Proliferative Vitreoretinopathy (PVR) Update: Current Surgical Techniques and Emerging Medical Management

Abstract

Purpose:

To provide an update on current surgical techniques and emerging medical management in proliferative vitreoretinopathy (PVR).

Methods:

A literature search was conducted on studies in the past decade with the inclusion of historical, landmark studies.

Results:

Proliferative vitreoretinopathy remains the primary obstacle to successful retinal detachment (RD) surgery, despite increasing knowledge on its pathophysiology and efforts to reduce its occurrence. A number of recent visualization and surgical advancements, including smaller gauge vitrectomies, have shown promising results. Likely, effective PVR prevention and treatment may rest on a multimodal approach, with particular attention toward adjunct pharmacological use. There is a growing body of literature on effective anti-inflammatory, antineoplastic/proliferative, antigrowth factor, and antioxidant adjunct therapy. Nonetheless, a number of preoperative and perioperative risk factors must be assessed before considering any surgical or medical management. Newer preoperative risk factor findings, such as smoking, highlight the need for a broad consideration during patient counseling.

Discussion:

Most studies in this field are retrospective in design, and the number of randomized control trials is limited, owing to the uncommon nature and complicated clinical profiles of patients with PVR RDs. Prospective studies should consider including combination drug formulations as a part of its intervention. Surgical techniques that may mitigate the inflammatory response by reducing ocular trauma should also continue to be investigated.