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The authors conducted a retrospective review of 32 patients with posterior retinal folds following retinal reattachment surgery. Twenty-eight of these patients underwent combined pars plana vitrectomy, fluid-air exchange with either internal drainage through a preexisting retinal break or external drainage of subretinal fluid, and scleral buckle. We believe these drainage techniques resulted in incomplete elimination of subretinal fluid, with resultant sequestration of fluid at the dependent border between attached and detached retina. Metamorphopsia and decreased visual acuity were noted in patients with folds involving the macula. The likelihood of fold formation may be greatly reduced by internal drainage through a posterior retinotomy combined with more complete removal of slowly gravitating fluid as it flows dependently to the drainage site.

Abstract: Purpose: To compare the postoperative anatomic success rates and the frequency of complications between prone or supine postoperative positioning after transconjunctival sutureless vitrectomy (TSV) for rhegmatogenous retinal detachment (RRD). Methods: All patients underwent primary 27‐gauge TSV for the treatment of primary RRD. Patients were divided into two groups as follows: group A was patients instructed to keep strict postoperative prone positioning for a minimum of 8 days. Group B was patients instructed to keep the prone positioning on the day of the surgery followed by supine positioning for minimum of 7 days from the day after surgery. Result: Sixty‐two eyes were enrolled (group A: 32, group B: 30). There was no significant difference in baseline data between two groups. The initial and final anatomical success rates were 93.8% and 100% in group A and 93.3% and 100% in group B, respectively (p = 1, p = 1, respectively). Posterior synechia of the iris occurred in one eye in group A and in two eyes in group B (p = 0.61). Macular pucker and retinal fold did not occur in either group. Preoperative intraocular pressure (IOP; mmHg) was 14.5 ± 2.9 in group A and 14.5 ± 2.6 in group B (p = 0.92). Intraocular pressure (IOP) was not statistically different between the groups during the follow‐up period (p = 0.36, p = 0.07, respectively). Conclusion: Supine positioning may be an option as a postoperative positioning after TSV and gas tamponade for the treatment of RRD. [ABSTRACT FROM AUTHOR]

Background: Formation of retinal folds is a serious and possibly underreported complication of vitrectomy with intraocular gas for retinal detachment. Certain risk factors are associated with this complication.Materials and methods: Presentation of our own cases with retinal folds after retinal detachment surgery and review of the relevant literature.Results: Spontaneous resolution of a retinal fold without surgical intervention with excellent visual outcome was observed in a patient operated with vitrectomy and intraocular gas for retinal detachment. In another case surgical intervention with repeat vitrectomy and macular detachment followed by intraocular gas resulted in complete resolution of a retinal fold with excellent visual outcome.Conclusion: Retinal fold formation after vitrectomy for superior bullous retinal detachments running through the fovea can be managed both conservatively and surgically. Treatment decision is made on an individual basis depending on patient symptoms. Knowledge of the risk factors for fold formation and postoperative posturing after retinal detachment surgery is very important in order to avoid this complication. [ABSTRACT FROM AUTHOR]

Background: Retinal folds (RF) following retinal detachment (RD) surgery are infrequent complications and their management is controversial. Spontaneous resolution of RF has been reported. Methods: An observational case report of a surgical complication of RD surgery was done. The progressive migration of a postoperative macular fold away from the center of the fovea was documented by optical coherence tomography (OCT) and retinography. Results: A macular fold was detected following 23G vitrectomy with liquid perfluorocarbon injection, photocoagulation, and SF6 injection to treat a bullous rhegmatogenous retinal detachment. In the following year, visual acuity remained stable at 20/25 while the macular fold migrated 1 mm away from the center of the fovea. Conclusions: A conservative approach may be appropriate in cases of macular fold following retinal detachment surgery, provided that good visual acuity is present and OCT shows a trend towards migration of the macular fold. [ABSTRACT FROM AUTHOR]

Background: To describe the surgical technique used in the management of two cases of dry retinal folds which occurred following retinal detachment surgery. Methods: Two patients with persistent dry retinal folds. Results: Patients underwent complete vitrectomy and membrane peeling, followed by injection of perfluorocarbon liquid. The retina was prodded and massaged flat with a silicone-tipped cannula under the perfluorocarbon liquid. The folds disappeared and the retina remained flat. Conclusion: The use of gentle manipulation under heavy perfluorocarbon liquids is an effective strategy for managing longstanding dry posterior retinal folds. [ABSTRACT FROM AUTHOR]

Here the management of a macular fold complicating retinal reattachment surgery is discussed. The macular fold was repaired by a technique similar to that used in retinal translocation surgery. Direct injection into the macular fold was performed, which caused a linear, rather than the intended concentric, detachment of the retina. Permanent flattening of the macula fold was achieved and the best-corrected Snellen visual acuity was 6/12 at 6 months. The importance of intervention, advantages and disadvantages of this technique and alternative methods of managing such cases are discussed. It may be prudent to consider peripheral, rather than direct, injection into the macular fold to detach the macula in such cases. [ABSTRACT FROM AUTHOR]