Purpose: To report the anatomical and functional outcomes of retinotomy and/or Retinectomy for the management of rhegmatogenous retinal detachment (RRD) complicated by advanced proliferative vitreoretinopathy (PVR). Methods: In this retrospective study, the charts of patients who underwent pars plana vitrectomy with retinotomy and/or Retinectomy for the management of RRD complicated by PVR were reviewed. Primary outcome measures were final best-corrected visual acuity (BCVA) and anatomical reattachment rate. Results: Sixty-one eyes of 61 patients with a mean age of 48. 56 ±,15. 92 were studied. The mean follow-up time was 21. 38 ±,23. 08 months. The mean angle of the retinotomy was 171. 31°,±,79. 15°, . Thirty-two (52. 5%) of them needed extensive (≥, 180°, ) retinotomy. In addition, simultaneous Retinectomy was performed in 36. 2% of the cases. The BCVA was 2. 18 ±,0. 63 and 1. 85 ±,0. 71 logMAR before the surgery and at the last visit, respectively (P = 0. 001). The initial anatomical success was achieved in 45 eyes (73. 8%) after retinotomy surgery. Sixteen eyes (26. 2%) had recurrent RD and needed reoperation, which was performed 5. 60 ±,4. 01 months after the initial retinotomy surgery. At the last examination, the retina was attached in all patients. Conclusion: Retinotomy with/without Retinectomy is an effective procedure in the majority of patients with RRD associated with advanced PVR,however, additional surgeries are needed in a significant number of eyes to achieve final anatomical success.

During retinal surgeries, the presence of large retinal defects or breaks (giant retinal tears or retinotomies ≥ 3 clock hours) requires the use of perfluorocarbon liquid (PFCL) to stabilize the posterior retina. Thereafter, direct PFCL‑ oil exchange is preferred to avoid posterior slippage of the retina. However, in an eye filled with PFCL, fluid currents at the surface of the PFCL pose a few problems when laser is attempted. Multiple bubbles are formed due to fluid currents, and the fluid jet from the infusion port may continually dislodge the free end of the retina despite the presence of PFCL. This effect is accentuated when instruments are exchanged or if the active port is unoccluded. On the other hand, if laser is postponed until the eye is filled with oil, fluid accumulation may occur under the macula, as posterior tamponade is absent. We present a modified technique that entails the use of a “ sandwich” of anterior SO and posterior PFCL to comfortably perform laser in a well‑ formed closed vitreous chamber with continuous maintenance of retinal attachment.