PERIPHERAL 360° RETINECTOMY IN COMPLEX RETINAL DETACHMENT

Abstract

In Brief Purpose: To report the functional and anatomical results and complications of 360° peripheral retinectomy for management of complicated retinal detachment. Methods: Patients with complicated retinal detachment underwent pars plana vitrectomy, 360° retinectomy, intraoperative endolaser, and internal tamponade with silicone oil. Postoperative visual acuity, intraocular pressure, retinal status, need for reoperation, and complications are presented. Results: Twenty eyes of 19 patients with a mean age of 32.4 years (8–75 years) underwent pars plana vitrectomy and 360° peripheral retinectomy for complicated retinal detachment due to anterior proliferative vitreoretinopathy, unstable edge of retinal break, anterior hyaloidal fibrovascular proliferation, retinal incarceration in scleral wound, and 300° giant retinal tear. Intraoperative reattachment was achieved in 18 eyes. Mean postoperative follow-up time was 24.2 months (2–70 months). Retina was attached in 14 eyes (70%) in the last visit. Eight eyes (40%) had 5/200 or greater visual acuity. Preoperative and postoperative visual acuities did not have significant correlation (Spearman correlation coefficient = 0.291). There was no relation between diagnosis and anatomical outcome (P > 0.2). Conclusion: Relaxing peripheral 360° retinectomy is an effective procedure for flattening the retina in complicated retinal detachments when no other option is available. Peripheral 360-degree retinectomy was done in 20 eyes with complicated retinal detachments. Ambulatory vision and retinal reattachment were achieved in 40% and 70% of cases, respectively. Keratopathy (50%), hypotony (40%), and macular pucker (30%) were the most common complications. This technique, although not ideal, may save vision in desperate cases.