Rupture of the Globe: What to Do, What not to Do

2020 ◽  
Vol 237 (09) ◽  
pp. 1070-1078
Author(s):  
Antonia M. Joussen ◽  
Bert Müller ◽  
Bernd Kirchhof ◽  
Theodor Stappler ◽  
Oliver Zeitz
Keyword(s):  
Pars Plana Vitrectomy ◽  
Peak Pressure ◽  
Eye Injury ◽  
Retinal Tear ◽  
Giant Retinal Tear ◽  
Macular Holes ◽  
Pars Plana ◽  
The One

AbstractDue to their complexity, globe ruptures are highly compromising traumas for the patient. This is due on the one hand to the eye injury itself with the accompanying loss of vision and on the other hand due to the need for extended treatment with uncertain prognosis and the resulting psychological stress. Globe ruptures are among the prognostically most unfavorable injuries due to the force and peak pressure impacting the eye. Furthermore, contusional retinal necrosis may be of significance prognostically. In the present review, we discuss treatment of globe ruptures involving retinal surgery. We discuss the primary sugery, its chronological planning and extent as well as the necessity for follow-up interventions. We also discuss the origin of traumatic retinal detachment with differential diagnosis of giant retinal tear versus oradialysis as well as secondary sequelae of traumas such as formation of macular holes and their treatment. On this basis, the use of buckling surgery versus pars-plana vitrectomy is discussed. Further focus is set on the role of the iris lens diaphragm in surgery of globe ruptures.

scholarly journals A Female Case of X-Linked Retinoschisis with Macular Hole Bilaterally

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
A. Altun
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Surgical Experience ◽  
Flap Technique ◽  
Macular Holes ◽  
Female Case ◽  
Pars Plana

Purpose. We aimed at reminding that X-linked retinoschisis may also be seen in female patients and share our vitreoretinal surgical experience. Methods. The patient underwent pars plana vitrectomy including the closure of the macular holes with inverted ILM flap technique bilaterally. Lens extractions were performed by phacoemulsification during the removal of silicone oil endotamponade. Patient. An 18-year-old girl with X-linked retinoschisis and large macular holes in both eyes presented to the clinic of ophthalmology. It was confirmed that the patient had RS1 mutation Results. Nine-month-follow-up was uneventful for retinal findings. Significant improvement in visual acuity was achieved, and macular holes were remained closed. Conclusion. In cases with large macular holes due to XLR, an inverted ILM flap technique might be safe and effective. Four-month-silicone-endotamponade might be sufficient.

scholarly journals Pars plana vitrectomy combined with scleral buckle versus pars plana vitrectomy for giant retinal tear

2017 ◽  
Author(s):  
Mario Gutierrez ◽  
Jose L Rodriguez ◽  
Diego Zamora-De la Cruz ◽  
Mariana Aracely Flores Pimentel ◽  
Aida Jimenez-Corona ◽  
...  
Keyword(s):  
Pars Plana Vitrectomy ◽  
Scleral Buckle ◽  
Retinal Tear ◽  
Giant Retinal Tear ◽  
Pars Plana

scholarly journals The outcome of vitrectomy with internal limiting membrane peeling for chronic macular hole at Biratnagar eye hospital: A tertiary eye care center in Nepal

2016 ◽  
Vol 7 (6) ◽  
pp. 43-46
Author(s):  
Lalit Agarwal ◽  
Nisha Agrawal ◽  
Pratap Karki ◽  
Abhishek Anand
Keyword(s):  
Macular Hole ◽  
Pars Plana Vitrectomy ◽  
Internal Limiting Membrane ◽  
Internal Limiting Membrane Peeling ◽  
Chronic Stage ◽  
Visual Improvement ◽  
Macular Holes ◽  
Pars Plana ◽  
Hole Closure

Background:  A macular hole is a full-thickness defect of retinal tissue involving the anatomic fovea, thereby affecting central visual acuity. Pars plana vitrectomy and gas tamponade is a recognised modality of treatment for macular hole.Larger holes are more likely to remain open after repair and late reopening after an initially closed macular hole is seen in macular holes larger than 400 μm.Aims and Objective: To evaluate the anatomical and functional outcome of pars plana vitrectomy with internal limiting membrane peeling for chronic stage 3 macular hole.Materials and Methods: Records of 15 patients with stage 3 chronic macular holes operated from 1st January 2013 to 30th June 2013 and completed 1 year of follow up were retrospectively evaluated and included in the study. Preoperative best distance corrected visual acuity (BCVA), preoperative macular hole size, final BCVA and macular hole status at 1 year follow up were recorded. Macular hole closure and visual improvement was calculated. Correlation of macular hole closure and visual improvement with various macular hole parameter was estimated.Results: Eleven (73.3%) macular holes closed at 1 year follow-up. Mean BCVA improved from 1.2 ± 0.27 to 0.89 ± 0.36 logarithm of minimum angle of resolution at 1 year (p<0.001). Visual improvement was seen in only eight (53.3%) eyes. Both macular hole closure and visual improvement showed no correlation with minimum linear diameter, base diameter and hole height.Conclusion: Chronic stage 3 macular hole can be closed successfully in majority of patients with fairly good visual improvement. Macular hole parameters of stage 3 holes may not have any correlation with the anatomical and visual outcome.Asian Journal of Medical Sciences Vol.7(6) 2016 43-46

Rhegmatogenous retinal detachment with giant retinal tear in a child with Marfan’s syndrome: a rare ocular emergency

2021 ◽  
Vol 14 (6) ◽  
pp. e241354
Author(s):  
Parrina Sehgal ◽  
Subina Narang ◽  
Deepak Chandra
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Marfan’S Syndrome ◽  
Marfan's Syndrome ◽  
Retinal Tear ◽  
Giant Retinal Tear ◽  
Pars Plana ◽  
23 Gauge ◽  
The Right

A 7-year-old boy with Marfanoid habitus presented with sudden and painless decrease in the vision of the right eye. Ocular examination revealed rhegmatogenous retinal detachment with 360° giant retinal tear in the right eye and small peripheral retinal breaks with lattice degeneration in the left eye. The patient underwent a 23-gauge pars plana vitrectomy with scleral buckling in the right eye and laser around the breaks in the left eye. At 1-week follow-up visit, the child presented with similar complaints in the left eye as were seen in the right eye. This was later managed effectively with 23-gauge pars plana vitrectomy only. So, with our case report, we would like to highlight the need for aggressive screening in children who are diagnosed with Marfan’s syndrome and the need for prophylactic treatment in the unaffected eye.

scholarly journals Pars plana vitrectomy combined with scleral buckle versus pars plana vitrectomy for giant retinal tear

2019 ◽  
Author(s):  
Mario Gutierrez ◽  
Jose L Rodriguez ◽  
Diego Zamora-de La Cruz ◽  
Mariana Aracely Flores Pimentel ◽  
Aida Jimenez-Corona ◽  
...  
Keyword(s):  
Pars Plana Vitrectomy ◽  
Scleral Buckle ◽  
Retinal Tear ◽  
Giant Retinal Tear ◽  
Pars Plana

Anatomical and Functional Outcomes of Relaxing Parafoveal Nasal Retinotomy for Refractory Macular Hole Repair

2021 ◽  
pp. 247412642098714
Author(s):  
Michael S. Tsipursky ◽  
Matthew Byun ◽  
Rama D. Jager ◽  
Veeral S. Sheth
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Pars Plana Vitrectomy ◽  
Internal Limiting Membrane ◽  
Postoperative Outcomes ◽  
Aperture Diameter ◽  
Internal Limiting Membrane Peeling ◽  
Macular Holes ◽  
Pars Plana

Purpose: This work aimed to assess postoperative outcomes associated with relaxing parafoveal nasal retinotomy for refractory macular hole repair. Methods: This was a retrospective interventional study of patients with persistent or recurrent macular holes following 1 or more standard repair procedures with pars plana vitrectomy and internal limiting membrane peeling. Patients received an additional pars plana vitrectomy and relaxing parafoveal nasal retinotomy, followed by fluid-air and air-gas exchange. Key postoperative outcomes included the achievement of macular hole closure and changes in visual acuity from baseline. Results: Thirteen patients with refractory macular holes were included, with a median age of 65 years (range, 49-90 years). The aperture diameter of the 13 macular holes ranged from 180 to 799 µm (median, 538 µm). Vitrectomy and relaxing parafoveal nasal retinotomy were performed in all 13 eyes, and after a median follow-up of 12 months (range, 3-34 months), anatomical closure was achieved in 12 of 13 eyes (92.3%). Overall, visual acuity (mean ± SE) improved significantly from 1.20 ± 0.15 logMAR (approximate Snellen equivalent, 20/320) at baseline to 0.84 ± 0.11 logMAR (Snellen, ∼ 20/125) during postoperative follow-up ( P < .05). Central and paracentral scotomas were observed in 8 of 11 eyes with postoperative Humphrey visual field 10-2 and/or 24-2 data available. Conclusions: Relaxing parafoveal nasal retinotomy may be an effective method to promote anatomical closure and improve vision outcomes in patients with recalcitrant macular holes.

scholarly journals Subretinal crystalline lens – an unusual complication of blunt trauma

2013 ◽  
Vol 13 (2) ◽  
pp. 68-70
Author(s):  
Kalpana Badami Nagaraj ◽  
Srilatha Tirumale ◽  
K S Sriprakash ◽  
C S Savitha ◽  
Chaitra Jayadev
Keyword(s):  
Blunt Trauma ◽  
Pars Plana Vitrectomy ◽  
Crystalline Lens ◽  
Vitreous Cavity ◽  
Unusual Complication ◽  
Retinal Tear ◽  
Giant Retinal Tear ◽  
Pars Plana ◽  
Indian Male

We describe the case of a 65-year-old Indian male with a subretinal crystalline lens; an unusual complication of blunt trauma. The patient underwent a three port pars plana vitrectomy during which the subretinal location of the crystalline lens under the inferior giant retinal tear was confirmed. The lens was maneuvered into the vitreous cavity and appropriately managed.

scholarly journals Giant Retinal Tear Management at Referral Eye Hospital

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Mia Purnama ◽  
Erwin Iskandar ◽  
Rova Virgana ◽  
Grimaldi Ihsan ◽  
Iwan Sovani ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
High Myopia ◽  
Intraoperative Complications ◽  
Retinal Tear ◽  
Giant Retinal Tear ◽  
Retinal Tears ◽  
Pars Plana ◽  
Temporal Quadrant

Introduction: to report the characteristics, management and outcome in giant retinal tear (GRT) associated retinal detachment patients at Cicendo Eye Hospital Methods: this retrospective study was performed on medical records who had undergone retinal detachment surgery between January 2014 and March 2017. Age, sex, etiologies, size of GRT, quadrant involvement, lens status, proliferative vitreo-retinopathy (PVR), managements and outcomes were evaluated in association with giant retinal tears Result: Twenty-six patients (23 males, 3 females) age between 11-59 years with follow up from 2 months to 18 months were enrolled in this study. Twenty-five eyes have retinal detachment with macular involvement and 11 patients had high myopia. Majority of patients had 90° of GRTs. Most retinal tears were located at temporal quadrant (73%). Nineteen patients had undergone pars plana vitrectomy (PPV) and 7 patients had combined PPV with encircling buckle. Fifteen patients had used heavy liquid, 24 patients had silicon oil and 2 had gas tamponade. Intraoperative complications included lens trauma, retinal slippage and choroidal detached were found in 1 eye respectively. Fourteen eyes had recurrent retinal detachment. At the last follow up, 14 patients had anatomically attached retina. Twelve patients had total retinal detachment and marked PVR. Five fellow eyes were treated with prophylactic laser. Visual acuity improved in 11 eyes. Conclusion: Giant retinal tears were more common in patients with high myopia. Management of GRT currently with PPV and PPV combined with encircling buckle. The success rate of anatomy and visual acuity was less than other previous studies

TWENTY-FIVE–GAUGE PARS PLANA VITRECTOMY IN COMPLEX RETINAL DETACHMENTS ASSOCIATED WITH GIANT RETINAL TEAR

Retina ◽  
2018 ◽  
Vol 38 (4) ◽  
pp. 670-677 ◽  
Author(s):  
Vinod Kumar ◽  
Devesh Kumawat ◽  
Anju Bhari ◽  
Parijat Chandra
Keyword(s):  
Pars Plana Vitrectomy ◽  
Retinal Tear ◽  
Giant Retinal Tear ◽  
Pars Plana
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