Retinal cryopexy stimulates traction retinal detachment formation in the presence of an ocular wound

Pigmented rabbits were treated with retinal cryopexy applied to 180 degrees of the peripheral inferior retina in one eye, and then a 6-mm full-thickness circumferential wound was made in both eyes 3 mm posterior to the superior limbus. The wounds were sutured, and only eyes with minimal vitreous hemorrhage and no retinal breaks were included in the study. Eyes were then examined with indirect ophthalmoscopy on postoperative days 1, 7, 14, 21, and 28. Of eyes that received cryopexy and an ocular wound (n = 13), the retina in three became totally detached between postoperative days 14 and 28; seven eyes had traction retinal detachment first noted on postoperative day 14 that did not become total by postoperative day 28; and two retinas remained attached, but showed folds suggesting the presence of epiretinal membranes. One retina remained attached without folding. In eyes that received only an ocular wound (n = 13), the retina in one showed folds, and in 12 eyes it remained attached with no evidence of epiretinal membrane formation. Retinas treated with cryopexy alone (n = 4) remained attached without folds. On postoperative day 28, the rabbits were killed, and, after fixation, eyes were examined grossly and by light and electron microscopy. Examination confirmed the presence of vitreous and epiretinal cellular membranes in eyes with retinal detachment. These data suggest that in the presence of an ocular wound, retinal cryopexy, which has previously been shown to cause extensive breakdown of the blood-retinal barrier, stimulates the formation of intraocular cellular membranes and traction retinal detachment.