Outcomes of surgery for progressive symptomatic retinal detachment complicating retinoschisis

To select the best surgical technique and predict the surgical success in cases of progressive symptomatic retinal detachment complicating retinoschisis (PSRDCR).

Cases were divided into three groups: group I, those with outer layer breaks (OLBs) positioned anterior to the equator and no proliferative vitreoretinopathy (PVR); group II, those with OLB(s) at or posterior to the equator and no PVR at presentation; and group III, PVR greater than grade B at presentation. A retrospective study of 30 such eyes presenting to the authors and a review of the 47 previously reported cases to which the three-group anatomical classification might be applied were performed.

In group I, the overall primary and final success rates were 85% (17/20) and 95% (19/20), respectively. In group II, the corresponding data were 67% (34/51) and 94% (48/51), respectively. Group III eyes fared badly with primary and final success rates of 0 (0/6) and 17% (1/6), respectively.

The overall 66% primary anatomical success rate was lower than those reported in most series of rhegmatogenous retinal detachment uncomplicated by retinoschisis. In group I, the surgical technique used had no detectable influence on outcome. Vitrectomy appears to have been the procedure of choice in group II, but a significant P value could not be demonstrated to support it (Yates corrected chi test, P = 0.84). This study, however, had very low power with which to investigate for such effects. PVR greater than grade B at presentation was not previously been recognized in cases of PSRDCR and when present was associated with very poor primary and final reattachment rates.