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S.S.K.İstanbul Eğitim Hastanesi Göz Kliniği Hospital Ophthalmology Department 61 patients with complicated retinal detachment were operated between 1995-1998. Retinal attachment was achieved in 58 (96%) patients during the surgery. Silicone oil was used in 40 (%69) , C3F8 in 18 (%31) patients as a long acting intravitreal tamponade. Patients were followed up between 4-24(mean 7) months. Retinal redetachment was observed in 17 (29%) patients during the follow up period. Anterior PVR, posterior PVR, perisilicone and subretinal proliferation were the most important causes of retinal redetachment.
All redetachment cases had undergone to further surgery. 7 patient operated for three and 4 patients for four times for recurrent detachment. Additional to membrane pealing , intraocular lens explantation in 4, clear lens extraction in 3, 90-360 degree peripheric retinotomy in 9 patients had been performed. Silicone oil was used in all cases and retinal attachment was achieved in 13 (76%) patients at the end of the surgeries. During follow up period 9 patients remained attached. We observed hypotonia in 2 patients, and redetachment in 4 cases in this period.
The most important cause of reccurent retinal detachment is reproliferation. Today the most important approach to prevent recurrences is to evaluate vitreus base very carefully and remove it completely, especially in inadequete midriasis like in aphkia or pseudophakia. If retinal attachment couldn't be achievied in spite of removal of the vitreus base with all epiretinal membranes, more complicated procedures must be done without delay although they could affect the visual prognosis negatively. Keywords : retinal detachment, pars plana vitrectomy,silicone oil, proliferative vitreoretinopathy