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G.Ü.Tıp Fak.Göz Hast. ABD., Beşevler, Ank. Purpose : To determine the anatomical and functional success rates of relaxing retinotomies and retinectomies and to determine the predictors of visual outcome.
Methods : We evaluated 52 eyes, which had been operated with relaxing retinotomy and retinectomy for complicated retinal detachment (RD) that previously operated with scleral buckling and/or pars plana vitrectomy (PPV). Eyes were devided into two groups; nontraumatic RD (group 1) and RD with blunt or perforated eye trauma (group 2). In summary, local retinectomy was applied to 10 eyes, relaxing retinotomy less than 180° to 18 eyes and more than 180° to 18 eyes and more than 180° to 24 eyes were performed with peripheral retinectomies. Mean tbllowup time was calculated as 17,7±8,0 mounts (6-38 mounts). The anatomical and functional success rate was evaluated at the end of that follow up time.
Results : The anatomical and functional success rate were calculated as respectively within the group 1 % 70 and % 54, and within the group 2 % 20 and % 20. The anatomical and functional success rates respectively were found as decreased if RD was traumatic with advanced PVR (%2(), %20), preoperative vision was light perception (%13,%13), retinotomy was more than 180° (%33,%21) and if eyes were not operated previously for RD (%35,%31). The most important late complication was recurrent detachment due to reproliferation (%52), and the others were severe hypotony, keratopathy, cataract, and perisilicone proliferation secondary to use of silicone oil.
Conclusions: In complicated RD, retinal attachment may be successfully provided with relaxing retinotomy and retinectomy. Attachment of macula, preoperative visual acuity, previous operations, size of retinotomy, lens complications like reproliferation and keratopathy, and retinal diseases like uveitis and Coats' disease effect postoperative visual acuity. Keywords : Complicated retinal detachment, retinotomy, retinectomy