CHARACTERISTICS AND VITREORETINAL MANAGEMENT OF RETINAL DETACHMENT IN EYES AFTER PENETRATING KERATOPLASTY IN a 10-YEAR STUDY.

Abstract

To investigate the incidence, clinical characteristics, and possible pathogenesis of retinal detachment (RD) after penetrating keratoplasty (PK), and to assess the impact of RD and vitreoretinal surgery on the postoperative effects and prognosis of PK surgery. A retrospective review of 3,241 eyes from 2,884 patients who underwent PK was conducted. RD incidence, characteristics, and outcomes of vitreoretinal surgery were analyzed. The incidence of RD after PK was 1.32%, with a mean follow-up of 7.7 years. RD occurred on average 28.3 months post-PK, sooner in eyes with multiple PKs. A unique traction RD pattern was identified, with anterior proliferative vitreoretinopathy (PVR) observed in 73.9% of cases during pars plana vitrectomy (PPV). This caused RD without detectable retinal breaks due to anterior displacement of the retina and vitreous base. Endoscope-assisted PPV in eyes with opaque corneas resulted in better visual acuity and silicone oil removal rates than standard techniques. Clear graft eyes retained silicone oil more frequently than those with opaque grafts. RD after PK is a rare complication, characterized by severe anterior PVR, presenting significant surgical challenges. Effective management involves specialized surgical interventions. Early detection and tailored surgical strategies are crucial for improving patient outcomes after PK.