PVR Recurrence and the Timing of Silicone Oil Removal

Halberstadt, Markus; Domig, Diego; Kodjikian, Laurent; Koerner, Frederick C.; Garweg, Justus G.

doi:10.1055/s-2006-926594

Cited by 15 publications

(6 citation statements)

References 24 publications

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“…However, after silicon oil removal, there is a significant risk of retinal redetachment [ 67 ]. Despite a successful surgery with good retinal flattening, many eyes have a poor visual potential and multiple surgeries may be needed if recurrence is noted [ 68 – 70 ]. Cataract almost always occurs with the use of silicon oil and at times oil gets emulsified leading to glaucoma and requires urgent removal.…”

Section: Pathophysiologymentioning

confidence: 99%

Managing PVR in the Era of Small Gauge Surgery

Nagpal¹,

Juneja

Talati³

2021

Journal of Ophthalmology

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Proliferative vitreoretinopathy (PVR) is the leading cause of failed rhegmatogenous retinal detachment (RRD) surgery. Based upon the presence of clinical features and due to associated underlying risk factors, it is classified into various grades based upon its severity and extent of involvement. Despite excellent skills, flawless techniques, and high-end technology applied in the management of RRD, PVR still occurs in 5–10% of cases. Due to the advancements in wide angle viewing systems, advance vitrectomy machines and fluidics, early identification, use of long-term heavy silicon oil tamponades, high-speed cutters, small-gauge vitrectomies, use of perfluorocarbon liquid (PFCL), and small-gauge forceps and scissors, the success rate in the management of PVR has increased leading to improved anatomical outcomes. However, functional outcomes do not correlate well with improved anatomical outcomes. Various complications occur after RRD repair that are responsible for re-retinal detachment and recurrence of PVR. This article highlights causes, risk factors, classification, grading, diagnosis, and approach to management of PVR and post-PVR surgery complications.

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Section: Pathophysiologymentioning

confidence: 99%

Managing PVR in the Era of Small Gauge Surgery

Nagpal¹,

Juneja

Talati³

2021

Journal of Ophthalmology

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“…In order to minimize the burden of disease, SO removal was not enforced in eyes without functional potential well tolerating this tamponade. 32 We hypothesized that re-detachment after unsuccessful primary reattachment surgery might be associated with a less favourable functional outcome. Accordingly, the primary outcome parameter was change in BCVA from before SO instillation to 12 months postoperatively.…”

Section: Surgical Proceduresmentioning

confidence: 99%

Impact of Vitreal Tamponade on Functional Outcomes in Vitrectomy with ILM Peeling in Primary Macula-Involving Retinal Detachment: A Retrospective Analysis

Deiss

Kaya²,

Pfister³

et al. 2020

OPTH

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Background To compare visual outcomes of vitrectomy with internal limiting membrane (ILM) peeling and failed SF 6 gas tamponade requiring silicone oil (SO) in a second procedure with primary SO tamponade in fovea-involving retinal detachment (FiRD). Methods Retrospective analysis of 82 eyes with retinal detachment and mild, but without advanced proliferative retinopathy (PVR ≥C2) requiring vitrectomy for FiRD. Group 1 comprised 23 eyes that underwent SF 6 tamponade resulting in re-detachment requiring revision surgery with secondary SO tamponade. Based on the intraoperative findings, group 2 patients had primarily received SO as vitreal tamponade (n=59). Patients receiving a scleral buckle surgery or with advanced PVR as well as patients with underlying vascular diseases and uveitis were excluded. Results Preoperative visual acuity (Early Treatment Diabetic Retinopathy Study letters) was 13.5 ± 19.1 in group 1 and 14.0 ± 18.3 in group 2 ( p =0.44). Twelve months after first surgery for FiRD, visual acuity was 49.8 ± 19.8 in group 1 and 51.7 ± 18.7 letters in group 2 ( p= 0.63). Re-detachment after SO removal requiring revision surgery developed in 17.4 (n=4) and 15.3% (n=9) cases. Conclusion Our findings suggest that if retinal traction is completely relieved at the end of surgery, vitrectomy with ILM peeling and SF 6 may, if successful, improve the functional outcomes in instances with visual potential, ie, a foveal detachment of short duration despite the presence of a mild to moderate PVR, but with the inherent increased risk of re-detachment requiring further intervention and the use of a SO tamponade. Hence, secondary SO installation during re-vitrectomy after failed primary reattachment surgery results in similar functional outcomes as primary oil filling.

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“…Die häufigste Ursache für eine Ablösung der Netzhaut nach Entfernung der Öltamponade ist die Entwicklung einer anterioren PVR. Ob sich die Netzhaut wieder ablöst, ist unabhängig von der Zeitdauer, in der die Öltamponade eingesetzt wurde, und von der Methode, mit der die Tamponade entfernt wurde [33,34]. Der Zeitpunkt der Entfernung der Tamponade sollte vom konkreten Krankheitsverlauf und vom Erfolg der Behandlungen abhängig gemacht werden.…”

Section: Entfernung Der öLtamponadeunclassified

Proliferative Vitreoretinopathie – Pathogenese undÂ Therapie

Iandiev

Bringmann

Wiedemann

2010

Klin Monatsbl Augenheilkd

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Proliferative vitreoretinopathy (PVR) is the most important complication of retinal detachment and vitreoretinal surgery. PVR is considered to represent a maladapted retinal wound repair process; proliferation of retinal and immune cells induces the formation of epiretinal membranes which cause tractional retinal detachment. This publication gives a brief overview on the pathogenesis and operative treatment of PVR as well as on adjunct pharmacological therapy which may target the components of the proliferative process. At the moment surgical approaches are the first choice for the treatment of PVR. Scleral buckling provides good anatomic results in the treatment of a PVR stage B or C1 / C2. From stage C 3 onwards vitrectomy offers advantage.

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PVR Recurrence and the Timing of Silicone Oil Removal

Cited by 15 publications

References 24 publications

Managing PVR in the Era of Small Gauge Surgery

Managing PVR in the Era of Small Gauge Surgery

Impact of Vitreal Tamponade on Functional Outcomes in Vitrectomy with ILM Peeling in Primary Macula-Involving Retinal Detachment: A Retrospective Analysis

Proliferative Vitreoretinopathie – Pathogenese undÂ Therapie

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