RETINAL-DETACHMENT CAUSED BY RETINAL DIALYSIS

Purpose: To determine the characteristics of patients developing retin al detachment secondary to retinal dialysis in Western Australia and t o confirm the clinical impression that these patients had a low rate o f proliferative vitreoretinopathy (PVR). Methods: A retrospective anal ysis of the records of 1601 consecutive patients with rhegmatogenous r etinal detachment identified 71 patients in whom the retinal detachmen t was caused by a retinal dialysis. Results: The majority of these pat ients were young adults (mean age of 30 years) and the male to female ratio was 1.3 : 1. Seventy per cent of patients provided a history of significant trauma to the affected eye. Sporting injuries, assault, an d motor vehicle injuries together accounted for 72% of identifiable tr auma. Examination revealed a dialysis of the inferotemporal quadrant i n 75% of cases and despite obvious signs of chronicity of the associat ed retinal detachment (such as intraretinal macrocysts and demarcation lines) in approximately one-third of the eyes, only 5.6% developed gr ade CI PVR either pre- or postoperatively. Conclusion: The present stu dy supports the view that it is the low rate of PVR that explains the good prognosis and high surgical success rate for retinal detachments caused by retinal dialysis. It is postulated that a major reason for t he low rate of PVR is that the vitreous base attachment to the posteri or margin of a retinal dialysis acts as a significant barrier to the m igration of potentially proliferative retinal pigment epithelial cells . This may lead to containment of-the responsible proliferative cells within the loculated subretinal space.