Substantiation of partial inferior retinotomy efficiency for a retinal detachment recurrence appeared during silicone oil tamponade of vitreous cavity

    Purpose. To increase the effectiveness of microinvasive surgical treatment for an inferior localized retinal detachment (RD) recurrence appeared during silicone oil (SO) tamponade of vitreous cavity by means of partial inferior retinotomy and/or retinectomy.

    Material and methods. There is a retrospective analysis of surgical treatment in 118 eyes (118 patients) with RD recurrence by method of vitreous cavity revision with removal of epiretinal membranes and SO 1300 cst. repeated injection (group I) and endovitreal surgery with retinotomy and retinectomy and gas-air mix or heavy SO (group II) retamponade. The age of patients was from 18 to 74 years (46±3.1): 61 female (51.6%), 57 male (48.3%). Visual acuity (VA) before the operation varied from 0.001 to 0.4 (0.15±0.07). Intraocular preasure: from 12 to 23 mmHg (16.4±0.34). The follow-up: from 3 to 28 months (14±2.13).

    Results. Intraoperatively an anatomic retinal attachment was achieved in all 118 cases. According to visometry, VA in patients 1 month postoperatively varied 0.02-0.6 and the mean VA increase was 0.08±0.05: in the group I the VA increase was in 23% of patients, in the group II — in 39%. The repeated RD recurrence was observed in 12 cases (9%), in 8 patients of the group I (15%) and in 4 patients of the group II (6%).

    Conclusion. The obtained anatomic functional results and the performed comparative clinical evaluation of inferior RD recurrence surgical treatment appeared during SO tamponade of vitreous cavity confirms a safety and efficacy of method using partial inferior retinotomy and/or retinectomy in the air medium, allowes to increase functional and anatomic results and reduce a risk of repeated RD recurrence.

    Key words: retinal detachment recurrence, revision of vitreous cavity, silicone oil, retinotomy and retinectomy.