scholarly journals Outcomes of 25-Gauge Vitrectomy With Relaxing Retinectomy for Retinal Detachment Secondary to Proliferative Vitreoretinopathy

2019 ◽  
Vol 3 (2) ◽  
pp. 69-75
Author(s):  
Yi Jiang ◽  
Daniel J. Oh ◽  
Wyatt Messenger ◽  
Jennifer I. Lim
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Proliferative Vitreoretinopathy ◽  
Silicone Oil ◽  
Case Series ◽  
High Rate ◽  
Retrospective Case ◽  
Institutional Review ◽  
25 Gauge Vitrectomy

Purpose: The aim of this study is to evaluate visual and anatomic outcomes of 25-gauge vitrectomy with relaxing retinectomies for complex retinal detachment (RD) secondary to proliferative vitreoretinopathy (PVR). Methods: A single-center, retrospective case series of 44 patients who had undergone a 25-gauge vitrectomy with a relaxing retinectomy for the treatment of combined RD and PVR was performed. Preoperative characteristics, intraoperative techniques, and outcomes were analyzed. The rates of attachment, complications, and visual acuity were analyzed. Institutional review board/ethics committee approval was obtained, and the described research adhered to the tenets of the Declaration of Helsinki. Results: At the final follow-up, 27 eyes (61%) had attachment after 1 surgery, 41 eyes (93%) ultimately had attached retinas, 3 eyes (7%) had hypotony, 3 eyes had become phthisical (7%), and 24 eyes (56%) had improved visual acuity. After stratifying by visual outcomes, 20/400 or better best-corrected visual acuity was not associated with age ( P = .66), RD etiology ( P = .61), preoperative hypotony ( P = .60), nor size of retinectomy ( P = .48). Patients achieving 20/400 vision or better were statistically more likely to be pseudophakic ( P = .024) and have silicone oil removal ( P < .0001). Conclusion: The use of 25-gauge vitrectomy and relaxing retinectomy provides a high rate of reattachment and improved visual acuity.

scholarly journals Scleral buckle surgery for pseudophakic and aphakic retinal detachment in western Nepal

1970 ◽  
Vol 3 (2) ◽  
pp. 109-117
Author(s):  
RN Byanju ◽  
S Bajimaya ◽  
I Kansakar ◽  
A Melamud
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Case Series ◽  
Scleral Buckle ◽  
Retrospective Case ◽  
Repeat Surgery ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity ◽  
Aphakic Retinal Detachment

Introduction: Retinal detachment remains one of the most serious complications of cataract surgery. Treatment of this condition has represented a challenge for vitreoretinal surgeons. Scleral buckle (SB) surgery is one of the treatment options in pseudophakic and aphakic retinal detachment (RD). Aims: To find out the anatomical and visual outcome of SB in pseudophakic and aphakic RD. Subjects and methods: Retrospective case series of 46 consecutive eyes of 46 patients with RD (38 pseudophakic and 8 aphakic eyes) that had undergone conventional SB surgery were reviewed from patient files. Postoperative retinal status at 3 weeks, 6 weeks and 3 months were recorded to see the anatomical success rate after retinal reattachment surgery. Best corrected visual acuity (BCVA) at 3 months follow-up was noted. Results: The mean age of the patients was 54.28 ± 13.49 years. Forty eyes (86.9 %) had primary attachment by 6 weeks duration. Five eyes had undergone repeat surgery within a six-week duration (pars plana vitrectomy). Forty patients had follow-up visit to 12 weeks, achieving retinal attachment in 37 eyes (80.5 %). Best corrected visual acuity (BCVA) at 3 months was better than 6/60 in 18 eyes (39.1%), BCVA better or equal to 1/60 but less than 6/60 in 18 eyes (39.1%) and BCVA less than 1/60 in 4 eyes (8.7 %). Conclusion: Conventional scleral buckling has good outcome for pseudophakic and aphakic RD and can be useful for patients in peripheral eye hospitals where patients cannot afford high cost surgeries. Keywords: scleral buckle, pseudophakia, retinal detachment DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5261 Nepal J Ophthalmol 2011; 3(2): 109-117

Characteristics and Outcomes of Retinal Detachment Associated With Atopic Dermatitis: A Retrospective Case Series

2019 ◽  
Vol 3 (2) ◽  
pp. 80-85
Author(s):  
Parampal S. Grewal ◽  
Uriel Rubin ◽  
Mark D.J. Greve ◽  
Rizwan Somani ◽  
Chad F. Baker ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Retinal Detachment ◽  
Case Series ◽  
High Rate ◽  
Scleral Buckle ◽  
Retrospective Case ◽  
Lens Subluxation ◽  
Physician Awareness ◽  
The Mean

Purpose: The purpose of this article is to describe the characteristics and outcomes of retinal detachment (RD) repair associated with atopic dermatitis (AD). Methods: A single-center, retrospective review of all patients with RD associated with AD between January 2007 and December 2017 was conducted. Results: Ten patients (13 eyes) were included with a mean age of 23.5 ± 6.4 years; 6 of the patients were male (60%). The average follow-up was 41.3 ± 34.8 months. Seven eyes developed proliferative vitreoretinopathy (PVR) and recurrent RD (53.8%). The mean number of retinal surgeries was 2.3 ± 1.3. Three eyes had a scleral buckle alone (23.1%), 4 eyes had vitrectomy only (30.8%), and 6 eyes had both scleral buckle and vitrectomy (46.2%). Five eyes had prior cataract surgery (38.5%), 5 eyes had cataract at presentation (38.5%), and 5 eyes developed lens subluxation (38.5%). The mean presenting best-corrected visual acuity (BCVA) was 1.14 logarithm of the minimum angle of resolution (Snellen equivalent, 20/276) and the mean final BCVA was 1.06 (Snellen, 20/230; P = .83). The retina was successfully reattached at final follow-up in all 13 eyes (100%). Conclusions: RD is a challenging complication of AD with a high rate of PVR, recurrent RD, cataract, and lens subluxation. Patient education and physician awareness are necessary for timely diagnosis, appropriate counseling, and optimal surgical planning.

scholarly journals Outcomes of Vitrectomy in Pediatric Retinal Detachment with Proliferative Vitreoretinopathy

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Robert Rejdak ◽  
Dominika Nowakowska ◽  
Katarzyna Wrona ◽  
Ryszard Maciejewski ◽  
Anselm G. Junemann ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Proliferative Vitreoretinopathy ◽  
Intellectual Development ◽  
Silicone Oil ◽  
Case Series ◽  
Functional Results ◽  
Hand Motion ◽  
Common Etiology ◽  
Pars Plana

Aim. To report outcomes of pars plana vitrectomy (PPV) in pediatric retinal detachment (RD) with proliferative vitreoretinopathy (PVR), complications, factors influencing the final anatomical and functional results. Methods. Retrospective consecutive case series of 14 eyes. Average postoperative follow-up period was 34 months. Results. Mean age of patients was 10 years; eleven patients (79%) were males. The most common etiology was trauma (57%), the second—myopia (36%) and one case of uveitis (7%). At the day of presentation, the best-corrected visual acuity (BCVA) was worse than hand motion (50%); macula was detached in 86% of cases. Simultaneous PPV and phacoemulsification with intraocular lens (IOL) implantation were performed in 12 cases (86%). The most common endotamponade during PPV was silicone oil (93%). Anatomic reattachment was accomplished in 86% of cases. Final BCVA was equal or better than 0.1 in 50% of patients. The postoperative complications were found in 5 eyes (36%). Conclusion. Complete PPV was allowed for anatomically reattached retina and preserved vision in pediatric complex RD with PVR. However, visual outcomes were not satisfactory. Preserving vision in children with RD is of great importance for their future motor and intellectual development. This trial is registered with ClinicalTrials.gov Identifier: NCT03208205.

scholarly journals Extensive Internal Limiting Membrane Peeling for Proliferative Vitreoretinopathy

2021 ◽  
Author(s):  
Anibal Francone ◽  
Martin Charles
Keyword(s):  
Retinal Detachment ◽  
Proliferative Vitreoretinopathy ◽  
Silicone Oil ◽  
3D Visualization ◽  
Case Series ◽  
Internal Limiting Membrane ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling ◽  
The Mean

Abstract Purpose: The aim of this study was to describe the anatomical outcomes of Brilliant Blue G (BBG)–assisted extensive internal limiting membrane peeling (eILMp) for proliferative vitreoretinopathy (PVR) under three-dimensional (3D) visualization. Methods: This study constitutes a retrospective case series conducted in a private retina practice, of 14 consecutive patients (14 eyes) with rhegmatogenous retinal detachment (RRD) complicated by PVR who underwent pars plana vitrectomy between January 2019 and January 2020. The internal limiting membrane (ILM) was selectively stained with BBG, and perspectives were enhanced with a 3D visualization system. We peeled off the ILM beyond the vascular arcades up to the periphery. The main outcome was anatomical success, defined as persistent retinal reattachment after removal of the silicone oil tamponade.Results: Anatomic success was achieved with a single surgery in 11 of 14 (78.6%) eyes, and eventual success was achieved in all eyes. The mean patient follow-up time was 12.3 months (range, 7–16 months). The mean preoperative logMAR BCVA was 2.09 (range, 2.8–1.3), which decreased to 1.54 (range, 2.8–0.6) at the last follow-up. Conclusion: This technique allowed the creation of a cleavage plane underlying the PVR membranes that facilitated its complete ILM removal, thereby reducing the risk of recurrence of retinal detachment.

Retinotomy and retinectomy for anterior inferior proliferative vitreoretinopathy: Can visual outcome be improved?

2021 ◽  
pp. 112067212110128
Author(s):  
Mumin Hocaoglu ◽  
Murat Karacorlu ◽  
M. Giray Ersoz ◽  
Isil Sayman Muslubas ◽  
Serra Arf
Keyword(s):  
Proliferative Vitreoretinopathy ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Clinical Stage ◽  
Case Series ◽  
Visual Outcome ◽  
Attachment Rate ◽  
Good Visual Outcome ◽  
The Mean

Purpose: To describe the treatment outcomes and prognostic factors of retinotomy/retinectomy for rhegmatogenous retinal detachment (RD) complicated anterior inferior proliferative vitreoretinopathy (PVR). Methods: Retrospective, nonrandomized, single-center case series. The outcomes of 126 cases of retinotomy/retinectomy for RD complicated by advanced (Grade C) anterior inferior PVR managed consistently by one surgeon during a 15-year period were evaluated. Results: Forty-two eyes (33%) had primary RDs and 84 (67%) had recurrent RDs. The extent of retinotomy/retinectomy varied: 90° in 21 eyes (17%), >90° to <180° in 49 eyes (39%), and ⩾180° to ⩽240° in 56 eyes (44%). The retinotomy/retinectomy location was peripheral in 58 eyes (46%) and equatorial in 68 eyes (54%). The mean follow-up period was 43 ± 42 months. The silicone oil (SO) was removed from 98% of the eyes. The single-operation success rate after the primary retinectomy was 87%, and the final attachment rate was 94%. Visual acuity improved from 20/630 to 20/160 ( p < 0.001). Vision ⩾20/200 was achieved in 101 eyes (80%). Good visual outcome was correlated positively with preoperative VA ( p = 0.02), previous vitrectomy with gas tamponade ( p = 0.007), and was negatively correlated with number of previous RD operations ( p = 0.01), larger extent of RD ( p = 0.02) and more extensive retinotomy/retinectomy ( p = 0.04). Conclusions: An appropriate and timely intervention, including vitrectomy alone, inferior relaxing retinotomy/retinectomy and standard SO tamponade provide satisfactory outcomes for RDs complicated by PVR. Lesser extension of grade C PVR at baseline, such as PVR limited to one quadrant should encourage vitreoretinal specialists to consider retinotomy/retinectomy at a milder clinical stage of PVR development.

scholarly journals Combined Pars Plana Glaucoma Drainage Device Placement and Vitrectomy Using a Vitrectomy Sclerotomy Site for Tube Placement: A Case Series

2020 ◽  
Author(s):  
Enchi Kristina Chang ◽  
Sanchay Gupta ◽  
Marika Chachanidze ◽  
John B. Miller ◽  
Ta Chen Chang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Statistical Tests ◽  
Case Series ◽  
Tube Placement ◽  
Glaucoma Drainage Device ◽  
Retrospective Case ◽  
Tube Obstruction ◽  
Pars Plana ◽  
Sclerotomy Site

Abstract Background: The purpose of this study is to report the safety and efficacy of pars plana (PP) glaucoma drainage devices (GDDs) with pars plana vitrectomy (PPV) 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 PP GDD and PPV 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 (BCVA), 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 11.4 mmHg at 1.5 years (p = 0.009), and mean medication burden decreased from 4.3 to 1.7 at 1.5 years (p = 0.009). 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 77.7% at 1 year and 45.8% at 1.5 years. At their last visit, four eyes (14.3%) achieved complete success with IOP reduction as above without medications, and 13 eyes (46.2%) achieved qualified success with medications. 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 PPV for tube obstruction, and one eye had transient hypotony.Conclusions: The results of pars plana GDD and 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 GDDs 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 Limited Open Reduction and Internal Fixation of Calcaneal Fractures

2019 ◽  
Vol 41 (1) ◽  
pp. 57-62 ◽  
Author(s):  
Anne K. Bremer ◽  
Lukas Kraler ◽  
Lars Frauchiger ◽  
Fabian G. Krause ◽  
Martin Weber
Keyword(s):  
Wound Healing ◽  
Internal Fixation ◽  
Open Reduction ◽  
Case Series ◽  
Functional Results ◽  
High Rate ◽  
Calcaneal Fractures ◽  
Retrospective Case ◽  
Level Of Evidence

Background: The treatment of displaced intra-articular calcaneal fractures remains a challenge and the optimal approach is still controversial. The main reason to avoid the extended lateral approach is the high complication rate due to wound healing problems. We report on 16 years of experience with a standardized limited open reduction and internal fixation technique. Methods: Between 2001 and 2017, we prospectively followed 240 consecutive patients operatively treated for a displaced intra-articular calcaneal fracture. Patients with open, multiple, bilateral, extra-articular, and Sanders IV fractures and those lost to follow-up were excluded. A lateral subtalar approach was used, with a cast for 8 weeks and full weightbearing allowed after 12 weeks. Follow-up examinations were scheduled until 24 months. Subjective and clinical assessment included gait abnormality, subtalar and ankle range of motion, and stability and alignment. The American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score was calculated. Alignment was analyzed on standard radiographs. In total, 131 patients were excluded. The remaining 109 patients were followed for a minimum of 24 months (34.4 ± 14.2 [range, 24-102] months). Results: The mean AOFAS score was 87 ± 13 (range, 32-100). “Excellent” and “good” results, as well as hindfoot motion with “normal/mild” and “moderate” restrictions, were seen in 80% of patients. Early reoperations were performed for insufficient reduction (2 patients), delayed wound healing (debridement, 3 patients), and hematoma (1 patient). Late revisions were arthrodesis (3 patients), medializing calcaneal osteotomy (1 patient), and implant removal (53 patients; 49%). Conclusion: The presented approach has remained unmodified for 16 years and resulted in consistently good functional results. The main disadvantage was the high rate of heel screw removal. Level of Evidence: Level IV, retrospective case series.

Intravitreal Dexamethasone Implant (Ozurdex®) for Exudative Retinal Detachment after Proton Beam Therapy for Choroidal Melanoma

2017 ◽  
Vol 27 (5) ◽  
pp. 596-600 ◽  
Author(s):  
Ariane Malclès ◽  
Anh-Minh Nguyen ◽  
Thibaud Mathis ◽  
Jean-Daniel Grange ◽  
Laurent Kodjikian
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Proton Beam ◽  
Safety Profile ◽  
Choroidal Melanoma ◽  
Case Series ◽  
Proton Beam Therapy ◽  
Exudative Retinal Detachment ◽  
Dexamethasone Implant

Purpose To evaluate the efficacy and safety of intravitreal 0.7-mg dexamethasone implant (DEX-I) (Ozurdex®) in the treatment of extensive exudative retinal detachment (RD) associated with uveal melanoma treated using proton beam therapy (PBT). Methods Data from 10 patients with exudative RD after PBT treated with intravitreal injection of 0.7-mg DEX-I were reviewed retrospectively. The main outcome measures were resolution of exudative RD, visual acuity, and safety profile. Results Mean age was 55.6 years (range 34-85). Mean time between PBT and DEX-I was 12.4 months (range 3-25). Mean follow-up was 9.9 months (range 4-15). Intravitreal Ozurdex® reduced exudative RD in 7 cases (70%) on average 3.1 months after injection with complete resolution of RD in 6 of these (60%). For half of the patients, their level of vision remained stable; the other half experienced a deterioration in visual acuity at the end of follow-up. No adverse effects were observed. Conclusions In this small case series, treatment with intravitreal DEX-I reduced exudative RD in the majority of cases and had an acceptable safety profile.

scholarly journals Bullous X linked retinoschisis: clinical features and prognosis

2017 ◽  
Vol 102 (5) ◽  
pp. 622-624 ◽  
Author(s):  
Anne-Marie Hinds ◽  
Abigail Fahim ◽  
Anthony T Moore ◽  
Sui Chien Wong ◽  
Michel Michaelides
Keyword(s):  
Retinal Detachment ◽  
Age Of Onset ◽  
Case Series ◽  
Peripheral Retina ◽  
Exudative Retinal Detachment ◽  
Retrospective Case ◽  
Tertiary Centre ◽  
Unilateral Case ◽  
The Mean

Background/AimsA subset of patients with X linked retinoschisis (XLRS) have bullous schisis cavities in the peripheral retina. This study describes the characteristics and prognosis of the bullous form of XLRS.MethodsA retrospective case series was performed of nine patients with molecularly proven bullous XLRS seen at a single tertiary centre.ResultsAll cases of bullous peripheral schisis were bilateral, with one unilateral case at presentation which developed into bilateral bullous schisis over time. The mean age of onset was 1.9 years (range: 1 month–7 years, SD: 2.1 years) and at clinical diagnosis was 5.9 years (range: 1 month–27 years, SD: 9.0 years). Mean follow-up was 11 years (range: 6 months–36 years, SD: 10.8 years). Strabismus was the most common presentation (n=7). Other presenting complaints included decreased vision, floaters and an irregularly shaped pupil. The most frequently associated ocular features were strabismus (100%), vitreous haemorrhage (4/18 eyes, 22%), nystagmus (2/9, 22%) and persistent fetal vasculature (1/18, 6%). Localised tractional detachment was seen in 2/18 (11%) eyes, total detachment that underwent surgical repair in 1/18 (6%) and pigmented demarcation lines in a further 22% of the eyes. There was one eye with exudative retinal detachment.ConclusionIn XLRS, bullous schisis may be congenital or develop soon after birth and most commonly presents with strabismus. Cases may be complicated by some form of retinal detachment, which may be tractional or a Coats-like exudative detachment.

scholarly journals 25-Gauge Vitrectomy in Open Eye Injury with Retained Foreign Body

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
G. Sborgia ◽  
N. Recchimurzo ◽  
A. Niro ◽  
L. Sborgia ◽  
A. Sborgia ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Foreign Body ◽  
Clinical Status ◽  
Case Series ◽  
Eye Injury ◽  
Retained Foreign Body ◽  
Open Globe ◽  
Open Globe Injuries ◽  
25 Gauge Vitrectomy

Purpose. Ocular trauma with retained foreign body is an important cause of visual impairment in working-age population. Clinical status impacts on the timing and planning of surgery. In the last year small gauge vitrectomy has become safer and more efficient, extending the range of pathologies successfully treated.Aims. To evaluate the safety and outcomes in patients with open eye injury with retained foreign body that underwent early 25-gauge vitrectomy.Methods. In this retrospective, noncomparative, interventional case series, we performed 25-gauge vitrectomy on 10 patients affected by open globe injuries with retained foreign body, over 3 years. We analyzed age, wound site, foreign body characteristics, ocular lesions correlated, relative afferent pupillary defect, visual acuity, and intraocular pressure. Follow-up evaluations were performed at 1, 3, and 6 months. According to the clinical status we performed other procedures to manage ocular correlated lesions.Results. The median age of patients was 37 years. The foreign body median size was 3.5 mm (size range, 1 to 10 mm). 25-gauge vitrectomy was performed within 12 hours of trauma. Foreign body removal occurred via a clear corneal or scleral tunnel incision or linear pars plana scleral access. Visual acuity improved in all patients. Endophthalmitis was never reported. Only two cases reported postoperative ocular hypertension resolved within the follow-up. Retinal detachment recurred in one case only.Conclusions. 25-gauge vitrectomy could be considered as early approach to manage open globe injuries with a retained posterior segment foreign body in selected cases with good outcomes and low complication rate.

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