Priglinger S G, Siedlecki J, Hattenbach L-O, Grisanti S
Augenklinik und Poliklinik des Klinikums der Universität München, LMU, Mathildenstr. 8, 80336, München, Deutschland.
Augenklinik Ludwigshafen, Ludwigshafen, Deutschland.
Ophthalmologe. 2021 Jan;118(1):18-23. doi: 10.1007/s00347-020-01293-1.
After initially successful surgery of retinal detachment, proliferative vitreoretinopathy (PVR) is the most common cause of renewed retinal detachment. With an incidence of 5-20% it represents a frequent surgical challenge based on a pronounced epiretinal, subretinal and intraretinal scar formation.
The five most important steps leading to a successful repair of a PVR retinal detachment are described.
1. The basic prerequisite is the complete removal of the vitreous body in order to remove the substrate for proliferation of pathological cells. 2. Furthermore, the complete removal of all tractional PVR membranes is necessary. Subretinal PVR membranes that show no traction can be left in place. 3. The professional care of the macular is still important. As approximately 12% of all patients who undergo surgery for retinal detachment develop an epiretinal gliosis/macular pucker, peeling of the internal limiting membrane (ILM) is obligatory in cases of PVR. 4. Particularly in PVR detachment the mentioned surgical procedure is facilitated by the selection of suitable modern instruments, including wide-angle optics, such as the binocular indirect ophthalmomicroscope (BIOM), chandelier lights, perfluorocarbons (PFCL) and silicone oil. 5. Last but not least, the credo as much as necessary, as little as possible is of essential importance, as PVR eyes have usually been previously operated on and any further surgical intervention leads to subsequent inflammation and a persisting stimulation of the PVR reaction and further damage.
Following a few decisive rules and tips is a prerequisite for a successful reattachment in cases of PVR retinal detachment.
视网膜脱离初次手术成功后，增殖性玻璃体视网膜病变（PVR）是视网膜再次脱离最常见的原因。其发病率为5%-20%，由于明显的视网膜前、视网膜下和视网膜内瘢痕形成，这是一个常见的手术挑战。
描述了成功修复PVR性视网膜脱离的五个最重要步骤。
遵循一些决定性的规则和技巧是成功复位PVR性视网膜脱离的前提条件。
