Vitreous cortex remnants in patients with rhegmatogenous retinal detachment: A systematic review and meta-analysis

The terminology "vitreous cortex remnants" (VCR) indicates the outermost lamellae of vitreous cortex that remains attached to the retinal surface as a consequence of vitreoschisis. The relevance of VCR removal in eyes with rhegmatogenous retinal detachment (RRD) is unknown. We conducted a review from January 1, 2000, to July 30, 2023, examining 1493 eyes. Outcome measures included: prevalence of VCR, relationship between VCR and detachment recurrence due to proliferative vitreoretinopathy (PVR), and relationship between VCR and epiretinal membrane (ERM) formation. A meta-analysis was performed with data reported as odds ratios (OR) or mean difference and 95 % confidence intervals. Prevalence of macular and peripheral VCR was 53.4 and 46.8, respectively, with an overall VCR prevalence of 50.8 (95 % CI 42.6, 59.1) Given the scarcity of available data, meta-analysis regarding the relationship between peripheral VCR and redetachment due to PVR was not feasible. The odds of developing ERM were not statistically different between eyes that had had macular VCR removal vs. eyes that had not (log OR -0.08 [95% CI -1.06, 0.89 p= 0.89]. Additional prospective studies are required to verify whether removal of VCR may reduce the odds of recurrence of RRD due to PVR and the development of ERM.