Outcomes of Primary Rhegmatogenous Retinal Detachment Repair in Eyes With Preoperative Grade B or C Proliferative Vitreoretinopathy

2021 ◽  
pp. 247412642110467
Author(s):  
Travis J. Peck ◽  
Matthew R. Starr ◽  
Yoshihiro Yonekawa ◽  
M. Ali Khan ◽  
Anthony Obeid ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Approach ◽  
Proliferative Vitreoretinopathy ◽  
Functional Outcomes ◽  
Rhegmatogenous Retinal Detachment ◽  
Primary Grade ◽  
Success Rates ◽  
Surgical Success ◽  
Intraoperative Management ◽  
Anatomic Success

Purpose: This work evaluates the anatomic and functional outcomes of primary rhegmatogenous retinal detachments (RRDs) with preoperative grade B and C proliferative vitreoretinopathy (PVR) vs eyes without PVR. Methods: As a multi-institutional, interventional, retrospective study of all patients undergoing primary RRD surgical procedures from January 1, 2015, through December 31, 2015, this study evaluated the visual acuity (VA) outcomes and single-surgery anatomic success rates (SSAS) of patients with primary grade B and C PVR at the time of RRD repair. Results: A total of 2486 eyes underwent primary RD surgery during the study period, of which 153 eyes (6.2%) had documented preoperative PVR grade B or C. Eyes without PVR had better SSAS compared with eyes with grade B or C PVR (87% vs 83% vs 75%, respectively, P < .0001). Eyes without PVR also had better final mean (SD) logMAR VA (0.35 [0.47]; 20/45 Snellen equivalent) than eyes with PVR of grade B (0.50 [0.56]; 20/63 Snellen equivalent) or grade C ( P < .0001). In only eyes with preoperative PVR, there were no significant differences in final VA or SSAS on multivariate analysis based on surgical approach or use of retinectomy or membrane peeling alone in the intraoperative management of PVR. Conclusions: Eyes with primary preoperative grade B and C PVR appear to have significantly worse VA outcomes and lower surgical success rates. Surgical approach and management of PVR membranes did not appear to affect VA or success rates, indicating that preoperative PVR severity may dictate these outcomes.

scholarly journals Modelling postoperative visual acuity with and without proliferative vitreoretinopathy associated with primary rhegmatogenous retinal detachment

Eye ◽  
2012 ◽  
Vol 26 (10) ◽  
pp. 1329-1336 ◽  
Author(s):  
M Roldán-Pallarés ◽  
C Bravo-Llatas ◽  
A-S Musa ◽  
J Hernandez-Montero ◽  
R Fernández-Durango
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Proliferative Vitreoretinopathy ◽  
Rhegmatogenous Retinal Detachment ◽  
Postoperative Visual Acuity

scholarly journals Scleral Buckling for Primary Retinal Detachment: Outcomes of Scleral Tunnels versus Scleral Sutures

2021 ◽  
Author(s):  
Matthew R. Starr ◽  
Edwin H. Ryan ◽  
Anthony Obeid ◽  
Claire Ryan ◽  
Xinxiao Gao ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retrospective Study ◽  
Retinal Detachment ◽  
Success Rate ◽  
Rhegmatogenous Retinal Detachment ◽  
Scleral Buckling ◽  
Scleral Buckle ◽  
Scleral Tunnel ◽  
The Mean ◽  
Anatomic Success

Purpose: There are primarily two techniques for affixing the scleral buckle (SB) to the sclera in the repair of rhegmatogenous retinal detachment (RRD): scleral tunnels or scleral sutures. Methods: This retrospective study examined all patients with primary RRD who were treated with primary SB or SB combined with vitrectomy from January 1, 2015 through December 31, 2015 across six sites. Two cohorts were examined: SB affixed using scleral sutures versus scleral tunnels. Pre- and postoperative variables were evaluated including visual acuity, anatomic success, and postoperative strabismus. Results: The mean preoperative logMAR VA for the belt loop cohort was 1.05 ± 1.06 (Snellen 20/224) and for the scleral suture cohort was 1.03 ± 1.04 (Snellen 20/214, p = 0.846). The respective mean postoperative logMAR VAs were 0.45 ± 0.55 (Snellen 20/56) and 0.46 ± 0.59 (Snellen 20/58, p = 0.574). The single surgery success rate for the tunnel cohort was 87.3% versus 88.6% for the suture cohort (p = 0.601). Three patients (1.0%) in the scleral tunnel cohort developed postoperative strabismus, but only one patient (0.1%) in the suture cohort (p = 0.04, multivariate p = 0.76). All cases of strabismus occurred in eyes that underwent SB combined with PPV (p = 0.02). There were no differences in vision, anatomic success, or strabismus between scleral tunnels versus scleral sutures in eyes that underwent primary SB. Conclusion: Scleral tunnels and scleral sutures had similar postoperative outcomes. Combined PPV/SB in eyes with scleral tunnels might be a risk for strabismus post retinal detachment surgery.

scholarly journals Success Rates of Vitrectomy in Treatment of Rhegmatogenous Retinal Detachment

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Yasser Helmy Mohamed ◽  
Kozue Ono ◽  
Hirofumi Kinoshita ◽  
Masafumi Uematsu ◽  
Eiko Tsuiki ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Success Rate ◽  
Rhegmatogenous Retinal Detachment ◽  
Multiple Logistic Regression Analysis ◽  
University Hospital ◽  
Success Rates ◽  
Pars Plana ◽  
Anatomical Success ◽  
Anatomical Success Rate

Aim. To investigate the anatomical success rates of pars plana vitrectomy (PPV) after primary rhegmatogenous retinal detachment (RRD).Methods. This retrospective study was conducted between December 2008 and October 2014 at Nagasaki University Hospital. The preoperative data recorded included the lens status, location of the retinal tear, whether a tear was visualized, presence of multiple tears, macula status, presence of peripheral lattice retinal degeneration, and best-corrected visual acuity (BCVA). The primary outcome measures were anatomical (primary and final) and functional success (visual acuity better than 6/60).Results. This study evaluated 422 eyes of 411 patients with a mean age of57.7±11.2years. The single-operation reattachment rate (primary anatomical success) was 89.8%. The final anatomical success rate was 100% after 2–6 operations (mean =3.14±1.03). Functional success rate after the primary reattachment operation was 96.7%, while it was 97.2% at the end of the follow-up. Multiple logistic regression analysis of the possible risk factors for the primary anatomical failure showed a significant relation with the 25 G instruments (P=0.002) and the presence of multiple tears (P=0.01).Conclusion. The primary anatomical success of PPV for primary uncomplicated RRD was 89.8% and the final anatomical success rate was 100%.

Rhegmatogenous Retinal Detachment with Vitreous Hemorrhage

2020 ◽  
pp. 206-211
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Treatment Period ◽  
Proliferative Vitreoretinopathy ◽  
Rhegmatogenous Retinal Detachment ◽  
Vitreous Hemorrhage ◽  
Retinal Disease ◽  
Retinal Diseases

Rhegmatogenous retinal detachment is one of the most important pathologies within the retinal diseases that threaten the visual acuity. It may be complicated for any other retinal disease. One of them is vitreous hemorrhage. Vitreous hemorrhage may cause some difficulties either during diagnosis or treatment period. Vitreous hemorrhage may also lead to some treatment challenges as proliferative vitreoretinopathy and threatens visual acuity.

scholarly journals Rhegmatogenous retinal detachment: a review of current practice in diagnosis and management

2020 ◽  
Vol 5 (1) ◽  
pp. e000474
Author(s):  
Ziyaad Nabil Sultan ◽  
Eleftherios I Agorogiannis ◽  
Danilo Iannetta ◽  
David Steel ◽  
Teresa Sandinha
Keyword(s):  
Retinal Detachment ◽  
Systematic Approach ◽  
Rhegmatogenous Retinal Detachment ◽  
Current Practice ◽  
Scleral Buckling ◽  
Success Rates ◽  
Surgical Success ◽  
Equipment Availability ◽  
Surgeon Experience ◽  
Surgical Options

Rhegmatogenous retinal detachment (RRD) is a common condition with an increasing incidence, related to the ageing demographics of many populations and the rising global prevalence of myopia, both well known risk factors. Previously untreatable, RRD now achieves primary surgical success rates of over 80%–90% with complex cases also amenable to treatment. The optimal management for RRD attracts much debate with the main options of pneumatic retinopexy, scleral buckling and vitrectomy all having their proponents based on surgeon experience and preference, case mix and equipment availability. The aim of this review is to provide an overview for the non-retina specialist that will aid and inform their understanding and discussions with patients. We review the incidence and pathogenesis of RRD, present a systematic approach to diagnosis and treatment with special consideration to managing the fellow eye and summarise surgical success and visual recovery following different surgical options.

scholarly journals Factors Affecting the Outcome of Scleral Buckling Surgery for Primary Rhegmatogenous Retinal Detachment

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Ritesh Shah ◽  
Raghunandan Byanju ◽  
Sangita Pradhan ◽  
Sudha Ranabhat
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Surgical Techniques ◽  
Scleral Buckling ◽  
Correct Selection ◽  
Success Rates ◽  
Scleral Buckle ◽  
Preoperative Visual Acuity ◽  
Anatomical Success

Introduction. Scleral buckle surgery retains a special place in treatment of retinal detachment despite development of new and advanced vitreoretinal surgical techniques. The outcome of any retinal detachment surgery depends on correct selection of patient, type and nature of detachment, and the expertise. This study aims to evaluate various other parameters that determine the outcome of scleral buckle surgery. Method. Records of 55 patients with primary rhegmatogenous retinal detachment treated with scleral buckling over a duration of 18 months that had a minimum of 3-month follow-up were retrospectively reviewed. Preoperative and postoperative characteristics were recorded. Parameters that were evaluated to determine the outcome were best-corrected visual acuity (BCVA), anatomical success, and complications. Results. A total of 51 eyes of 50 patients that met the inclusion criteria were included. Mean age was 41 ± 19.9 years (range: 9 to 83). Primary anatomical success was achieved in 80.4%. Parameters significantly associated with the anatomical outcome of surgery were status of lens, preoperative visual acuity, and extent of retinal detachment. There was a significant improvement of visual acuity postoperatively. Conclusion. Scleral buckle surgery is a highly effective surgery in uncomplicated retinal detachment cases, and single surgery success rates are better in cases with good preoperative visual acuity, partial detachment, and clear crystalline lens.

scholarly journals Anatomical and Functional Outcomes of Vitrectomy with/without Intravitreal Methotrexate Infusion for Management of Proliferative Vitreoretinopathy Secondary to Rhegmatogenous Retinal Detachment

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Samir El Baha ◽  
Mahmoud Leila ◽  
Ahmed Amr ◽  
Mohamed M. A. Lolah
Keyword(s):  
Retinal Detachment ◽  
Proliferative Vitreoretinopathy ◽  
Functional Outcomes ◽  
Rhegmatogenous Retinal Detachment ◽  
Visual Outcome ◽  
Rank Test ◽  
Control Groups ◽  
Retinal Reattachment ◽  
The Difference

Purpose. To assess the anatomical and functional outcomes of intravitreal infusion of methotrexate (MTX) during pars plana vitrectomy (PPV) for proliferative vitreoretinopathy (PVR) associated with rhegmatogenous retinal detachment (RRD). Methods. Comparative interventional nonrandomized study including consecutive patients who had vitrectomy for RRD. The study included six groups. Groups I (established PVR), II (high risk of PVR), and III (no risk of PVR) comprised prospectively recruited study eyes, which received PPV and adjuvant intravitreal MTX infusion equivalent to 400 μg/0.1 mL. Groups IA, IIA, and IIIA comprised retrospectively recruited control groups. Main outcome measures were retinal reattachment at the end of 6 months, visual outcome, and complications. Chi-square test or Fisher’s exact test analyzed categorical variables. ANOVA test and Kruskal–Wallis test analyzed quantitative variables. Mann–Whitney U-test and independent t-test evaluated the difference between each group and its control. Comparison between two paired groups was done by Wilcoxon Rank test. The Kaplan–Meier method was used for survival analysis and the log-rank test estimated differences in event-free survival across the groups. P was significant at <0.05. Results. The study included 190 eyes of 188 patients. Study Groups I, II, and III included 42, 35, and 24 eyes, respectively. Mean age was 45 years. Male gender constituted 70% of patients. Mean follow-up period was 6 months. Control Groups IA, IIA, and IIIA included 30, 30, and 29 eyes, respectively. Mean age was 50 years. Male gender constituted 50%. Mean follow-up period was 7 months. Median rate of retinal reattachment was 82% in the study eyes versus 86% in the control eyes. The difference in the retinal reattachment rates between each study group and its respective control was not statistically significant, Group I-IA p =   0. 2 , Group II-IIA p = 0.07 , and Group III-IIIA p = 0.07 . BCVA improved by a mean of 4 lines in the study eyes versus 3 lines in the control eyes. The difference in visual outcome between each study group and its respective control was statistically significant between Groups II-IIA and III-IIIA, p = 0.03 , but not between Groups I-IA, p = 0.07 . We did not detect complications attributed to MTX use in the study eyes. Conclusion. Intravitreal infusion of MTX during PPV is a safe adjuvant therapy in RRD patients with and without PVR. MTX yields superior functional outcomes in patients at high risk of PVR and in patients with no risk of PVR compared to PPV without MTX, but not in cases with established PVR. MTX did not confer an additional advantage in terms of retinal reattachment rate. Summary. Proliferative vitreoretinopathy is a major cause of failure in surgery for rhegmatogenous retinal detachment. Methotrexate as an adjuvant therapy blocks essential drivers in the pathogenetic cascade leading to PVR. Intravitreal infusion has the advantage of blocking the pathology in its nascence and obviates the need for repeated intravitreal injections of the drug.

scholarly journals Variations in Functional and Anatomical Outcomes and in Proliferative Vitreoretinopathy Rate along a Prospective Collaborative Study on Primary Rhegmatogenous Retinal Detachments: The Retina 1 Project—Report 4

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
J. Carlos Pastor ◽  
Itziar Fernández ◽  
Rosa M. Coco ◽  
María R. Sanabria ◽  
Enrique Rodríguez de la Rúa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Visual Acuity ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Proliferative Vitreoretinopathy ◽  
Functional Outcomes ◽  
Collaborative Study ◽  
Multicentric Study ◽  
Project Report ◽  
Anatomical Outcomes

Purpose. To analyse variations in the anatomical and functional outcomes and in proliferative vitreoretinopathy (PVR) rate of a prospective multicentric study that was primarily designed for identification of clinical risk factors for PVR. Methods. 1,046 retinal detachment (RD) cases were analysed. Cases were divided into two series based upon variation in PVR rate determined by logistic regression analysis. Series 1 (S1) included RD treated during 2004-2005 (n=481) and Series 2 (S2) during 2006–2008 (n=565). Pre-, intra-, and postoperative characteristics were recorded. Results. There were few differences in the preoperative characteristics. S2 had more vitrectomies and scleral bands and fewer explants and associated cataract extractions than S1. Anatomic reattachment improved from 87.9% to 92.9% in S1 and S2, respectively, (P=0.006). Visual acuity at 3 months ≥20/40 increased from 36.5% of S1 to 44.2% in S2 (P=0.049). PVR rate diminished from 14.1% in S1 to 8.1% in S2 (P=0.002). Centres with higher rates of PVR in S1 showed the greatest reductions in S2. Conclusion. An improvement in anatomical and functional outcome and PVR rate occurred in participating centres cannot be attributed to the learning curve of surgeons. We speculated that it could be an effect of their participation in the study.

Inverted Internal Limiting Membrane Flap vs Complete Internal Limiting Membrane Peeling for Large Macular Holes in Nonposturing Surgery

2021 ◽  
pp. 247412642110222
Author(s):  
Rubina Rahman ◽  
Mohammad Waseem Sarfraz ◽  
Mohamad El-Wardani
Keyword(s):  
Visual Acuity ◽  
Functional Outcomes ◽  
Internal Limiting Membrane ◽  
Full Thickness ◽  
Ilm Peeling ◽  
Minimum Diameter ◽  
Internal Limiting Membrane Peeling ◽  
Surgical Success ◽  
Macular Holes ◽  
Hole Closure

Purpose: This study compared anatomical and functional outcomes of the inverted internal limiting membrane flap (ILMF) technique with complete ILM peeling (ILMP) in nonposturing surgery for large, full-thickness macular holes (MHs). Methods: This was a retrospective, comparative, single-surgeon study. Eyes with idiopathic large full-thickness MHs (minimum diameter > 400 μm) were included. A total of 46 patients including 22 ILMF cases and 24 ILMP cases were analyzed. No positioning instructions were advised postoperatively. Results: Primary hole closure was achieved in all patients (100%) in both groups. Mean logMAR visual acuity (VA) improved significantly in both groups compared with the preoperative values (ILMF: 0.60 [SD, 0.26] postoperatively, vs 0.93 [SD, 0.3] preoperatively, P = .032; ILMP: 0.43 [SD, 0.22] postoperatively vs 0.83 [SD, 0.16] preoperatively, P < .01). However, ILMP showed a statistically significant improvement in VA compared with ILMF ( P = .02). Conclusions: All MHs in both groups closed after surgery (100%). There was a statistically significant improvement of VA in the ILMP group compared with the ILMF group ( P = .02). Not posturing after surgery did not compromise surgical success in both groups.

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