Clinical Characteristics of Rhegmatogenous Retinal Detachment Combined with Proliferative Vitreoretinopathy Grade C or Higher

Purpose: To classify rhegmatogenous retinal detachment (RRD) combined with proliferative vitreoretinopathy (PVR) grade C or higher according to clinical difficulties and age and to investigate the outcomes and operation methods.Methods: Eyes with RRD with PVR grade C or higher were reviewed retrospectively among 752 eyes of RRD over a period of 5 years.The cases with total retinal detachment combined with ocular hypotony, giant retinal tear, uveitis treated within 3 months, or atopic dermatitis were classified as the high risk group, and the others were the low risk group.Additionally, the low risk group was classified as the low risk group-older and low risk group-younger according to age 40.Operation methods and anatomical outcomes were analyzed according to group.Results: Eighty-two eyes with RRD with PVR grade C or higher were enrolled, representing 10.9% of the total RRD eyes.Of these, 36 eyes were assigned to the high risk group, and 46 eyes were in the low risk group.In the low risk group, 14 eyes were classified in the low risk group-older, and 32 eyes were in low risk group-younger.The eyes in the high risk group were mainly treated with encircling combined with vitrectomy (89.0%), but the primary anatomical success rate was low (61.1%).Comparatively, scleral buckling was the main procedure performed in the low risk group-younger (94%), and a higher primary anatomical success rate was achieved (96.7%).The primary success rate of the low risk-older group was 71.4%.Conclusions: The risk factors seem to be important when deciding the operation method and for predicting the prognosis of RRD with PVR grade C or higher.Scleral buckling could be considered as the first option for treating RRD with PVR grade C or higher in the absence of risk factors in patients aged less than 40.