Vitreoretinal surgery in advanced Coat's disease.

Massive subretinal exudates as well as vitreal traction often induce complicated retinal detachments in patients with advanced Coats' disease. If left untreated, most patients experience secondary glaucoma by rubeosis and phthisis bulbi in addition to irreversible visual loss. We report on the surgical procedures used and results obtained in three patients aged between 21 and 28 years with combined exudative and traction-induced detachment. In all cases, extensive but unsuccessful retinal coagulation had been performed. The surgical intervention was done by application of an encircling buckle followed by vitrectomy and removal of preretinal membranes and subretinal lipid exudates via retinectomies. Particular attention was paid to the intensive endodiathermy of retinal teleangiectasies during surgery. Surgery was concluded by siliconeoil tamponade. Postoperatively, progressive resorption of remaining exudates and teleangiectatic vessels could be observed. All patients demonstrated stable functional and anatomic results at the last follow-up examination performed at 13 months to 6 years after surgery. A stabilization of the anatomic and functional situation can be achieved even in advanced cases of Coats'-induced traction retinal detachment by vitreoretinal surgery.