Three months after an apparently successful scleral buckling procedure for rhegmatogenous retinal detachment, a patient presents with recurrent detachment. Examination shows stiff, folded retina with fixed corrugations and grey epiretinal membranes bridging the original break. What is the underlying process?

• A Vitreous liquefaction causing renewed fluid influx through a normal break-free retina
• B Choroidal neovascularisation extending under the detached retina
• C Reopening of the break due to inadequate cryotherapy adhesion
• D Retinal pigment epithelial and glial cell proliferation with membrane contraction over the retinal surfaces ✓

Explanation

Proliferative vitreoretinopathy is the most common cause of late failure after retinal detachment surgery. Retinal pigment epithelial cells migrate through the retinal break into the vitreous cavity, along with glial cells and fibroblasts, and proliferate to form contractile membranes on both surfaces of the retina. Membrane contraction reopens breaks and produces fixed folds. Inadequate cryotherapy alone would cause early rather than delayed failure without epiretinal membranes.

Reference: Ryan's Retina, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.