Vitreoschisis and retinal detachment: New insight in proliferative vitreoretinopathy. Issue 5 (September 2022)

• Record Type: Journal Article
• Authors: Rizzo, Stanislao; de Angelis, Lorenzo; Barca, Francesco; Bacherini, Daniela; Vannozzi, Lorenzo; Giansanti, Fabrizio; Faraldi, Francesco; Caporossi, Tomaso
• Is Part Of: European journal of ophthalmology. Volume 32:Issue 5(2022)
• Page Start: 2833
• Page End: 2839
• Publication Date: 2022-09
• Subjects: Retinal detachment -- vitreoschisis -- vitreous cortex remnants -- proliferative vitreoretinopathy; Ophthalmology -- Periodicals; Eye -- Diseases -- Periodicals; 617.7005
• DOI: 10.1177/11206721211057672
• Languages: English
• ISSNs: 1120-6721

Abstract

Purpose: To assess the occurrence of peripheral vitreoschisis-induced vitreous cortex remnants (p-VCRs) in primary rhegmatogenous retinal detachment (RD) and investigate whether the presence of p-VCRs results in a greater risk of RD recurrence, secondary to Proliferative Vitreoretinopathy (PVR) development after pars plana vitrectomy (PPV). Methods: Patients who underwent PPV for primary rhegmatogenous RD between January 2016 and December 2018 were included. The presence of residual p-VCRs was confirmed intraoperatively using triamcinolone acetonide (TA). Patients with p-VCRs were divided into two groups: Group A comprised of patients who underwent PPV without p-VCR removal, while Group B included patients who underwent PPV with p-VCR removal. Results: Four hundred-thirteen eyes with evidence of p-VCR were analyzed. Two-hundred-twenty-three eyes underwent PPV without VCR removal (Group A), while 190 eyes underwent PPV with p-VCR removal (Group B). Primary anatomical success was 91.5% in the Group A and 95.4% in the group B. Retinal re-detachment due to PVR occurred in 17 (7.6%) eyes in Group A and in four (2.1%) eyes in Group B within the first 3 months (p = 0.01). Among group A, in 11 eyes, there was a diffuse posterior PVR grade C, while six eyes were focal PVR grade C. In Group B, we observed four retinal re-detachment due to focal PVR grade C. Conclusion: The presence of p-VCRs seems to be associated with a higher incidence of PVR development and might also result in more complex RD recurrence, this suggests the need for more aggressive VCRs removal during the first surgery.