Incidence of Retinal Detachment after Macular Surgery

2021 ◽  
Author(s):  
Luise Grajewski ◽  
Olaf Grajewski ◽  
Jens Carstens ◽  
Lothar Krause
Keyword(s):  
Retinal Detachment ◽  
Functional Outcomes ◽  
Pars Plana Vitrectomy ◽  
Cystoid Macular Oedema ◽  
Retinal Break ◽  
Macular Surgery ◽  
Surgical Methods ◽  
Pars Plana ◽  
The Mean ◽  
Mean Time

AbstractMacular surgery has become an increasingly atraumatic procedure for the eye with the surgical methods that have been further developed in recent years. The most common complications include cystoid macular oedema and retinal detachment, more rarely endophthalmitis. The aim of this retrospective study is to record the number of retinal detachments following elective macular surgery. In this study we included all patients who underwent pars plana vitrectomy (ppV, 20 or 25 gauge) in the years 2009 – 2016. We then identified the patients who were hospitalised again because of retinal detachment. For the affected patients, the rate of retinal detachment, functional outcomes and possible risk factors were recorded. A total of 904 eyes were identified, of which 667 had surgery for epiretinal membrane, 188 for macular hole, and 49 for vitreomacular traction with a 20 or 25 gauge ppV. Of these 904, retinal detachment occurred in 17 (1.88%) cases. The mean time between first ppV and second ppV with retinal detachment was 248 days (3 – 1837 days). Two of the 17 patients had at least one retinal break before or during surgery. The retinal break was located inferior in six cases, superior in four; in four cases PVR retinal detachment and in three cases the foramina were distributed. Mean visual acuity was 0.27 (decimal) before macular surgery and 0.28 at the time of last presentation. Modern vitrectomy techniques reduce the complications in elective macular surgery, but do not replace the surgeonʼs experience.

scholarly journals Four Cases of Rhegmatogenous Retinal Detachment That Recurred More than 10 Years after Initial Reattachment by Pars Plana Vitrectomy

2021 ◽  
pp. 219-226
Author(s):  
Takayuki Baba ◽  
Tomoaki Tatsumi ◽  
Toshiyuki Oshitari ◽  
Shuichi Yamamoto
Keyword(s):  
Retinal Detachment ◽  
Functional Outcomes ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Scleral Buckling ◽  
Retinal Break ◽  
Corrected Visual Acuity ◽  
Lattice Degeneration ◽  
Pars Plana ◽  
Best Corrected Visual Acuity

<b><i>Purpose:</i></b> The purpose of this report was to present our findings in 4 cases of rhegmatogenous retinal detachment (RRD) that recurred 10, 11, 12, and 17 years after a reattachment surgery by pars plana vitrectomy (PPV). <b><i>Methods:</i></b> Four cases of a recurrent RRD had undergone scleral buckling surgery and vitrectomy. <b><i>Patients:</i></b> The recurrence of the RRD was observed 10–17 years after the successful attachment by PPV. The macula was detached in all cases, and none of the eyes had severe proliferative vitreoretinopathy. The cause of the recurrence was a new retinal break in 3 eyes and a reopening of an old retinal break in the other eye. The new breaks had a punched-out shape and had neither a horseshoe tear nor an atrophic hole associated with lattice degeneration. PPV combined with scleral buckling was performed, and a reattachment was achieved in all cases. The best-corrected visual acuity (BCVA) at the last visit ranged from 20/30 to 20/25, but the BCVA in 1 eye was 20/200 because of amblyopia. <b><i>Conclusions:</i></b> We experienced 4 rare cases of a recurrent retinal detachment 10–17 years after the primary RRD. PPV and scleral buckling were effective and the anatomical and the functional outcomes were good.

Endoscopy-Assisted Vitrectomy Outcomes During Silicone Oil Removal After Complex Retinal Detachment Repair

2019 ◽  
Vol 3 (6) ◽  
pp. 445-451 ◽  
Author(s):  
Natalia Vila ◽  
Emmanouil Rampakakis ◽  
Flavio Rezende
Keyword(s):  
Retrospective Study ◽  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Endoscopic Examination ◽  
Oil Removal ◽  
Visualization System ◽  
Silicone Oil Removal ◽  
Pars Plana ◽  
The Mean

Purpose: This retrospective study recorded intraoperative findings during silicone oil removal and postoperative anatomical outcomes comparing endoscopy-assisted pars plana vitrectomy (E-PPV) vs pars plana vitrectomy (PPV) alone after proliferative vitreoretinopathy (PVR)-related retinal detachment (RD) repair. Methods: This single-center retrospective study included patients who underwent PPV for silicone oil removal after RD with PVR from July 2009 to January 2017. Patients with diabetic tractional RD, history of trauma, uveitis, or endophthalmitis were excluded. After 2013, an endoscopic visualization system (E2 MicroProbe; Endo Optiks) was used in a nonrandomized fashion. Data collection included reattachment rate, intraoperative endoscopic findings and phthisis rate. Results: Fifty-four eyes of 54 patients were included. The mean participant age was 58.4 ± 12.9 years and 36 (65.5%) participants were male. The mean (± SD) follow-up duration after oil removal was 24.3 ± 20.1 months. E-PPV combined with wide-angle visualization system was performed in 26 (48.1%) of the patients; the surgical management was modified after endoscopic examination in 17 (65.4%) of the cases. Reattachment rate in the E-PPV group was 96.2% compared with 76.0% in the PPV-alone group ( P = .04). Conclusions: E-PPV for silicone oil removal appears to be advantageous for prevention of RD recurrence, thus achieving better reattachment rates. A thorough examination is facilitated by endoscopic visualization and contributory factors for anterior PVR can be identified and treated.

scholarly journals Posterior Segment Retained Intraocular Foreign Body: A Study from Western Nepal

2021 ◽  
Vol 13 (1) ◽  
pp. 22-30
Author(s):  
Bikram Bahadur Thapa ◽  
Sweta Singh ◽  
Gyanendra Lamichhane ◽  
Shanti Gurung ◽  
Saurav Piya
Keyword(s):  
Visual Acuity ◽  
Foreign Body ◽  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Large Diameter ◽  
Visual Outcome ◽  
Posterior Segment ◽  
Intraocular Foreign Body ◽  
Pars Plana ◽  
The Mean

Introduction: Posterior segment retained Intraocular foreign body (IOFB) management is challenging. Facility of pars plana vitrectomy (PPV) and availability of well trained vitreo retina surgeons are the basic need to accomplish this work.  Encircling band provide permanent 360° support to close the anterior retinal break and prevent traction on the retina. The objective of this study is to analyse the clinical characteristics and predictors of the final visual outcome and survival of the globe in cases of retained IOFB in the posterior eye segment. Materials and methods: A hospital based retrospective observational study was conducted. All the patients of retained IOFB in the posterior segment presented from January 2016 to June 2019 were enrolled. Patients presented with visual acuity of NPL were excluded. Statistical analysis was performed using a variety of tests using SPSS version 21.   Results: Forty eyes of 40 patients were included. The mean age was 27.08±10.68 years (range 5-66). 95% of our patients were male. Most of them (52.5%) worked on the farm. 26(65%) of 40 eyes had Zone I injury. The median time spent before presentation was 13.5 day. Retinal detachment, vitreous hemorrhage, and endophthalmitis were present in 15, 23 and 5 eyes, respectively, before IOFB removal. The mean LogMAR visual acuity was improved significantly from 2.50±0.87 to 1.33± 1.01 (p=0.003). Poor presenting visual acuity, retinal detachment and large diameter of IOFB were found as the predictor of poor final visual acuity. Conclusion:  Pars plana vitrectomy by a vitreo retinal surgeon can give encouraging results in the cases of retained posterior segment IOFB. Poor presenting visual acuity, large diameter of IOFB and RD before IOFB removal are predictors of poor visual outcome.

25-Gauge Pars Plana Vitrectomy for Retained Lens Fragments in Complicated Cataract Surgery

2015 ◽  
Vol 234 (2) ◽  
pp. 101-108 ◽  
Author(s):  
Andrea Scupola ◽  
Edoardo Abed ◽  
Maria Grazia Sammarco ◽  
Gabriela Grimaldi ◽  
Paola Sasso ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Nuclear Material ◽  
Early Vitrectomy ◽  
Complicated Cataract ◽  
Duration Of Surgery ◽  
Pars Plana ◽  
The Mean ◽  
Group B ◽  
Lens Material

Purpose: To verify the efficacy of 25-gauge pars plana vitrectomy (PPV) for the management of posteriorly dislocated lens material after complicated cataract extraction and to determine in what patients this approach offers the optimal benefit in terms of efficacy and safety, considering the amount of retained nuclear material and the duration of surgery. Methods: Forty eyes of 40 patients with retained lens fragments undergoing early (within 1 week) or late (within >1 week) 25-gauge PPV were retrospectively reviewed. The amount of dislocated nuclear material was graded by the surgeon intraoperatively, and the patients were divided into two groups according to the nuclear grading: group A (≤50% dropped nucleus) and group B (>50% dropped nucleus). The presence of brunescent nuclear pieces was considered. The outcomes measured included best-corrected visual acuity (BCVA) and postoperative complications such as retinal detachment, cystoid macular edema (CME) and postoperative ocular hypertension or hypotonia. Results: The patients had a mean age of 78 years. The mean preoperative logarithm of the minimum angle of resolution (logMAR) BCVA was 0.57 ± 0.24 (20/80). A significant positive correlation was found between nuclear material grade and PPV duration (R2 = 0.81, p < 0.0001). None of the patients had dislocation of brunescent nuclear pieces. On postoperative day 1, the mean postoperative intraocular pressure was 16.75 ± 2.7 mm Hg, with no case of ocular hypotonia. At 6 months of follow-up, the mean logMAR BCVA improved to 0.23 ± 0.3 (20/32). Retinal detachment developed in 4 patients (10%), occurring only in patients of group B (p < 0.002). Four patients with late PPV developed postoperative CME, with no case of CME among patients with early vitrectomy (p = 0.014). Conclusion: Removal of dislocated lens fragments after complicated cataract surgery can be effectively managed with 25-gauge PPV, although it appears to be most efficient for cases with a limited amount of dislocated lens material. In consideration of the higher rate of retinal detachment observed in cases of prolonged PPV time, the expected duration of surgery should be taken into account when choosing the best surgical approach. Visual outcomes are not affected by the timing of PPV, whereas early vitrectomy seems to prevent the onset of inflammatory macular edema.

scholarly journals Morphological and functional outcome of scleral buckling surgery compared to primary vitrectomy in patients with retinal detachment

2014 ◽  
Vol 71 (10) ◽  
pp. 920-924
Author(s):  
Miroslav Stamenkovic ◽  
Ivan Stefanovic ◽  
Ivan Sencanic ◽  
Vesna Jaksic ◽  
Milka Mavija ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Functional Outcomes ◽  
Pars Plana Vitrectomy ◽  
Surgical Intervention ◽  
Classical Method ◽  
Scleral Buckling ◽  
Mean Value ◽  
Operative Techniques ◽  
Primary Vitrectomy ◽  
Pars Plana

Background/Aim. Among the proposed operative techniques for retinal detachment (RD) the most commonly applied are classical method with scleral buckling and pars plana vitrectomy (PPV). The aim of this paper was to determine which surgical intervention of these two leads to better morphological results in terms of the applied retina and better functional outcomes in terms of visual acuity (VA) of the operated eye in patients with RD. Methods. A retrospective study on the comparative section of the effects of scleral buckling surgery and PPV in uncomplicated rhegmatogenous RD was performed. In a 2-year period 97 patients, i.e. 98 eyes with RD were operated on (68 eyes with scleral buckling surgery vs 30 by PPV). Results. In the group with classically operated detachment, the retina was applied in 52 (76.5%) cases vs 30 (100%) patients in PPV group (p < 0.05). Postoperative VA in logMAR was significantly better in both groups compared to preoperative VA: in the classically operated was 1.89 ? 1.04 preoperatively vs 0.98 ? 0.70 postoperatively, while in the PPV group, preoperative value was 2.56 ? 0.67 vs 1.31 ? 0.74 postoperatively (p = 0.001). Conclusion. PPV in uncomplicated forms of RD gives better anatomical results than scleral buckling surgery. VA was significantly improved in both observed groups, while its mean value was postoperatively better in the group that was operated with the classical method. The reason for this could be due to better VA in baseline in the scleral buckling surgery group.

scholarly journals A pilot study on vitrectomy combined with scleral shortening for eyes with myopic macular retinoschisis—2y follow-up results

2021 ◽  
Vol 14 (2) ◽  
pp. 263-268
Author(s):  
Peng Zhang ◽  
◽  
Ling-Xin Hou ◽  
Yu-Hua Hao ◽  
Kun Wang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Macular Hole ◽  
Pars Plana Vitrectomy ◽  
Macular Retinoschisis ◽  
Corrected Visual Acuity ◽  
Pars Plana ◽  
The Mean ◽  
Best Corrected Visual Acuity

AIM: To evaluate the effect of vitrectomy combined with scleral shortening for eyes with myopic macular retinoschisis. METHODS: Thirty-seven patients with myopic macular retinoschisis who underwent pars plana vitrectomy (PPV) combined with scleral shortening were reviewed. Axial length (AL), the height of macular retinoschisis, the height of retinal detachment if existed, the diameter of macular hole if existed and best corrected visual acuity (BCVA) were obtained. The preoperative and postoperative parameters were compared. RESULTS: At postoperative 24mo, the mean AL and height of macular retinoschisis were reduced significantly by 0.79 mm and 256.51 μm (t=8.064, P<0.0001; Z=-5.086, P<0.0001) respectively. In addition, the mean height of retinal detachment and diameter of macular hole were also reduced significantly by 365.38 μm and 183.68 μm (Z=-4.457, P=0.000008; Z=-2.983, P=0.003) respectively. Meanwhile, the postoperative BCVA was improved markedly (Z=-2.126, P=0.033). CONCLUSION: Vitrectomy combined with scleral shortening is an effective surgical method for eyes with myopic macular retinoschisis, whether or not macular hole and retinal detachment are present.

scholarly journals Development of Macular Holes after Rhegmatogenous Retinal Detachment Repair in Japanese Patients

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Mamiko Shibata ◽  
Toshiyuki Oshitari ◽  
Fusae Kajita ◽  
Takayuki Baba ◽  
Eiju Sato ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Medical Records ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Japanese Patients ◽  
Scleral Buckling ◽  
Factors Associated ◽  
Macular Holes ◽  
Pars Plana ◽  
The Mean

Purpose. To determine the factors associated with the development of a macular hole (MH) after successful rhegmatogenous retinal detachment (RRD) surgery.Methods. Of 1260 eyes that underwent surgery for RRD between April 2005 and March 2010 in our hospital, the medical records of 4 cases from our hospital and one case from another hospital that had undergone RRD surgery and later developed MH were reviewed. This is a retrospective study.Results. 837 eyes underwent pars plana vitrectomy (PPV) with or without scleral buckling (SB), and 423 eyes underwent SB. The four cases that developed MH had PPV alone and one case had PPV with SB. After including the results of three earlier reports, the mean interval for the MH to develop after SB alone was significantly shorter than after PPV alone or after PPV with SB.Conclusions. The SB procedures might accelerate the development of MH after RRD surgery.

scholarly journals Outcomes of Ahmed Glaucoma Valv Implantation in Patients with Pars Plana Vitrectomy History

2021 ◽  
Author(s):  
Sevgi Subasi ◽  
Nursen Yuksel ◽  
Levent Veysel Karabas ◽  
Busra Yilmaz Tugan ◽  
Ece Basaran
Keyword(s):  
Pars Plana Vitrectomy ◽  
Neovascular Glaucoma ◽  
Success Rates ◽  
Surgical Success ◽  
Surgical Methods ◽  
Significant Difference ◽  
History Of ◽  
Pars Plana ◽  
The Mean ◽  
Time Required

Abstract Background and Objective: Ahmed glaucoma valv (AGV) implantation is one of the successful surgical methods in secondary glaucoma that develops after pars plana vitrectomy (PPV). In our study, we aimed to evaluate the 1-year results of AGV implantation in patients with a history of PPV.Study Design: A total of 26 patients who underwent AGV implantation after PPV were included in our retrospective study. Fourteen of 26 patients had AGV implantation due to neovascular glaucoma (NVG) and 12 of them had secondary refractory galucoma. Data of these two groups of patients were evaluated in terms of IOP reduction, number of medication use, surgical complete and qualified success, surgical failure, and complications.Results: The mean IOP was 29.54±4.87 mmHg at the preoperative of AGV implantation and 12.88±4.17 at the twelfth month visit in overal group. There was no statistically significant difference between two groups in terms of IOP in preoperative and all postoperative visits (p>0.05). The mean intervals between PPV and AGV implantation were 67 ± 34 days in NVG and 391 ± 500 days in non-NVG group (p=0.017). In overal group, 91.7% of patients had improvement in BCVA at the twelfth month visit. Complete and qualified surgical success rates were 75%, 83.3% in NVG group and 50%, 91.7% in non-NVG group respectively. There was no devastating complication in both group.Conclusion: AGV implantation is a safe and effective surgical method in uncontrolled IOP elevations after PPV. While surgical success and failure rates was similar between etiologies, the time required for AGV implantation after PPV was shorter in NVG etiology.

scholarly journals Treatment of Localized Retinal Redetachment in Silicon Oil Filled Eyes

2019 ◽  
Vol 34 (2) ◽  
Author(s):  
Muhammad Tariq Khan Sidrah Riaz Qasim Lateef Chaudhry
Keyword(s):  
Retinal Detachment ◽  
Local Anesthesia ◽  
Pars Plana Vitrectomy ◽  
Case Series ◽  
Proliferative Retinopathy ◽  
Retinal Break ◽  
Time Saving ◽  
Silicon Oil ◽  
Retinal Reattachment ◽  
Pars Plana

Purpose: To assess the success rate of retinal reattachment surgery in localized re-detachment in Silicon oil filled eyes which had previously undergone primary retinal detachment (RD) repair with pars plana vitrectomy (PPV) with silicon oil. Study Design: Retrospective cross sectional case series. Place and Duration: Farooq Hospital and Medicare eye centre, Lahore from October 2016 to November 2017. Material and Methods: All those patients were included in our study who underwent primary retinal attachment surgery with pars plana vitrectomy (PPV) and silicon oil for complicated retinal detachment as an internal tamponade and later presented with localized inferior retinal detachment within 6 months of previous RD repair. Patients with total detachment, extensive PVR, retinal shortening, gas tamponade, total Re RD, and external scleral buckle were excluded. Two ports were made under local anesthesia instead of three conventional ports, simple non irrigation vitrectomy technique was used to achieve retinal reattachment under silicon oil without exchange of SO. Results: Ten eyes of ten patients were included, eight (8) males and two (2) females. The age range was from 18 to 79 years. Most common cause of re detachment (RD) in all cases was proliferative retinopathy (PVR) followed by retinal break. The new retinal break was identifiable in three (3) cases. All cases attained anatomical success in term of complete retinal attachment after second operation in one year follow up period. Conclusion: Simple non irrigation vitrectomy surgical technique under local anesthesia is effective, economical and time saving as compared to complicated three port vitrectomy with oil exchange. Keywords: Silicon oil, rhegmatogenous retinal detachment, proliferative retinopathy, retinal break, Perflourocarbon.

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