Resources Involved in Managing Retinal Detachment Complicated by Proliferative Vitreoretinopathy

In Brief Purpose: To report the differences in cost of treatment and outcome in retinal detachment (RD) cases with and without proliferative vitreoretinopathy (PVR). Methods: Analysis of clinical trial databases of RD observed in 190 eyes of 190 patients. Eyes were classified as no PVR, developing PVR, or established PVR. For each eye, total cost of treatment undertaken on Moorfields Eye Hospital vitreoretinal unit, final retinal status, and best-corrected visual acuity were recorded. Results: Management of patients who developed PVR involved approximately double the resources of RD without PVR. Eyes with pre-exiting PVR had similar resource input to those with RD without PVR. Patients who developed PVR had a mean of 3.7 operations (including subsequent cataract surgery) compared to 1.8 and 2.1 respectively for noncomplicated RD and pre-existing PVR. Anatomic success and visual outcome was significantly worse in eyes with PVR. Conclusions: Treatment of eyes that developed PVR after initial surgery cost significantly more than eyes with no PVR or established PVR (P < 0.01). Improvements in the management of RD aimed at preventing PVR and advances in PVR treatment may have significant financial as well as clinical benefits. The management of PVR cases is generally perceived to require greater resource expenditure both for the caregiver and the patient although the exact quantity of additional resources is uncertain. In this study, the authors have quantified the differences in the resources required to treat retinal detachment with and without PVR. Additionally, they report differences in final outcome as reflected by the rate of retinal reattachment and visual acuity.