scholarly journals Loss of Visual Acuity after Successful Surgery for Macula-On Rhegmatogenous Retinal Detachment in a Prospective Multicentre Study

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Salvatore Di Lauro ◽  
Melissa Castrejón ◽  
Itziar Fernández ◽  
Jimena Rojas ◽  
Rosa M. Coco ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Visual Loss ◽  
Vision Loss ◽  
Multicentric Study ◽  
Prospective Multicentre Study ◽  
Snellen Chart ◽  
Pars Plana ◽  
Phakic Eyes

Purpose. To quantify the frequency of visual loss after successful retinal detachment (RD) surgery in macula-on patients in a multicentric, prospective series of RD.Methods. Clinical variables from consecutive macula-on RD patients were collected in a prospective multicentric study. Visual loss was defined as at least a reduction in one line in best corrected visual acuity (VA) with Snellen chart. The series were divided into 4 subgroups: (1) all macula-on eyes (n=357); (2) macula-on patients with visual loss at the third month of follow-up (n=53) which were further subdivided in (3) phakic eyes (n=39); and (4) pseudophakic eyes (n=14).Results. Fifty-three eyes (14.9%) had visual loss three months after surgery (n=39phakic eyes;n=14pseudophakic eyes). There were no statistically significant differences between them regarding their clinical characteristics. Pars plana vitrectomy (PPV) was used in 67.2% of cases, scleral buckle in 57.7%, and scleral explant in 11.9% (36.1% were combined procedures).Conclusions. Around 15% of macula-on RD eyes lose VA after successful surgery. Development of cataracts may be one cause in phakic eyes, but vision loss in pseudophakic eyes could have other explanations such as the effect of released factors produced by retinal ischemia on the macula area. Further investigations are necessary to elucidate this hypothesis.

scholarly journals Recurrent Retinal Detachment after Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment

2020 ◽  
Author(s):  
Yan Fu ◽  
Yue-ling Zhang ◽  
Zhaohui Gu ◽  
Ren-Fei Geng ◽  
Xin-Yu Yuan
Keyword(s):  
Visual Acuity ◽  
Risk Factor ◽  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Univariate Analysis ◽  
Visual Outcomes ◽  
Primary Surgery ◽  
Pars Plana

Abstract Background The recurrence of retinal detachment (RD) following rhegmatogenous retinal detachment (RRD) is a relatively common complication that threatens vision and needs further surgery. The purpose of this study is to investigate the risk factors and visual outcomes of recurrent RD following pars plana vitrectomy (PPV) for primary RRD.Methods This was a retrospective follow-up of 343 eyes that underwent initial PPV surgery for primary RRD. Patients were divided into a recurrence group and a reattachment group. The main outcome measures included the causative factors, visual outcomes of RD recurrence, and the perioperative factors most affecting the recurrence of RD.Results After retinal reattachment, we observed recurrence of RD after PPV for primary RRD in 42 out of 343 eyes (12.2%) during the follow-up period. Most recurrence (69%) occurred within 6 months after surgery. Univariate analysis showed that the primary risk factor significantly associated with recurrent RD was the presence of proliferative vitreoretinopathy (PVR) ≥ Grade C ( P = 0.003). Logistic regression analysis showed that a PVR ≥ Grade C (odds ration [OR]: 9.421, 95% confidence interval [CI]: 2.432 - 56.39; P =0.020) was a significant predictor for the development of recurrent RD. The recurrence of RD resulted in a significant decline in best-corrected visual acuity (BCVA) at the last follow-up visit compared with the reattachment group ( P =0.000). Eyes with PVR prior to primary surgery or at the diagnosis of re-detachment showed a worse final BCVA.Conclusions The presence of PVR ≥ Grade C was the predominant risk factor for the recurrence of RD. PVR prior to primary surgery, or at the diagnosis of re-detachment, limited the recovery of final visual acuity.

Visual Loss

2013 ◽  
Author(s):  
Jess T. Whitson
Keyword(s):  
Visual Acuity ◽  
Visual Loss ◽  
Vision Loss ◽  
Neovascular Glaucoma ◽  
Shunt Surgery ◽  
Shunt Implantation ◽  
Shunt Group ◽  
Long Term Follow Up ◽  
Tube Shunt

Tube shunt surgery use has increased significantly in recent years. Once reserved as a treatment option for more refractory types of disease, such as uveitic or neovascular glaucoma, or for eyes that had failed one or more trabeculectomies, tube shunts are now being used by some surgeons in place of trabeculectomy as a first-line surgical alternative in eyes with other less aggressive or less difficult to control forms of glaucoma. Visual loss can occur following tube shunt implantation as a result of complications during the postoperative period or from the progression of underlying disease (see Table 40.1). Although tube shunt implantation is associated with similar postoperative complications as trabeculectomy surgery, such as hypotony, hemorrhage, and failure to control IOP, there are several unique complications that may develop with the use of tube shunts, many of which may result in vision loss. Visual loss following tube shunt surgery is not uncommon. A large, systematic literature review of tube shunts by Hong and coworkers reported rates of vision loss following tube shunt surgery (defined as loss of 2 or more lines of visual acuity at last follow-up) ranging from (mean [SD]) 24 (7)% with the Ahmed™ Glaucoma Valve (New World Medical, Inc., Rancho Cucamonga, California) to 33 (18)% with the Molteno® implant (Molteno Ophthalmic Ltd., Dunedin, New Zealand). In the Tube Versus Trabeculectomy (TVT) Study, an ongoing, prospective, randomized clinical trial that is comparing the Baerveldt® 350 mm tube shunt (Abbott Medical Optics, Inc., Santa Ana, California) to trabeculectomy with mitomycin-C (MMC) in eyes with previous trabeculectomy and/or cataract surgery, vision loss (defined as loss of 2 or more lines of Snellen visual acuity) occurred in 31 of the 107 patients (29%) in the tube shunt group. The occurrence of any postoperative complication significantly increased the risk of vision loss (p < 0.001), and this risk correlated to the number of complications. Corneal decompensation has been reported to occur in up to 30% of patients during long-term follow-up after tube shunt surgery.

scholarly journals Recurrent Retinal Detachment After Pars Plana Vitrectomy For Rhegmatogenous Retinal Detachment

2021 ◽  
Author(s):  
Yan Fu ◽  
Tian-hao Xie ◽  
Zhao-Hui Gu ◽  
Na Yang ◽  
Ren-Fei Geng ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Univariate Analysis ◽  
Visual Outcomes ◽  
Primary Surgery ◽  
Pars Plana ◽  
Recurrence Group

Abstract Background The recurrence of retinal detachment (RD) following rhegmatogenous retinal detachment (RRD) is a relatively common complication that threatens vision and requires further surgery. The purpose of this study was to investigate the risk factors and visual outcomes of recurrent RD following pars plana vitrectomy (PPV) for primary RRD. Methods This was a retrospective follow-up of 343 eyes that underwent initial PPV surgery for primary RRD. Patients were divided into a recurrence group and a reattachment group. The main outcome measures included causative factors, visual outcomes related to the recurrence of RD, and the perioperative factors most affecting the recurrence of RD. Results After retinal reattachment, we observed RD recurrence after PPV for primary RRD in 42 out of 343 eyes (12.2%) during the follow-up period. Most causes of recurrence (69%) occurred within 6 months of surgery. Univariate analysis showed that the presence of proliferative vitreoretinopathy (PVR) ≥ Grade C was significantly associated with recurrent RD (P = 0.003). Logistic regression analysis further showed that a PVR ≥ Grade C (odds ratio [OR]: 9.421; 95% confidence interval [CI]: 2.432 - 56.39; P = 0.020) was a significant predictor for the development of recurrent RD. Compared with the reattachment group, the recurrence group exhibited a significant decline in best-corrected visual acuity (BCVA) at the last follow-up visit (P = 0.000). Eyes with PVR prior to primary surgery, or at the diagnosis of re-detachment, showed a worse final BCVA. Conclusions Our analysis shows that the predominant risk factor for the recurrence of RD is a PVR ≥ Grade C. PVR prior to primary surgery, or at the diagnosis of re-detachment, was also shown to limit the recovery of final visual acuity.

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 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

scholarly journals Outcomes Following Pars Plana Vitrectomy for Severe Ocular Trauma

2021 ◽  
Author(s):  
Natalia K. Bober ◽  
Neruban Kumaran ◽  
Tom H Williamson
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Ocular Trauma ◽  
Final Visual Acuity ◽  
Ocular Injury ◽  
Significant Difference ◽  
Pars Plana ◽  
Type Of Injury

Purpose: To investigate outcomes and presenting characteristics for subjects undergoing pars plana vitrectomy for ocular trauma. Methods: Retrospective study of 113 patients who underwent pars plana vitrectomy for severe ocular trauma at [name deleted to maintain the integrity of the review process] between 1999 and 2018. Data were collected on age, gender, initial and final visual acuity (LogMAR), mode of injury, type of injury, number of surgeries performed, follow-up duration, type of tamponade, presence of phthisis, and retinal detachment. The Birmingham Eye Trauma Terminology System (BETTS) was employed. Results: We identified assault and contusion injuries to be the most common mode and type of ocular injury in our cohort. Furthermore, through follow-up we noted a varied number of operations required by patients presenting with ocular trauma and a statistically significant improvement in visual acuity from 1.73 (±0.86) LogMAR to 1.17 (±1.03; p <0.01) LogMAR. A statistically significant difference in final visual acuity was also noted between BETTS classified type of injury groups (p < 0.01). Notably, only 7.3% and 8.2% of patients developed phthisis or a persisting retinal detachment, respectively, during follow-up. Conclusion: Our study demonstrates that ocular trauma requiring pars plana vitrectomy can require a varied number of operations with a guarded visual prognosis. However, a small percentage will proceed to develop phthisis following intervention.

scholarly journals ANATOMICAL AND VISUAL OUTCOME OF COMBINED PHACO-VITRECTOMY VS VITRECTOMY ALONE

2021 ◽  
Vol 31 (04) ◽  
pp. 204-209
Author(s):  
Irfan Muslim ◽  
Asad Aslam Khan ◽  
Nasir Chaudhry
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Visual Outcome ◽  
P Value ◽  
Corrected Visual Acuity ◽  
Group A ◽  
Pars Plana ◽  
Group B ◽  
Anatomical Outcome

Introduction Separation of Neurosensory retina from RPE(Retinal Pigment Epithelium) is described as retinal detachment. Recently Pars plana vitrectomy has emerged as a preferred surgical treatment for management of uncomplicated primary rhegmatogenous retinal detachment. Various studies have evaluated the results of combined phaco-vitrectomy, the combined approach allows faster visual recovery and has cost effectivity for patient. The rationale of this study is to compare the anatomical and visual outcome of combined phacoemulsification and vitrectomy vs vitrectomy alone Materials and methods This prospective randomized controlled trial was performed at Eye Unit II Mayo Hospital Lahore (tertiary care eye hospital in Lahore), Pakistan from August 2019 to February 2020. 36 patients full filling the inclusion criteria were divided into two groups 18 patients each. Group A was of combined Phaco-vitrectomy and Group B was of vitrectomy only. The Mann-whitney test as test of significance was applied and P≤0.05 was considered statistically significant. Results BCVA done Pre-operatively for Group A and B, P-value was > 0.05 which was insignificant. Best corrected visual acuity at first week post operatively was significantly lower in patients in which we used gasses as internal tamponade as compared those in which we used silicon oil as tamponade. The BCVA at 1 month showed improvements in both groups, however the BCVA in group B was significantly lower than group A, P-value being < 0.05. The BCVA at 3 month showed improvements in both groups, however the BCVA in group B was significantly lower than group A, P-value being < 0.05. Anatomical Outcome was seen as weather retina was attached or detached. In Group A detachment was present in all follow-ups in 2/18 patients while in Group B detachment was present in all follow-ups in 3/18 patients. The P-value was >0.05 and thus the difference between two groups was insignificant. Conclusion visual acuity did not differ among the two groups preoperatively and on first follow-up at 1 week. The P value being >0.05 in both. However there was significant difference between the two group at 1 month and 3 months follow up, P value being < 0.05 in each. The visual acuity was significantly better in Group A i.e combined phaco- vitrectomy. For anatomical outcome no difference was seen between the groups. The P value was > 0.05. So the visual outcome of group A was significantly better than group B while the anatomical outcome was the same.   Keywords Phacoemulsification, Three ports pars plana vitrectomy, best corrected visual acuity, retinal detachment.

scholarly journals Recurrent Intraocular Lens Dislocation in a Patient with Familial Ectopia Lentis

2021 ◽  
Vol 18 (9) ◽  
pp. 4545
Author(s):  
Tomasz K. Wilczyński ◽  
Alfred Niewiem ◽  
Rafał Leszczyński ◽  
Katarzyna Michalska-Małecka
Keyword(s):  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Vision Loss ◽  
Silicone Oil ◽  
Single Case ◽  
Recurrent Dislocation ◽  
Ectopia Lentis ◽  
Pars Plana ◽  
The Right

A 36-year-old patient presented to the hospital with recurrent dislocation of the intraocular lens (IOL). The patient with the diagnosis of familial ectopia lentis was first operated on for crystalline lens subluxation in the left eye in 2007 and in the right eye in 2009. In both eyes, lens extraction with anterior vitrectomy and transscleral fixation of a rigid IOL was performed. In 2011, the IOL in the right eye luxated into the vitreous cavity due to ocular trauma. The patient underwent a pars plana vitrectomy with the IOL resuturation to the sclera. Seven years later, a spontaneous vision loss in the right eye was caused by a retinal detachment. The pars plana vitrectomy with silicone oil tamponade and a consequential oil removal three months later were performed in 2018. The follow-up examination revealed recurrent IOL dislocation in the same eye. Due to a history of previous suture-related complications a decision was made to remove the subluxated rigid polymethyl-methacrylate (PMMA) IOL and fixate to sclera a sutureless SOLEKO FIL SSF Carlevale lens. The purpose of this report is to present a single case of a 36-year-old patient who was presented to the hospital with recurrent dislocation of the intraocular lens. In a three-month follow-up period, a good anatomical and functional outcome was finally obtained with transscleral sutureless intraocular lens. This lens is an option worth considering especially in a young patient with a long life expectancy and physically active.

scholarly journals Combined pars plana glaucoma drainage device placement and vitrectomy using a vitrectomy sclerotomy site for tube placement: a case series

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Enchi Kristina Chang ◽  
Sanchay Gupta ◽  
Marika Chachanidze ◽  
John B. Miller ◽  
Ta Chen Chang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Pars Plana Vitrectomy ◽  
Case Series ◽  
Tube Placement ◽  
Glaucoma Drainage Device ◽  
Drainage Device ◽  
Glaucoma Drainage Devices ◽  
Pars Plana ◽  
Sclerotomy Site

Abstract Purpose The purpose of this study is to report the safety and efficacy of pars plana glaucoma drainage devices with pars plana vitrectomy using one of the vitrectomy sclerotomy sites for tube placement in patients with refractory glaucoma. Methods Retrospective case series of 28 eyes of 28 patients who underwent combined pars plana glaucoma drainage device and pars plana vitrectomy between November 2016 and September 2019 at Massachusetts Eye and Ear. Main outcome measures were intraocular pressure (IOP), glaucoma medication burden, best corrected visual acuity, and complications. Statistical tests were performed with R and included Kaplan-Meier analyses, Wilcoxon paired signed-rank tests, and Fisher tests. Results Mean IOP decreased from 22.8 mmHg to 11.8 mmHg at 1.5 years (p = 0.002), and mean medication burden decreased from 4.3 to 2.1 at 1.5 years (p = 0.004). Both IOP and medication burden were significantly lower at all follow-up time points. The probability of achieving 5 < IOP ≤ 18 mmHg with at least 20% IOP reduction from preoperative levels was 86.4% at 1 year and 59.8% at 1.5 years. At their last visit, three eyes (10.7%) achieved complete success with IOP reduction as above without medications, and 14 eyes (50.0%) achieved qualified success with medications. Hypotony was observed in 1 eye (3.6%) prior to 3 months postoperatively and 0 eyes after 3 months. Visual acuity was unchanged or improved in 23 eyes (82.1%) at their last follow-up. Two patients had a visual acuity decrease of > 2 lines. Two eyes required subsequent pars plana vitrectomies for tube obstruction, and one eye had transient hypotony. Conclusions The results of pars plana glaucoma drainage device and pars plana vitrectomy using one of the vitrectomy sclerotomy sites for tube placement are promising, resulting in significant IOP and medication-burden reductions through postoperative year 1.5 without additional risk of postoperative complications. Inserting glaucoma drainage devices into an existing vitrectomy sclerotomy site may potentially save surgical time by obviating the need to create another sclerotomy for tube placement and suture one of the vitrectomy ports.

scholarly journals Valsalva Retinopathy Associated with Sexual Activity

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Khalid Al Rubaie ◽  
J. Fernando Arevalo
Keyword(s):  
Visual Acuity ◽  
Sexual Activity ◽  
Vision Loss ◽  
Internal Limiting Membrane ◽  
Internal Limiting Membrane Peeling ◽  
Sudden Loss ◽  
Initial Visual Acuity ◽  
Pars Plana ◽  
23 Gauge ◽  
The Right

A 54-year-old healthy male presented complaining of sudden loss of vision in the right eye. Initial visual acuity was counting fingers. The patient’s acute vision loss developed after sexual activity. Color fundus photos and fluorescein angiography were performed showing a large subinternal limiting membrane hemorrhage in the macular area. A 23-gauge sutureless pars plana vitrectomy with brilliant blue assisted internal limiting membrane peeling was performed with best-corrected visual acuity recovery to 20/50 at 6 months of followup.

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