Unal M.,GATA Haydarpasa Militar Hospital |
DUzgUn E.,GATA Haydarpasa Militar Hospital
Retina-Vitreus | Year: 2013
In cases with proliferative vitreoretinopathy (PVR), for a successful urgical goal, while releasing of tractions by removing proliferative tissues, closing tears and ensuring of retinal adhesion, our primary target should be correcting the disadvantages caused by the lens.To prevent from anterior proliferative vitreoretinopathy, the most common cause of relapsed detachment, phakic and pseudophakic patients should be addressed separately depending on preoperative evaluation and intraoperative requirements. Also cornea, iris, lens, ciliary body and choroid should be evaluated carefully because they affect the sugical prosess. Attempts to lens, facilitate surgical imaging ,ensure clear visualization, allow better approach to the anterior vitreus and so provide the convenience of manipulation of tissue. In cases with PVR, if there is no indication of lensectomy for clear lens then lens should not be removed but if situations require removal of the lens then refractive rehabilitation concerns should not take precedence over lensectomy. After a surgery that is considered successfully finalized, the formation of cyclitic membrane due to the vitreous base is not completely cleaned, ciliary detachment develops because of contraction of these membranes and this brings hipotony or relapsed detachments that may cause undesirable outcomes we don't want to encounter. Therefore, in these cases phacoemulsification surgery can be applied in combination with pars plana vitrectomy and also applicable to sequential surgery. Although not a classic surgical approach, pars plana vitrectomy combined with pars plana lensectomy, especially in phakic patients with PVR and in patients with retinal detachment due to giant tear complicated by PVR, may be a second surgical option.