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180° retinectomy most common technique for proliferative retinopathy
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CHICAGO — Excision of the retina, or retinectomy, has been increasingly performed over the years in cases of proliferative retinopathy, with the inferior 180° technique being most used, according to a speaker here.
Not as common is the 360° technique, and even less common is focal posterior retinectomy, Dean Eliott, MD, told colleagues at Retina Subspecialty Day preceding the joint meeting of the American Academy of Ophthalmology and Asia Pacific Academy of Ophthalmology.
Dean Eliott
“The location of the retinectomy is posterior to the vitreous base, and the orientation is circumferential,” Eliott said. “The most common location is inferiorly with the edges at 3 o’clock and 9 o’clock. These edges are most vulnerable to reproliferation and traction, and that’s why we avoid retinectomy edges at 6 o’clock, because [proliferative retinopathy] is a gravity-dependent disease.”
Hemostasis is critical to success, Eliott said. Diathermy is used to delineate the intended edge and prevent bleeding.
“Reproliferation is associated with hemorrhage,” he said, “so it’s very important that, intraoperatively and postoperatively, there’s no hemorrhage at the edge of the retinectomy.”
Disclosure: Eliott is a consultant for Alimera, Arctic, Bausch + Lomb, Genentech, Glaukos, Ophthotech and ThromboGenics.