Imaging Features of a Retinal Detachment and Secondary Epiretinal Membrane Following Inadvertent Globe Penetration From Peribulbar Anesthesia

2020 ◽  
pp. 247412642096534
Author(s):  
Joshua Lim ◽  
Andrew S.H. Tsai ◽  
Shu Yen Lee
Keyword(s):  
Retinal Detachment ◽  
Epiretinal Membrane ◽  
Pars Plana Vitrectomy ◽  
Fundus Photography ◽  
Imaging Features ◽  
Postoperative Visual Acuity ◽  
Neurosensory Retina ◽  
Pars Plana ◽  
Peribulbar Anesthesia ◽  
High Index Of Suspicion

Purpose: We present imaging features of retinal detachment (RD) and secondary epiretinal membrane in a case of an inadvertent globe penetration following preoperative peribulbar anesthesia. Methods: A 60-year-old woman was referred for a localized RD and epiretinal membrane following uneventful cataract surgery. Widefield fundus photography and optical coherence tomography were used to assess and record the pathology. The current literature was reviewed. Results: Full-thickness breaks were noted in the neurosensory retina extending into the scleral wall. Vertical tracks were noted in the inferotemporal quadrant of the eye. The patient underwent trans pars plana vitrectomy, membrane peel, and gas. Her 1-month postoperative visual acuity was 20/30. Conclusions: Globe penetration with RD is a rare but potentially sight-threatening complication of peribulbar anesthesia. Diagnosis can be challenging because of the infrequency of occurrence and delays in presentation. A high index of suspicion is key alongside consideration of other likely differentials.

scholarly journals F6H8 as an Intraoperative Tool and F6H8/Silicone Oil as a Postoperative Tamponade in Inferior Retinal Detachment with Inferior PVR

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Gian Marco Tosi ◽  
Davide Marigliani ◽  
Tommaso Bacci ◽  
Napoleone Romeo ◽  
Angelo Balestrazzi ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Functional Results ◽  
The Other ◽  
Light Perception ◽  
Postoperative Visual Acuity ◽  
Pars Plana ◽  
Better Than

Purpose. To evaluate the effectiveness and safety of perfluorohexyloctane (F6H8) for intraoperative flattening of the retina and of F6H8/silicone oil (SO) 1000 cSt as a postoperative tamponade for inferior retinal detachment with inferior proliferative vitreoretinopathy.Methods. This is a retrospective review of 22 patients who underwent pars plana vitrectomy using F6H8 as an intraoperative tool to flatten the retina. At the end of the surgery a direct partial exchange between F6H8 and SO 1000 cSt was performed, tamponing the eye with different ratios of F6H8/SO (70/30, 60/40, 50/50, 40/30, and 30/70). Anatomical and functional results and complications were evaluated over the follow-up period (mean 22.63 months).Results. F6H8 was efficacious for intraoperative flattening of the retina. Twenty-one of the 22 patients achieved a complete retinal reattachment. Postoperative visual acuity (VA) ranged from light perception to 20/70, with 72% of patients obtaining VA better than 20/400. No emulsification/inflammation was observed whatever the ratio of F6H8/SO used. With higher ratios of F6H8/SO (70/30 and 60/40) cloudiness of the tamponade was observed. A transparent mixture was present with all the other ratios.Conclusions. The surgical technique adopted is very simple and safe. The optimal F6H8/SO ratio seems to be between 50/50 and 30/70.

scholarly journals Comparison of Methylprednisolone and Placebo toward Incidence and Severity of Epiretinal Membrane Post Pars Plana Vitrectomy in Rhegmatogenous Retinal Detachment

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Salmarezka Dewiputri ◽  
Elvioza Elvioza ◽  
Aria Kekalih
Keyword(s):  
Placebo Group ◽  
Retinal Detachment ◽  
Epiretinal Membrane ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Control Group ◽  
Inclusion Criteria ◽  
Early Step ◽  
Double Blind ◽  
Pars Plana

Introduction: Epiretinal membrane is one post-operative complication of vitrectomy that can lead to decrease visual acuity. Epiretinal membrane is the early step of proliferative vitreoretinopathy caused by inflammation. Steroid has been used in the treatment of intraocular inflammation. The aim of this study is to compare oral methylprednisolone and placebo toward incidence and severity of epiretinal membrane post pars plana vitrectomy in rhegmatogenous retinal detachment. Methods: This was prospective, double blind, randomized clinical trial. Fourty six eyes who met inclusion criteria were randomized into 2 groups: 26 patients received oral methylprednisolone 0.8 mg /kgBW/day for 6 days, 0.4 mg/kg BW/day for 4 days, and 0.2 mg/kg BW/days for 4 days. The control group of 26 patients received placebo in a comparable manner. Result: Four weeks after vitrectomy incidences of epiretinal membrane were 47.6 % and 58.8 % in methylprednisolone group and placebo group, respectively. Eight weeks post vitrectomy incidences of epiretinal membrane was 47.6 % and 56.2 % in methylprednisolone group and placebo group, respectively. At 4 weeks the severity of epiretinal membrane in methylprednisolone group was 60%; 0%; 40% in grade 0, 1, and 2, respectively. Meanwhile, in placebo group were 60%; 10%; 30% in grade 0, 1, and 2,respectively. Eight weeks post vitrectomy the severity of epiretinal membrane in methylprednisolone group were 40%; 0 %; 60% in grade 0, 1, and 2, respectively. Meanwhile, at placebo group were 55.6 %; 11.1 %; and 33.3 % in grade 0, 1, and 2, respectively. Conclusion: There were no significant differences in incidence and severity of epiretinal membrane at 4 and 8 weeks among 2 groups. Oral methylprednisolone had a tendency to lower incidence of epiretinal membrane compared to placebo.

scholarly journals Microperimetry-Assessed Functional Alterations and OCT-Changes in Patients after Retinal Detachment Surgery Using Pars Plana Vitrectomy and SF6 Tamponade

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1157
Author(s):  
María D. Díaz-Barreda ◽  
Isabel Bartolomé-Sesé ◽  
Ana Boned-Murillo ◽  
Antonio Ferreras ◽  
Elvira Orduna-Hospital ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Structural Changes ◽  
Cross Sectional Study ◽  
Retinal Sensitivity ◽  
Cross Sectional ◽  
Swept Source ◽  
Integrity Assessment ◽  
Integrity Index ◽  
Pars Plana

Background: We study the retinal function measured by macular integrity assessment microperimetry (MAIA) and structural changes assessed by scanning swept source optical coherence tomography (SS-OCT) between healthy individuals and patients undergoing pars plana vitrectomy (PPV) after rhegmatogenous retinal detachment (RRD). Methods: Cross-sectional study. Early Treatment Diabetic Retinopathy Study (ETDRS) grids were measured by SS-OCT and compared with the MAIA parameters. Results: Thirty-eight eyes with RRD (19 macula-on and 19 macula-off) were compared with 113 healthy eyes. The retinal sensitivity and average total threshold were reduced in all sectors in the RRD group; macular integrity index was increased. Macular thicknesses in total retina and ganglion cell layer (GCL)++ protocols were higher in the RRD group in nasal outer (NO) and central (C) sectors and only in C sector for GCL+ protocol. Thicknesses were lower in total retina, GCL++ protocols in the temporal outer (TO) sector and in the GCL+ protocol in NO sector. Best-corrected visual acuity (BCVA) correlated moderately with retinal sensitivity in all sectors and in just several sectors with time between the date of surgery and the test. The central nasal (CN) sector thickness and the average total threshold were higher in the macula-on subgroup. Conclusions: RRD and subsequent surgery results in functional and structural changes, especially in individuals with macular detachment.

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