Proliferative vitreoretinopathy (PVR) occurs when a scar forms on or under the retina after retinal detachment, preventing the retina from healing and falling back into place.
There are no proven preventive measures.
What causes PVR?One of the common causes of PVR is failed repair of retinal detachment.
When there is a hole in the retina, cells that normally reside under the retina enter the eyeball and settle on the inner layer of the eye on top of the retina. These cells multiply and form a scar on the surface (and sometimes under) the retina.
This scar tissue then contracts and detaches the retina away from the innermost walls of the eye, resulting in a second retinal detachment.
What are the risk factors for PVR?Risk factors include large retina tears or retinal detachment that is not treated early. Bleeding within the eye, increased inflammation from trauma and previous retinal detachment operations also increase the risk.
Many of the factors that increase the risk of PVR are similar to that of retinal detachment, such as high degree myopia (short-sightedness), family history and post-surgery for cataracts. Retinal detachments can also be caused by other eye diseases such as tumours, severe inflammation or complications from diabetes.
Early detection and treatment of retinal detachment can prevent PVR from occurring, so regular eye examination play an important preventative role.
Diagnosis is made through clinical examination.
Vitrectomy is one form of treatment. It is a form of keyhole surgery that uses small probes to enter inside the eye and remove the vitreous.
Another treatment is scleral buckling – an operation using a silicone bane outside the eyeball.
If vitrectomy is performed, gas or silicone oil may be used to replace the jelly inside the eye. Post-surgery, the patient will need to lie in a face-down position for one to two weeks.
Eyes with serious PVR may not be treated with surgery if the vision is unlikely to improve after surgery. The success of improving the vision varies from person to person and ranges from 60% to 80%.
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