DECREASED INCIDENCE OF POSTOPERATIVE PVR IN PRIMARY RHEGMATOGENOUS RETINAL-DETACHMENT

Purpose To determine whether the incidence of severe postoperative PVR in primary rhegmatogenous retinal detachment has decreased over the l ast twelve years. Materials and methods We prospectively evaluated 595 eyes of 554 consecutive patients with primary rhegmatogenous retinal detachment, referred before any failed attempt to reattach the retina, managed bl the same surgeon between March 1983 and December 1994. The eye were divided into two consecutive series : 275 eyes operated on f rom March 1983 through February 1988 (series no. 1), and 320 eyes oper ated on from February 1988 through December 1994 (series no. 2). We co nducted univariate and multivariate statistical analyses to compare th e incidence of postoperative PVR in the two consecutive series. Result s The overall incidence of postoperative PVR was 8.72 % (24/275 eyes) in series no. 1, versus 2.81 % (9/320 eyes) in series no. 2 (p < 0.01) . The incidence of postoperative PVR in retinal detachments due to atr ophic holes in lattice degeneration, oral dialyses, and macular holes in myopic eyes, was nil in both series. The postoperative PVR in retin al detachments dire to horseshoe tears with mobile posterior edges was 1.16 % (1/86 eyes) in series no. 1, and 0 % (0/109 eyes) in series no . 2. The incidence of postoperative PVR in retinal detachments associa ted with horseshoe rears with es was 21.15 % (11/52 eyes) in series no . 1 versus 3.2 % (3/93 eyes) in series no. 2 (p < 0.001). The incidenc e of postoperative PVR in giant tears was 35.5 % (11/31 eyes) in serie s no. 1, and 14.7 % (5/34 eyes) in series no. 2 (chi square 3.77; at t he limit of significance). The incidence of postoperative PVR in retin al detachments du to paravascular tears of the postequatorial region i n myopic eyes was 25 % (1/4 eyes) in series no. 1, and 14 % (1/7 eyes) in series no. 2. Conclusion In our own experience, the incidence of p ostoperative PVR in primary rhegmatogenous retinal detachment has decr eased at a statistically significant level since 1988. We believe that the decreased incidence of postoperative PVR in our most recent serie s is mainly related to the use of laser photocoagulation retinopexy ra ther than cryopexy in the management of high risk eyes (retinal detach ments associated with horseshoe tears with curled posterior edges, and giant tears).