Surgical and Visual Outcome for Recurrent Retinal Detachment Surgery

Purpose. To evaluate the anatomical and functional outcome of repeated surgeries for recurrent retinal detachment.Methods. We retrospectively reviewed 70 cases with refractory retinal detachment of various etiologies that required multiple operations. Anatomical success (attached retina) or failure (totally/partially-detached retina) was assessed biomicroscopically. The BCVA was used for the evaluation of the functional outcome, at presentation and at the end of follow-up. Various pre-, intra-, and postoperative factors were associated with anatomical success or failure as well as with final functionality.Results. The mean number of surgeries was 4 (range: 2 to 10). The anatomical success rate was 80% (56 attached cases, 14 detached cases). 29% of the attached cases had a BCVA better than 20/40 (Snellen chart). The number of operations doesn’t seem to affect significantly the final visual acuity. The PVR was found to affect both the anatomical and functional outcome (P=0.014&P=0.002, respectively).Conclusions. In the present study, it is suggested that multiple operations for refractory retinal detachment may result in successful anatomic results, with a fare functional outcome at the same time. Eventually, we verified that the existence of PVR worsens the prognosis.

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Autologous internal limiting membrane flap for retinal detachment due to posterior retinal tears over choroidal atrophy in highly myopic eyes

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-313099 ◽

2018 ◽

Vol 103 (8) ◽

pp. 1133-1136 ◽

Cited By ~ 1

Author(s):

Tommaso Rossi ◽

Tomaso Caporossi ◽

Stanislao Rizzo ◽

Carlandrea Trillo ◽

Serena Telani ◽

...

Keyword(s):

Retinal Detachment ◽

Pars Plana Vitrectomy ◽

Silicone Oil ◽

Internal Limiting Membrane ◽

Control Group ◽

Retinal Breaks ◽

Pars Plana ◽

Anatomical Success ◽

Anatomical Success Rate

PurposeTo review a series of highly myopic eyes with retinal detachment undergoing pars plana vitrectomy with autologous internal limiting membrane (ILM) flap placed over posterior retinal breaks located in areas of choroidal atrophy.MethodsRetrospective review of 13 consecutive patients receiving pars plana vitrectomy with ILM flap over causative breaks, compared with 19 controls receiving the same surgery with ILM peeling but no ILM flap. Main outcome measures included anatomical success rate, visual acuity, number of surgeries and the rate of silicone oil removal.ResultsPatients in the ILM group required 2.08±0.37 interventions versus 2.58±0.75 in the control group (p=0.037). One (1/13; 7.6%) patient in the ILM group required additional unplanned surgery versus 8/19 (42.10%) in the control group (p=0.038). Final anatomical success rate defined as attached retina after silicone oil (SiO) removal was 13/13 in the I-ILM group and 14/19 (73.6%) in the control group (p=0.052). No patients (0/13) in the I-ILM group retained SiO at the end of follow-up versus 4/19 (21.1%) patients in the control group (p=0.061). Best-corrected visual acuity at the end of follow-up was logMAR 0.65±0.36 (20/91 Snellen) in the ILM group and logMAR 0.89±0.44 (20/158 Snellen) in the control group (p=0.20).ConclusionAutologous ILM may help seal posterior retinal breaks and improve the surgical prognosis of retinal detachment due to breaks located over areas of choroidal atrophy within the myopic staphyloma.

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Comparison of 25- and 27-Gauge Pars Plana Vitrectomy in Repairing Primary Rhegmatogenous Retinal Detachment

Journal of Ophthalmology ◽

10.1155/2018/7643174 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 8

Author(s):

Keiko Otsuka ◽

Hisanori Imai ◽

Ayaka Fujii ◽

Akiko Miki ◽

Mizuki Tagami ◽

...

Keyword(s):

Retinal Detachment ◽

Pars Plana Vitrectomy ◽

Rhegmatogenous Retinal Detachment ◽

Success Rates ◽

Significant Difference ◽

Pars Plana ◽

Anatomical Success ◽

Better Than ◽

Baseline Demographic

Aim. To compare the anatomic and visual outcomes of 25-gauge (25G), and 27-gauge (27G) transconjunctival sutureless pars plana vitrectomy (TSV) for the management of primary rhegmatogeneous retinal detachment (RRD).Design. A retrospective nonrandomized clinical trial.Methods. A retrospective comparative analysis of 62 consecutive eyes from 62 patients with 6 months of follow-up was performed.Results. Thirty-two patients underwent 25G TSV, and 30 patients underwent 27G TSV for the treatment of primary RRD. There was no significant difference in baseline demographic and preoperative ocular characteristics between the two groups. The initial and final anatomical success rates were 93.8% and 100% in 25G TSV and 96.7% and 100% in 27G TSV, respectively (p=1andp=1, resp.). Preoperative best-corrected visual acuity (BCVA) (logMAR) was 0.44 ± 0.69 and 0.38 ± 0.61 for 25G and 27G TSV, respectively (p=0.73). The final follow-up BCVA was 0.07 ± 0.25 and −0.02 ± 0.17 for 25G and 27G TSV, respectively (p=0.16). The final BCVA was significantly better than the preoperative BCVA in both groups (p=0.02andp=0.002, resp.). Preoperative intraocular pressure (IOP) (mmHg) was 13.0 ± 3.5 in 25G TSV and 14.3 ± 2.8 in 27G TSV (p=0.11). IOP did not statistically significantly change in both groups during the follow-up period (p=0.63andp=0.21, resp.).Conclusion. The 27G TSV system is safe and useful for RRD treatment as 25G TSV.

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Long-term Clinical Outcomes of Vitrectomy with 360° Laserpexy or Scleral Encircling in Rhegmatogenous Retinal Detachment

Annals of Optometry and Contact Lens ◽

10.52725/aocl.2021.20.4.150 ◽

2021 ◽

Vol 20 (4) ◽

pp. 150-157

Author(s):

Min Jin Kim ◽

Sung Jin Lee ◽

Kyung Seek Choi

Keyword(s):

Retinal Detachment ◽

Success Rate ◽

Clinical Outcomes ◽

Pars Plana Vitrectomy ◽

Rhegmatogenous Retinal Detachment ◽

Pars Plana ◽

Anatomical Success ◽

Anatomical Success Rate

Purpose: To compare long-term clinical outcomes of pars plana vitrectomy (PPV) combined with intraoperative 360° laserpexy and pars plana vitrectomy combined with scleral encircling for the treatment of primary rhegmatogenous retinal detachment (RRD).Methods: This retrospective, comparative case study included 70 patients who had at least 1 year of follow-up after vitrectomy for primary uncomplicated RRD from 2015 to 2019. The patients were divided into two groups. Group I included 34 patients who underwent PPV + 360° laserpexy (LP), while group II included 36 patients who underwent PPV + scleral encircling (SE). Main outcome measures were the anatomical success rate, the functional success rate, final best-corrected visual acuity (BCVA), and the incidence of post-operative complications. We also examined the long-term changes in axial length, corneal curvature, and refractive error before and after surgery.Results: LP and SE groups showed no significant differences with respect to the primary anatomical success rate (97.05% and 94.44%, respectively; p = 0.592) or the functional success rate (BCVA ≥ 20/40 at final follow-up; 82.35% and 77.78%, respectively; p = 0.635). Detachment reoccurred in three cases (one in the LP group and two in the SE group) because of proliferative vitreoretinopathy; both cases in the SE group had successful anatomical re-attachment after repeating the PPV procedure. Complications included post-operative epiretinal membrane and cystic macular edema, as well as increased intraocular pressure.Conclusions: Primary vitrectomy combined with 360° laserpexy has effectiveness similar to vitrectomy combined with scleral encircling in patients with RRD in long-term clinical outcomes.

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Outcomes of Rhegmatogenous Retinal Detachment

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v37i1.1073 ◽

2020 ◽

Vol 37 (1) ◽

Author(s):

Sidrah Riaz ◽

Muhammad Tariq Khan ◽

Khurram Azam Mirza

Keyword(s):

Retinal Detachment ◽

Pars Plana Vitrectomy ◽

Rhegmatogenous Retinal Detachment ◽

Scleral Buckling ◽

Success Rates ◽

Cross Sectional ◽

Pars Plana ◽

Anatomical Success ◽

Anatomical Success Rate

Purpose: To study demographic characteristics and treatment outcomes of Rhegmatogenous retinal detachment in a private Vitreo-retinal setup of Lahore. Study Design: Cross sectional Observational study. Place and Duration of Study: Private Vitreo-retinal setup, from March 2017 to April 2019. Methods: Total 102 patients with Rhegmatogenous retinal detachment (RRD) were included. Patients with retinal detachment other than RRD were excluded. Detailed history and ocular examination was performed. Type of break, procedure adopted for RRD repair and type of endo-tamponade were also recorded. These patients had either 23 G pars plana vitrectomy (PPV) or scleral buckling (SB) procedures or combined sclera buckling with PPV. Patients were followed-up for six months. Results: Out of 102 total RRD cases, 63.70% were males and 36.30%were females. Mean age was 47.44 ± 18.44. Macula was on in 48% and off in 52%. Phakic patients were 46.50%, pseudophakic 48.50% and 5.10% were aphakic. Position of break in RRD was superotemporal in 39.2%, inferotemporal in 30.4% and inferonasal in 2.9%. Total RD was observed in 27.5% patients. One or more breaks were identified in 82.4% patients and giant tear in 4.9%. Three ports 23 G PPV was done in 64.7%, PPV with IOL in 18.6%, scleral buckling in 10.8% and combined PPV + SB in 5.9% patients. The anatomical success rate was observed in 96.07%, 3.9% needed second surgery to get anatomical success in six months follow-up. Conclusion: Anatomical success rates in retinal attachment surgeries in experienced hands is comparable with more developed retinal centers of the world. Key Words: Rhegmatogenous retinal detachment, Pars plana vitrectomy, Scleral buckling, Silicon oil.

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Medium-term tamponade with vitrectomy and perfluorodecalin for the management of complex retinal detachments

European Journal of Ophthalmology ◽

10.1177/1120672120945108 ◽

2020 ◽

pp. 112067212094510

Author(s):

Luke K Chehade ◽

Brad Guo ◽

Weng Chan ◽

Jaqjit Gilhotra

Keyword(s):

Retinal Detachment ◽

Medical Records ◽

Case Series ◽

Visual Outcome ◽

Medium Term ◽

Retrospective Case ◽

Retinal Tears ◽

Safe Technique ◽

Anatomical Success

Purpose: To describe the clinical presentation, anatomical and visual outcome of a series of patients in our department with complex retinal detachments, managed with vitrectomy and perfluorodecalin (PFD) for medium-term tamponade. Study design: Retrospective case series. Methods: Retrospective analysis of the medical records of all patients in the last 6 years presenting with complex retinal detachment managed with vitrectomy where PFD was used as a medium-term tamponade. Results: A total of 85 eyes in 85 patients were included in the study, with a mean follow-up period of 16.0 ± 2.67 months (range 3–59). About 26 detachments presented with associated PVR-C, and 10 had giant retinal tears. The location of the retinal detachment was inferior in 40% of cases, and total in 18.9% of cases. Anatomical success, defined as retinal reattachment at 12 months, was achieved in 98.8% of cases, and there was a mean improvement in BCVA of logMAR 0.64 ± 0.20, which was statistically significant ( p < 0.001, paired t-test 6.23). Of the 41 phakic eyes included in the study, 20 underwent cataract surgery within the follow-up period. Conclusion: In this case series, we have demonstrated a 98.8% anatomical success and significant improvement in BCVA, with no reports of retinal toxicity. Medium-term tamponade PFD appears to be an efficacious and safe technique for management of a variety of complex retinal detachments, including those secondary to GRT, the presence of PVR-C, inferior location, tractional, traumatic, and re-detachments.

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Comparative Study of 27-Gauge versus 25-Gauge Vitrectomy for the Treatment of Primary Rhegmatogenous Retinal Detachment

Journal of Ophthalmology ◽

10.1155/2017/6384985 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5 ◽

Cited By ~ 14

Author(s):

Stanislao Rizzo ◽

Silvio Polizzi ◽

Francesco Barca ◽

Tomaso Caporossi ◽

Gianni Virgili

Keyword(s):

Retinal Detachment ◽

Rhegmatogenous Retinal Detachment ◽

Outcome Measure ◽

Interventional Study ◽

Postoperative Visit ◽

Retinal Breaks ◽

The Mean ◽

Anatomical Success ◽

Anatomical Success Rate ◽

25 Gauge Vitrectomy

Purpose. To compare the vitrectomy time, clinical outcomes, and complications between 27-gauge (27-G) and 25-gauge (25-G) vitrectomy in patients with primary rhegmatogenous retinal detachment (PRRD).Methods. Prospective, nonrandomized, comparative, interventional study. Forty consecutive patients with PRRD were recruited. Twenty patients underwent the 27-gauge procedure and twenty patients had the 25-gauge procedure. The main outcome measure of the study was the actual vitrectomy time.Results. The mean duration of vitreous removal was 23.2 min (SD 6.5) with 27-G vitrectomy and 19.6 min (SD 7.3) with 25-G vitrectomy, resulting in a difference of 3.6 min (95% confidence interval (95%CI): −8.0 to 0.8 mins,p=0.11). Mean logMAR visual acuity improved from 1.70 ± 1.18 preoperatively to 0.12 ± 0.14 at final postoperative visit (p<0.001) in the 27-G group and from 1.52 ± 1.15 preoperatively to 0.22 ± 0.30 at final postoperative visit (p<0.001) in the 25-G group. The anatomical success rate after a single operation was 90.0% and 85.0% in the 27-G and in the 25-G groups (p=0.63), respectively. Intraoperative iatrogenic retinal breaks (IRBs) occurred in 2 eyes in the 27-G group and 1 eye in the 25-G group.Conclusions. Twenty-seven-gauge vitrectomy may be a safe and effective surgery for the treatment of PRRD.

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Robotic-Assisted Patellofemoral Replacement—Correlation of Preoperative Planning with Intraoperative Implant Position and Early Clinical Experience: A Minimum 2-Year Follow-up

The Journal of Knee Surgery ◽

10.1055/s-0040-1716848 ◽

2020 ◽

Author(s):

Veenesh Selvaratnam ◽

Andrew Cattell ◽

Keith S. Eyres ◽

Andrew D. Toms ◽

Jonathan R. P. Phillips ◽

...

Keyword(s):

Functional Outcome ◽

Preoperative Planning ◽

Trochlear Dysplasia ◽

Oxford Knee Score ◽

Implant Position ◽

Robotic Assisted ◽

Implant Positioning ◽

Flexion Extension ◽

The Mean

AbstractPatello-femoral arthroplasty (PFA) is successful in a selected group of patients and yields a good functional outcome. Robotic-assisted knee arthroplasty has been shown to provide better implant positioning and alignment. We aim to report our early outcomes and to compare Mako's (Robotic Arm Interactive Orthopaedic System [RIO]) preoperative implant planning position to our intraoperative PFA implant position. Data for this study was prospectively collected for 23 (two bilateral) patients who underwent robotic-assisted PFA between April 2017 and May 2018. All preoperative implant position planning and postoperative actual implant position were recorded. Presence of trochlear dysplasia and functional outcome scores were also collected. There were 17 (two bilateral) female and 6 male patients with a mean age of 66.5 (range: 41–89) years. The mean follow-up period was 30 (range: 24–37) months. Eighteen knees (72%) had evidence of trochlear dysplasia. The anterior trochlear line was on average, 7.71 (range: 3.3–11.3) degrees, internally rotated to the surgical transepicondylar axis and on average 2.9 (range: 0.2–6.5) degrees internally rotated to the posterior condylar line. The preoperative planning range was 4-degree internal to 4-degree external rotation, 4-degree varus to 6-degree valgus, and 7-degree flexion to 3-degree extension. The average difference between preoperative planning and intraoperative implant position was 0.43 degrees for rotation (r = 0.93), 0.99 degrees for varus/valgus (r = 0.29), 1.26 degrees for flexion/extension (r = 0.83), and 0.34 mm for proudness (r = 0.80). Six patients (24%) had a different size component from their preoperative plan (r = 0.98). The mean preoperative Oxford Knee Score (OKS) was 16 and the mean postoperative OKS was 42. No patient had implant-related revision surgery or any radiological evidence of implant loosening at final follow-up. Our early results of robotic PFA are promising. Preoperative Mako planning correlates closely with intraoperative implant positioning. Longer follow-up is needed to assess long-term patient outcomes and implant survivorship.

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Retinotomy and retinectomy for anterior inferior proliferative vitreoretinopathy: Can visual outcome be improved?

European Journal of Ophthalmology ◽

10.1177/11206721211012848 ◽

2021 ◽

pp. 112067212110128

Author(s):

Mumin Hocaoglu ◽

Murat Karacorlu ◽

M. Giray Ersoz ◽

Isil Sayman Muslubas ◽

Serra Arf

Keyword(s):

Proliferative Vitreoretinopathy ◽

Rhegmatogenous Retinal Detachment ◽

Silicone Oil ◽

Clinical Stage ◽

Case Series ◽

Visual Outcome ◽

Attachment Rate ◽

Good Visual Outcome ◽

The Mean

Purpose: To describe the treatment outcomes and prognostic factors of retinotomy/retinectomy for rhegmatogenous retinal detachment (RD) complicated anterior inferior proliferative vitreoretinopathy (PVR). Methods: Retrospective, nonrandomized, single-center case series. The outcomes of 126 cases of retinotomy/retinectomy for RD complicated by advanced (Grade C) anterior inferior PVR managed consistently by one surgeon during a 15-year period were evaluated. Results: Forty-two eyes (33%) had primary RDs and 84 (67%) had recurrent RDs. The extent of retinotomy/retinectomy varied: 90° in 21 eyes (17%), >90° to <180° in 49 eyes (39%), and ⩾180° to ⩽240° in 56 eyes (44%). The retinotomy/retinectomy location was peripheral in 58 eyes (46%) and equatorial in 68 eyes (54%). The mean follow-up period was 43 ± 42 months. The silicone oil (SO) was removed from 98% of the eyes. The single-operation success rate after the primary retinectomy was 87%, and the final attachment rate was 94%. Visual acuity improved from 20/630 to 20/160 ( p < 0.001). Vision ⩾20/200 was achieved in 101 eyes (80%). Good visual outcome was correlated positively with preoperative VA ( p = 0.02), previous vitrectomy with gas tamponade ( p = 0.007), and was negatively correlated with number of previous RD operations ( p = 0.01), larger extent of RD ( p = 0.02) and more extensive retinotomy/retinectomy ( p = 0.04). Conclusions: An appropriate and timely intervention, including vitrectomy alone, inferior relaxing retinotomy/retinectomy and standard SO tamponade provide satisfactory outcomes for RDs complicated by PVR. Lesser extension of grade C PVR at baseline, such as PVR limited to one quadrant should encourage vitreoretinal specialists to consider retinotomy/retinectomy at a milder clinical stage of PVR development.

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Results and Complications after Implantation of a Black Iris-Lens Diaphragm in Patients with Traumatically Induced Aphakia and Aniridia

European Journal of Ophthalmology ◽

10.5301/ejo.2011.6484 ◽

2011 ◽

Vol 21 (6) ◽

pp. 754-759 ◽

Cited By ~ 5

Author(s):

Vasileios Petousis ◽

Lothar Krause ◽

Gregor Willerding ◽

Michael H. Foerster ◽

Nikolaos E. Bechrakis

Keyword(s):

Anterior Chamber ◽

Surgical Repair ◽

Silicone Oil ◽

Case Series ◽

Corrected Visual Acuity ◽

Time Out ◽

Anatomic Results ◽

The Mean ◽

Positive Effect

Purpose. The black iris-lens diaphragm (ILD) can be used in the treatment of traumatic aniridia and aphakia. The aim of our study was to show postoperative functional and anatomic results and complications in a small case series. Methods. We retrospectively analyzed the files of 16 patients managed with a black ILD or a sole iris diaphragm in the period 1994–2007. Four of them were female and 12 were male. The mean age of the group was 50±17 years. At the time of the implantation, all of the eyes had already undergone primary surgical repair. Results. The preoperative best-corrected visual acuity in half of the patients was ≥0.1 and remained stable after the first postoperative year. During the follow-up years, one eye developed a subluxation of the implant and one eye an anterior chamber hemorrhage. At the same time, out of 8 eyes carrying a silicone tamponade in the vitreous cavity, silicone oil entered the anterior chamber in 3 cases. In one case, enucleation was undertaken due to phthisis. Conclusions. In the case of severely traumatized eyes with aniridia and aphakia, the implantation of a black ILD can have a positive effect on functional and anatomic stabilization.

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A New Sutureless Illuminated Macular Buckle Designed for Myopic Macular Hole Retinal Detachment

Journal of Ophthalmology ◽

10.1155/2017/6742164 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Ahmed M. Bedda ◽

Ahmed M. Abdel Hadi ◽

Mohamed Lolah ◽

Muhammad S. Abd Al Shafy

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Macular Hole ◽

High Myopia ◽

Terminal Part ◽

Macular Hole Retinal Detachment ◽

Myopic Macular Hole ◽

The Mean ◽

Visual Results

Purpose. To report the anatomic and visual results of a new sutureless illuminated macular buckle designed for patients with macular hole retinal detachment related to high myopia (MMHRD). Design. Prospective nonrandomized comparative interventional trial. Methods. Twenty myopic eyes of 20 patients (mean age, 51.4 years; range, 35–65 years) presenting with MMHRD with a posterior staphyloma, in whom the new buckle was used, were evaluated. The buckle used was assembled from a 5 mm wide sponge and a 7 mm wide silicone tire; it was fixed utilizing the sterile topical adhesive Histoacryl Blue (B Braun, TS1050044FP) which polymerizes in seconds upon being exposed to water-containing substances. The primary outcomes measured included aided visual acuity (BCVA) and optical coherence tomography (OCT) findings. The mean follow-up period was 6 months. Results. Postoperatively, the MH closure was identified by OCT in 8 (40%) eyes. The mean BCVA increased from 0.11 to 0.21 (p<0.005). The axial length of the eyes included decreased from 30.5 mm preoperatively to 29.8 mm (p=0.002) postoperatively. Conclusion. Preparation of the new sutureless macular buckle is simple and easy. Illumination of the terminal part of the buckle ensures proper placement. Histoacryl Blue is effective in fixing the buckle in its place for at least 6 months with no reported intra- or postoperative complications.

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