PERIPHERAL 360° RETINECTOMY IN COMPLEX RETINAL DETACHMENT TOUKA BANAEE, MD, SEYYEDEH MARYAM HOSSEINI, MD, ALIREZA ESLAMPOOR, MD, MAJID ABRISHAMI, MD, MIRNAGHI MOOSAVI, MD 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 vitrec- tomy, 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 post- operative 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 flatten- ing the retina in complicated retinal detachments when no other option is available. RETINA 29:811– 818, 2009 P erforming relaxing retinectomy is sometimes in- evitable during vitreoretinal surgery. Examples include cases of severe intraretinal fibrosis when the detached retina is too contracted to be reattached, retinal incarceration in traumatic or iatrogenic wounds, and when there is the need for stabilization of the edge of retinal breaks for prevention of future contraction and redetachment. In these cases, relaxing retinec- tomies and sometimes even partial retinectomies are the only means to release traction on the retina, allowing the retina to reattach and prevent future redetachment. 1–5 Although there are many articles about retinectomy during surgery for complicated retinal detachment (RD), we are aware of only one article focusing on cases with 360° retinectomy. 2 Peripheral 360° retino- tomies are also used for macular translocation surgery in age-related macular degeneration, 6–8 but the results are certainly not applicable to cases with complicated RDs. Here, we report the anatomic and visual outcomes and complications of 360° peripheral retinectomy for the management of complicated RD. Patients and Methods This is a retrospective interventional study of eyes that underwent pars plana vitrectomy with 360° reti- nectomy for management of complicated RD from November 2001 to July 2003 at Imam Reza, Ghaem, and Khatam-al-anbia Medical Centers of Mashhad University of Medical Sciences. All surgeries were performed by one surgeon (TB). A minimum postop- erative follow-up period of 2 months was required for inclusion in the study. All patients underwent preop- erative and postoperative complete ophthalmic exam- From the Khatam-al-anbia Eye Hospital and Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Presented in part in the 14th Iranian Congress of Ophthalmol- ogy, Tehran, December 14 –17, 2004. The authors have no proprietary interests in any of the materials used in this article. Reprint requests: T. Banaee, MD, Khatam-al-anbia Eye Hospital and Research Center, Ghareni Blvd. 91559, 61151, Mashhad, Iran; e-mail: banaeet@mums.ac.ir 811