Radial relaxing retinotomy in complicated rhegmatogenous retinal detachment surgery

Abstract

PURPOSE

The study aimed to evaluate the efficacy of pars plana vitrectomy with radial relaxing retinotomy in achieving stable anatomical and functional outcomes in patients with complicated rhegmatogenous retinal detachment.

SETTING / VENUE

The Department of Retina and Vitreous Pathology of SI «The Filatov Institute of Eye Diseases and Tissue Therapy of NAMS of Ukraine»

METHODS

This case series included 3 patients (3 eyes) with rhegmatogenous retinal detachment complicated by proliferative vitreoretinopathy between February 2023 and September 2023. Comorbidities included uveal melanoma in 1 eye, von Hippel-Lindau disease in 1 eye, and retinal necrosis in 1 eye. The patients’ age ranged from 33 to 65 years, and 100% of them were male. The follow-up ranged from 2 to 6 months. Best-corrected visual acuity (BCVA) at baseline varied from light perception to 0.1. Intraocular pressure was normal in all cases. All patients signed an informed consent form before surgery. High-frequency electric welding of biological tissues with a modified ЕK-300M1 generator was performed to achieve hemostasis in 2 cases (2 eyes). Radial relaxing retinotomy was performed after perfluorodecalin injection, followed by endolaser retinopexy at the edge of retinotomy. Silicone oil (5700 cSt) was used as a tamponade in all cases.

RESULTS

Before radial relaxing retinotomy, we used perfluorodecalin and air to test for retinal reattachment. Radial retinotomy was performed after confirming severe radial and tangential traction in all cases. Retina reattachment was achieved in all cases without postoperative complications. One month post-surgery, chorioretinal scars with signs of pigmentation were ophthalmoscopically identified at the retinotomy edge. Visual acuity improved in all cases (postoperative BCVA ranged from 0.1 to 0.4). After 3.5 months, silicone oil was removed without complications in 1 eye.

CONCLUSIONS

Radial relaxing retinotomy allows a surgeon to remove radial and tangential traction and achieve positive anatomical and functional outcomes during pars plana vitrectomy in complicated rhegmatogenous retinal detachment surgery.