They have shown that IVB can result in tractional retinal break
formation, thus intravitreal injections are to be used with caution.8 In a study conducted on 14 eyes undergoing PPV for ED, it was observed that PPV has to be performed within seven days of IVB.
Measurement of Range of RD and Size of Retinal Break
. Retinal breaks
and RD were imaged by ultra-wide-field scanning ophthalmoscope (Optos, Marlborough, MA, USA) before and after surgery.
In retinal detachment, a full-thickness retinal break
exposes cells, allowing macrophages, retinal pigment epithelial cells, glial cells, and fibroblasts to migrate into the vitreous, a rich source of growth factors and cytokines correlated to PVR activity [4-6].
Silicone oil, the most frequently used vitreous substitute, has also very high viscosity but less than vitreous and is associated with many complications such as hydrophobicity, partial filling of vitreal cavity, and inhibition of effective closure of retinal break
, which necessitate its removal from the vitreal cavity after sometime.
This needs investigating thoroughly to exclude the likelihood of a retinal break
, and that means dilating.
Although preoperative vitreous hemorrhage is assumed a PVR-inducing factor in RRD10 and PPV today is certainly more widely accepted, some surgeons still remain conservative especially in RRD with vitreous hemorrhage that the retinal break
(s) are visible.
Then, simultaneous air-fluid exchange along with internal drainage was performed through the retinal break
at the margin of, or within, the chorio retinal coloboma.
Rhegmatogenous retinal detachment (RRD) occurs when a retinal break
allows vitreous fluid to access subretinal space and thus separates the retina from the RPE.
As superior break, we defined a retinal break
located between 9 and 3o'clock meridian, and as inferior break, a retinal break
between 4 and 8o'clock meridian.
It is characterized by the presence of a retinal break
which is a defect involving whole thickness of neurosensory retina.2 Successful retinal detachment repair was initially described by Gonin in 1920 and advancements in technology have resulted in better results of surgery.3,4 This is a very debatable topic in retina community about which technique should be adopted to repair different types of retinal detachments.
Evaluation of the type of break was done preoperatively and intraoperatively and the commonest retinal break
noted was atrophic hole in 51.5% (33), dialysis was seen in 15.6% (10), Giant Retinal Tear in 14.6% (9) & only 6.25% (4) had Horse Shoe Tear.
This low anatomic success rate may be due to the fact that eyes with complicated RD due to anterior PVR, unstable edge of retinal break
, anterior hyaloidal fibrovascular proliferation, retinal incarceration in scleral wound or 3600 giant retinal tear", that required 3600 retinectomy were included in this study.