Retained Intraocular Perfluoro-n-octane After Valved Cannula Pars Plana Vitrectomy for Retinal Detachment.

BACKGROUND AND OBJECTIVE: To investigate cases of retained intraocular perfluoro-n-octane (PFO) after pars plana vitrectomy (PPV) for retinal detachment (RD). PATIENTS AND METHODS: Retrospective, noncomparative case series of six eyes with retained intraocular PFO after RD repair. Clinical data were supplemented with an experimental silicone eye model. RESULTS: A cluster of six cases of retained intraocular PFO after PPV for RD repair were noted shortly after transitioning to valved cannulas. PFO was noted in the anterior chamber (AC) and/or vitreous and removed with AC paracentesis, AC wash-out, and/or PPV. A silicone eye model demonstrated that PFO levels are maintained anterior to cannula insertion with valved cannulas only. CONCLUSION: The authors hypothesize that anterior PFO fill using valved cannulas can lead to sequestration within the AC, zonules, ciliary sulcus, ciliary teeth, and/or capsular bag. They suggest vigilance in not overfilling PFO, particularly when transitioning to use of valved cannulas, to minimize the risk of intraocular retention.

Strategy for the management of uncomplicated retinal detachments: the European vitreo-retinal society retinal detachment study report 1.

OBJECTIVE: To study success and failure in the treatment of uncomplicated rhegmatogenous retinal detachments (RRDs). DESIGN: Nonrandomized, multicenter retrospective study. PARTICIPANTS: One hundred seventy-six surgeons from 48 countries spanning 5 continents provided information on the primary procedures for 7678 cases of RRDs including 4179 patients with uncomplicated RRDs. METHODS: Reported data included specific clinical findings, the method of repair, and the outcome after intervention. MAIN OUTCOME MEASURES: Final failure of retinal detachment repair (level 1 failure rate), remaining silicone oil at the study's conclusion (level 2 failure rate), and need for additional procedures to repair the detachment (level 3 failure rate). RESULTS: Four thousand one hundred seventy-nine uncomplicated cases of RRD were included. Combining phakic, pseudophakic, and aphakic groups, those treated with scleral buckle alone (n = 1341) had a significantly lower final failure rate than those treated with vitrectomy, with or without a supplemental buckle (n = 2723; P = 0.04). In phakic patients, final failure rate was lower in the scleral buckle group compared with those who had vitrectomy, with or without a supplemental buckle (P = 0.028). In pseudophakic patients, the failure rate of the initial procedure was lower in the vitrectomy group compared with the scleral buckle group (P = 3×10(-8)). There was no statistically significant difference in failure rate between segmental (n = 721) and encircling (n = 351) buckles (P = 0.5). Those who underwent vitrectomy with a supplemental scleral buckle (n = 488) had an increased failure rate compared with those who underwent vitrectomy alone (n = 2235; P = 0.048). Pneumatic retinopexy was found to be comparable with scleral buckle when a retinal hole was present (P = 0.65), but not in cases with a flap tear (P = 0.034). CONCLUSIONS: In the treatment of uncomplicated phakic retinal detachments, repair using scleral buckle may be a good option. There was no significant difference between segmental versus 360-degree buckle. For pseudophakic uncomplicated retinal detachments, the surgeon should balance the risks and benefits of vitrectomy versus scleral buckle and keep in mind that the single-surgery reattachment rate may be higher with vitrectomy. However, if a vitrectomy is to be performed, these data suggest that a supplemental buckle is not helpful. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Hearing impairment in Stickler syndrome: a systematic review.

BACKGROUND: Stickler syndrome is a connective tissue disorder characterized by ocular, skeletal, orofacial and auditory defects. It is caused by mutations in different collagen genes, namely COL2A1, COL11A1 and COL11A2 (autosomal dominant inheritance), and COL9A1 and COL9A2 (autosomal recessive inheritance). The auditory phenotype in Stickler syndrome is inconsistently reported. Therefore we performed a systematic review of the literature to give an up-to-date overview of hearing loss in Stickler syndrome, and correlated it with the genotype. METHODS: English-language literature was reviewed through searches of PubMed and Web of Science, in order to find relevant articles describing auditory features in Stickler patients, along with genotype. Prevalences of hearing loss are calculated and correlated with the different affected genes and type of mutation. RESULTS: 313 patients (102 families) individually described in 46 articles were included. Hearing loss was found in 62.9%, mostly mild to moderate when reported. Hearing impairment was predominantly sensorineural (67.8%). Conductive (14.1%) and mixed (18.1%) hearing loss was primarily found in young patients or patients with a palatal defect. Overall, mutations in COL11A1 (82.5%) and COL11A2 (94.1%) seem to be more frequently associated with hearing impairment than mutations in COL2A1 (52.2%). CONCLUSIONS: Hearing impairment in patients with Stickler syndrome is common. Sensorineural hearing loss predominates, but also conductive hearing loss, especially in children and patients with a palatal defect, may occur. The distinct disease-causing collagen genes are associated with a different prevalence of hearing impairment, but still large phenotypic variation exists. Regular auditory follow-up is strongly advised, particularly because many Stickler patients are visually impaired.

Persistent submacular fluid diagnosed with optical coherence tomography after successful scleral buckle surgery for macula-off retinal detachment.

Crataegus species have been widely used in herbal medicine, especially for the hearth diseases. In the present study, the effect of Crataegus aronia var. dentata Browicz extract on partially hepatectomized rats was investigated with biochemical and TUNEL apoptosis assays. The extracts of the plant at the concentrations of 0.5 and 1 ml/100 g body weight/day were administered orally to the two experimental groups including partially hepatectomized rats for 42 days. At the end of the experimental period, animals were sacrificed, blood was collected for the assessment of serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyltransferase (GGT), and the liver tissue was used for TUNEL assay. In biochemical assay, it was found a significant decrease in the levels of serum ALT and AST in the experimental groups. On the other hand, the plant extract did not cause any significant changes in the level of GGT in these groups. In apoptosis assay, TUNEL positive hepatocytes could not be detected in both experimental groups. The present findings can suggest that Crataegus aronia var. dentata Browicz extract can decrease the levels of serum ALT and AST and play a role in apoptosis of hepatocytes in the liver of partially hepatectomized rats. However, further studies are required to confirm the effects of the plant extract on hepatoprotection and apoptosis in the regenerating liver after partial hepatectomy in animal models.

Treatment of serous macular detachment associated with circumscribed choroidal hemangioma.

PURPOSE: To evaluate the effects of transpupillary thermotherapy and intravitreal bevacizumab injection on serous macular detachment and cystoid macular edema (CME) associated with circumscribed choroidal hemangioma. DESIGN: Retrospective, interventional case series. METHODS: We reviewed the records of 12 patients with circumscribed choroidal hemangioma treated with transpupillary thermotherapy and/or intravitreal injection of bevacizumab. We assessed changes in best-corrected visual acuity (BCVA), central foveal thickness by optical coherence tomography, and resolution of serous macular detachment and CME. RESULTS: Six of 8 patients treated with transpupillary thermotherapy showed complete resolution of serous macular detachment and CME and the median minimal angle of resolution (logMAR) BCVA improved from 0.85 to 0.35 (P = .026). Among these 6 patients, 1 had no recurrence for 86 months and 5 had sustained resolution of serous macular detachment for a mean duration of 32.8 months before recurrence. Among the 9 patients treated with bevacizumab (including 5 patients who had transpupillary thermotherapy as a primary treatment), 5 showed resolution of serous macular detachment and the median logMAR BCVA improved from 0.7 to 0.5 (P = .042). Among these 5 patients, 3 had sustained resolution for a mean duration of 5.7 months and 2 showed recurrent serous macular detachment after 3 and 12 months. CONCLUSION: Transpupillary thermotherapy and intravitreal bevacizumab appear effective in the management of symptomatic circumscribed choroidal hemangioma, although recurrence of serous macular detachment and CME developed after long-term follow-up of transpupillary thermotherapy, and the duration of treatment effectiveness appears to be short with bevacizumab.

Twenty-three-gauge pars plana vitrectomy, Densiron-68, and 360° endolaser versus combined 20-gauge pars plana vitrectomy, scleral buckle, and SF6 for pseudophakic retinal detachment with inferior retinal breaks.

PURPOSE: To compare the anatomical and functional outcomes of 23-gauge pars plana vitrectomy (PPV) with Densiron-68 tamponade and 360° endolaser versus 20-gauge PPV with encircling scleral buckling (ESB) and an SF6 gas tamponade for the repair of primary pseudophakic retinal detachment with inferior retinal breaks. METHODS: Prospective, randomized, comparative, interventional study. Eighty-two eyes of 82 consecutive patients were randomly assigned to 1 of the 2 treatment groups: 23-gauge PPV/Densiron-68 (44 eyes, 54%) or 20-gauge PPV/ESB/SF6 (20%) (38 eyes, 46%). The inclusion criterion was the presence of primary pseudophakic retinal detachment with at least 1 retinal break between the 4- and 8-o'clock positions. The study protocol involved a minimum of 7 visits: baseline, day of surgery, 1 week, and 1, 3, 6, and 9 months postoperation. Densiron-68 removal was performed within 12 weeks of the initial surgery. Two surgical procedures were required in the Densiron group to remove the oil. RESULTS: After the primary procedure, the retina was reattached in 90% (40 of 44) of cases in the 23-gauge PPV/Densiron group and in 92% (35 of 38) of cases in the 20-gauge PPV/ESB/SF6 group (P = 0.2, Fisher's exact test). After resolution of redetachments, final anatomical success rate rose to 97% (43 of 44) in the 23-gauge PPV/Densiron group and 94% (36 of 38) in the 20-gauge PPV/SB/SF6 group (P = 0.32, Fisher's exact test). Mean final best-corrected visual acuity (logarithm of the minimum angle of resolution) was 0.40 in the 23-gauge PPV/Densiron group and 0.48 in the 20-gauge PPV/ESB/SF6 group (P = 0.31, t-test). Operative time was significantly less in the 23-gauge PPV/Densiron group (P = 0.002, t-test). No statistically significant difference in the complication rate between the two groups was recorded. CONCLUSION: Twenty-three-gauge PPV combined with Densiron-68 and 360° endolaser and 20-gauge PPV combined with ESB/SF6 seemed to have similar efficacy in the repair of primary pseudophakic retinal detachment. Supplementary scleral buckling can be avoided using a Densiron-68 tamponade for retinal detachment with inferior retinal breaks.

Peripapillary schisis with serous detachment in advanced glaucoma.

PURPOSE: To describe features associated with the development and resolution of peripapillary retinoschisis with an underlying serous detachment in a patient with primary open angle glaucoma. This presentation occurred in the absence of an observed optic nerve coloboma, congenital, or acquired optic nerve head pit. CASE REPORT: A patient with advanced glaucomatous optic nerve cupping developed a temporally localized peripapillary serous detachment in the right eye which spontaneously resolved. RESULTS: Optical coherence tomography demonstrated an area of retinoschisis with underlying serous detachment contiguous with the temporal disc margin. Although fluorescein angiography was not performed and the presence of a peripapillary subretinal neovascular membrane could not be ruled out, an atypical coloboma, optic nerve head pit, or peripapillary subretinal neovascular membrane was not observed during biomicroscopy or scanning laser ophthalmoscopy. The retinoschisis and detachment resolved without intervention. CONCLUSION: Peripapillary retinoschisis with an underlying serous detachment may develop in subjects with advanced glaucoma. Although the occurrence of the findings in this case may be unrelated to glaucomatous optic neuropathy, the likelihood that a pathogenic mechanism linked to advanced glaucoma may be responsible for the development of peripapillary schisis and serous detachment should alternatively be taken into consideration. This case documents its spontaneous resolution without intervention.

[Impact of ozone therapy on the electrophysiological parameters of the retina in patients operated on for its rhegmatogenous detachment].

The impact of ozone therapy on changes in the data of maximum combined electroretinography (ERG), macular ERG (MERG), and rhythmic ERG (RERG) at 12, 32, and 40 Hz was studied in the rehabilitative period in patients operated on for rhegmatogenous retinal detachment. The integral and local glial indices K(g) and K(c) were calculated. Studies were conducted before, within 1 week and 1 and 2 months after a course of therapy. With ozone therapy, ERG and RERG depended on the specific features of changes available in the fundus of the eye before surgery. In the early rehabilitative period after surgery (circlage with subretinal fluid removal), ozone therapy normalized the glial indices, by decreasing the supernormal activity of Muller's glial cells and drastically increasing their reduced activity. The maximum effect was revealed for the function of phororeceptors (except for the eyes showing pronounced myopic dystrophic changes in the fundus). There were increases in MERG, ERG b-wave, and low-frequency RERG by 12 Hz, i.e. improved functions of the macular region and distal neurons of the retinal rod cell system. A latent period was established for the manifestation of a positive effect of ozonwe therapy on the functional of neurons of the internal retinal nuclear layer, as evidenced by RERG changes. Ozone therapy positively affect retinal electrogenesis in cases of total retinal detachment accompanied by a pronounced reduction in the glial index Kg before surgery. The therapy was found to have a positive impact on the functional activity of the retina of pair eyes, by developing within a one-moth latent period.

Triamcinolone acetonide as an adjuvant in the surgical treatment of retinal detachment with proliferative vitreoretinopathy.

BACKGROUND AND OBJECTIVE: To report the efficacy of intravitreal triamcinolone acetonide as an adjuvant in the surgical management of cases with advanced proliferative vitreoretinopathy (PVR). PATIENTS AND METHODS: Patients with complicated rhegmatogenous retinal detachment and PVR grade C2 or greater were recruited for this interventional, noncomparative, prospective study. All patients underwent three-port pars plana vitrectomy, membrane peeling, laser photocoagulation, and silicone oil injection to reattach the retina followed by 0.1 mL (4 mg) of triamcinolone acetonide injected through the pars plana into the silicone oil. All patients had supplemental laser therapy around retinal breaks and retinectomy edges at 1 to 2 weeks postoperatively. RESULTS: Patients included 15 males and 9 females, with an average age of 53.6 years (range: 15 to 84 years) and PVR grade C2 to PVR C9. The mean follow-up period was 11.0 months (range: 3 to 26 months). Twenty-one (87.5%) patients had attached retinas at the final followup visit. Visual acuity improved in all patients following surgery (P < .05). CONCLUSION: Triamcinolone acetonide may have potential as an adjuvant in the treatment of retinal detachment with PVR. Further research is required to evaluate the efficacy of this adjuvant treatment.

[Surgical treatment of late tractional retinal detachment appearing on the basis of retinopathy of prematurity]. / Chirurgická lécba pozdního trakcního odchlípení sítnice vzniklého na podklade retinopatie nedonosených.

Retinopathy of prematurity (ROP) is a proliferative retinopathy affecting predominantly immature children and children with low birth weight under 2500 g in 5-6%. During 11 years we operated on 15 eyes of 15 patients aged 5-31 years, because of late tractional retinal detachment (TRD) appearing on the basis of ROP. The average follow-up period was 37.2 months; the minimal follow-up period was 1 year. In all patients, the personal medical history revealed the pre-term birth at the gestation age of 28-34 weeks. The birth weight was in the range 850-1600 grams. According to the extend of vitreoretinal traction and type of retinal defect we indicated: a) primary cryosurgical procedure (CP) with episcleral silicone implants. The operation was indicated in 6 eyes: cerclage, segmental perilimbal plombage in the temporal half and puncture of the subretinal fluid; b) pars plana vitrectomy (PPV). In total in 9 eyes the PPV was indicated, in 5 eyes it was supplemented with relaxing retinotomy, and in 7 eyes with silicone oil (SO) implantation. Three eyes were re-operated by means of PPV with SO implantation. The final anatomical success of the surgical treatment of the prognostic unfavorable TRD, including re-operations was achieved in 12 eyes (80%), which we consider as a good one. The visual acuity improved or remained the same also in 12 eyes (80%) and visual acuity 6/60 and better (20/200 or 0.1) in 8 out of 15 eyes (53%).

A pilot study on the use of a perfluorohexyloctane/silicone oil solution as a heavier than water internal tamponade agent.

AIMS: To report a prospective two centred non-comparative interventional pilot study of a solution of perfluorohexyloctane and silicone oil (Densiron-68) as a heavier than water internal tamponade. METHODS: 42 consecutive patients were recruited. The indications include proliferative vitreoretinopathy, retinal detachments arising from inferior retinal breaks, and inability to posture. RESULTS: The success rate with one operation using Densiron was 81% and with further surgery 93%. At the end of the study all tamponade agents were removed in 90% of patients. Visual acuity improved from mean logMAR of 1.41 (SD 0.64) to 0.94 (SD 0.57), p = 0.001. There was little evidence of dispersion and excessive inflammation. CONCLUSION: This new tamponade agent is being compared to conventional silicone oil in a prospective international randomised trial.

[Transpupillary thermotherapy in age-related serous detachment of retinal pigmented epithelium]. / Transpupilární termoterapie u vekem podmínené serózní ablace pigmentového epitelu sítnice.

UNLABELLED: The goal of this prospective study was to evaluate results of the transpupillary thermotherapy (TTT) in the age related macular degeneration (ARMD) where the serous detachment of the pigment epithelium (SDPE) was the dominant sign. MATERIAL AND METHODS: Thirty eyes of 29 patients were treated by TTT. All patients were examined before and 3, 6, 9, 12, 18, and 24 months after TTT in terms of visual acuity (VA), indirect binocular ophthalmoscopy, and indirect slitlamp biomicroscopy, fluorescein angiography, and optic coherent tomography (OCT) of the macular region. In 25 eyes (83,3%) signs of choroidal neovascularization (CNV) were present (vascular SDPE). TTT was performed with a standard technique by diode laser (wavelength 810 nm). In 14 eyes (46.7%) the TTT procedure was repeated after 3 to 38 weeks. The follow-up period was 7 to 28 month (mean 15.2 months). RESULTS: After TTT, VA improved in 6 eyes (20.0%), remained stable in 8 eyes (26.7%), and deteriorated in 16 eyes (53.3%). Indirect slitlamp biomicroscopy revealed, that the SDPE re-attached in 13 eyes (43.3%), decreased in size in 12 eyes (40.0%); fluorescein leakage disappeared in 16 eyes (53.3%) and was reduced in 10 eyes (33.3%). By OCT, the re-attachment of SDPE was confirmed in 14 eyes (46.7%) and it's reduction in 13 eyes (43.3%). The leading cause of the same or worse VA after diminishing of SDPE was chorioretinal atrophy, with or without subretinal fibrosis. CONCLUSION: In the long term, the TTT led to the decline of SDPE in the majority of eyes and improved or stabilized VA in nearly on half of eyes. In most cases, signs of neovascularization were present. After the SDPE regression, the chorioretinal atrophy prevented the better functional results. TTT is not economically expensive and widens treatment possibilities in exsudative form of ARMD including SDPE.

Ipsilateral globe penetration and transient contralateral amaurosis following retrobulbar anesthesia.

PURPOSE: To report a rare complication of retrobulbar anesthesia with ipsilateral globe penetration and transient contralateral amaurosis. DESIGN: Interventional case report. METHODS: A 63-year-old woman complained of vision loss in the right eye immediately following cataract surgery on the left eye. RESULTS: Right eye vision decreased to no light perception with clear media and normal fundus. The vision recovered to baseline in 12 hours. Left eye vision was checked and demonstrated only light perception. Fundus examination disclosed preretinal and vitreous hemorrhage. During vitrectomy of the left eye, a penetrating wound below the optic disk with retinal detachment was found. CONCLUSION: The ipsilateral globe penetration wound depicts the mechanism of contralateral amaurosis following retrobulbar anesthesia of the case.

Laser and proton radiation to reduce uveal melanoma-associated exudative retinal detachments.

PURPOSE: To assess whether laser-induced hyperthermia in conjunction with proton irradiation of choroidal melanoma may more rapidly decrease exudative retinal detachments. DESIGN: Case-control study. METHODS: This was a single-center prospective phase 1 study of choroidal melanoma patients with exudative retinal detachments. These tumors did not overhang the optic disc, involve the fovea, or have greater than 40% involvement of the ciliary body. Patients were treated with laser-induced hyperthermia and proton radiation; results were compared with those of similar patients treated at the same institution with only proton radiation. Patients were followed up in an identical manner for loss of subretinal fluid, visual acuity change, and visual field alterations. RESULTS: All 11 patients treated with combined laser and proton therapy had resorption of subretinal fluid with a mean duration of retinal detachment of 193 days, compared with 263 days in the group treated with only proton therapy (P<.04). At 1 year, visual acuity was similar in both groups. CONCLUSIONS: Combined laser-induced hyperthermia and proton radiation may dissipate exudative detachments more rapidly than radiation alone.

Oculocardiac reflex during retinal surgery using peribulbar block and nitrous narcotic anesthesia.

BACKGROUND AND OBJECTIVES: This study was designed to examine the effects of local and general anesthesia on the oculocardiac reflex (OCR) in adults during retinal detachment surgery, with an aim of determining the safest type of anesthesia and on which extraocular muscle traction causes a higher incidence of OCR. PATIENTS AND METHODS: The study was performed on 30 American Society of Anesthesiologists-I patients (age range 40-60 years) who were undergoing retinal detachment surgery. Fifteen patients underwent surgery with general anesthesia and 15 were given a local peribulbar block. A fixed traction of 400 g was applied to all the extraocular muscles, and the heart rate, rhythm, and electrocardiogram of each patient was monitored. RESULTS: The overall incidence of OCR was higher with general anesthesia (63.3%) than with local anesthesia (14.4%). There was a significant decrease in heart rate for the rectus muscles (P < .0005) as well as the oblique muscles (P < .005) during traction with general anesthesia. All four rectus muscles were equally sensitive in eliciting the reflex. The incidence of dysrhythmias was 20% with general anesthesia and 6.67% with local anesthesia. CONCLUSION: This study showed that local anesthesia produces less bradycardia and ectopic arrhythmias and, therefore, may be safer and better than general anesthesia for surgeries in which traction of extraocular muscles is required.

Office repair of retinal detachment using a Lincoff Temporary balloon buckle.

PURPOSE: The purpose of the study is to report on a series of patients with retinal detachments that were repaired in an office setting using a temporary Lincoff balloon scleral buckle. METHODS: A retrospective review was performed on 162 consecutive casepatients with retinal detachment repaired in the authors' office between January 1989 and June 1995 using a temporary Lincoff balloon scleral buckle. All procedures were performed using local anesthesia and minimal equipment. RESULTS: The retina was attached completely with a single procedure in 88% of patients. Of the 19 retinas (12%) that failed primary surgery, all except 1 ultimately were reattached using traditional scleral buckling in 14, combined scleral buckling and vitrectomy in 3, and pneumatic retinopexy in 1, for a total success rate of 99.4%. Complications were minimal. CONCLUSION: A temporary Lincoff balloon scleral buckle can be used safely and effectively in an office setting for retinal detachment repair. The results are comparable to other available methods that take more time, involve greater risk, have higher complication rates, and are more costly. This technique represents a viable alternative, particularly in a managed care environment.

[Vitrectomy in proliferative vitreoretinopathy. Anatomical and functional results in 501 patients]. / Vitrektomie bei proliferativer Vitreoretinopathie. Anatomische und funktionelle Resultate bei 501 Patienten.

BACKGROUND: Modern vitreoretinal surgery allows a successful management of most cases of retinal detachment (RD) due to proliferative vitreoretinopathy (PVR). Failure of a vitrectomy in these cases is generally caused by a recurrence of PVR. Little is known about the postoperative 'life cycle' of proliferative cellular processes within the periretinal space. An adequate retreatment of PVR recurrences may improve the anatomical and functional results of a vitrectomy. MATERIAL AND METHODS: The retrospective study comprises 501 consecutive eyes operated for non-diabetic traction RD. Conventional retinal surgery preceded the vitrectomy in 36% of the cases. PVR was staged according to the classification of the Retina Society (14) with supplemental stages for 'anterior loop' formation, epimacular and subretinal membranes. The mean follow up of 139 eyes with one single vitrectomy was 24.2 months. The time-course of recurrent PVR in 362 eyes (72%, mean follow-up 34.2 months) was analyzed. Silicone-oil tamponade was used in 343 (69%) eyes. RESULTS: Recurrent PVR occurred predominantly within 1 to 9 months (median 1.8 mos) after vitrectomy. Latencies of recurrences did not differ significantly between PVR-C and D stages. Reattachment of the retina was achieved in about 85% of PVR-C and 70% of PVR-D stages. Anatomical results were better in non-traumatic RD cases. Final visual acuity of eyes operated since 1990 was 5/200 or better in 78% C-stages and 65% D-stages (follow-up of > or = 12 months). The final visual acuity was 20/100 or better in 33% of all PVR-C cases and 9.5% of all PVR-D cases. Significantly improved visual results were achieved in eyes operated with silicone oil tamponade, and in the later series of 279 eyes operated since 1990. The rate of postoperative total blindness was reduced from 16.7% before 1990 to 3.6% after 1990. CONCLUSION: Blindness due to traction RD can be avoided by vitreoretinal surgery in about 75% of PVR-C and over 50% of PVR-D cases provided that PVR recurrences are detected early and treated adequately.