Neovascular complications associated with rubeosis iridis and peripheral retinal detachment after retinal detachment surgery

Barile, GaetanoR; Chang, Stanley; Horowitz, JasonD; Reppucci, VincentS; Schiff, WilliamM; Wong, DavidT

« Previous Next »American Journal of Ophthalmology
Volume 126, Issue 3 , Pages 379-389, September 1998

Neovascular complications associated with rubeosis iridis and peripheral retinal detachment after retinal detachment surgery☆

Presented in part at the Retina Society, Vancouver, British Columbia, Canada, Sept 9, 1997.

GaetanoR Barile, MD
- Department of Ophthalmology, Columbia University College of Physicians and Surgeons, Edward S. Harkness Eye Institute and St Luke’s–Roosevelt Hospital Center, New York, New York, USA (Drs Barile, Chang, Reppucci, and Schiff)
- Dr Barile was a 1996–1997 Heed Foundation Fellow.
- Reprint requests to Gaetano R. Barile, MD, 635 W 165 St, New York, NY 10032; fax: (212) 305-0900
Stanley Chang, MD
- Department of Ophthalmology, Columbia University College of Physicians and Surgeons, Edward S. Harkness Eye Institute and St Luke’s–Roosevelt Hospital Center, New York, New York, USA (Drs Barile, Chang, Reppucci, and Schiff)
JasonD Horowitz, MD
- Opticare Eye Health Center, Waterbury, Connecticut, USA (Dr Horowitz)
VincentS Reppucci, MD
- Department of Ophthalmology, Columbia University College of Physicians and Surgeons, Edward S. Harkness Eye Institute and St Luke’s–Roosevelt Hospital Center, New York, New York, USA (Drs Barile, Chang, Reppucci, and Schiff)
WilliamM Schiff, MD
- Department of Ophthalmology, Columbia University College of Physicians and Surgeons, Edward S. Harkness Eye Institute and St Luke’s–Roosevelt Hospital Center, New York, New York, USA (Drs Barile, Chang, Reppucci, and Schiff)
DavidT Wong, MD
- Department of Ophthalmology, University of Toronto, St Michael’s Hospital, Toronto, Ontario, Canada (Dr Wong)

Accepted 3 February 1998.

Abstract

PURPOSE: To report clinical features and surgical management of neovascular complications associated with rubeosis iridis and peripheral retinal detachment after retinal detachment surgery in nondiabetic patients.

METHODS: Seven consecutive eyes of seven nondiabetic patients who developed neovascular complications associated with rubeosis iridis and peripheral retinal detachment after scleral buckling and vitrectomy procedures were retrospectively reviewed. None of the eyes had clinical evidence of anterior segment ischemia or retinal vascular disease, but each eye developed rubeosis iridis and neovascular complications.

RESULTS: Of the seven eyes with rubeosis iridis and peripheral retinal detachment, six developed recurrent or progressive vitreous hemorrhage, and three developed progressive neovascular glaucoma. Four eyes underwent a revision procedure to repair the peripheral retinal detachment, and anterior proliferative vitreoretinopathy was found in each of these cases. Rubeosis iridis regressed in all three eyes in which surgery resulted in complete reattachment of the retina. In one eye with persistent peripheral retinal detachment and in the three remaining eyes that did not undergo revision surgery, rubeosis iridis persisted and was associated with long-term neovascular complications. Final corrected visual acuity was 20/70 to 20/400 in three eyes with total retinal reattachment and no light perception to hand motions in four eyes with persistent peripheral retinal detachment and rubeosis iridis.

CONCLUSION: Visually significant neovascular complications may occur in eyes that develop rubeosis iridis associated with peripheral retinal detachment after retinal detachment surgery in nondiabetic patients. Successful repair of the peripheral retinal detachment may induce regression of rubeosis iridis, reduce associated complications, and improve the long-term prognosis of these eyes.