The urgency of surgical treatment for rhegmatogenous retinal detachment

2021 ◽  
Author(s):  
Nicolas Feltgen ◽  
Josep Callizo ◽  
Lars-Olof Hattenbach ◽  
Hans Hoerauf
Keyword(s):  
Surgical Treatment ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment

Extrascleral Filling Using Endoillumination the First Experiencethe

2020 ◽  
pp. 43-49
Author(s):  
V.Y. Markevich ◽  
◽  
T.A. Imshenetskaya ◽  
O.A. Yarmak ◽  
◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Subretinal Fluid ◽  
Crystalline Lens ◽  
Vitreous Cavity ◽  
Macular Area ◽  
General Group ◽  
Anatomical Outcome

Purpose. To study the effectiveness of extrascleral filling (ESF) using endoillumination in the surgical treatment of patients with primary rhegmatogenous retinal detachment (RRD). Material and methods. The material for the study was the data of a comprehensive clinical examination and surgical treatment by ESF method using endoillumination in 17 patients (17 eyes) with RRD. In 7 cases (41%), the macular area was involved in the detachment process. In 5 cases (29.4%), local scleral filling was performed. In the remaining 12 cases (70.6%), the local ESF was supplemented with a circling silicone element. Surgical intervention was supplemented by transscleral drainage of subretinal fluid (SRF) in 10 cases (59%) and pneumatic retinopexy with SF6 gas 50% in 8 cases (48%). Results. In the general group of patients, best corrected visual acuity (BCVA) increased from 0.35 to 0.46. In the subgroup of patients with a detached macular area, the positive dynamics is more pronounced, BCVA increased from 0.1 to 0.28. The progression of proliferative vitreoretinopathy caused the recurrence of retinal detachment in two patients (11.8%). Recurrences were diagnosed after 3 and 5 months, respectively. In both cases, a vitrectomy with tamponade of the vitreous cavity with silicone oil 5000 Cst was performed. The percentage of successful anatomical outcome after the first operation in our study was 82%. The percentage of successful achievement of the final anatomical result was 94%. In two cases, additional injection of SF6 gas into the vitreous cavity was required. Conclusion. This type of surgical treatment is an effective method of surgical treatment of patients with RRD. In our study, the successful anatomical outcome after the first operation was recorded in 82% of patients, which correlates with the data of the authors who also used this method (83–92%). Surgeons who performed surgical treatment using this technique in our study note improved workplace ergonomics when visualizing the fundus using an operating microscope and endoillumination compared with indirect ophthalmoscopy. Other teams of authors came to this conclusion as well. In our study, there were no complications associated with the introduction of a light pipe into the vitreous cavity (iatrogenic crystalline lens injury, endophthalmitis), which indicates the safety of this type of surgical treatment.

scholarly journals A review of secondary surgical procedures for failed primary retinal detachment repair

2014 ◽  
Vol 7 (1) ◽  
pp. 8-12
Author(s):  
Nina Grigorivna Lukovskaya ◽  
Elizaveta Aleksandrovna Sajgina ◽  
Zalina Nikolayevna Dzhanayeva
Keyword(s):  
Surgical Treatment ◽  
Retinal Detachment ◽  
Surgical Procedures ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Surgical Treatments

An analysis of rhegmatogenous retinal detachment (RRD) surgical treatment after external stages of surgical treatment was performed. The main types of surgical treatments of RRD recurrences were reviewed. The principal surgical treatment for secondary repair is vitrectomy with retinal endophotocoagulation and silicone oil or gas-air mixture injection.

Rhegmatogenous Retinal Detachment: Pathophysiology and Risk Factors

2019 ◽  
pp. 138-141
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Retinal Detachment ◽  
Cataract Surgery ◽  
Rhegmatogenous Retinal Detachment ◽  
Posterior Vitreous Detachment ◽  
Retinal Diseases ◽  
Retinal Tears ◽  
Lattice Degeneration ◽  
Major Factors

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.

Retrospective analysis of the results of episcleral filling in the surgical treatment of primary rhegmatogenous retinal detachment

2021 ◽  
pp. 171-174
Author(s):  
A.V. Tereshchenko ◽  
◽  
N.N. Yudina ◽  
Y.A. Sidorova ◽  
O.S. Kulikov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Retinal Detachment ◽  
Key Words ◽  
Retrospective Analysis ◽  
Rhegmatogenous Retinal Detachment ◽  
Vitreoretinal Surgery ◽  
State Institution ◽  
Federal State

Purpose – to conduct a retrospective analysis of the results of episcleral filling in the surgical treatment of primary rhegmatogenous retinal detachment. Material and methods. Patients diagnosed with rhegmatogenous retinal detachment whom were undergone episcleral filling from 2015 to 2020 at the S. Fyodorov Eye Microsurgery Federal State Institution, the Kaluga Branch, were performed to a detailed retrospective analysis. Additionally, cases were analyzed when, after episcleral filling, the retina did not attach and later vitreoretinal surgery was performed. Results. Episcleral surgery was performed to the 486 eyes, repeated interventions were required to 126 eyes (26%). The presence of peripheral chorioretinal dystrophy of the retina (PCHDR) in paired eyes was found in only 45% of patients. In these patients’ retinal attachment was achieved with only one episcleral filling. In cases of lack of retinal attachment after episcleral surgery, the proportion of the presence of PCHDR in the paired eye was 84%. The superior and temporal segments were the most frequent places of localization of retinal rupture. At the same time, there were retinal ruptures in the upper segment in 30% of patients. The proportion of rupture in the external segment was 32%. The retinal rupture was localized in the upper external segment at 18% of cases. At 20% of cases, retinal ruptures were localized in the lower external and lower segments. Conclusion. The success of episcleral surgery depends on the thoroughness of the diagnosis, the detection of all existing retinal ruptures and their blocking during the surgical treatment. Key words: rhegmatogenous retinal detachment, episcleral filling, intravitreal surgery.

scholarly journals ASSESSMENT OF EFFICACY AND SAFETY OF COMBINED MICROINVASIVE LASER-SURGICAL TREATMENT OF RHEGMATOGENOUS RETINAL DETACHMENT

2020 ◽  
pp. 535-541
Author(s):  
A.V. DOGA ◽  
◽  
D.O. SHKVORCHENKO ◽  
L.A. KRY ◽  
M.R. TAEVERE ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Surgical Treatment ◽  
Retinal Detachment ◽  
Laser Photocoagulation ◽  
Rhegmatogenous Retinal Detachment ◽  
Wide Field ◽  
Efficacy And Safety ◽  
Pneumatic Retinopexy ◽  
Retinal Tear

Objective: To evaluate the efficacy and safety of combined laser-surgical treatment of rhegmatogenous retinal detachment (RRD). Methods: The 32 eyes from 32 patients with a local RRD due to horseshoe tear were enrolled. In addition to standard examination, all patients underwent multispectral laser scanning and wide-field optical coherence tomography (WFOCT) to determine the extention and localization of vitreoretinal tractions (VRT). All patients underwent the combined microinvasive laser-surgical technology of RRD treatment, including YAG-laser excision of the VRT area, pneumatic retinopexy, and barrier laser photocoagulation around the retinal tear after complete retinal attachment (2-3 days). The post-operative examination was performed on days 3 and 7, and in 3, 6, 12, 18, and 24 months. The follow-up period was 2 years. Results: Retinal attachment was achieved in 30 patients (93.8%). The retina did not attach in 2 cases (6.4%) – in a patient with pseudophakia and in a patient who did not follow the recommendations on the proper head position after surgery. The recurrence of retinal detachment occurred in 2 cases (6.7%) as a result of the new tears formation in lower parts of the fundus periphery. The rest of the patients had a stable anatomical and functional result and no recurrence of the disease during the follow-up period. In 2 cases (6.7%) post-operative WFOCT revealed an additional zone of VRT in the adjacent areas to primary retinal tear which could not be visualized when retina was detached. These patients underwent additional barrier laser photocoagulation around revealed areas. No relapses occurred in these patients. Clinically insignificant retinal bleeding was observed in 4 cases (12.5%) during combined laser angiotomy. Full haemostasis was achieved by the 3-mirror contact lens pressure on the eye. Conclusions: The presented technology demonstrates efficiency in 93.8% of cases after a single surgical intervention. The advantage of the technology is the complete elimination of VRT, as the main factor of the disease pathogenesis, which increases the anatomical efficacy of surgery and reduces the risk of recurrence. The micro-invasiveness and low trauma of this type of treatment help to minimize complications and accelerate the rehabilitation of patients. Further study of this technology with a large number of patients and a long follow-up period is required. Keywords: Rhegmatogenous retinal detachment, wide-field optical coherence tomography, vitreoretinal traction, YAG-laser retinotomy, pneumatic retinopexy, barrier laser photocoagulation.

scholarly journals Surgical treatment of retinal detachment with inferior break using combined gas-air tamponade with viscoelastic

2021 ◽  
pp. 52-56
Author(s):  
I.M. Gorshkov ◽  
◽  
D.O. Shkvorchenko ◽  
A.V. Yukhananova ◽  
A.A. Shpak ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Surgical Treatment ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Clinical Observation ◽  
Sodium Hyaluronate ◽  
Functional Results ◽  
Air Tamponade ◽  
New Surgical Technique

Surgical treatment of rhegmatogenous retinal detachment with an inferior break remains a challenge for ophthalmic surgeons. When using silicone tamponade, complications can develop, such as increased intraocular pressure and emulsification of silicone. In recent years, tamponade of the vitreous cavity with a gas-air mixture has been actively used, however, not all patients can observe the forced position face down, and the tamponade itself is not long-term. Purpose. The authors proposed a method for the treatment of rhegmatogenous retinal detachment with an inferior break using a combined tamponade with a gas-air mixture and viscoelastic based on sodium hyaluronate. Material and methods. A clinical observation of a patient successfully operated on with the use of the specified combined tamponade is presented. A detailed description of a new surgical technique is presented, which allows achieving a higher anatomical and functional results. Conclusion. To confirm the effectiveness and safety of the proposed method, further studies on a group of patients are needed. Key words: rhegmatogenous retinal detachment, inferior break, gas-air tamponade, tamponade with viscoelastic, sodium hyalur onate

Rhegmatogenous Retinal Detachment in Children

2020 ◽  
pp. 29-35
Author(s):  
O.V. Diskalenko ◽  
◽  
O.A. Konikova ◽  
V.V. Brzheskiy ◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Retinal Detachment ◽  
Treatment Efficacy ◽  
Rhegmatogenous Retinal Detachment ◽  
Clinical Course ◽  
Vitreoretinal Surgery ◽  
Scleral Buckling ◽  
Stickler Syndrome ◽  
Pediatric Practice

Purpose. To study the etiological structure of rhegmatogenous retinal detachment, the efficacy and outcomes of its surgical treatment in pediatric practice. Material and Methods. A retrospective series of cases in one vitreoretinal center in 2015–2019 was presented. The age of the children with rhegmatogenous retinal detachment (57 patients / 66 eyes) was from 0 to 18. Surgical treatment included vitreoretinal and scleral buckling techniques. Results. Rhegmatogenous retinal detachment in 30.3% of cases developed against the background of ROP, in 24.2% – against the background of Stickler‘s syndrome, in 12.1% – against the background of myopia, in 12.1% – against the background of trauma, and in 21.3 % – against the background of other reasons. On average, the anatomical treatment efficacy was 77.4%. The leading factors of an unfavorable outcome of treatment were the duration of presence of retinal detachment (OR 21.44; CI 3.76– 122.16) and 3–5 stages ROP (OR 2.56; CI 0.76–8.44). Visual acuity exceeding the blindness threshold (Vis > 0.02) was maintained or achieved in 72% of cases. Conclusions. The specificity of the clinical course and adherence to surgical treatment of children with rhegmatogenous retinal detachment is determined by its etiology. Key words: retinal detachment in children, Stickler syndrome, retinopathy of prematurity, scleral buckling, vitreoretinal surgery.

scholarly journals Macular edema risk factors after vitrectomy for rhegmatogenous retinal detachment complicated by proliferative vitreoretinopathy

2021 ◽  
Vol 14 (3) ◽  
pp. 7-16
Author(s):  
Igor V. Khizhnyak ◽  
Ernest V. Boiko ◽  
Yaroslav V Bayborodov
Keyword(s):  
Risk Factors ◽  
Mathematical Model ◽  
Surgical Treatment ◽  
Visual Field ◽  
Retinal Detachment ◽  
Macular Edema ◽  
Postoperative Period ◽  
Proliferative Vitreoretinopathy ◽  
Rhegmatogenous Retinal Detachment ◽  
Significant Information

BACKGROUND: Despite significant advances in the technology of surgical treatment of regmatogenous retinal detachment, a certain proportion of patients with emerging macular edema against the background of silicone oil tamponade remains. AIM: To evaluate the risk factors of macular edema development and to work out a mathematical model for its prediction based on a retrospective analysis of clinical data of patients with rhegmatogenous retinal detachment complicated by proliferative vitreoretinopathy. MATERIALS AND METHODS: A retrospective case series of 64 patients (64 eyes) with regmatogenous retinal detachment complicated by grade CP proliferative vitreoretinopathy who underwent primary retinal detachment repair. Patients were divided into two groups: with the presence of macular edema in the postoperative period and without it (32 patients in each group). In all cases, at the initial examination, retinal detachment involved the macular area. RESULTS: Using regression analysis, two significant factors were identified: the sum of the 8 meridians of the visual field before surgery (p=0.015) and the number of detached quadrants (p=0.021). Based on the identified factors, a model for predicting macular edema occurrence in the postoperative period in the surgical treatment of regmatogenous retinal detachment was obtained. CONCLUSIONS: The investigation results allowed establishing that the retinal detachment area and the sum of the 8 meridians of the visual field are significant pre-operative factors for macular edema development in retinal detachments with proliferative vitreoretinopathy of CP 1-2 degree. The developed mathematical model based on these indicators is characterized by significant information content and allows predicting macular edema occurrence in the postoperative period. The use of the proposed prognostic model determines a differentiated approach to surgical prevention of macular edema and allows making a decision on the removal of internal limiting membrane at the preoperative stage.

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