scholarly journals Retrospective Comparison of 27-Gauge and 25-Gauge Microincision Vitrectomy Surgery with Silicone Oil for the Treatment of Primary Rhegmatogenous Retinal Detachment

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Jie Li ◽  
Bo Zhao ◽  
Sanmei Liu ◽  
Fang Li ◽  
Wentao Dong ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Final Visit ◽  
Functional Difference ◽  
Surgical Time ◽  
Intraoperative Complication ◽  
Significant Difference ◽  
Microincision Vitrectomy Surgery ◽  
Vitrectomy Surgery

Aim. To retrospectively compare the safety and effectiveness of 27-gauge (27G) microincision vitrectomy surgery (MIVS) with 25-guage (25G) MIVS for the treatment of primary rhegmatogenous retinal detachment (RRD) with silicone oil tamponade. Methods. Ninety-two patients with RRD who underwent MIVS from May 1, 2015, to June 30, 2017, were included in this study. Fifty-eight eyes underwent 25G MIVS and 34 eyes underwent 27G MIVS. We analyzed the characteristics of the patients, surgical time, main clinical outcomes, and rate of complications. Results. The mean surgical time was 56.7 ± 35.9 min for the 25G MIVS and 55.7 ± 36.1 min for the 27G MIVS, and there was no significant difference (P=0.894) between the two groups. The primary anatomical success rate after a single operation was 94.8% for 25G MIVS and 91.2% for 27G MIVS (P=0.666). Baseline and final visit best-corrected visual acuity (BCVA) were 1.9 ± 1.1 and 1.0 ± 0.8 in the 25G group, and 1.7 ± 1.0 and 1.1 ± 0.8 in the 27G group. Last visit BCVA increased significantly in both groups (P<0.001). However, there were no significant differences in terms of visual improvement ratio (>0.2 logMAR) between the two groups (P=0.173). No severe intraoperative complication was observed. Iatrogenic retinal breaks occurred in 2 eyes (3.4%) in the 25G group and 1 eye (2.9%) in the 27G group during the peripheral vitreous base shaving. The transient ocular hypertension (>25 mmHg) within postoperative week 1 was 25.9% in the 25G group and 11.8% in the 27G group (P=0.120). Conclusions. This study found no significant anatomical or functional difference between 27G and 25G MIVS in the treatment of primary RRD. Therefore, 27G vitrectomy appears to be a safe and effective surgery for the treatment of primary RRD.

scholarly journals The effect of silicone oil tamponade on retinal layers and choroidal thickness in patients with rhegmatogenous retinal detachment: a systematic review and meta-analysis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Heshmatollah Ghanbari ◽  
Farzan Kianersi ◽  
Alireza Jamshidi Madad ◽  
Alireza Dehghani ◽  
Alireza Rahimi ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Choroidal Thickness ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Subfoveal Choroidal Thickness ◽  
Retinal Layers ◽  
Significant Difference ◽  
Before And After

Abstract Background To evaluate the effects of intravitreal silicone oil (SO) on the retinal and choroidal thickness in eyes with rhegmatogenous retinal detachment (RRD). Methods A literature search was performed in Web of Science, Scopus, ProQuest, Embase, Clinical Key, Science Direct, Cochrane Library, and Springer, as well as Persian databases, including IranDoc, MagIran, SID, MOH thesis, and MOH articles until June 2020. Two reviewers independently searched and extracted the data. Results Sixteen studies (n = 391) met the inclusion criteria. The meta-analysis showed that the SO tamponade could significantly reduce the central macular thickness (CMT) in patients with RRD as compared to gas tamponade WMD = − 14.91; 95% CI: − 22.23, − 7.60; P < 0.001, I2 = 71%). No significant change was found in CMT between the eye with SO tamponade (after SO removal) and the fellow healthy eye in patients with RRD (WMD = − 3.52; 95% CI: − 17.63, 10.59; I2 = 68.6%). Compared to the preoperative stage, the SO tamponade could significantly reduce the subfoveal choroidal thickness in patients with RRD (WMD = − 18.67, 95% CI: − 30.07, − 1.28; I2 = 80.1%). However, there was no significant difference in the subfoveal choroidal thickness before and after SO removal (WMD = − 1.13, 95% CI: − 5.97, 3.71; I2 = 87.6%). Conclusion The SO tamponade had a significant effect on the reduction of retinal layers and the subfoveal choroidal thickness.

scholarly journals Predictive Risk Factors for Retinal Redetachment Following Uncomplicated Pars Plana Vitrectomy for Primary Rhegmatogenous Retinal Detachment

2020 ◽  
Vol 9 (12) ◽  
pp. 4037
Author(s):  
Josef Guber ◽  
Maico Bentivoglio ◽  
Christophe Valmaggia ◽  
Corina Lang ◽  
Ivo Guber
Keyword(s):  
Risk Factors ◽  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Detachment Rate ◽  
Significant Difference ◽  
Pars Plana ◽  
Predictive Risk ◽  
Control Study

Purpose: To investigate clinical and surgical factors influencing the outcome after primary rhegmatogenous retinal detachment surgery. Methods: A retrospective, single-centre, case-control study of 1017 eyes of 1017 consecutive patients with primary rhegmatogenous retinal detachment (RRD) who underwent pars plana vitrectomy (PPV), were included in the study. Analysed surgical factors were: combined procedure with phacoemulsification, type of retinopexy (cryocoagulation, endolaser, combined), type of tamponade (gas, silicone oil), and anatomical factors: primary proliferative vitreoretinopathy (PVR) and macular detachment at the time of surgery. Results: Overall retinal re-detachment rate was 10.1%. The main reason for re-detachment was an insufficient retinopexy in 53.6%, followed by PVR (37.3%), and retinal detachment occurred at a different location caused by another break in 9.1%. No significant difference in the rate of re-detachment was found if a phacoemulsification with simultaneous IOL implantation was performed (p = 0.641). No significant difference between the various retinopexy techniques was found (p = 0.309). Risk factors re-detachment were primary PVR (p = 0.0003), silicone oil as initial tamponade (p = 0.0001) as well as macula off detachments (p = 0.034). Conclusions: The present study showed no significant difference between the types of retinopexy and if additional phacoemulsification was performed or not. Factors associated with a higher risk for re-detachment were detached macula at surgery, primary PVR and primary oil-filling.

scholarly journals Risk factors for ellipsoid zone integrity after macula-off rhegmatogenous retinal detachment repair

2020 ◽  
Author(s):  
Wei Fang ◽  
Miao Chen ◽  
Jing Zhai ◽  
Jiuke Li ◽  
Yiqi Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Vital Role ◽  
Hazard Ratio ◽  
Final Visit ◽  
Posterior Staphyloma ◽  
Ellipsoid Zone ◽  
Silicone Oil Tamponade

Abstract Background: ellipsoid zone (EZ) layer plays a vital role in visual performance of human retina, hereby we try to find some risk factors for EZ integrity after primary macula-off rhegmatogenous retinal detachment (RRD) repair. Methods: a retrospective cases study. Patients with macula-off RRD undergoing successful primary retinal repair surgery were reviewed and spectral domain optical coherence tomography images of them were analyzed. Comprehensive preoperative, intraoperative and postoperative clinical factors were screened. Results: A total of 118 patients (118 eyes) were enrolled in this study. The mean age of those patients was 52.16 years old (52.16 ±12.87 years). The follow-up time ranged from 0.1 to 84 months (10.21 ±14.81 months). 54 cases (45.76%) had their EZ fully reconstructed at final visit. The mid-quartile time of EZ reconstruction was 14.0 months (95% CI: 11.3 ~20.0 months). Multivariate proportional haphazard regression test revealed that the independent factors were: silicone oil tamponade (Hazard ratio=0.414, p=0.0400), posterior staphyloma (Hazard ratio=0.141, p=0.0021) and disorganization of retinal inner layer (Hazard ratio=0.167, p=0.0166). Conclusion: After successful retinal reattachment for macula-off retinal detachment, the mid-quartile time of EZ recovery was about 14 months. The independent risk factors for EZ recovery might include silicone oil tamponade, posterior staphyloma and disorganization of retinal inner layer.

scholarly journals Changes in Axial Length After Vitrectomy for Rhegmatogenous Retinal Detachment With Associated Choroidal Detachment

2020 ◽  
Author(s):  
Jipeng LI ◽  
Jun XU ◽  
Meng ZHAO
Keyword(s):  
Retinal Detachment ◽  
Axial Length ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Choroidal Detachment ◽  
Pathological Myopia ◽  
Number Of Patients ◽  
Significant Difference ◽  
Potential Factors ◽  
Lens Power

Abstract BACKGROUND The precise pre-operative measurements of axial length (AL) are essential for calculating intraocular lens power in cases undertaking pars plana vitrectomy (PPV) combined with cataract surgery. The changes in AL after PPV for rhegmatogenous retinal detachment (RRD) combined with choroidal detachment (CD) has not been reported. Here, we studied the postoperative AL changes in patients with RRD combined with CD (RRD-CD) and compared the changes in patients with RRD and tractional retinal detachment (TRD). METHODS In this retrospective cohort study, medical records of 129 patients who received PPV combined with silicone oil tamponade from January 2015 to December 2018 were reviewed. Patients included were divided into three groups, RRD-CD, RRD, and TRD. All patients had received AL measurements before PPV and before silicone oil removal (SOR). The changes in AL of three groups before PPV and before SOR were compared. The potential factors related to AL changes were analyzed. RESULTS The number of patients included in RRD-CD, RRD, TRD groups were 41, 43, and 45, respectively. In RRD-CD group, AL measured before SOR was longer than that measured before PPV with a median of 1.01 [0.37,1.79] mm (p = 0.02). There was no such significant difference in RRD group (0.15 [0.04, 0.42] mm, p = 0.58) or TRD group (0.07[-0.03,0.15] mm, p = 0.53). The amplitude of AL changes in RRD-CD group was greater than that in RRD group (p < 0.001) and that in TRD group (p < 0.001). AL increased 0.06 mm (0.06, R2 = 0.11, p = 0.03) in RRD-CD group and 0.02 mm (0.02, R2 = 0.11, p = 0.01) in RRD group when the IOP before SOR was 1 mmHg higher than that before PPV. After adjusting the effect of the factors as the presence of pathological myopia (p = 0.45), IOP before PPV (p = 0.86), sustained elevation of IOP in post-PPV follow up (p = 0.51), AL in RRD-CD group was 11.42 times (3.54, 46.80) more likely to increase for more than 1 mm compared to that in RRD group (p < 0.001, AIC = 86.15). CONCLUSION Patients with RRD-CD are very likely to have postoperative elongation of AL. The primary IOL implantation using pre-operative AL data may cause significant refractive error in combined surgery in patients with RRD-CD.

scholarly journals Bilateral Simultaneous Rhegmatogenous Retinal Detachment following Laser in situ Keratomileusis

2016 ◽  
Vol 7 (2) ◽  
pp. 340-344 ◽  
Author(s):  
Erhan Yumusak ◽  
Kemal Ornek ◽  
Fatma Ozkal
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Scleral Buckling ◽  
Laser In Situ Keratomileusis ◽  
Pars Plana ◽  
Silicone Oil Tamponade ◽  
The Right ◽  
Vitrectomy Surgery

A 21-year-old woman developed simultaneous rhegmatogenous retinal detachment after laser in situ keratomileusis (LASIK) in both eyes. She underwent pars plana vitrectomy surgery combined with endolaser photocoagulation and silicone oil tamponade in the right eye. A week later, pneumatic retinopexy was done in the left eye. As the retinal tear did not seal, 360° scleral buckling surgery was performed and retina was attached. Bilateral simultaneous rhegmatogenous retinal detachment after LASIK for correction of myopia can be a serious complication. Patients should be informed about the possibility of this complication.

scholarly journals Differences in Axial Length and IOLs Power Basing on Alternative A-Scan or Fellow-Eye Biometry in Macular-off Rhegmatogenous Retinal Detachment Eyes

2020 ◽  
Author(s):  
Rui Liu ◽  
Hongrong Li ◽  
Qingchen Li
Keyword(s):  
Retinal Detachment ◽  
Axial Length ◽  
Prediction Error ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Fellow Eye ◽  
Lens Extraction ◽  
Significant Difference ◽  
Silicone Oil Tamponade ◽  
The Difference

Abstract Background: To observe the potential refractive prediction error basing on alternative A-scan ultrasound and fellow-eye biometry for phacovitrectomy in macula-off rhegmatogenous retinal detachment (RRD) eyes, when the optic biometry IOLMaster fails to obtain data.Methods: Phakic macula-off RRD eyes without axial length (AL) measured using IOLMaster were included. Vitrectomy with silicone oil tamponade but not lens extraction was performed. Preoperative AL was measured using A-scan ultrasound, and postoperative AL, as well as fellow-eye biometry, was obtained using IOLMaster. The IOLs power was calculated according to preoperative A-scan, postoperative IOLMaster and fellow-eye AL.Results: AL measured by alternative A-scan (AL-US) was 25.39±2.14 mm, and AL of fellow-eyes (AL-FE) was 25.85±2.16 mm, and AL in eyes with silicone oil tamponade (AL-SO) was 26.08±2.53 mm. The Bland-Altman agreements among AL-US, AL-FE and AL-SO were well (95.5%, 21/22 of cases were in LoA). The mean IOLs power calculated using AL-US (Power-US) was 16.81±7.19 D, using AL-FE (Power-FE) was 14.74±6.95 D, and using AL-SO (Power-SO) was 13.54±8.32 D. The difference between AL-US and AL-SO was significant (P<0.05), while that between AL-FE and AL-SO was not (P>0.05). The difference between Power-US and Power-SO was significant (P<0.05), while that between Power-FE and Power-SO was not (P>0.05).Conclusion: The alternative A-scan ultrasound leads to a significant difference in AL and prediction error in IOLs power, while fellow-eye biometry provided similar results compared with those of silicone oil-filled eyes after RRD repair.

scholarly journals Anatomical and Functional Results Following 23-Gauge Primary Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment: Superior versus Inferior Breaks

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Panagiotis Stavrakas ◽  
Paris Tranos ◽  
Angeliki Androu ◽  
Paraskevi Xanthopoulou ◽  
Dimitrios Tsoukanas ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Functional Results ◽  
Intraoperative Complication ◽  
Significant Difference ◽  
Group A ◽  
Pars Plana ◽  
23 Gauge ◽  
Group B

Purpose. In this retrospective study, we evaluated the anatomical and functional outcomes of patients with rhegmatogenous retinal detachment primarily treated with pars plana vitrectomy in regard to the location of the breaks. Methods. 160 eyes were enrolled in this study, divided into two groups based on break location: the superior break group (115 eyes) and the inferior break group (45 eyes). The main endpoint of our study was the anatomical success at 3 months following surgery.Results. Primary retinal reattachment was achieved in 96.5% of patients in group A and in 93.3% in group B (no statistically significant difference, OR 1.98, 95% CI: 0.4, 7.7). Mean BCVA change and intraoperative complication rate were also not statistically significantly different between the two groups (p>0.05, OR: 1.0, 95% CI: 0.9, 1.01, resp.). Statistical analyses showed that macula status, age, and preoperative BCVA had a significant effect on mean BCVA change (p=0.0001,p=0.005, andp=0.001, resp.).Conclusion. This study supports that acceptable reattachment rates can be achieved using PPV for uncomplicated RRD irrespective of the breaks location and inferior breaks do not constitute an independent risk factor for worse anatomical or functional outcome.

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.

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