scholarly journals Long-term Clinical Results of Vitrectomy and Scleral Buckling in Treatment of Rhegmatogenous Retinal Detachment

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
I. Schmidt ◽  
N. Plange ◽  
G. Rößler ◽  
H. Schellhase ◽  
A. Koutsonas ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Success Rate ◽  
Rhegmatogenous Retinal Detachment ◽  
Case Series ◽  
Clinical Results ◽  
Scleral Buckling ◽  
Long Term Results ◽  
Encircling Band

Purpose. Most studies about retinal detachment cover a limited follow-up period. The purpose of this research is to assess the long-term results after pars plana vitrectomy (PPV) and scleral buckle (SB) surgery in patients with rhegmatogenous retinal detachment (RRD). Methods. 155 patients with RRD are treated either with SB or PPV with a mean follow-up of more than 5 years. Retrospective analysis of patient data with RRD was performed between January 2006 and June 2008 at a tertiary eye clinic. Results. Overall primary success rate was 85.2% (PPV: 84.6%, SB: 89.5%; p=0.57). 90.5% of redetachments appeared within the first 124 days. No significant different success rate was found for vitrectomy with and without additional encircling band (p=0.09). No advantage of a supplemental encircling band in cases of preoperative inferior breaks was seen (p=0.81). Patients of SB group were treated more frequently in follow-up time because of epiretinal membrane (ERM) (SB: 15.5% versus PPV: 7.3%). No patient of the PPV group without intraoperative use of endolaser cerclage (14.7%) had any peeling surgery postoperatively. Conclusion. Redetachment rates of both methods are comparable in a clinical setting where PPV is considered a suitable method for pseudophakic patients and in complex cases and SB was performed in younger phakic patients with clearly identified retinal tears. PPV seems to show a more heterogenous pattern of complications. No advantage of a supplemental encircling band could be found in these case series of patients with primary RRD. No relevant long-term risk of redetachment was seen after SB.

Anatomical and functional outcomes of surgery of rhegmatogenous retinal detachment

1970 ◽  
Vol 2 (2) ◽  
pp. 132-137 ◽  
Author(s):  
H Sharma ◽  
SN Joshi ◽  
JK Shrestha
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Success Rate ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Case Series ◽  
Scleral Buckling ◽  
Pars Plana ◽  
A Prospective Study ◽  
Physiological Outcome

Introduction: Rhegmatogenous retinal detachment (RRD) is a potentially blinding condition. Objective: To evaluate the anatomical and functional outcome of surgery of RRD. Materials and methods: A prospective study of interventional case series was designed including 50 consecutive patients with RRD in a tertiary level eye center in Kathmandu. The patients underwent scleral buckling (SB) or pars plana vitrectomy (PPV) according to the proliferative vitreo-retinopathy (PVR) changes. All the patients had at least 3 months of follow-up. The anatomical and physiological outcome measures were primary retinal reattachment and improvement in visual acuity respectively. The surgery was considered successful when there was attachment of retina after the first surgery. Results: The mean age of these patients at the time of presentation was 46.24 ± 19.82 years. Of 50, sixty-six percent of the patients underwent SB and 34 % underwent PPV. Primary surgical success rate was 88 %. While comparing the initial best corrected visual acuity (BCVA) with the final, 72% had an improvement, 12 % unchanged and 16 % had a deteriorated visual acuity. Conclusion: The visual acuity improves and the anatomical success rate is high in the majority of the patients after surgery for rhegmatogenous retinal detachment. Keywords: rhegmatogenous retinal detachment; scleral buckling; pars plana vitrectomy; anatomical outcome; physiological outcome DOI: 10.3126/nepjoph.v2i2.3720 Nep J Oph 2010;2(2) 132-137

Postchemonucleolysis discectomy versus repeat discectomy: a prospective 1- to 13-year comparison

1996 ◽  
Vol 85 (2) ◽  
pp. 231-238 ◽  
Author(s):  
Manucher J. Javid
Keyword(s):  
Success Rate ◽  
Lumbar Disc ◽  
Clinical Results ◽  
Long Term Results ◽  
Content Type ◽  
Employment Rates ◽  
Second Procedure ◽  
Fine Print

✓ This long-term prospective study evaluates the clinical results of subsequent laminectomy in 103 consecutive patients who initially underwent chemonucleolysis (CNL) or laminectomy for lumbar disc herniation. Between 1981 and 1994, 53 patients who had received CNL initially and then underwent laminectomy and 50 patients treated initially with laminectomy underwent a repeat laminectomy. Clinical assessment at 6 weeks showed a success rate of 80.8% for post-CNL laminectomy and 78% for repeat laminectomy. At 6 months, the success rate for patients treated with CNL was 86% versus 78.7% for laminectomy. At 12 months, the overall success rate for the CNL group was 80.4% versus 83.3% for the laminectomy group, but in patients who had not obtained relief from the first procedure the success rate for the second procedure was higher for the post-CNL patients. A questionnaire was sent to all patients for 1- to 13-year follow-up review. The average follow-up period was 6.6 years for post-CNL laminectomy and 5.2 years for repeat laminectomy. The long-term success rate (81.8%) was higher in the post-CNL group compared to 64.4% in the repeat laminectomy group. Seven patients in the post-CNL group and nine in the repeat laminectomy group had undergone a third operation. When these originally successfully treated patients were reassigned after unsuccessful outcomes, the success rate for the CNL groups was 72.7%, versus 51.1% in the laminectomy group (p = 0.049). Employment rates were 80% for patients with CNL (21.8% changed jobs) and 76.3% for patients undergoing laminectomy (48.3% changed jobs) (p = 0.036). In conclusion, patients who underwent laminectomies after receiving CNL had significantly better long-term results than those who had repeat laminectomies.

scholarly journals Long-term results of endonasal dacryocystorhinostomy with and without stenting

2013 ◽  
Vol 95 (3) ◽  
pp. 196-199 ◽  
Author(s):  
SH Mohamad ◽  
I Khan ◽  
M Shakeel ◽  
V Nandapalan
Keyword(s):  
Success Rate ◽  
Statistical Significance ◽  
Case Series ◽  
Senior Author ◽  
Long Term Results ◽  
P Value ◽  
Stent Group ◽  
Chi Squared

Introduction This study aimed to evaluate the short and long-term results of endoscopic dacryocystorhinostomy (DCR) with and without silicone stenting in chronic dacrocystorhinitis due to postsaccal blockage. Methods The study involved a case series of consecutive 89 patients (128 eyes) who underwent endoscopic DCR. All patients were operated on by the senior author. The stent group comprised 63 eyes (44 patients), for which the DCR was performed between September 2002 and September 2005. The non-stent group with 65 eyes (45 patients) underwent the DCR between October 2005 and December 2006. The follow-up duration was up to 33 months after surgery. The statistical significance (p-value) was calculated using the chi-squared test. Results The short-term success rate at six months’ follow-up was 70% in the stent group and 97% in the non-stent group (p=0.0005) while the long-term success rate at 33 months was only 57% in stent group compared with 89% in the non-stent group (p=0.0003). Conclusions In this study, the non-stent group showed a higher success rate than the stent group on both short and longterm follow-up. Our study suggests that postoperative stents are not necessary for primary DCR and may be associated with a worse outcome.

Premacular membrane formation after scleral buckling for primary rhegmatogenous retinal detachment: prospective study and pathophysiological insights

2018 ◽  
Vol 103 (4) ◽  
pp. 481-487 ◽  
Author(s):  
Viviana Cacioppo ◽  
Andrea Govetto ◽  
Paolo Radice ◽  
Gianni Virgili ◽  
Antonio Scialdone
Keyword(s):  
Risk Factors ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Case Series ◽  
Subretinal Fluid ◽  
Scleral Buckling ◽  
Key Factor ◽  
Subretinal Fluid Drainage ◽  
Functional Deterioration

PurposeTo investigate the incidence, clinical features and risk factors of premacular membrane (PMM) formation after primary rhegmatogenous retinal detachment (RRD) repair with scleral buckling (SB) alone.MethodsThis institutional, prospective and consecutive case series included phakic eyes with RRD, treated with SB alone within 7 days from the occurrence of symptoms, with a follow-up of 6 months. Spectral-domain optical coherence tomography images were reviewed. The association of PMM development and morphology with preoperative and intraoperative RRD features was analysed.ResultsNinety-two patients with a mean age of 56±13 years completed the 6 months follow-up period. Postoperatively, eyes with any PMM stage were 30 out of 92 (32.6%) at 1 month and 47 out of 92 (51,1%) at both 3 months and 6 months. Over the follow-up period, 17 out of 47 PMMs (36.2%) progressed to later stages. Progression of PMMs to later stages were observed only in RRDs involving the macular region (17 out of 35 eyes, 48.5%), while none of the PMMs in macula-sparing detachments progressed to later stages (p=0.020). The risk factors significantly associated with postoperative new onset of PMM were preoperative RRDs involving the macular region (p=0.001), cryopexy time (p=0.045), presence of horseshoe tears (p=0.003), worse preoperative visual acuity (p=0.004) and subretinal fluid drainage (p=0.047).ConclusionThe incidence of postoperative PMM formation after RRD repair with SB alone was high. In retinal detachments involving the macular region PMM were more severe, tending to anatomical progression and functional deterioration. Activation of foveal Müller cell in detachments involving the macula may be a key factor in PMM progression.

scholarly journals Pneumatic retinopexy combined with scleral buckling in the management of relatively complicated cases of rhegmatogenous retinal detachment: A multicenter, retrospective, observational consecutive case series*

2017 ◽  
Vol 46 (1) ◽  
pp. 316-325 ◽  
Author(s):  
Chuandi Zhou ◽  
Qiurong Lin ◽  
Yuxin Wang ◽  
Qinghua Qiu
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Case Series ◽  
Subretinal Fluid ◽  
Scleral Buckling ◽  
Success Rates ◽  
Pneumatic Retinopexy ◽  
The Mean ◽  
Final Operation

Objective To evaluate the efficacy of maximal pneumatic retinopexy (PR) and subretinal fluid (SRF) drainage combined with scleral buckling (SB) in the treatment of complicated rhegmatogenous retinal detachment (RRD). Methods Patients with RRD who underwent maximal PR and SRF drainage combined with SB from June 2007 to June 2012 were included in this multicenter retrospective study. The outcome measures were the primary and final operation success rates and best-corrected visual acuity (BCVA). Results In total, 159 consecutive patients were included. The mean follow-up period was 13.76 ± 1.97 months. Primary operation success was achieved in 146/159 (91.82%) eyes. After salvage management, the final reattachment rate increased to 98.11%. All eyes had improved BCVA, with 62/159 (38.99%) attaining BCVA of ≥20/40. Conclusions Maximal PR and SRF drainage combined with SB achieved satisfactory anatomical and visual recovery in relatively complicated cases of RRD. The decreased need for vitrectomy makes this surgical approach more widely available.

scholarly journals Six-Year Outcomes of 25-Gauge Chandelier Illumination-Assisted Scleral Buckling

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Hui Li ◽  
Conghui Zhang ◽  
Jiayi Wei ◽  
Khusbu Keyal ◽  
Fang Wang
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Average Length ◽  
Insertion Site ◽  
Case Series ◽  
Final Analysis ◽  
Ultrasound Biomicroscopy ◽  
Scleral Buckling ◽  
Long Term Results ◽  
Fundus Photography

Objectives. To report the long-term results of scleral buckling using 25-gauge chandelier illumination. Methods. The medical records of all patients presenting to Shanghai Tenth People’s Hospital with simple rhegmatogenous retinal detachment (RRD) from June 2013 to Oct 2015 were retrospectively reviewed in this consecutive case series. All patients underwent preoperative and postoperative best corrected visual acuity (BCVA), B-ultrasound, fundus photography, and optical coherence tomography examination. Ultrasound biomicroscopy (UBM) was obtained postoperatively. Results. Ten patients (10 eyes) were included in the final analysis. Of 10 patients, the average age was 49.3 ± 18.9 years old, the average duration of RRD was 30.9 ± 53.3 days, and the mean follow-up period was 6.2 ± 0.9 years. There were nine eyes with myopia and four eyes with macular detachment. The primary anatomical success rate was 90%. Five eyes underwent 360-degree band with element surgery, and five eyes underwent element surgery alone. The average length of encircling band and element was 68.2 ± 1.3  mm and 10.5 ± 2.5  mm, respectively. There were no intraoperative or postoperative complications that occurred. The final BCVA was greater than or equal to 20/40 in nine eyes, of which four eyes achieved 20/20. UBM examination of the 25-gauge chandelier insertion site revealed no tissue proliferation. Conclusions. For simple rhegmatogenous retinal detachment treatment, 25-gauge chandelier illumination-assisted scleral buckling is a kind of effective and safe method.

scholarly journals Scleral Buckling in Phakic Uncomplicated Primary Rhegmatogenous Retinal Detachment: Long-Term Outcomes

2016 ◽  
Vol 27 (2) ◽  
pp. 220-225 ◽  
Author(s):  
Claudia Quijano ◽  
Micol Alkabes ◽  
Maria Gómez-Resa ◽  
Andrea Oleñik ◽  
Edoardo Villani ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Open Angle Glaucoma ◽  
Scleral Buckling ◽  
Long Term Outcomes ◽  
Clinical Notes ◽  
Pars Plana ◽  
Surgical Cost

Purpose Scleral buckling (SB) is a surgical technique that has been used successfully to treat retinal detachments for the last 6 decades. The aim of this study was to report the long-term anatomical and functional outcomes of SB surgery in phakic patients with uncomplicated primary rhegmatogenous retinal detachment (PRRD). This article also outlines the benefits of SB compared to pars plana vitrectomy, such as reducing the risk of developing cataract, high intraocular pressure, and glaucoma, in addition to reducing surgical cost. Methods We retrospectively reviewed the clinical notes of 90 phakic eyes with PRRD treated with SB surgery that had a minimum of 5 years follow-up. Preoperative and postoperative characteristics were recorded. Main outcome measures were reattachment rate, best-corrected visual acuity (BCVA) improvement, and complications. Results A total of 90 eyes (88 patients) with phakic PRRD repaired through SB surgery were included. Mean age was 49.2 ± 14.6 years (range 20-80). Primary and final anatomic success was 96.7% and 100%, respectively. Mean preoperative BCVA was 0.3 ± 0.31 logMAR (6/12) and mean postoperative BCVA 0.1 ± 0.2 logMAR (p<0.001) (6/7.5). There were no cataract or primary open-angle glaucoma cases after 1 year of follow-up. Mean follow-up was 8.5 ± 2.6 years (range 5-13). Conclusions We report a high single operation success rate over time in phakic PRRD, repaired through SB surgery. Functional and anatomical success was maintained throughout the follow-up without complications. Therefore, the authors recommend the use of this technique in selected cases in order to reduce morbidity and the incidence of reoperations.

scholarly journals Transmuscular Migration of a Scleral Tunnel-Secured Encircling Silicone Band

2016 ◽  
Vol 7 (3) ◽  
pp. 416-419 ◽  
Author(s):  
Yui Nishida ◽  
Masanori Fukumoto ◽  
Teruyo Kida ◽  
Hiroyuki Suzuki ◽  
Tsunehiko Ikeda
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Rectus Muscle ◽  
Scleral Buckling ◽  
Scleral Tunnel ◽  
Nasal Side ◽  
Encircling Band ◽  
Pars Plana ◽  
One Year

The migration of an encircling silicone band through a rectus muscle is a rare postoperative complication associated with scleral buckling surgery for retinal detachment. In this present study, we describe what we believe to be the first reported case of a patient who experienced postoperative migration of an encircling silicone band through the rectus muscle, despite the band being surgically secured to the sclera in a scleral tunnel. A 58-year-old man presented with a rhegmatogenous retinal detachment in his left eye. Pars plana vitrectomy was performed with the placement of an encircling silicone band, and the patient’s retina was successfully reattached. One year postoperatively, the encircling band became exposed on the nasal side of the conjunctiva next to the limbus without any symptoms. Two weeks later, the exposed encircling band was surgically removed without any complications. The findings of this study show that even when an encircling silicone band is surgically secured around the eye, periodic and careful postoperative follow-up examinations should be performed to ensure no migration of the band.

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

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.

Scleral buckling with chandelier illumination system in rhegmatogenous retinal detachment surgery: a large case series

2020 ◽  
Vol 1 (3) ◽  
pp. 203-206
Author(s):  
Valerio Piccirillo ◽  
◽  
Carlo Irregolare ◽  
Antonello Iovine ◽  
Agostino Diplomatico ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Case Series ◽  
Scleral Buckling ◽  
Surgical Time ◽  
Illumination System ◽  
Before And After ◽  
Group A ◽  
Group B

AIM: To evaluate advantages of chandelier illumination system during scleral buckling (SB) procedures for rhegmatogenous retinal detachment (RRD) surgery. METHODS: In this comparative, retrospective study, 72 eyes of 72 patients undergoing SB for RRD at Minerva Hospital (Santa Maria Capua Vetere, Italy), divided in 2 groups of 36 eyes each were collected. In one group (A) eyes underwent SB with chandelier, in the other one (B) eyes underwent SB without using chandelier illumination system. Every eye of both groups was checked before surgery and at 1, 3, 7, 14, 30, 90 and 180d follow up. Parameters such as additional procedures, best spectacles visual acuity (BSVA; measured with Snellen Lines as decimal fraction), surgical time and retinal breaks recurrences had been analyzed before and after surgery and statistical comparison have been run between two groups. RESULTS: A significant (P<0.01) improvement in BSVA was observed at 6mo follow up in both groups; comparing groups A and B, no significant clinical differences was found in recurrences rate whereas mean surgical time in group A was statistically lower than the group B ones. CONCLUSION: According to results observed, even if they need to be confirmed in further studies with larger population, chandelier illumination system could be considered a valuable tool for SB surgery in eyes affected by RRD.

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