Formation of proliferative vitreoretinopathy in primary rhegmatogenous retinal detachment

Proliferative vitreoretinopathy (PVR) is the only cause of ultimate failure following retinal detachment surgery. This study aimed to review the rate of postoperative PVR in a series of 186 consecutive patients with primary rhegmatogenous retinal detachments. All 186 detachments were repaired with a scleral buckling procedure combined with cryotherapy. Drainage of subretinal fluid was done at the discretion of the surgeon. The mean follow-up was 12 months. In this series 152 (82%) of primary detachments were repaired succesfully with a single operation. Sixty-eight percent of patients regained 0.3 or better visual acuity, and 3% of patients were left with visual acuity of 1/60 or less. After two or more operations the retina was attached in 96% of the cases. In 12 (6%) eyes PVR was responsible for the initial surgical failure. In 4 cases PVR (grade B and limited C) was present prior to surgery. In 3 cases PVR developed within 2 days postoperatively, in 3 cases after 3-6 weeks and in another 2 cases after 8-10 months. Eight out of 12 (66%) PVR patients had undergone cataract surgery. One PVR case had preoperative intraocular inflammation. An association between the duration of retinal detachment, or drainage of subretinal fluid and the development of PVR could not be demonstrated. In conclusion, the rate of postoperative PVR in primary rhegmatogenous retinal detachments was low. PVR preoperatively present and pseudophakia may be risk factors.