Vitreoschisis and retinal detachment: New insight in proliferative vitreoretinopathy

2021 ◽  
pp. 112067212110576
Author(s):  
Stanislao Rizzo ◽  
Lorenzo de Angelis ◽  
Francesco Barca ◽  
Daniela Bacherini ◽  
Lorenzo Vannozzi ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Proliferative Vitreoretinopathy ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Vitreous Cortex ◽  
Group A ◽  
Pars Plana ◽  
Group B ◽  
Removal Group ◽  
Anatomical Success

Purpose To assess the occurrence of peripheral vitreoschisis-induced vitreous cortex remnants (p-VCRs) in primary rhegmatogenous retinal detachment (RD) and investigate whether the presence of p-VCRs results in a greater risk of RD recurrence, secondary to Proliferative Vitreoretinopathy (PVR) development after pars plana vitrectomy (PPV). Methods Patients who underwent PPV for primary rhegmatogenous RD between January 2016 and December 2018 were included. The presence of residual p-VCRs was confirmed intraoperatively using triamcinolone acetonide (TA). Patients with p-VCRs were divided into two groups: Group A comprised of patients who underwent PPV without p-VCR removal, while Group B included patients who underwent PPV with p-VCR removal. Results Four hundred-thirteen eyes with evidence of p-VCR were analyzed. Two-hundred-twenty-three eyes underwent PPV without VCR removal (Group A), while 190 eyes underwent PPV with p-VCR removal (Group B). Primary anatomical success was 91.5% in the Group A and 95.4% in the group B. Retinal re-detachment due to PVR occurred in 17 (7.6%) eyes in Group A and in four (2.1%) eyes in Group B within the first 3 months (p  =  0.01). Among group A, in 11 eyes, there was a diffuse posterior PVR grade C, while six eyes were focal PVR grade C. In Group B, we observed four retinal re-detachment due to focal PVR grade C. Conclusion The presence of p-VCRs seems to be associated with a higher incidence of PVR development and might also result in more complex RD recurrence, this suggests the need for more aggressive VCRs removal during the first surgery.

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.

scholarly journals The contribution of the proximity of the retinal detachment to the fovea for postoperative metamorphopsia after 27-gauge pars plana vitrectomy for the primary rhegmatogenous retinal detachment

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258775
Author(s):  
Hiroko Yamada ◽  
Hisanori Imai ◽  
Akira Tetsumoto ◽  
Mayuka Hayashida ◽  
Keiko Otsuka ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Medical Records ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Clinical Factors ◽  
Foveal Detachment ◽  
Vascular Arcade ◽  
Group A ◽  
Pars Plana ◽  
Group B

Purpose To investigate clinical factors contributing to metamorphopsia after 27-gauge pars plana vitrectomy (27GPPV) for primary rhegmatogenous retinal detachment (RRD) to reveal whether the proximity of the preoperative retinal detachment to the fovea is associated with postoperative metamorphopsia. Methods We retrospectively reviewed medical records of 77 eyes of 77 patients after 27GPPV for RRD. Patients were subdivided into three groups using optical coherence tomography findings: Group A, patients with RRD outside the vascular arcade; Group B, patients whose condition was present within the vascular arcade, but without foveal detachment; and Group C, patients with foveal detachment. Results The average metamorphopsia score (°) assessed with M-charts 12 months after surgery was 0.01 ± 0.04 in Group A (24 eyes), 0.08 ± 0.18 in Group B (20 eyes), and 0.49 ± 0.48 in Group C (33 eyes) (p<0.001). Logistic regression analysis revealed that metamorphopsia at 12 months after surgery significantly correlated with the proximity of the retinal detachment to the fovea (p = 0.007). Conclusion Metamorphopsia after 27GPPV for RRD correlated with the proximity of the preoperative retinal detachment to the fovea. Attention should be paid to the possibility of postoperative metamorphopsia development when retinal detachment is present within a vascular arcade even if the fovea is not involved.

scholarly journals Quantification of the peripheral vitreous after vitreous shaving using intraoperative optical coherence tomography

2021 ◽  
Vol 6 (1) ◽  
pp. e000605 ◽  
Author(s):  
Koichi Nishitsuka ◽  
Katsuhiro Nishi ◽  
Hiroyuki Namba ◽  
Yutaka Kaneko ◽  
Hidetoshi Yamashita
Keyword(s):  
Optical Coherence Tomography ◽  
Pars Plana Vitrectomy ◽  
Optical Coherence ◽  
Slit Lamp ◽  
Vitreous Cortex ◽  
Intraoperative Optical Coherence Tomography ◽  
Group A ◽  
Pars Plana ◽  
The Mean ◽  
Group B

ObjectiveTo evaluate the technique of peripheral vitreous shaving during vitrectomy, we measured the residual peripheral vitreous using intraoperative optical coherence tomography (iOCT).Methods and AnalysisThis retrospective study included 44 eyes that underwent 25-gauge pars plana vitrectomy with iOCT by a single surgeon. In all cases, the surgery was performed via ocular indentation. Cases in group A were treated with vitreous shaving under slit lamp microscope illumination, whereas cases in group B were treated with vitreous shaving under a wide-angle viewing system. Residual peripheral posterior vitreous-cortex detachment (PVD) was quantified by iOCT.ResultsiOCT image analysis enabled the visualisation of the angle formed between the retina and peripheral PVD around the vitreous base in all cases. After the completion of vitreous shaving, the mean length of the peripheral PVD was shorter in group A (961.7±214.7 µm) compared with group B (1925.3.7 ± 626.1 µm; p<0.01).ConclusioniOCT enabled the quantification of the residual peripheral vitreous after vitreous shaving. The quantification of the residual peripheral vitreous after different shaving procedures will be important for advocating appropriate vitreous shaving in future.

scholarly journals Unintentional Retinal Displacement in Eyes Treated for Rhegmatogenous Retinal Detachment Complicated by Proliferative Vitreoretinopathy with Pars Plana Vitrectomy and Silicone Oil

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Mariaelena Filippelli ◽  
Pasquale Napolitano ◽  
Ciro Costagliola ◽  
Michele Rinaldi ◽  
Flavia Chiosi ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Proliferative Vitreoretinopathy ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Fundus Autofluorescence ◽  
Final Analysis ◽  
Internal Limiting Membrane ◽  
Primary Success ◽  
Pars Plana

Purpose. To examine the clinical characteristics, outcomes, and rate of unintentional displacement in eyes treated for rhegmatogenous retinal detachment (RRD) with pars plana vitrectomy (PPV) and silicone oil (SO). Methods. This retrospective observational study examined 50 eyes of 50 patients who underwent surgical repair for primary RRD complicated by proliferative vitreoretinopathy (PVR) by PPV and 1000-centistoke SO injection at a single institutional centre. The patients assumed a face-down posture immediately after surgery. Blue-fundus autofluorescence (B-FAF) pictures were obtained at 1 month after surgical procedures using a Spectralis HRA + OCT (Heidelberg Engineering, Heidelberg, Germany). Results. The primary success rate was obtained in 44 eyes (88%), on which the final analysis was conducted. Preoperative PVR was grade A in 7 eyes (15.9%), grade B in 28 eyes (63.6%), and grade C in 9 eyes (20.5%). The fovea was off and the detachment involved both the superior and inferior hemispheres of the retina in all cases. Breaks were located in the upper quadrants in 19 eyes (43.2%), in the lower quadrants in 12 eyes (27.3%), and in both upper and lower quadrants in 13 eyes (29.5%). The mean number of breaks was 3.4 ± 1.9. Intraoperative PFCL was used in 30 eyes (68.2%). Peeling of the epiretinal membrane/internal limiting membrane in the macula area was performed in 13 eyes (29.5%) during the first operation and carried out in all other eyes in occasion of SO removal. Preoperative BCVA was 2.1 ± 1.0 logMAR and improved to 0.8 ± 0.7 logMAR at the last follow-up ( P < 0.0001 ). An upward unintentional retinal displacement was observed in 2 cases (4.5%). Conclusion. PPV and SO tamponade for complicated RRD are associated with good anatomical and functional outcomes and a very low rate of unintentional retinal displacement. Of the factors potentially implicated in favouring displacement that were studied, none were found significant.

scholarly journals Primary rhegmatogenous retinal detachment: evaluation of a minimally restricted face-down positioning after pars plana vitrectomy and gas tamponade

2021 ◽  
Vol 14 (6) ◽  
pp. 936-939
Author(s):  
Kiichiro Kusaba ◽  
◽  
Tsuneaki Handa ◽  
Yukihiko Shiraki ◽  
Takuya Kataoka ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Retinal Detachment ◽  
Success Rate ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Gas Tamponade ◽  
Retinal Tears ◽  
Pars Plana ◽  
Anatomical Success ◽  
Anatomical Success Rate

AIM: To evaluate the safety and efficacy of a minimally restricted face-down postoperative positioning following pars plana vitrectomy (PPV) with gas tamponade for primary rhegmatogenous retinal detachment (RRD). METHODS: Patients with primary RRD treated with PPV and gas tamponade and followed up for at least 6mo were selected for the study. All phakic eyes underwent simultaneous cataract surgery. The patients were required to be in a postoperative position that prevented downward flow of retinal tears. Patients with macular detachment were positioned face-down for only a couple of hours. The patients were assessed for preoperative and postoperative best-corrected visual acuity (BCVA), anatomical retinal reattachment rate, and postoperative complications. RESULTS: In total, 40 eyes of 39 patients with primary RRD were included in the study. A single tear was present in 30 eyes (75.0%), multiple retinal tears were present in nine eyes (22.5%), and oral dialysis was present in one eye (2.5%). The anatomical success rate was 90.0% (36 cases) after the primary surgery, and the final anatomical success rate was 100%. The BCVA improved significantly (P<0.001) from 0.75 logarithm angle of resolution (logMAR) preoperatively to 0.12 logMAR at the final visit. Postoperative complications included intraocular pressure elevation (≥25 mm Hg) in 11 patients (27.5%), fibrin formation in two patients (5.0%), pupillary capture of the intraocular lens in two patients (5.0%), and posterior synechia in one patient (2.5%). CONCLUSION: A minimally restricted face-down and flexible postoperative positioning after PPV and gas tamponade for primary RRD is effective and safe.

scholarly journals 212 Outcomes Of 25-Gauge Pars Plana Vitrectomy Surgery in Primary Rhegmatogenous Retinal Detachment in Pakistan: A Multi-Center Study

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
S Z M Hussain ◽  
M A Awan ◽  
M A R Siddiqui
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Tertiary Care ◽  
National Study ◽  
P Value ◽  
Retinal Surgery ◽  
Pars Plana ◽  
Anatomical Success

Abstract Aim To evaluate the primary anatomical success and visual outcomes in patients with rhegmatogenous retinal detachment (RRD) undergoing 25-gauge pars plana vitrectomy (25g PPV) surgery in Pakistan. Method This is a five-year retrospective, interventional cohort study of 418 consecutive patients with RRD who underwent 25g PPV. Surgeries were performed by two experienced surgeons at tertiary care hospitals in Pakistan. Consecutive patients, who underwent 25 g PPV surgery as treatment for RRD between October 2013-October 2018 were included. We excluded patients who had a history of previous retinal surgery or who did not complete the 4-8 weeks primary outcome visit. Data was collected from the patient’s files by using a pro forma. SPSS version 23.0 (IBM SPSS Statistics, Armonk, NY) was used. A p-value of &lt; 0.5 was considered significant. Results We identified 452 patients through coding system of hospitals who underwent 25g PPV surgery between October 2013-October 2018. Secondary retinal surgery and incomplete follow up cases were excluded. A total of 441 patients’ files were reviewed for the study, out of which 418 patients met the criteria for final analysis. Males were in a higher number 284 (67.9 %). The average age was 49±15.8. In our study, 186 (44.4%) patients were phakic at the time of presentation. At 2 months follow up, the primary anatomical success rate was 87.1 %. Conclusions Surgical outcomes of RRD with 25g PPV surgery in our study were similar to the outcomes reported in the developed world. We propose a prospective multicenter national study to prospectively evaluate the risk factors for RRD surgical failure in the Pakistani population.

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

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
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.

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.

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