Surgical Outcomes and Complications of Rhegmatogenous Retinal Detachment in Eyes With Chorioretinal Coloboma

Abstract

The optimal option for managing retinal detachment in eyes with chorioretinal colobomas is pars plana vitrectomy with long-acting tamponade (silicone oil or octafluoropropane) and retinopexy to the edge of the coloboma and the primary breaks. Cryotherapy is associated with poor anatomical outcomes. An encircling band does not seem to affect the final anatomical outcome.

A Study on Pattern of Retinal Detachment in Patients with Choroidal Coloboma and Its Outcome after Surgery at a Tertiary Eye Hospital in Nepal

“…In our study, anatomic success after RD repair was 92.3% at the last follow-up visit (1 week after silicon oil removal at 6 months) which is comparable to other reports which had a success rate that ranging from 35 to 100% at the last follow-up visit [3, 7, 11–21].…”

“…Among them, the commonest was secondary glaucoma (30.7%), followed by recurrent retinal detachment, cataract, and band-shaped keratopathy (7.69% each). Other articles also cite secondary rise in intraocular pressure to be the commonest complication following surgery which can range from 11.9% to 48% [13, 20, 21]. In our study, all glaucoma patients were managed with topical antiglaucoma medicines.…”

“…Subsequent silicon oil removal may not be possible in up to 70% of the cases [3, 12, 21]. Hence, management of retinal detachment in the setting of coloboma is challenging and often complex [4].…”

Repair of Superior Chorioretinal Coloboma-Associated Retinal Detachments: Case Report and Literature Review

“…Schisislike changes occur, and a locus minoris resistentiae is formed that eventually leads to a retinal break and/or RD at the coloboma margin. [7][8][9] Retinal breaks have also been reported outside the coloboma, leading previous authors to suggest that an abnormal vitreoretinal interface may also be partly responsible for coloboma-associated retinal breaks and RDs.…”

“…3,4,10 Management of colobomaassociated RDs has included pars plana vitrectomy with silicone oil or gas tamponade, endolaser photocoagulation, and/or cryotherapy. 9,[11][12][13] Scleral buckling has also been described but appears to have limited success, likely because of difficulty in identifying breaks in the intercalary membrane, posterior location of the break, and lack of normal retinal pigment epithelium underlying the break, leading to a lack of adequate chorioretinal adhesion. 9,12 Reattachment rates have been reported to be 35% to 100% 4,11,12 and were reported to be 75% in a large review of 85 eyes with surgically managed colobomaassociated RDs.…”