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Single-Port Vitrectomy and "Oleodelamination" for the Management of Retinal Detachment Complicated by Proliferative Vitreoretinopathy.

Single-Port Vitrectomy and “Oleodelamination” for the Management of Retinal Detachment Complicated by Proliferative Vitreoretinopathy Proliferative vitreoretinopathy (PVR) is usually seen as a complication of unsuccessful retinal detachment surgery. Early referral, risk stratification, and case selection can reduce the incidence of recurrent detachment and PVR after primary retinal detachment repair to less than 3%, as described by Alexander et al.1 However, PVR (and inferior PVR in particular) continues to represent a complex surgical challenge, despite the recent surgical advances in this area, including the introduction of heavy tamponades. Internal tamponades (whether light or heavy) serve to maintain closure and apposition of retinal breaks to the underlying retinal pigment epithelium while the retinopexy matures to full strength. In this respect, with current conventional techniques, they are deployed toward the completion of the surgical intervention, solely as a tamponade. Single-port “oleodelamination,” a technique developed by Scott2–4 and further described by Snead,5 involves deploying silicone oil before vitrectomy, to delaminate retinal surface membranes, and then subsequently at single-port vitrectomy to enhance the tamponade effect beyond what is possible with conventional 3-port approaches using infusion and exchange. In this article, we provide an updated description and video demonstration of single-port “oleodelamination” vitrectomy surgery, an effective alternative technique for managing retinal detachment complicated by PVR. A summary of the outcomes from a case series of 11 patients who underwent single-port vitrectomy and oleodelamination after unsuccessful conventional vitrectomy approaches (or in whom such approaches were deemed inoperable by another center) is presented.