[Retinectomies in the treatment of retinal detachments with vitreoretinal proliferation].
OBJECTIVE
To investigate the anatomical and functional results of retinectomy in the treatment of complex retinal detachment.


METHODS
We reviewed the files of 48 patients who underwent peripheral retinectomy of 90% or more for retinal detachment with anterior proliferative vitreoretinopathy stage A1 (6 cases), A2 (23 cases, A3 (11 cases) or A4 (8 cases). Retinotomy was performed when complete reattachment of the retina posterior to the buckling was not obtained despite careful dissection of the peripheral vitreoretinal contraction. Retinotomy was completed by excision of the anterior retinal flap. After perfluorocarbon liquid injection, laser retinopexy and perfluorocarbon-silicone exchange were performed.


RESULTS
Silicone oil was removed from 46 eyes (96%). The retina remained attached in 37 eyes (77%) with a visual acuity of 1/20 or more in 19 of them. Functional results did not correlate with the size of the retinectomy. The major complications were retraction of the retinectomy edge and recurrence of proliferative vitreoretinopathy, responsible for anatomic failure in 9 of the 11 cases. Hypotony (i.e. intraocular pressure of 5 mmHg or less) only occurred in 6 of the 37 successful cases.


CONCLUSIONS
Retinectomy is a useful surgical tool for eyes with advanced proliferative vitreoretinopathy when careful membrane dissection and encircling buckling seem to be insufficient to obtain retinal setting. Its success rate is good and leads to relatively few complaints.
Metge
F
F
Service d'Ophtalmologie, Hôpital Lariboisière, Paris.
Massin
P
P
Gaudric
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D006801:Humans; D008722:Methods; D008875:Middle Aged; D011183:Postoperative Complications; D011184:Postoperative Period; D012008:Recurrence; D012086:Reoperation; D012160:Retina / Q000601:surgery*; D012163:Retinal Detachment / Q000150:complications / Q000601:surgery*; D012827:Silicone Oils; D014792:Visual Acuity; D018630:Vitreoretinopathy, Proliferative / Q000209:etiology / Q000601:surgery*
D012827:Silicone Oils
Rétinectomies dans le traitement des décollements de rétine compliqués de prolifération vitréo-rétinienne.