A series of 595 eyes of 554 patients with primary rhegmatogenous
retinal detachment, referred before any failed surgery, were prospectively evaluated. Univariate and multivariate statistical analyses of the data were conducted.
RESULTS: The incidence of postoperative PVR in relation to the methods used for retinopexy was dependent on the types and anatomy of
retinal breaks associated with
retinal detachment. The incidence of postoperative PVR was nil in
retinal detachments due to atrophic holes in lattice, oral dialyses, and
macular holes, regardless of the retinopexy methods. Postoperative PVR occurred solely in
retinal detachments due to horseshoe tears (incidence 4.42%), paravascular tears of the postequatorial region (18.18%), and giant tears (24.6%) (P < 0.00001). The incidence of postoperative PVR was 0.5% in eyes with horseshoe tears with mobile posterior edges vs 9.72% in eyes with horseshoe tears with curled posterior edges, regardless of the retinopexy methods (P < 0.00001). In
retinal detachments due to horseshoe tears with mobile posterior edges the incidence of postoperative PVR (0.5%) was not influenced by the retinopexy methods. In contrast, in
retinal detachments due to horseshoe tears with curled posterior edges the incidence of postoperative PVR was higher in eyes managed with cryopexy (14.77%) than in eyes managed with
laser retinopexy (1.78%) (P < 0.02). In
retinal detachments due to giant tears the incidence of postoperative PVR was not statistically significantly greater in eyes managed with cryopexy (33.3%) than in eyes managed with
laser retinopexy (15.6%). In tears 180 degrees and over in size, however, the incidence of postoperative PVR was significantly higher in eyes managed with cryopexy (9/11 eyes) than in eyes managed with
laser retinopexy (5/17 eyes) (P = 0.006).
CONCLUSIONS: Cryopexy is not a stimulating factor for postoperative PVR in primary rhegmatogenous
retinal detachments due to atrophic holes in lattice, oral dialyses,
macular holes, or horseshoe tears with mobile posterior edges. In contrast, cryopexy probably is a stimulating factor for postoperative PVR in
retinal detachments due to horseshoe tears with curled posterior edges or to
retinal tears 180 degrees and over.