Rhegmatogenous Retinal Detachment with a High Risk of Proliferative Vitreoretinopathy Treated with Episcleral Surgery and an Intravitreal Dexamethasone 0.7-mg Implant
A 35-year-old Caucasian man presented with a macula-off rhegmatogenous subtotal retinal detachment extending 3 quadrants, sparing the inferior nasal quadrant, that had persisted for 1 month in his myopic left eye (fig. ). He had no history of previous vitreoretinal surgery, and his best corrected visual acuity was hand motion. Fifteen days before the beginning of the symptoms, he had had an ocular blunt trauma and presented with a large tear in the superior temporal quadrant extending 2 clock hours (fig. ), and wrinkling of the edges of the retinal tear and the inner retinal surface, denoting a grade B PVR. His medical history was unremarkable. On examination, the anterior segment was unremarkable and the intraocular pressure was normal. He underwent scleral buckling surgery with circumferential silicone sponge and an encircling silicone band, and subretinal fluid drainage was employed. Cryotherapy was performed to achieve retinopexy (fig. ). At the end of the surgery, he received a single intravitreal injection, via pars plana, of dexamethasone 0.7 mg (Ozurdex) as off-label treatment (fig. ).\nHis condition has been stable for at least 9 months now, as seen on the last examination, with his best corrected visual acuity having improved to 0.2 and no sign of PVR or pucker having developed in the treated eye. No complications have been observed, including raised intraocular pressure.