Laser endoscope in the management of proliferative vitreoretinopathy

To evaluate the ability of the ophthalmic laser microendoscope for improving the outcome of vitrectomy in the management of grade D3 anterior proliferative vitreoretinopathy.

Ten consecutive patients without diabetes who had grade D3 anterior proliferative vitreoretinopathy underwent vitrectomy, lensectomy, membranectomy, gas-fluid exchange, and endophotocoagulation. Endoscopically guided portions of the vitrectomy and endophotocoagulation process were assessed, particularly in the region of the pars plana, ciliary body, posterior iris, and internal aspect of sclerotomy sites.

Follow-up ranged from 3 months to 1 year (mean, 9.2 months). Six of ten patients maintained total reattachment of the retina throughout the follow-up period. The retinas of the remaining patients redetached. Visual acuity for patients with reattached retinas ranged from 20/80 to hand motions.

Because endoscopy enhances the ability of the surgeon to image and dissect gliotic membranes in the regions of the pars plana, ciliary body, and posterior iris, as well as allow complete photocoagulation, a higher probability of anatomic success seems possible.