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RHEGMATOGENOUS RETINAL DETACHMENT AFTER VITRECTOMY AND SUBRETINAL TISSUE PLASMINOGEN ACTIVATOR FOR SUBMACULAR
Jordan P Safran1,2, Bita Momenaei1, Jonathan Martin3
1The Retina Service of Wills Eye Hospital, Wills Eye Physicians-Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania.
Rhegmatogenous retinal detachment (RRD) occurred in 9% of eyes after pars plana vitrectomy and subretinal tissue plasminogen activator for submacular hemorrhage (SMH). This complication, often involving macular detachment and proliferative vitreoretinopathy (PVR), requires timely repair for successful visual outcomes.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Vitreoretinal Diseases
Background:
- Submacular hemorrhage (SMH) is a serious condition affecting central vision.
- Pars plana vitrectomy with subretinal tissue plasminogen activator (tPA) is a treatment option for SMH.
- Understanding potential complications is crucial for patient management.
Purpose of the Study:
- To determine the incidence of rhegmatogenous retinal detachment (RRD) following pars plana vitrectomy and subretinal tPA for SMH.
- To evaluate the outcomes and visual acuity following RRD repair in this patient cohort.
Main Methods:
- Retrospective chart review of eyes treated with pars plana vitrectomy/subretinal tPA for SMH between April 2014 and September 2023.
- Analysis of RRD development, associated complications (macular detachment, PVR), treatment, and visual outcomes.
Main Results:
- Fifteen of 167 eyes (9%) developed RRD, with 80% having macular detachment and 60% developing proliferative vitreoretinopathy (PVR).
- The median time to RRD diagnosis was 41 days post-procedure.
- Initial RRD repair achieved 85% anatomical success, with a final success rate of 92% after subsequent repairs; visual acuity worsened significantly at RRD diagnosis.
Conclusions:
- Postoperative RRD is a significant complication occurring in approximately 10% of eyes after SMH treatment with pars plana vitrectomy/subretinal tPA.
- The incidence of PVR is notably high in these cases.
- Prompt surgical intervention for RRD is essential for achieving anatomical success, though visual recovery may be limited.
