Comparative study of incomplete posterior vitreous detachment as a risk factor for proliferative vitreoretinopathy.
BACKGROUND
Abnormal vitreoretinal relationships have recently been implicated in many vitreoretinal disorders. Sites of abnormal vitreoretinal adherences are likely to exist in eyes predisposed to rhegmatogenous retinal detachment (RD), causing either retinal tears or incomplete posterior vitreous detachment (PVD). The present study was designed in two parts to identify the risk for preoperative and postoperative proliferative vitreoretinopathy (PVR) due to incomplete PVD.


METHODS
We prospectively evaluated the vitreoretinal relationships using high-resolution kinetic echography in 102 consecutive eyes of 100 patients with rhegmatogenous RD. In the first part, a case-control study was conducted to compare the vitreous status in patients with preoperative PVR (cases) with that in patients with non-PVR-complicated RD (controls). During the second part, patients with noncomplicated RD (65 eyes) who were operated on by a simple retinal attachment procedure were followed up for a mean period of 6.6 months to compare the recurrence of RD due to postoperative PVR according to their vitreous status.


RESULTS
Patients with PVR on study entry had a higher prevalence of partial PVD (28 of 32 eyes, 87%) than did controls (25 of 70 eyes, 35%). The statistical significance of this difference was independent of all other variables studied. After a mean follow-up period of 6.6 months, the incidence of recurrence of RD associated with postoperative PVR was 33% in the eyes with incomplete PVD, compared with 4.9% in the eyes without incomplete PVD.


CONCLUSIONS
Our results support the notion that the occurrence of incomplete PVD in RD is a significant risk factor for preoperative and postoperative PVR.
Department of Ophthalmology, University Hospital of Santiago, Santiago de Compostela, Spain.
C
C
Capeans
J
J
Lorenzo
L
L
Santos
A
A
Suarez
M J
MJ
Copena
M J
MJ
Blanco
M
M
Sánchez-Salorio
D016022:Case-Control Studies; D005128:Eye Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D011183:Postoperative Complications; D011446:Prospective Studies; D012008:Recurrence; D012163:Retinal Detachment / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D012167:Retinal Perforations / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D012307:Risk Factors; D012591:Scleral Buckling; D014463:Ultrasonography; D018630:Vitreoretinopathy, Proliferative / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D014822:Vitreous Body / Q000000981:diagnostic imaging / Q000473:pathology*