Definition: Proliferative vitreoretinopathy (PVR) a complication of retinal detachment (RD). It occurs in approximately 8-10% of patients who develop an RD. Proliferative vitreoretinopathy is simply scar tissue formation within the eye. It’s called "Proliferative" because cells proliferate and "Vitreoretinopathy" because the problems involve the vitreous and retina.
At the time of a retinal detachment or retinal tear, retinal pigment epithelium (RPE) cells that are normally under the retina come through the tear and enter the vitreous cavity. After the retinal detachment is repaired or not repaired (if the patient does not seek help) these cells proliferate on the surface of the retina in sheets, which contract and pull the retina back off. These sheets can occur in any location of the retina and cause redetachment.
Treatment: Surgery to repair a retina detached from PVR includes eye vitrectomy, membrane peeling, where small instruments are used to peel the membranes from the surface of the retina, and scleral buckling.
These techniques are combined with fluids or gasses placed in the eye to flatten the retina and reattach it to the outer wall of the eye. This may be followed by laser treatment to connect the retina to the outer layers permanently. A gas bubble may be placed in the eye to hold the retina in place while it is healing, or alternatively, silicone oil may be used to hold the retina in position. The advantage to the gas bubble is that is goes away on its own, and the patient does not require another operation. The advantage to the silicone oil bubble is that the patient does not have to specially positioning for up to three weeks following surgery, as they would with gas bubble placement, and can go back to normal activities in a few days. The disadvantage is that silicone oil requires removal in several months following the procedure, via another surgery.
Although PVR is a catastrophic complication of retinal detachment surgery and can cause profound visual loss, it has gone from being extremely difficult to repair in the late 1970s to having a very high success rate in repairing PVR detachments today.