Rubeosis of the iris in proliferative vitreoretinopathy

Area of Science:

• Ophthalmology
• Retinal Surgery
• Vitreoretinal Diseases

Background:

• Rubeosis, a complication of proliferative vitreoretinopathy (PVR), can occur after vitrectomy and silicone oil tamponade.
• Understanding the clinical course and contributing factors of rubeosis in this context is crucial for patient management.

Purpose of the Study:

• To investigate the findings and clinical course of rubeosis in patients with reattached retinas following vitrectomy and silicone oil for PVR.
• To identify potential causative factors and treatment outcomes associated with rubeosis in this specific patient cohort.

Main Methods:

• A prospective study of 38 patients (38 eyes) who developed rubeosis after vitrectomy and silicone oil for PVR and rhegmatogenous retinal detachment.
• Monitoring for peripheral residual retinal detachment, hypotony, neovascular glaucoma, and anterior synechiae.
• Evaluating the impact of surgical removal of peripheral detached retina on rubeosis.

Main Results:

• Peripheral residual retinal detachment was present in all studied patients with rubeosis.
• Removal of the peripheral detached retina led to the disappearance or regression of rubeosis in a significant number of patients.
• Hypotony was observed in six patients, and neovascular glaucoma occurred in four patients who underwent cyclocryocoagulation.

Conclusions:

• Peripheral detached retina appears to be a causative factor for rubeosis in patients treated with vitrectomy and silicone oil for PVR.
• Surgical removal of peripheral detached retina is associated with a statistically significant resolution of rubeosis.
• The infrequent formation of extensive anterior synechiae may explain the low incidence of neovascular glaucoma, though hypotony is more common.