INVESTIGATING NOVEL SURGICAL TECHNIQUES FOR THE MANAGEMENT OF COMPLEX RETINAL DETACHMENTS

Abstract

Background: Complex retinal detachment remains one of the most challenging conditions in vitreoretinal surgery due to its association with proliferative vitreoretinopathy, giant retinal tears, and tractional components. Despite significant advancements in surgical instrumentation and visualization, achieving stable reattachment and restoring functional vision remain difficult. This study aimed to evaluate the outcomes of novel surgical techniques designed to enhance anatomical and visual recovery in patients with complex retinal detachments.

Methods: A prospective interventional study was conducted on 60 patients diagnosed with complex retinal detachment. All patients underwent pars plana vitrectomy utilizing advanced adjunctive methods, including chandelier-assisted bimanual surgery, perfluorocarbon liquid application, selective membrane peeling, and retinectomy when indicated. Endolaser photocoagulation and internal tamponade with either silicone oil or C3F8 gas were applied in all cases. Patients were followed for six months, and outcomes were assessed based on anatomical reattachment, best-corrected visual acuity (BCVA), and postoperative complications.

Results: The study included 36 males (60%) and 24 females (40%) with a mean age of 54.3 ± 11.2 years. Rhegmatogenous retinal detachment with proliferative vitreoretinopathy was the most common presentation (46.7%). Anatomical reattachment was achieved in 54 cases (90%), and functional improvement of at least two Snellen lines was observed in 70% of patients. The mean BCVA improved significantly from 1.78 ± 0.42 logMAR preoperatively to 0.94 ± 0.38 logMAR at six months (p < 0.001). Postoperative complications included elevated intraocular pressure (16.7%), silicone oil emulsification (10%), and recurrent detachment (8.3%).

Conclusion: Novel surgical techniques integrating advanced visualization, bimanual dissection, and optimized tamponade selection significantly improved both anatomical and functional outcomes in complex retinal detachment. These results support the efficacy and safety of modern vitreoretinal surgical innovations and highlight their role in enhancing long-term visual prognosis for patients with complicated retinal pathology.