Retinal cryopexy stimulates traction retinal detachment formation in the presence of an ocular wound
P. A. Campochiaro, H. C. Gaskin and S. A. Vinores
Department of Ophthalmology, University of Virginia School of Medicine, Charlottesville 22908.
Pigmented rabbits were treated with retinal cryopexy applied to 180 degrees
of the peripheral inferior retina in one eye, and then a 6-mm
full-thickness circumferential wound was made in both eyes 3 mm posterior
to the superior limbus. The wounds were sutured, and only eyes with minimal
vitreous hemorrhage and no retinal breaks were included in the study. Eyes
were then examined with indirect ophthalmoscopy on postoperative days 1, 7,
14, 21, and 28. Of eyes that received cryopexy and an ocular wound (n =
13), the retina in three became totally detached between postoperative days
14 and 28; seven eyes had traction retinal detachment first noted on
postoperative day 14 that did not become total by postoperative day 28; and
two retinas remained attached, but showed folds suggesting the presence of
epiretinal membranes. One retina remained attached without folding. In eyes
that received only an ocular wound (n = 13), the retina in one showed
folds, and in 12 eyes it remained attached with no evidence of epiretinal
membrane formation. Retinas treated with cryopexy alone (n = 4) remained
attached without folds. On postoperative day 28, the rabbits were killed,
and, after fixation, eyes were examined grossly and by light and electron
microscopy. Examination confirmed the presence of vitreous and epiretinal
cellular membranes in eyes with retinal detachment. These data suggest that
in the presence of an ocular wound, retinal cryopexy, which has previously
been shown to cause extensive breakdown of the blood-retinal barrier,
stimulates the formation of intraocular cellular membranes and traction
retinal detachment.
