ASRS Live: Phaco-buckle-vitrectomy and retinectomy for progressive retinal detachment complicating degenerative retinoschisis

Fernando Arevalo, MD, PhD, FACS, FASRS, spoke with our team to share information on his presentation on the treatment of progressively symptomatic retinal detachments associated to retinoschisis cases at the 2023 ASRS annual meeting.

Video Transcript

Editor's note - This transcript has been edited for clarity.

Fernando Arevalo, MD, PhD, FACS, FASRS:

Hello, my name is Fernando Arevalo, and I'm a professor of ophthalmology at Johns Hopkins University and Wilmer Eye Institute in Baltimore, Maryland. I'm here in Seattle at the American Society of Retinal Specialists, and 1 of the things that I am presenting is the treatment of progressively symptomatic retinal detachments associated to retinoschisis cases.

I presented on a patient that had, or was treated with phaco-vitrectomy and retinectomy to repair one of those complex detachments. We performed a complete vitrectomy with peripheral vitrectomy as well, the use of perfluorocarbon to flood in the retina, and that was to some traction in the periphery with the phaco to allow us to do more peripheral shaving, and even with that there was still some traction and elevation in the periphery.
In addition, the patient had already a 41 band [in] place, and with this traction is still in the periphery, I decided to perform a retinectomy. Basically the roofing of the inner retina to allow the area of the retina peripherally to flatten, and that allowed the retina to reattach in the laser was applied, perfluorocarbon was injected, and then an [inaudible] change and then silicone oil because it was a monocular patient but gas can also be used.

This technique comes from a study that we published recently on 18 cases with progressively symptomatic retinal detachment associated retinas cases where we usually, most of the cases combination of a buckle and vitrectomy, and we found that, in a follow up of about four years, there was a third of patients that had a failure with 1 surgery, and although their final success rate was 100%, but I think that the fact that the 1 surgery success rate was only 66% emphasizes how difficult it is to repair, these retinal detachments. And more research is needed to evaluate what are the best surgical techniques to repair these kinds of retinal detachments