and evisceration were avoided over a mean 100 ± 30.2 month follow-up. All 7 eyes had corneal opacity and band keratopathy after a mean 4.4 ± 3.2 months. Four eyes had phthisis bulbi after a mean 7 ± 4.2 months. No patients developed rubeosis iridis related to the total retinectomy.

CONCLUSION: Total retinectomy may be a last option to preserve the eyeball in cases with massive fibrosis and rhegmatogenous retinal detachment, despite previous complex surgical treatments.