Primary Combined Pars Plana Vitrectomy and Phacoemulsification With Anterior Segment Removal of Posterior Segment Intraocular Foreign Bodies: A 30-Month Longitudinal Study

Purpose: To describe a surgical technique and report visual and anatomical outcomes after primary combined pars plana vitrectomy (PPV) and phacoemulsification in patients with posterior segment intraocular foreign bodies (IOFBs) removed via the anterior chamber without enlarging preexisting sclerotomies. Posterior IOFBs are generally managed in a stepwise surgery consisting of phacoemulsification/lensectomy for traumatic cataract removal then PPV and removal of IOFB through enlarged sclerotomies. Enlarged sclerotomies may carry a significant risk of hypotony, vitreous hemorrhage, vitreous and retinal incarceration, and rhegmatogenous retinal detachment with proliferative vitreoretinopathy. Limited studies exist on long-term results of primary anterior segment removal of posterior IOFB combined with primary phacoemulsification. Methods: Medical records of consecutive patients who had ocular lacerations and posterior segment IOFB between October 2003 and June 2017 in a university hospital were reviewed. Patients who received a combined primary IOFB removal and phacoemulsification were included in the study. The postoperative evolution including visual acuity and complications were all recorded. Results: Thirteen patients (13 eyes) were included in the study. All patients were men, and the average age at presentation was 38 years. All IOFB were metallic, and their size ranged from 2 to 7 mm. All patients were operated within 24 hours of presentation. Six (46%) of the 13 lacerations were corneal, and 7 (54%) were scleral. Overall, 9 of 13 (69%) had a final postoperative best-corrected visual acuity equal to or better than 20 of 25. There were 3 (23%) postoperative complications of recurrent rhegmatogenous retinal detachment that occurred within the first postoperative year. Conclusion: Primary combined PPV and phacoemulsification with the removal of IOFB via the anterior segment is a safe and promising approach for repairing open globe injuries. Our results demonstrate the favorable prognostic benefit of this technique, which is recommended in cases with small corneal laceration and posterior segment pathology resulting from IOFB.

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Recurrent Retinal Detachment after Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment

10.21203/rs.2.21163/v1 ◽

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.

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Anatomical and functional outcomes of surgery of rhegmatogenous retinal detachment

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v2i2.3720 ◽

1970 ◽

Vol 2 (2) ◽

pp. 132-137 ◽

Cited By ~ 1

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

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Posterior Segment Retained Intraocular Foreign Body: A Study from Western Nepal

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v13i1.28981 ◽

2021 ◽

Vol 13 (1) ◽

pp. 22-30

Author(s):

Bikram Bahadur Thapa ◽

Sweta Singh ◽

Gyanendra Lamichhane ◽

Shanti Gurung ◽

Saurav Piya

Keyword(s):

Visual Acuity ◽

Foreign Body ◽

Retinal Detachment ◽

Pars Plana Vitrectomy ◽

Large Diameter ◽

Visual Outcome ◽

Posterior Segment ◽

Intraocular Foreign Body ◽

Pars Plana ◽

The Mean

Introduction: Posterior segment retained Intraocular foreign body (IOFB) management is challenging. Facility of pars plana vitrectomy (PPV) and availability of well trained vitreo retina surgeons are the basic need to accomplish this work. Encircling band provide permanent 360° support to close the anterior retinal break and prevent traction on the retina. The objective of this study is to analyse the clinical characteristics and predictors of the final visual outcome and survival of the globe in cases of retained IOFB in the posterior eye segment. Materials and methods: A hospital based retrospective observational study was conducted. All the patients of retained IOFB in the posterior segment presented from January 2016 to June 2019 were enrolled. Patients presented with visual acuity of NPL were excluded. Statistical analysis was performed using a variety of tests using SPSS version 21. Results: Forty eyes of 40 patients were included. The mean age was 27.08±10.68 years (range 5-66). 95% of our patients were male. Most of them (52.5%) worked on the farm. 26(65%) of 40 eyes had Zone I injury. The median time spent before presentation was 13.5 day. Retinal detachment, vitreous hemorrhage, and endophthalmitis were present in 15, 23 and 5 eyes, respectively, before IOFB removal. The mean LogMAR visual acuity was improved significantly from 2.50±0.87 to 1.33± 1.01 (p=0.003). Poor presenting visual acuity, retinal detachment and large diameter of IOFB were found as the predictor of poor final visual acuity. Conclusion: Pars plana vitrectomy by a vitreo retinal surgeon can give encouraging results in the cases of retained posterior segment IOFB. Poor presenting visual acuity, large diameter of IOFB and RD before IOFB removal are predictors of poor visual outcome.

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Recurrent Retinal Detachment After Pars Plana Vitrectomy For Rhegmatogenous Retinal Detachment

10.21203/rs.2.21163/v2 ◽

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.

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Management of Rhegmatogenous Retinal detachment with Buckle Sclera and Cryoretinopexcy

International Journal of Retina ◽

10.35479/ijretina.2018.vol001.iss002.33 ◽

2018 ◽

Vol 1 (2) ◽

Author(s):

Ria Mutiara ◽

Ramzi Amin

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Rhegmatogenous Retinal Detachment ◽

Anterior Segment ◽

Topical Steroid ◽

Operative Therapy ◽

Posterior Segment ◽

Eye Drops ◽

Oral Antibiotic ◽

Fundus Photograph

Introduction: Retinal detachment is divided into three categories. The most common type is the regmatogen retinal detachment (rhegmatogenous retinal detachment), which is the result of the tearing of the retinal lining. Actions can be Buckle Sclera, vitrectomy pars plana and pneumatic retinopexy. The purpose of this case report to reported Management of Rhegmatogenous Retinal detachment with Buckle Sclera and Cryoretinopexcy. Method: A 58 years old man with chief complaint The left eye blurred like a curtain covered since 5 days,floaters (+), photopsia (+),headache (+), Patients never complain of lost vision suddenly before, eyeball pain is not there.History of trauma (+),On examination, the visual acuity 6/9 RE and 1/60 LE, anterior segment lens cloudy (+)nuclaer gr III, fundus photograph we found retinal contours of the blood vessels well, tear (+) is directed at 2-3 hours of superior-temporal and fovea reflex (-), B-scan ultrasound of the posterior segment the retina is not intact, Membran like lession detachment which attach to optic nerve. Results: The Sclera buckles and cryoretinopexy were performed under general antesthesia. Visual acuity post-operative on left eye 2/60. subconjunctival bleeding (+), the fundus photographs retinal attach but the macular reflex is still negative. post-operative theraphy with topical steroid and antibiotic eye drops, oral antibiotic, and oral analgetic. follow up 1-month post-operative visual acuity 5/60 with fundus photograph obtained retina attach. Conclusion: a diagnosis of retinal detachment can be found, with the discovery of fullthickness breaks or defects occurring from the retinal neurosensory, this break will allow the vitreous to enter the defect gap between the retinal neurosensory and RPE. Based on the clinical features of the posterior segment, the detachment area was found with the location of the Linchoff Rule 2 break based on the American Academy of Ophthalmology. The objective of operative therapy was to reattach the retinal portion of which one of them was buckle sclera and cryoretinopexcy.

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