Management of recurrent retinal detachment in silicone oil-filled eyes

PURPOSE: To report causes of failure, management options, and outcomes after reoperations for recurrent retinal detachment in silicone oil-filled eyes. METHODS: One hundred eighteen silicone oil-filled eyes with recurrent retinal detachment were managed with revision of vitrectomy with membrane surgery with or without silicone oil removal, just scleral buckling, or both. Anatomical success was defined as complete reattachment of the retina, and functional success was defined as recovery of ambulatory visual acuity of >or=5/200 at the last follow-up (mean follow-up, 29.7 months). RESULTS: In 82.2% of the cases, proliferative vitreoretinopathy was responsible for recurrent retinal detachment in silicone oil-filled eyes. Reoperations without removal of the silicone oil were performed in 65.3% of the cases. Anatomical success occurred in 62.7% of the eyes, and functional success occurred in 52.5%. Silicone oil was removed in 59.5% of the eyes with retinal reattachment; the retina remained attached in 90.9% of the eyes. Predictors of poor anatomical success were presence of posterior diffuse proliferative vitreoretinopathy and combined posterior and anterior proliferative vitreoretinopathy (P <0.02). CONCLUSION: Reoperations for recurrent retinal detachment in silicone oil-filled eyes were successful in nearly two thirds of the cases, and over one half of the eyes recovered ambulatory vision.     

Regression of diabetic rubeosis iridis following successful surgical reattachment of the retina by vitrectomy

The relationship between successful surgical reattachment of the retina following diabetic vitrectomy and regression of preoperative rubeosis iridis was investigated. Seventy-nine (9.2%) of 850 diabetic cases undergoing vitrectomy had both preoperative iris rubeosis and retinal detachment. The iris could be adequately evaluated and the retina could be visualized after surgery in 36 cases. Regression of the rubeosis iridis occurred after surgery in 16 (76%) of 21 eyes in which the retina was reattached successfully. Only four (27%) of 15 eyes had regression of rubeosis iridis when the retina was not reattached completely. Retention of the lens also correlated with regression of rubeosis iridis. Regression occurred in 10 (55%) of 18 cases in which the lens was not removed, 13 (28.2%) of 46 eyes in which lensectomy was combined with vitrectomy, and none of eight previously aphakic eyes. Although the combination of preoperative retinal detachment and rubeosis iridis is associated with a worsened prognosis, successful reattachment of the retina and retention of the lens favorably influence later regression of preoperative rubeosis iridis.     

Silicone oil insertion: A review of 127 consecutive cases

Silicone oil was used in combination with vitrectomy to treat 127 cases of complicated retinal detachments. An initial anatomic success in 120 cases (94%) was reduced to 68 (54%) after an average follow-up of 32 months and was attributable to ongoing proliferative vitreo-retinopathy (PVR). The indications for the use of silicone oil were:
1. Retinal detachment complicated by PVR (107 cases), 20 of which required multiple operations. Anatomic success was achieved in 59 (55%) and of these 23 (40%) had visual acuity of 6/60.
2. Giant retinal tears (GRT) (7 cases). Four (57%) of these remained attached, three (75%) having final vision of 6/36.
3. GRTs complicated by PVR (8 cases). Four (50%) were anatomically successful and two had final vision of 6/60.
4. Proliferative diabetic retinopathy (5 cases). Two (40%) remained attached and one of these (50%) had hand movements vision.
The silicone oil was removed electively in 23 eyes, 16 (70%) of these being anatomically successful. Oil was removed in 43 eyes because of complications, and in 20 (46%) of these, the retina remained attached at the end of follow-up. Complications included cataract in all 14 phakic eyes; rubeosis in 19 eyes (15%); corneal opacification in 52 eyes (41%), there being no clear cut difference between those eyes with an inferior iridectomy (35 of 85 eyes — 41%) and those without (12 of 29 eyes — 41%); and raised intraocular pressure in 55 eyes (43%). We conclude that although far from being ideal, silicone oil appears to have played some part in achieving the successful results reported in this study.     

Different outcome among eyes with proliferative diabetic retinopathy indicated for vitrectomy

PURPOSE: The postoperative outcome was evaluated in each group of surgical indications of vitreous surgery for proliferative diabetic retinopathy (PDR), to investigate the factors responsible for postoperative visual prognosis. METHODS: Primary vitrectomy was performed in 119 eyes of 92 patients with PDR. Average postoperative follow-up period was 19 months. The indications for vitrectomy included vitrous hemorrhage in 58 eyes, macular tractional retinal detachment in 17 eyes, extramacular tractional retinal detachment in 10 eyes, macular heterotopia in 11 eyes, and progressive fibrovascular proliferation in the posterior fundus in 23 eyes. RESULTS: The visual acuity finally improved by 2 lines or more in 91 eyes (77%), remained unchanged in 10 eyes (8 %), and decreased by 2 lines or more in 18 eyes (15%). Final postoperative visual acuity was significantly better in cases of vitreous hemorrhage or progressive fibrovascular proliferation in the posterior fundus than in others. Preoperative rubeosis iridis and macular tractional retinal detachment were probably responsible for the final visual impairment, and intraocular tamponade affected the difference in visual prognosis between the groups of surgical indication. Multivariate analysis in all cases revealed that factors influencing visual outcome were preoperative rubeosis iridis and anemia. CONCLUSION: Rubeosis iridis and macular tractional retinal detachment were prognostic factors of the surgery. Vitrectomy for PDR may be effective in improving postoperative visual acuity if performed in the early stage of progressive fibrovascular proliferation in the posterior fundus after sufficient retinal photocoagulation.     

复杂性视网膜脱离术中视网膜切开技术的应用及疗效观察

目的观察复杂性视网膜脱离眼术中应用视网膜切开技术的临床疗效。方法23例伴有严重增生性玻璃体视网膜病变(proliferative vitreoretinopathy,PVR)的视网膜脱离眼,经常规玻璃体手术不能使视网膜复位,选择视网膜缩短僵硬处切开松解,或掀起切开的视网膜清除其下增生膜,再予眼内激光光凝、硅油填充。视网膜切开范围30～360°平均为132°。结果术毕23例均取得视网膜解剖复位,15例于术后3．0～11．0个月（平均5．6个月）取出硅油。所有病例随访6个月以上,17例视网膜完全复位 (4例未取硅油) ,占74.0%,视力 0. 02及 其以上者 11例,占48.0%, 2例取硅油后复发视网膜脱离;未取硅油者中 3例下方视网膜增生 伴浅脱离,1例因白内障而眼底情况不明。主要并发症为眼内增生(26.0%)和低眼压(13.0%) 。 结论复杂性视网膜脱离玻璃体手术中应用视网膜切开技术能取得一定的疗效。(中华眼底病杂志,2001,17:87-89)     

Endolaser photocoagulation in penetrating and perforating intraocular foreign bodies.

Ten consecutive eyes that had undergone a pars plana vitrectomy and argon endolaser photocoagulation for penetrating or perforating posterior segment foreign bodies were reviewed. All eyes had undergone a pars plana vitrectomy plus or minus lensectomy, removal of the intraocular foreign body in those eyes with a retained foreign body, endolaser photocoagulation of posterior chorioretinal tears, and peripheral buckle for peripheral retinal pathology. Postoperatively (minimum follow-up, 6 months), all eyes had an attached retina. Eighty percent of the eyes had a visual acuity of 20/40 or better. Advantages of endolaser photocoagulation of posterior breaks include: microscopically controlled sealing of posterior tears, less destructive than posterior cryotherapy, effective when severe choroidal swelling is present, and absence of dispersion of viable retinal pigment epithelial cells which has been documented with external cryotherapy.     

Intraocular cysticercosis: clinical characteristics and visual outcome after vitreoretinal surgery

PURPOSE: To report the clinical characteristics of, discuss the surgical options for, and analyze the factors affecting the anatomic and visual outcome of intraocular cysticercosis. DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: Forty-five eyes of 44 Indian patients with posterior segment intraocular cysticercosis. METHODS: The charts of 45 eyes, in which intraocular cysticercosis was removed by vitreoretinal surgery (either transscleral or transvitreal), were reviewed. MAIN OUTCOME MEASURES: These included the postoperative retinal status and the best-corrected Snellen visual acuity. RESULTS: Intraocular cysticercosis was present in the vitreous cavity of 27 eyes (60%) and in the subretinal space of 18 eyes (40%). Anterior segment inflammation was seen in 13 eyes (28.8%) and vitreous inflammation in 38 eyes (84.4%). Retinal detachment was observed in 22 eyes (48.8%), with proliferative vitreoretinopathy in 13 eyes (59.09%). Subretinal cysts anterior to the equator (4 eyes) were removed transsclerally, whereas subretinal cysts posterior to the equator and intravitreal cysts (41 eyes) were removed transvitreally. The mean follow-up was 10.5 months. At the last follow-up, the retina was attached in 39 eyes (86.6%); visual acuity of >/=5/200 was achieved in 67.5%. CONCLUSIONS: Current vitreoretinal surgical techniques enable removal of intraocular cysticercosis in all cases, with reattachment of the retina in 86.6% and recovery of ambulatory vision in approximately 67% of cases.     

Rhegmatogenous retinal detachment and retinal tear with intravitreous hemorrhage

A retrospective study was conducted on a series of 28 eyes with primary retinal tears associated with vitreous hemorrhage. At initial presentation, the retina was detached in 17 eyes and attached in 11. In the series of eyes with an attached retina, the vitreous hemorrhage was massive in 5 eyes (45%), the average number of retinal tears was 1.36. All eyes showed a retinal tear located in the upper quadrants. Three patients (27%) experienced recurrent vitreous hemorrhage after sealing of the retinal tears. In the series of eyes with a detached retina, the vitreous hemorrhage was massive in 5 eyes (29%) and the average number of retinal tears was 1.9. The retinal detachment was located in the upper quadrants in 16 eyes (94%). Clinical evidence of proliferative vitreoretinopathy was noted, at initial presentation, in 6 eyes (35%). Permanent retinal reattachment was achieved in only 12 eyes (70%). All surgical failures were related to proliferative vitreoretinopathy. In the present series the prognosis of primary retinal tears with significant vitreous hemorrhage was guarded because of recurrent vitreous hemorrhages. The prognosis of primary rhegmatogenous retinal detachments with significant vitreous hemorrhage at initial presentation was guarded because of the high incidence of proliferative vitreoretinopathy.     

Management of giant retinal tears with vitrectomy, internal tamponade, and peripheral 360 degrees retinal photocoagulation

PURPOSE: To determine the effectiveness of vitrectomy, internal tamponade, and peripheral 360 degrees retinal photocoagulation in the management of giant retinal tears (GRTs). PARTICIPANTS: Eighteen eyes of 18 consecutive patients with GRTs were operated on at Jules Gonin Eye Hospital between 1992 and 1999. None of them had previous vitreoretinal surgery. METHODS: Eyes in the series underwent pars plana vitrectomy, perfluorocarbon liquid and silicone oil (17 eyes) or gas (one eye) exchange, and retinopexy. Retinopexy was applied to the edges of the tear using photocoagulation, and it was extended over 360 degrees to the peripheral attached retina. No scleral buckle was placed, even if proliferative vitreoretinopathy (PVR) was present. RESULTS: The GRT was 180 degrees or greater in seven eyes and 90 degrees to 180 degrees in 11 eyes. The lower edge of the GRT was located in an inferior quadrant in 15 eyes. PVR was grade A in seven eyes, grade B in eight eyes, and grade C in three eyes. In the last three eyes, PVR was anterior (C-A9, Patient 4) and posterior (C-P6 subretinal, Patient 11; C-P3, Patient 13). In 16 (88.8%) of the 18 eyes, the retina was successfully reattached after surgery, and silicone oil was removed after a mean period of 7.7 weeks. In the other two eyes, the retina remained detached or redetached despite the silicon oil tamponade. One of these two eyes underwent three further surgeries, but the retina did not reattach. The other eye was successfully reoperated on with an encircling and radial scleral buckle, and silicone oil was removed later. At the end of the follow-up, the retina was attached in 17 (94.4%) of the 18 eyes. The mean follow-up was 28.6 months (range, 4.5-73 months). CONCLUSIONS: The success rate of management of GRTs with vitrectomy, internal tamponade, and peripheral 360 degrees photocoagulation of the retina without scleral buckle is high. Photocoagulation of the peripheral retina over 360 degrees appears to decrease the risk of secondary peripheral retinal tears.     

松弛性视网膜切开术治疗视网膜脱离合并严重前增殖性玻璃体视网 …

目的 探讨松弛性周边视网膜切开术联合眼内激光治疗视网膜脱离合并严重前增殖性玻璃体视网膜病变的效果。方法 对４４例视网膜脱离合并严重前增殖性玻璃体视网膜病变的患者行松弛性周边视网膜切开术,联合眼内激光和硅油填充治疗。观察术后视网膜解剖复位,视功能及术后眼压变化情况。其中２２例取出了硅油。结果 ４４例全部获得视网膜复位（其中８例合并皱褶）,３８例获得不同程度的视力改善。２２例取出硅油后,有２１例视网膜     

外伤性视网膜脱离的玻璃体手术治疗

目的:评价外伤性视网膜脱离的玻璃体手术治疗方法及疗效。方法:对24例(24眼)外伤性视网膜脱离患者行常规经平坦部玻璃体切除、膜剥离、松解性视网膜切开、眼内激光、硅油或长效气体眼内填充等治疗,部分病例联合巩膜扣带术;随访3～24mo,观察疗效。结果:24眼术后视网膜均复位,视力均有不同程度的提高,随访期间,19例视网膜保持平复,5例复发视网膜脱离,其中3例经再手术视网膜复位,另2例因眼球萎缩未再手术。结论:外伤性视网膜脱离多伴有浓密的玻璃体积血、视网膜嵌塞及严重的增殖性玻璃体视网膜病变(prolifera-tivevitreoretinopathy,PVR),通过适时的玻璃体手术能获得比较满意的治疗效果。     

视网膜切开及切除治疗复杂性视网膜脱离

目的 探讨治疗复合性视网膜脱离的行之有效的方法。方法 对16例（16眼）视网膜脱离合并严重增生性玻璃体视网膜病变患者行闭合式玻璃体切除联合巩膜环扎、视网膜切开或切除及眼光内光凝术。观察术后视网膜解剖复位、视功能的改善情况。结果 16眼视网膜完全复位者13眼、视力较术前增加者10眼、下降者2眼，视力＞0．05者7眼。随访，1眼视网膜脱离复发，5眼出现低眼压。结论 视网膜切开／切除是治疗复杂性视网膜脱离的有效方法之一。     

视网膜下膜的处理

目的：探讨视网膜下膜的处理原则及方法。方法：回顾性分析62例视网膜脱离伴视网膜下膜病例的治疗情况。结果：取出视网膜下膜20例（32．3％）,术后视网膜复位18例,占90％。未取下膜42例（67．7％）,术后视网膜复位39例,占90．5％。结论：多数视网膜下膜不影响视网膜复位不需手术处理。     

Preoperative Iris Rubeosis and Diabetic Vitrectomy Results

Six hundred and forty-five patients undergoing pars plana vitrectomy for diabetic retinopathy without preoperative iris rubeosis were followed for six months and compared with 69 patients that had preoperative pupillary rubeosis and 30 patients that had preoperative peripheral iris and/or angle rubeosis. Preoperatively, the patients' general characteristics were quite similar, but those cases with peripheral iris rubeosis had poorer visual acuities due to a higher incidence of dense vitreous hemorrhages (70%), as compared with those without rubeosis (56%), and a higher incidence of cataracts and prior cataract surgery. The operative procedures were complicated by retinal holes in 40% of the cases with peripheral rubeosis compared with 24% of those without rubeosis. Postoperatively, elevated intraocular pressures occurred in 67% of the cases with preoperative peripheral rubeosis compared with 58% of those with preoperative pupillary rubeosis and 37% of those without preoperative rubeosis. Postoperative steroids were required more frequently in those eyes with preoperative rubeosis. Six months after vitrectomy, the visual results were much better in those eyes without preoperative rubeosis, but 27% of the cases with preoperative peripheral rubeosis had obtained 6/60 visual acuity or better. As expected, there was a direct correlation between the extent of iris rubeosis at the preoperative examination and at the six-month postoperative examination. Regression of preoperative rubeosis definitely occurred in some eyes during the postoperative period. Phthisis had occurred or was occurring in 23% of the eyes with preoperative peripheral rubeosis compared with 15% of the eyes without preoperative rubeosis or with rubeosis confined to the pupil. Determination of the exact incidence of neovascular glaucoma during the six-month follow-up period was difficult, but was probably 33% for those cases with preoperative peripheral rubeosis, as compared with 17% for those without preoperative rubeosis.Opacities of the anterior segments prevented evaluation of more posterior structures in many cases, especially those with preoperative peripheral rubeosis of which 47% had obscured vitreous cavities, as compared with 20% of those without preoperative rubeosis. Of those that could be visualized, the vitreous cavities were usually clear and the retinas attached.     

The adjunctive use of perfluoroperhydrophenanthrene (Vitreon) in diabetic vitrectomy

Objective: To evaluate the utility and efficacy of perfluoroperhydrophenanthrene in the management of retinal detachments secondary to severe proliferative diabetic retinopathy. Patients and Methods: Forty consecutive patients with proliferative diabetic retinopathy and retinal detachments were entered into the study at nine participating clinical centers. Perfluoroperhydrophenanthrene (Vitreon) was used as an adjunct to pars plana vitrectomy and membranectomy. Results: Preoperative diagnoses included combined traction and rhegmatogenous retinal detachments in 23 eyes (57.5%), traction retinal detachments in 13 eyes (32.5%), and recurrent rhegmatogenous retinal detachments in 4 eyes (10%). Vitreous hemorrhage was present in 17 eyes (42.5%). Preoperative visual acuity ranged from light perception or hand motion in 28 eyes (70%) to 5/200 or greater in 12 eyes (30%). Vitreon was primarily used to flatten the retina following relaxing retinotomy in 12 eyes (30%), to displace subretinal fluid in a posterior-to-anterior direction without performing a drainage retinotomy in 15 eyes (37.5%), and to manage intraoperative complications such as iatrogenic tears in 8 (20%) and retinal dialysis in 5 eyes (12.5%). The retina flattened intraoperatively in all cases, facilitating administration of laser photocoagulation. Patients were followed for a minimum of six months (mean 13.2 months). At last follow up, the macula remained attached in 37 eyes (92.5%), including 31 (77.5%) in which the retina was totally attached. The retina remained detached in 3 eyes (7.5%). Visual acuity improved postoperatively in 20 patients (50%), was unchanged in 13 patients (32.5%), and worsened in 7 patients (17.5%). Conclusions: Perfluoroperhydrophenanthrene is a useful and effective intraoperative tool for the management of complex retinal detachments secondary to severe proliferative diabetic retinopathy. This revised version was published online in July 2006 with corrections to the Cover Date.     

Fluorescein angiography of extreme peripheral retina and rubeosis iridis in proliferative diabetic retinopathy.

PURPOSE: To study the fluorescein angiographic appearance of the extreme peripheral retina in patients with proliferative diabetic retinopathy with rubeosis iridis. METHODS: Using a modified endoscope, fluorescein angiography was performed prospectively during pars plana vitrectomy on 14 eyes of 12 patients with proliferative diabetic retinopathy who had or developed postoperative rubeosis. These findings were compared with those obtained from 41 eyes of 35 patients without rubeosis. RESULTS: A fibrovascular ridge was observed at the ora serrata in 11 of 12 eyes (92%) with rubeosis but in only 15 of 35 (43%) eyes without rubeosis. Seven of 12 (58%) eyes with rubeosis showed the continuous type of fibrovascular ridge, whereas only 5 of 35 (14%) eyes without rubeosis showed the continuous type. A broom-shaped continuous fibrovascular ridge was observed only in eyes with rubeosis. CONCLUSIONS: Many eyes with proliferative diabetic retinopathy showed unusual findings in the extreme retinal periphery, which were more frequent in the eyes with rubeosis iridis. Fluorescein angiography of this region may provide valuable information for possible anterior neovascularization.     

Survey of surgical indications and results of primary pars plana vitrectomy for rhegmatogenous retinal detachments.

BACKGROUND: Several surgical techniques to repair rhegmatogenous retinal detachment have been developed. Recently, both the method of reattaching the retina and of obtaining an early visual recovery are considered important factors when determining which surgical techniques to perform to treat retinal detachment. CASES: The surgical outcome in a series of 63 consecutive patients, who were treated at Osaka Rosai Hospital between 1993 and 1996, was reviewed retrospectively to evaluate the efficacy of primary vitrectomy to treat uncomplicated rhegmatogenous retinal detachment associated with posterior hyaloid separation. The criteria for vitrectomy included the presence of not only posterior retinal breaks, but also of multiple peripheral retinal breaks. OBSERVATIONS: The reattachment rate after the first surgery was 92.1% (58 eyes), and by the final examination it increased to 100%. Of the 46 eyes with macular detachment, good visual rehabilitation and a visual acuity improvement of 5 or more lines was obtained in 33 eyes (71.7%) by 1 month postoperatively. No statistically significant difference in the reattachment rate was found when eyes that underwent an encircling procedure were compared with those that did not. In eyes with lens opacity, cataract surgery was also performed and intraocular lenses were implanted uneventfully in all but one case with myopia. There was a high incidence (53.8%) of cataract progression in phakic eyes. However, no other serious complications, such as proliferative vitreoretinopathy, were found throughout the follow-up period. CONCLUSIONS: The results indicate that vitrectomy performed to alleviate peripheral vitreoretinal traction is an effective surgical technique to treat primary rhegmatogenous retinal detachment. Vitrectomy combined with cataract surgery may also be a valuable surgical option in selected cases to maintain long-standing visual rehabilitation.     

松弛性视网膜切开术治疗视网膜脱离合并严重前增殖性玻璃体视网膜病变

目的探讨松弛性周边视网膜切开术联合眼内激光治疗视网膜脱离合并严重前增殖性玻璃体视网膜病变的效果。方法对４４例视网膜脱离合并严重前增殖性玻璃体视网膜病变的患者行松弛性周边视网膜切开术，联合眼内激光和硅油填充治疗。观察术后视网膜解剖复位、视功能及术后眼压变化情况。其中２２例取出了硅油。结果４４例全部获得视网膜复位（其中８例合并皱褶），３８例获得不同程度的视力改善。２２例取出硅油后，有２１例视网膜保持复位。部分患者术后眼压偏低。１例患者黄斑移位。结论松弛性周边视网膜切开术是治疗严重前增殖性玻璃体视网膜病变的有效方法之一。视网膜下膜的清除有利于视网膜展平复位。部分患者出现术后眼压偏低和黄斑移位现象，因此应严格掌握手术适应证，术中尽可能避免黄斑移位，同时应在视网膜复位、眼压正常时再取出硅油。     

巩膜扣带术在玻璃体切除术后视网膜未复位患者中的应用

目的 探讨应用巩膜扣带术治疗玻璃体切除术后视网膜未复位患者的手术疗效.设计回顾性病例系列.研究对象2004～2010年北京同二医院43例43眼玻璃体切除术后视网膜未复位患者.方法 所有患者采用间接检眼镜直视下冷冻裂孔、巩膜环扎或外垫压、外放液方法治疗.对硅油填充眼,先行巩膜扣带术,术后1～4周后再行硅油取出.主要指标术后视网膜复位情况、视力、眼压和并发症等.结果 43眼中,12眼为单纯行玻璃体切除或联合玻璃体腔注气术后视网膜脱离,经一次巩膜扣带术,11眼复位,1眼失败后再次行玻璃体切除硅油填充术 24眼为硅油填充眼,其中22眼行巩膜扣带术后视网膜完全复位,1～4周后行硅油取出,2眼视网膜未复位,取油时联合视网膜切开,硅油再填充,最终1眼完全复位,1眼广泛视网膜增殖,增生性玻璃体视网膜病变（PVR）形成,光感消失,眼球萎缩 7眼为硅油取出术后视网膜再脱离眼,行巩膜扣带手术后6眼视网膜完全复位,1眼再次硅油填充.随访3～72个月,经一次巩膜扣带术后视网膜复位39眼（90.7%）,最终42眼（97.7%）视网膜复位.结论 对于玻璃体切除手术失败且裂孔位于周边部的视网膜脱离患者,采用巩膜扣带术式能有效地使视网膜再复位.     

Postoperative laser coagulation as retinopexy in patients with rhegmatogenous retinal detachment treated with scleral buckling surgery: a prospective clinical study

PURPOSE: To evaluate postoperative laser photocoagulation as retinopexy mode in patients with rhegmatogenous retinal detachment treated with scleral buckling surgery. METHODS: The authors conducted a prospective feasibility study of consecutive patients with rhegmatogenous retinal detachment treated with scleral buckling surgery and postoperative laser during an 18-month period with a minimal follow-up of 6 months. Outcome measures were total retinal reattachment and the occurrence of proliferative vitreoretinopathy (PVR). RESULTS: A total of 123 patients (124 eyes) were included in this study. Seventy-six percent were phakic and 24% were pseudophakic. Fifty percent presented with one horseshoe tear, 15% with multiple tears, 30% with round breaks, and 5% with no identifiable break. Ten percent presented with a vitreous hemorrhage and 25% with three or four quadrants of detached retina. Six patients had PVR C1. Twelve patients required a postoperative gas injection, five patients received an additional buckle, and five patients underwent a vitrectomy, in four because of PVR. In all patients the retina was fully reattached at the end of follow-up. Planned postoperative laser coagulation took place 1 day to 10 weeks (median 3(1/2) weeks) after buckling surgery. Buckling material was removed in three patients without redetachment. CONCLUSION: Postoperative laser coagulation is a feasible alternative retinopexy mode in scleral buckling surgery, with encouraging anatomical results and a low incidence of PVR.