SURGICAL RISK-FACTORS FOR SEVERE POSTOPERATIVE PROLIFERATIVE VITREORETINOPATHY (PVR) IN RETINAL-DETACHMENT WITH GRADE-B PVR

Background: Previous studies have shown that grade B proliferative vit reoretinopathy (PVR) is a considerable risk factor for the development of severe postoperative PVR. We conducted a prospective study to eluc idate which surgical procedures used in retinal detachment management may stimulate the PVR process in such eyes. Materials and methods: The study included 156 eyes of 152 consecutive patients with rhegmatogeno us retinal detachment complicated by grade B PVR referred before any f ailed surgery and operated on between 1983 and 1993. The parameters ev aluated by multivariate statistical analysis included the cumulative c ircumferential extent of the retinal tears, the extent of the scleral buckle, gas injection, vitrectomy, the method used for retinopexy, and the time of surgical management during the period of the study. Resul ts: The incidence of severe postoperative PVR was 25.8% in eyes manage d with cryotreatment versus 2.2% in eyes managed with argon laser phot ocoagulation (P = 0.001). The rate of severe postoperative PVR was not influenced by the other surgical variables. Conclusion: We conclude t hat cryotherapy may be a risk factor for the development of severe pos toperative PVR in retinal detachments associated with grade B PVR.