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Stand-alone pars plana vitrectomy versus pars plana vitrectomy with retinopexy for retinal vasoproliferative tumors
Piergiacomo Grassi1,2,3,4
1Department of Ophthalmology, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.
Purpose:
The purpose of this study was to compare surgical indications, functional outcomes, and postoperative complications of stand-alone pars plana vitrectomy (PPV) versus PPV with retinopexy for retinal vasoproliferative tumors (RVPTs).
Methods:
Retrospective multicenter cohort study: 12 consecutive pars plana vitrectomies in 12 eyes with RVPTs performed either stand alone (Group S), or associated with intraoperative retinopexy on the RVPT (Group R) between April 2017 and December 2020 were included.
Results:
Surgical indications included epiretinal membranes (ERMs) (42%), vitreous opacities (25%), recurrent-persistent vitreous hemorrhage (VH) (17%), rhegmatogenous retinal detachment with proliferative vitreoretinopathy (8%), and biopsy of retinal lesion (8%). The mean preoperative best-corrected visual acuity (BCVA) was 0.97 ± 0.78 logarithm of the minimal angle of resolution (logMAR) in Group S and 1.09 ± 0.67 in Group R (P = 0.344). The mean postoperative follow-up was 29.33 ± 8.73 in Group S and 27.66 ± 16.93 months in Group R (P = 0.424). The mean postoperative BCVA was 1.29 ± 0.94 logMAR in Group S and 0.32 ± 0.19 in Group R (P = 0.115). Compared to preoperatively, postoperative BCVAs significantly improved in Group R (P = 0.012). The final BCVA ≥20/80 logMAR was achieved in 2 (33%) cases in Group S and in 6 (100%) cases in Group R. Complications included recurrent-persistent VH (n = 3) and dragged fovea (n = 1) in Group S (67%) and ERM (n = 1), cystoid macular edema (n = 1), and subretinal exudation (n = 1) in Group R (50%).
Conclusion:
Vitrectomy in RVPTs seemed efficacious and safe for certain indications. Functional outcomes and complications appeared to be superior in eyes which underwent retinopexy on RVPTs compared to the stand-alone vitrectomy group.
