Nonrhegmatogenous tractional retinal detachment occurs when mechanical vitreous traction displaces the neurosensory retina without an underlying retinal break. Because there is no tear, repair requires directly addressing the traction forces at the vitreoretinal interface.
In this subtype, the detachment is sustained by traction rather than by fluid passing through a retinal hole. The retina remains structurally intact, but vitreous traction holds it away from the retinal pigment epithelium — a distinction that determines the surgical strategy.
Management involves a trans pars plana vitrectomy as the central intervention, combined with surgical release of the tractional membranes responsible for the detachment. The choice of adjunctive intraoperative steps depends on the extent of traction and individual anatomical findings.
The complete structured regimen — including the full decision algorithm and the selection of adjunctive intraoperative procedures — is available in the protocol.
DOI: 10.1016/S1060-135X(98)90029-X