Medical Research Archives |https://esmed.org/MRA/index.php/mra/article/view/3666 1
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Published: March 31, 2023
Citation: Okonkwo ON, Hassan
AO, et al., 2023. Anatomical
and visual outcome of vitrectomy
for giant retinal tear detachment
with proliferative
vitreoretinopathy: A
retrospective, consecutive case
series, Medical Research
Archives, [online] 11(3).
https://doi.org/10.18103/mra.
v11i3.3666
Copyright: © 2023 European
Society of Medicine. This is an
open-access article distributed
under the terms of the Creative
Commons Attribution License,
which permits unrestricted use,
distribution, and reproduction in
any medium, provided the
original author and source are
credited.
DOI
https://doi.org/10.18103/mra.
v11i3.3666
ISSN: 2375-1924
CASE SERIES
Anatomical and visual outcome of vitrectomy for giant
retinal tear detachment with proliferative
vitreoretinopathy: A retrospective, consecutive case series
Ogugua Ndubuisi Okonkwo*
1
, Adekunle Olubola Hassan
1
,
Obinna Onyeaso
2
, Toyin Akanbi
1
, Rhoda Dein Komolafe
3
1
Department of Ophthalmology, Eye Foundation Hospital, Lagos state,
Nigeria
2
Ancilla Catholic Hospital Eye Centre, Lagos state, Nigeria.
3
Eye clinic, University of Port Harcourt teaching Hospital, Rivers state,
Nigeria
o_okonkwo@yahoo.com
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.