Retinal Detachment with Posterior Paravascular Retinal Tears

Author(s):  
Mireille Bonnet
2021 ◽  
pp. 112067212199268
Author(s):  
Jorge Fernández-Engroba ◽  
Muhsen Saman ◽  
Jeroni Nadal

Purpose: To report our anatomical outcome with the internal limiting membrane (ILM) graft procedure in the management of rhegmatogenous retinal detachment (RRD) secondary to optic disc coloboma (ODC). Methods: Description of a new surgical procedure in one eye of one patient who underwent pars plana vitrectomy (PPV) combined with ILM graft technique. Subsequent follow-up included optical coherence tomography (OCT) and visual acuity. Results: After only 1 week, the OCT revealed the ILM graft plugging the retinal tear with complete resorption of subretinal fluid. The sealing effect of this graft persisted after 6 months. However, visual outcome was poor and corrected distance visual acuity was 20/200 as a result of the previous long-standing retinal detachment with loss of photoreceptors. Conclusion: We suggest that ILM graft could be performed as a first line treatment in the management of RRD secondary to ODC. This direct closure of the retinal tears, allows a quick and effective interruption of the communication between the subretinal space and the vitreous cavity. Detecting these retinal tears and applying this technique as soon as possible could achieve not only an earlier anatomical success but obtain good visual results in retinal tears with RRD secondary to ODC. Further studies will be necessary to provide more evidences


2017 ◽  
Vol 8 (2) ◽  
pp. 436-439
Author(s):  
Mushawiahti Mustapha ◽  
Edward Roufail Franzco

Purpose: To describe the excellent outcome of surgery for bilateral giant retinal tears (GRTs) with better options of endotamponade. Methods: This is a case report of a 62-year-old man who presented with bilateral GRTs and associated retinal detachment. The tear in the right eye was supero-temporal and silicone oil was used as an endotamponade. The tear in the left eye was infero-temporal and perfluorocarbon liquid was used as an endotamponade. Results: The outcome at 6 months after surgery was excellent with visual acuities of 6/6 in both eyes. Conclusion: Improved availability of endotamponade agents allows repair of bilateral GRTs to be done at the same time, with good surgical outcomes.


2019 ◽  
Vol 4 (4) ◽  
pp. 61-65
Author(s):  
D. G. Arsiutov

Background. The method of the use of autologous conditioned platelet rich plasma is a promising method in the surgery of retinal pathology, particularly in the surgery of rhegmatogenous retinal detachment without the use of additional endolaser photocoagulation, but requires the foundation of its efficiency.Aim: to evaluate the effectiveness of the surgery of rhegmatogenous retinal detachment with central (macular) and peripheral retinal tears, including retinal abruption from the dentate line, with the use of 25, 27-gauge subtotal vitrectomy, pneumoretinopexy and silicone oil tamponade with blocking of retinal defect with the use of autologous conditioned plasma without the use of endolaser photocoagulation around retinal defects.Materials and methods. The surgery included 25, 27-gauge vitrectomy, posterior hyaloid membrane removal, internal limiting membrane removal in case of macular hole, pneumoretinopexy, instiilation in 2–3 layers of autologous conditioned platelet rich plasma, devoid of leukocytes and containing 1.5–3 times more thrombocytes than in whole blood into the area of retinal detachment or along the edge of retinotomy till the retinal defect and nearby intact retina are totally covered. A total of 29 patients with visual acuity from 0.03 to 1.0 underwent the surgery.Results. In the early postoperative period (up to 1 month) 96.6 % of patients showed total retinal reattachment, retinal detachment was blocked, in one patient with multiple retinal tears recurrent retinal detachment was detected; in the early delayed postoperative period (1–3 months) 82.8 % of patients showed total retinal reattachment, in 5 patient retinal reattachment was partial.In the late postoperative period (4–12 months) 86.2 % of patients showed total retinal reattachment, there were 4 recurrent retinal detachments. Patients with recurrent retinal detachment were successfully reoperated. Autologous conditioned plasma was not used during reoperations. Visual acuity of the patients, which underwent surgery in the late postoperative period, was 0.1–1.0.Conclusions. 25, 27-gauge vitreoretinal surgery of rhegmatogenous retinal detachment with central and peripheral retinal tears, including tears with abruption from the dentate line and retinal defects blocking with the use of autologous conditioned plasma rich with thrombocytes without the use of endolaser photocoagulation around retinal defects – is a method which allows to achieve in most cases total retinal reattachment, better functioning of the operated eye.


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Matteo Forlini ◽  
Purva Date ◽  
Domenico D’Eliseo ◽  
Paolo Rossini ◽  
Adriana Bratu ◽  
...  

Purpose. To evaluate whether limited vitrectomy is as effective as complete vitrectomy in eyes with epiretinal membrane (ERM) and to compare the surgical times and rates of complications. Methods. In this multicentre European study, data of eyes with ERM that underwent vitrectomy from January 2017 to July 2018 were analyzed retrospectively. In the limited vitrectomy group, a posterior vitreous detachment (PVD) was induced up till the equator as opposed to complete PVD induction till the vitreous base in the comparison group. Incidence of iatrogenic retinal breaks, retinal detachment, surgical time, and visual outcomes were compared between groups. Results. We included 139 eyes in the analysis with a mean age being 72.2 ± 6.9 years. In this, sixty-five eyes (47%) underwent limited vitrectomy and 74 eyes (53%) underwent complete vitrectomy. Iatrogenic retinal tears were seen in both groups (5% in limited vitrectomy versus 7% in complete vitrectomy, p = 0.49 ). Retinal detachment occurred in 2 eyes in the limited vitrectomy group (3%) compared to none in the complete vitrectomy group ( p = 0.22 ). Best-corrected visual acuity (BCVA) and central macular thickness improved significantly with no intergroup differences ( p = 0.18 ). Surgical time was significantly shorter in the limited vitrectomy group with 91% surgeries taking less than 1 hour compared to 71% in the complete vitrectomy group ( p < 0.001 ). Conclusion. A limited vitrectomy is a time-efficient and effective surgical procedure for removal of epiretinal membrane with no additional complications.


Intraoperative iatrogenic retinal tears leading to postoperative retinal detachments secondary to vitrectomy are an important sight-threatening complication of pars plana vitrectomy. Peripheral vitreous traction and retinal tears that incompletely removed, surgical instruments causing shrinkage on the basis of vitreous and incarceration of the vitreous to the entry points of the surgical instruments during entry and exit can be counted among the main causes of tears. In addition, small ruptures that may have been missed before the operation may cause retinal detachment after PPV. In order to reduce postoperative RD, it is based on the principle of detecting and treating the retinal breaks, if it is formed. Removing the peripheral vitreous completely without traction during PPV is important in preventing the formation of new tears.


Rhegmatogenous retinal detachment (RRD) is the separation of the neurosensory retina from the retinal pigment epithelium (RPE) due to retinal tears. Surgical techniques are used more frequently in the treatment of RRD. The two most commonly used options are PPV (Pars Plana Vitrectomy) and scleral surgery. When the results of primary treatment are evaluated, especially in patients with advanced PVR, the rate of failure and recurrence is higher than in uncomplicated patients. PVR is the main cause of failure in RRD, which has been treated with conventional surgery and PPV. In cases of treated RRD, other than PVR, recurrence can be seen for different reasons depending on the primary treatment technique. In this review, the causes and treatment of recurrence are discussed.


Rhegmatogenous retinal detachment is one of the most important retinal diseases requiring urgent surgical treatment. To be aware of the pathophysiology of the disease and to know the risk factors; it is crucial to prevent the development of the disease or overcome the complications that may arise and understand the surgical treatment principles. Major factors in the development of RRD: retinal tears, vitreous liquefaction, and detachment, traction on the retina surface. Myopia, previous cataract surgery, trauma, posterior vitreous detachment, lattice degeneration are the most important risk factors.


Author(s):  
A.V. Doga ◽  
◽  
L.A. Kryl ◽  
P.L. Volodin ◽  
D.O. Shkvorchenko ◽  
...  

Horseshoe-shaped retinal tear leads to rhegmatogenous retinal detachment (RRD) in 61-83% of cases. Vitreoretinal traсtion is the main factor in the development of horseshoe tears and RRD. In this aspect, YAG-laser retinotomy is promising, which makes it possible to eliminate the traction component by excision area of the horseshoe tear with vitreoretinal adhesion (VRA). Purpose. To analyze the results of YAG-laser retinotomy in the treatment of patients with complicated horseshoe tears and rhegmatogenous retinal detachment. Material and methods. The study included 97 patients (100 eyes). Of these, 54 patients (57 eyes) with complicated horseshoe retinal tears and 43 patients (43 eyes) with local RRD. Patients with complicated horseshoe tears underwent YAG-laser retinotomy at the base of the horseshoe tear. Patients with local RRD underwent a combined laser-surgical technology, which included YAG-laser retinotomy of the horseshoe tear area with vitreoretinal adhesion, pneumatic retinopexy and barrier laser photocoagulation. Results. In the group of patients with complicated horseshoe tears, complete retinal attachment was achieved in 15 eyes (58%), partial retinal attachment - in 7 eyes (27%). In the group of patients with local RRD complete retinal attachment was achieved in 40 patients (93%). There was a stable anatomical result and no changes in functional parameters. Conclusion. YAG-laser retinotomy eliminates vitreoretinal traction in the area of horseshoe tear and prevents the development of rhegmatogenous retinal detachment. Application of YAG-laser retinotomy as the first step of a microinvasive combined laser-surgical technology for the treatment of RRD makes it possible to obtain a high anatomical result, reduce the risk of retinal redetachment, and also preserve the initially high visual functions of patients.


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