Outcomes of the Perplexed Surgical Management of Retinal Detachment in Eyes with Coloboma

Purpose: To determine the anatomical and visual outcomes of retinal detachment in eyes with chorioretinal coloboma managedby pars plana vitrectomy, endolaser photocoagulation and silicone oil (SO) tamponade. Methods: Retrospective review of 29 eyes of 29 patients with retinal detachment associated with chorioretinal coloboma. All the cases were managed by vitrectomy procedures concluding with SO tamponade. Encircling band was placed based onpre-operative evaluation and/or surgeon’s discretion. Endolaser photocoagulation was applied around the peripheral retina,all around the peripheral breaks and around the colobomatous area. The outcome measures were evaluated with regard tofunctional and anatomical success. Results: The average age at the time of surgery was 21.76 ± 9.58 years (range, 10–50 years). The mean follow-up durationwas 12.28 ± 4.8 months (range, 6–24 months). Primary attached retina was obtained in 21 / 29 (72.4%) eyes after single surgery. Re-detachment in 8 / 29 (27.6%) eyes which required revision surgery was the most frequent postoperative complicationfollowed by raised intraocular pressure in 4 / 29 (13.8%) with SO in situ. Out of 29 eyes, 23 were followed up after the removalof SO. The mean duration of SO removal was 7.91 ± 3.9 months (range, 4–18 months). Implantation of encircling band,lens removal and cryotherapy provided no added advantage. At the final examination, improvement in vision was observedin 21 (72.4%) eyes and the anatomical attachment of the retina was attained in 27 (93.1%) eyes. Conclusions: Complete pars plana vitrectomy, endolaser photocoagulation along with SO tamponade is effective for retinaldetachment associated with chorioretinal coloboma. This technique improves the anatomical outcome and helps in regainingsignificant visual acuity.