title: Inferior retinotomy and silicone oil tamponade for recurrent inferior retinal detachment and grade C PVR in eyes previously treated with pars plana vitrectomy or scleral buckle.
abstract: BACKGROUND
  One of the most challenging problems in vitro-retinal surgery is the recurrence of retinal detachment in the context of high-grade proliferative vitreoretinopathy (PVR). The aim of our retrospective study was to assess the surgical outcomes of pars plana vitrectomy, 180° inferior retinotomy and silicone oil tamponade combined with phacoemulsification and IOL implantation for recurrent inferior retinal detachment with grade C PVR in phakic eyes. The study was carried out at tertiary referral centre - University Hospital of Rome "Tor Vergata".
  
  
  METHODS
  Retrospective analysis of 33 eyes affected by recurrent inferior retinal detachment and grade C PVR after primary encircle scleral buckling (SB group - 12 eyes), or pars plana vitrectomy (PPV group - 21 eyes). All patients subsequently underwent PPV and silicone oil tamponade at our Institution. The first outcome measure was retinal reattachment, and second outcomes were reoperation rates, best-corrected visual acuity (BCVA) and postoperative complications.
  
  
  RESULTS
  All patients in the SB group and 19 (90%) patients of the PPV group achieved retinal reattachment. Final BCVA was better in the SB group (p = 0.045). Two eyes in the PPV group required a third vitrectomy with heavy silicone oil tamponade. Postoperative complications included silicone oil in a deep anterior chamber (3 eyes in each group), untreatable hypotony in 1 eye in the PPV group (that led to enucleation due to phthisis bulbi), and elevated intraocular pressure in 3 patients (2 eyes in the PPV group).
  
  
  CONCLUSIONS
  Phacoemulsification with IOL implant, PPV with silicone oil tamponade associated with 180° inferior retinotomy may lead to better anatomical success in patients who have previously undergone SB procedure for inferior retinal detachment repair compared with eyes that underwent a primary PPV.
authors.affiliation: Ophthalmology Unit, Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Via Montpelier 1, 00133, Rome, Italy. mancino@med.uniroma2.it.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Mancino
authors.affiliation: Ophthalmology Unit, Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Via Montpelier 1, 00133, Rome, Italy. francescoaiello@hotmail.com.
authors.forename: Francesco
authors.initials: F
authors.lastname: Aiello
authors.affiliation: Ophthalmology Unit, Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Via Montpelier 1, 00133, Rome, Italy. elenaciuffoletti@gmail.com.
authors.forename: Elena
authors.initials: E
authors.lastname: Ciuffoletti
authors.affiliation: Ophthalmology Unit, Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Via Montpelier 1, 00133, Rome, Italy. emi.dicarlo@hotmail.it.
authors.forename: Emiliano
authors.initials: E
authors.lastname: Di Carlo
authors.affiliation: Ophthalmology Unit, Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Via Montpelier 1, 00133, Rome, Italy. angelica.cerulli@gmail.com.
authors.forename: Angelica
authors.initials: A
authors.lastname: Cerulli
authors.affiliation: Ophthalmology Unit, Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Via Montpelier 1, 00133, Rome, Italy. nucci@med.uniroma2.it.
authors.forename: Carlo
authors.initials: C
authors.lastname: Nucci
mesh_terms: D000328:Adult; D000368:Aged; D058450:Endotamponade; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications; D012008:Recurrence; D012160:Retina / Q000503:physiopathology / Q000601:surgery*; D012163:Retinal Detachment / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D012591:Scleral Buckling; D012827:Silicone Oils / Q000008:administration & dosage*; D058471:Subretinal Fluid; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D018630:Vitreoretinopathy, Proliferative / Q000145:classification / Q000503:physiopathology / Q000601:surgery*
chemical_list: D012827:Silicone Oils; C515608:densiron