Drain fluid cryo-explant technique for treatment of superior bullous rhegmatogenous retinal detachment in young adults

Abstract Background: Evaluation of the safety and efficacy of the Drain Fluid Cryo-Explant (DFCE) technique for management of uncomplicated superior bullous rhegmatogenous retinal detachment (RRD). Methods: A retrospective interventional case series study that included eyes with uncomplicated superior bullous RRD and a duration less than one month. The DFCE technique which involved sequential drainage of subretinal fluid (SRF), intravitreal fluid injection, cryotherapy and placement of a scleral explant(s). The primary outcome measure was the anatomical reposition of the retina after a single surgery. Secondary outcome measures included improvement in visual acuity and any reported complication related to the procedure. Results: The study included 52 eyes (52 patients) with a mean duration of retinal detachment 19.7±6.4 days. A single retinal break was found in 31 eyes (59.6%) and more than one break were found in 21 eyes (40.4%). The mean detached area per eye was 6.3±2.8 clock hours, and the macula was detached in 23 eyes (44.2%). The mean number of breaks per eye was 1.72±1.04. Flattening of the retina and closure of all retinal breaks were achieved in all eyes. Late recurrence of RD occurred in 2 eyes (3.9%) due to PVR. No retinal incarceration or retinal folding were reported. Conclusions: DFCE is an economic technique that could be effectively used for treatment of uncomplicated superior bullous RRD. It provides good visualization during surgery that allows accurate localization of all retinal breaks, proper placement of a relatively low buckle and precise application of cryotherapy to all margins of the retinal break(s).

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Subretinal fluid drainage via original retinal breaks for rhegmatogenous retinal detachment

Canadian Journal of Ophthalmology ◽

10.1016/j.jcjo.2014.03.001 ◽

2014 ◽

Vol 49 (3) ◽

pp. 256-260 ◽

Cited By ~ 5

Author(s):

Makoto Yamaguchi ◽

Shinsuke Ataka ◽

Kunihiko Shiraki

Keyword(s):

Retinal Detachment ◽

Rhegmatogenous Retinal Detachment ◽

Subretinal Fluid ◽

Retinal Breaks ◽

Subretinal Fluid Drainage

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The Impact of the Covid-19 Pandemic on Rhegmatogenous Retinal Detachment Treatment Patterns

10.21203/rs.3.rs-526339/v1 ◽

2021 ◽

Author(s):

Jipeng Li ◽

Meng Zhao ◽

Haicheng She

Keyword(s):

Retinal Detachment ◽

Surgical Procedures ◽

Rhegmatogenous Retinal Detachment ◽

Subretinal Fluid ◽

Scleral Buckling ◽

Retinal Breaks ◽

Surgery Outcomes ◽

Potential Factors ◽

Subretinal Fluid Drainage ◽

The Impact

Abstract Background: To describe changes in rhegmatogenous retinal detachment (RRD) surgical procedures in Beijing during the COVID-19 pandemic. Material and Methods:A retrospective cohort of RRD patients was analyzed. Patients were divided into the COVID-19 pandemic group and pre-COVID-19 group according to their presentation. The presurgery characteristics, surgical procedures, and surgery outcomes were collected. The potential factors related to the choice of pars plana vitrectomy (PPV) or scleral buckling (SB) were analyzed using logistic regression. The differences in the procedure choice under specific conditions were compared. Surgery outcomes were compared between the two groups.Results:In the COVID-19 pandemic group, less patients received SB (27.8%, 41.3%, p=0.02) while more patients received PPV (72.2%, 58.6%, p=0.02); in patients who received SB, fewer patients received subretinal fluid drainage (45.4%,75.7%, p=0.01); in patients who received PPV, fewer patients received phacovitrectomy (7.0%, 21.0%, p=0.02). The choice of PPV was related to older age (1.03, p=0.005), the presence of RRD with choroidal detachment (RRD-CD) (2.92, p=0.03), pseudophakia (5.0, p=0.002), retinal breaks located posterior to the equator(4.87, p<0.001), macular holes (9.76, p=0.005), and a presurgery visual acuity (VA) less than 0.02 (0.44 , p=0.03). Fewer phakia patients with retinal breaks located posterior to the equator (1/28, 11/30, p=0.01) and fewer patients with chronic RRD and subretinal strand (1/9, 9/16, p=0.03) received SB in the COVID-19 pandemic group. More patients with improved VA (55.7%, 40.2%, p=0.03) in the COVID-19 pandemic group. The overall single-surgery retinal attachment rate was similar in the two groups (94.9%, 94.5%, p=0.99).Conclusions:During the COVID-19 pandemic, the main reason for the increased number of PPV in RRD treatment was that more complicated cases were presented. However, the surgeons were conservative in procedure choice in specific cases. The adjustments on RRD treatments leads to comparable surgery outcomes.

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The impact of the COVID-19 Pandemic on rhegmatogenous retinal detachment treatment patterns

BMC Ophthalmology ◽

10.1186/s12886-021-02127-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jipeng Li ◽

Meng Zhao ◽

Haicheng She

Keyword(s):

Retinal Detachment ◽

Surgical Procedures ◽

Rhegmatogenous Retinal Detachment ◽

Subretinal Fluid ◽

Scleral Buckling ◽

Retinal Breaks ◽

Surgery Outcomes ◽

Potential Factors ◽

Subretinal Fluid Drainage ◽

The Impact

Abstract Backgrounds To describe changes in rhegmatogenous retinal detachment (RRD) surgical procedures in Beijing during the COVID-19 Pandemic. Methods A retrospective cohort of RRD patients was analyzed. Patients were divided into the COVID-19 pandemic group and pre-COVID-19 group according to their presentation. The presurgery characteristics, surgical procedures, and surgery outcomes were collected. The potential factors related to the choice of pars plana vitrectomy (PPV) or scleral buckling (SB) were analyzed using logistic regression. The differences in the procedure choice under specific conditions were compared. Surgery outcomes were compared between the two groups. Results In the COVID-19 pandemic group, less patients received SB (27.8, 41.3%, p = 0.02) while more patients received PPV (72.2, 58.6%, p = 0.02); in patients who received SB, fewer patients received subretinal fluid drainage (45.4,75.7%, p = 0.01); in patients who received PPV, fewer patients received phacovitrectomy (7.0, 21.0%, p = 0.02). The choice of PPV was related to older age (1.03, p = 0.005), the presence of RRD with choroidal detachment (RRD-CD) (2.92, p = 0.03), pseudophakia (5.0, p = 0.002), retinal breaks located posterior to the equator (4.87, p < 0.001), macular holes (9.76, p = 0.005), and a presurgery visual acuity (VA) less than 0.02 (0.44, p = 0.03). Fewer phakia patients with retinal breaks located posterior to the equator (1/28, 11/30, p = 0.01) and fewer patients with chronic RRD and subretinal strand (1/9, 9/16, p = 0.03) received SB in the COVID-19 pandemic group. There were more patients with improved VA (55.7, 40.2%, p = 0.03) in the COVID-19 pandemic group. The overall single-surgery retinal attachment rate was similar in the two groups (94.9, 94.5%, p = 0.99). Conclusions During the COVID-19 Pandemic, the main reason for the increased number of PPV in RRD treatment was that more complicated cases were presented. However, the surgeons were conservative in procedure choice in specific cases. The adjustments on RRD treatments lead to comparable surgery outcomes.

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The Safety and Efficacy of Adjustable Postoperative Position after Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment

Journal of Ophthalmology ◽

10.1155/2017/5760173 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7

Author(s):

Zhong Lin ◽

Jin Tao Sun ◽

Rong Han Wu ◽

Nived Moonasar ◽

Ye Hui Zhou

Keyword(s):

Retinal Detachment ◽

Rhegmatogenous Retinal Detachment ◽

Safety And Efficacy ◽

Retinal Breaks ◽

Pars Plana ◽

Vitreous Tamponade ◽

Lateral Decubitus ◽

The Mean ◽

Vitrectomy Surgery

Purpose.To report the safety and efficacy of adjustable postoperative position for rhegmatogenous retinal detachment (RRD).Methods.Retrospective review of 536 consecutive RRD eyes that underwent vitrectomy surgery for retina repair from year 2008 to 2014. The retinal breaks were divided into superior, lateral (nasal, temporal, and macular), and inferior locations, according to the clock of breaks. Patients with superior and lateral break location were allowed to have facedown position or lateral decubitus position postoperatively, while patients with inferior break location were allowed to have facedown position.Results.403 eyes of 400 patients were included. The mean follow-up interval was 22.7 ± 21.3 months. The overall primary retinal reattachment rate was 93.3%. There were 24 (6.0%), 273 (67.7%), and 106 (26.3%) patients with superior, lateral, and inferior break location, respectively. The primary reattachment rate was 95.8%, 92.3%, and 95.3% accordingly. After further divided the break location into subgroups as a function of duration of symptom, postoperative lens situation, number of retinal breaks, and different vitreous tamponade, the primary reattachment rates were all higher than 82%.Conclusion.Adjustable postoperative positioning is effective and safe for RRD repair with different break locations. Choosing postoperative position appropriately according to retinal break locations could be recommended.

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Pneumatic retinopexy combined with scleral buckling in the management of relatively complicated cases of rhegmatogenous retinal detachment: A multicenter, retrospective, observational consecutive case series*

Journal of International Medical Research ◽

10.1177/0300060517724931 ◽

2017 ◽

Vol 46 (1) ◽

pp. 316-325 ◽

Cited By ~ 3

Author(s):

Chuandi Zhou ◽

Qiurong Lin ◽

Yuxin Wang ◽

Qinghua Qiu

Keyword(s):

Retinal Detachment ◽

Rhegmatogenous Retinal Detachment ◽

Case Series ◽

Subretinal Fluid ◽

Scleral Buckling ◽

Success Rates ◽

Pneumatic Retinopexy ◽

The Mean ◽

Final Operation

Objective To evaluate the efficacy of maximal pneumatic retinopexy (PR) and subretinal fluid (SRF) drainage combined with scleral buckling (SB) in the treatment of complicated rhegmatogenous retinal detachment (RRD). Methods Patients with RRD who underwent maximal PR and SRF drainage combined with SB from June 2007 to June 2012 were included in this multicenter retrospective study. The outcome measures were the primary and final operation success rates and best-corrected visual acuity (BCVA). Results In total, 159 consecutive patients were included. The mean follow-up period was 13.76 ± 1.97 months. Primary operation success was achieved in 146/159 (91.82%) eyes. After salvage management, the final reattachment rate increased to 98.11%. All eyes had improved BCVA, with 62/159 (38.99%) attaining BCVA of ≥20/40. Conclusions Maximal PR and SRF drainage combined with SB achieved satisfactory anatomical and visual recovery in relatively complicated cases of RRD. The decreased need for vitrectomy makes this surgical approach more widely available.

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The Impact of the Covid-19 Pandemic on Rhegmatogenous Retinal Detachment Treatment Patterns

10.21203/rs.3.rs-526339/v2 ◽

2021 ◽

Author(s):

Jipeng Li ◽

Meng Zhao ◽

Haicheng She

Keyword(s):

Retinal Detachment ◽

Surgical Procedures ◽

Rhegmatogenous Retinal Detachment ◽

Subretinal Fluid ◽

Scleral Buckling ◽

Retinal Breaks ◽

Surgery Outcomes ◽

Potential Factors ◽

Subretinal Fluid Drainage ◽

The Impact

Abstract Background: To describe changes in rhegmatogenous retinal detachment (RRD) surgical procedures in Beijing during the COVID-19 pandemic. Material and Methods:A retrospective cohort of RRD patients was analyzed. Patients were divided into the COVID-19 pandemic group and pre-COVID-19 group according to their presentation. The presurgery characteristics, surgical procedures, and surgery outcomes were collected. The potential factors related to the choice of pars plana vitrectomy (PPV) or scleral buckling (SB) were analyzed using logistic regression. The differences in the procedure choice under specific conditions were compared. Surgery outcomes were compared between the two groups.Results:In the COVID-19 pandemic group, less patients received SB (27.8%, 41.3%, p=0.02) while more patients received PPV (72.2%, 58.6%, p=0.02); in patients who received SB, fewer patients received subretinal fluid drainage (45.4%,75.7%, p=0.01); in patients who received PPV, fewer patients received phacovitrectomy (7.0%, 21.0%, p=0.02). The choice of PPV was related to older age (1.03, p=0.005), the presence of RRD with choroidal detachment (RRD-CD) (2.92, p=0.03), pseudophakia (5.0, p=0.002), retinal breaks located posterior to the equator(4.87, p<0.001), macular holes (9.76, p=0.005), and a presurgery visual acuity (VA) less than 0.02 (0.44 , p=0.03). Fewer phakia patients with retinal breaks located posterior to the equator (1/28, 11/30, p=0.01) and fewer patients with chronic RRD and subretinal strand (1/9, 9/16, p=0.03) received SB in the COVID-19 pandemic group. More patients with improved VA (55.7%, 40.2%, p=0.03) in the COVID-19 pandemic group. The overall single-surgery retinal attachment rate was similar in the two groups (94.9%, 94.5%, p=0.99).Conclusions:During the COVID-19 pandemic, the main reason for the increased number of PPV in RRD treatment was that more complicated cases were presented. However, the surgeons were conservative in procedure choice in specific cases. The adjustments on RRD treatments leads to comparable surgery outcomes.

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Clinical characteristics and surgical outcomes of rhegmatogenous retinal detachment in patients ages 18-40 years

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-3-9-14 ◽

2021 ◽

pp. 9-14

Author(s):

T.A. Avanesova ◽

◽

V.V. Anisimova ◽

Keyword(s):

Young Adults ◽

Retinal Detachment ◽

Clinical Features ◽

Surgical Outcomes ◽

Rhegmatogenous Retinal Detachment ◽

Demographic Data ◽

Young Patients ◽

Patients Âgés ◽

The Mean ◽

Anatomic Success

The risk of rhegmatogenous retinal detachment (RRD) increases with age and its more common in the older age group, but several studies report a secondary peak of RRD in young patients. At the same time, RRD in young patients has clinical features. Purpose. To describe clinical features and surgical outcomes of RRD in young adults. Materials and мethods. Retrospective study of 33 patients (33 eyes) aged between 18 and 40 years, who underwent primary surgery between June 2018 and February 2021. The mean age of the patients was 33.9±6.7 years. All patients underwent either scleral buckling or pars plana vitrectomy. We analyzed demographic data, RRD characteristics, primary and final anatomic anatomic success rate and best-corrected visual acuity (BCVA) at the conclusion of follow-up. Results. The main etiologies were myopia (87.8%) and trauma (15%). were Macula on RRD was in 69.7% of patients. Primary anatomic success was in 69.7% cases, final anatomic success- 94%. (14 out of 16 eyes) after vitrectomy. The mean BCVA value improved to 0.65±0.35 (p=0.042). Conclusion. RRD in young adults aged between 18 and 40 years has clinical features and differs from that in older adults. The main causes are myopia, especially of high myopia and trauma. Macula off RRD is less common than macula on RRD. Primary anatomic success is less favorable compared to final anatomic success. The functional prognosis remains satisfactory and increased to 0.65±0.35 (p=0.042).

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Comparative Study of 27-Gauge versus 25-Gauge Vitrectomy for the Treatment of Primary Rhegmatogenous Retinal Detachment

Journal of Ophthalmology ◽

10.1155/2017/6384985 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5 ◽

Cited By ~ 14

Author(s):

Stanislao Rizzo ◽

Silvio Polizzi ◽

Francesco Barca ◽

Tomaso Caporossi ◽

Gianni Virgili

Keyword(s):

Retinal Detachment ◽

Rhegmatogenous Retinal Detachment ◽

Outcome Measure ◽

Interventional Study ◽

Postoperative Visit ◽

Retinal Breaks ◽

The Mean ◽

Anatomical Success ◽

Anatomical Success Rate ◽

25 Gauge Vitrectomy

Purpose. To compare the vitrectomy time, clinical outcomes, and complications between 27-gauge (27-G) and 25-gauge (25-G) vitrectomy in patients with primary rhegmatogenous retinal detachment (PRRD).Methods. Prospective, nonrandomized, comparative, interventional study. Forty consecutive patients with PRRD were recruited. Twenty patients underwent the 27-gauge procedure and twenty patients had the 25-gauge procedure. The main outcome measure of the study was the actual vitrectomy time.Results. The mean duration of vitreous removal was 23.2 min (SD 6.5) with 27-G vitrectomy and 19.6 min (SD 7.3) with 25-G vitrectomy, resulting in a difference of 3.6 min (95% confidence interval (95%CI): −8.0 to 0.8 mins,p=0.11). Mean logMAR visual acuity improved from 1.70 ± 1.18 preoperatively to 0.12 ± 0.14 at final postoperative visit (p<0.001) in the 27-G group and from 1.52 ± 1.15 preoperatively to 0.22 ± 0.30 at final postoperative visit (p<0.001) in the 25-G group. The anatomical success rate after a single operation was 90.0% and 85.0% in the 27-G and in the 25-G groups (p=0.63), respectively. Intraoperative iatrogenic retinal breaks (IRBs) occurred in 2 eyes in the 27-G group and 1 eye in the 25-G group.Conclusions. Twenty-seven-gauge vitrectomy may be a safe and effective surgery for the treatment of PRRD.

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Extrascleral Filling Using Endoillumination the First Experiencethe

Russian ophthalmology of children ◽

10.25276/2307-6658-2020-3-43-49 ◽

2020 ◽

pp. 43-49

Author(s):

V.Y. Markevich ◽

◽

T.A. Imshenetskaya ◽

O.A. Yarmak ◽

◽

...

Keyword(s):

Surgical Treatment ◽

Retinal Detachment ◽

Rhegmatogenous Retinal Detachment ◽

Silicone Oil ◽

Subretinal Fluid ◽

Crystalline Lens ◽

Vitreous Cavity ◽

Macular Area ◽

General Group ◽

Anatomical Outcome

Purpose. To study the effectiveness of extrascleral filling (ESF) using endoillumination in the surgical treatment of patients with primary rhegmatogenous retinal detachment (RRD). Material and methods. The material for the study was the data of a comprehensive clinical examination and surgical treatment by ESF method using endoillumination in 17 patients (17 eyes) with RRD. In 7 cases (41%), the macular area was involved in the detachment process. In 5 cases (29.4%), local scleral filling was performed. In the remaining 12 cases (70.6%), the local ESF was supplemented with a circling silicone element. Surgical intervention was supplemented by transscleral drainage of subretinal fluid (SRF) in 10 cases (59%) and pneumatic retinopexy with SF6 gas 50% in 8 cases (48%). Results. In the general group of patients, best corrected visual acuity (BCVA) increased from 0.35 to 0.46. In the subgroup of patients with a detached macular area, the positive dynamics is more pronounced, BCVA increased from 0.1 to 0.28. The progression of proliferative vitreoretinopathy caused the recurrence of retinal detachment in two patients (11.8%). Recurrences were diagnosed after 3 and 5 months, respectively. In both cases, a vitrectomy with tamponade of the vitreous cavity with silicone oil 5000 Cst was performed. The percentage of successful anatomical outcome after the first operation in our study was 82%. The percentage of successful achievement of the final anatomical result was 94%. In two cases, additional injection of SF6 gas into the vitreous cavity was required. Conclusion. This type of surgical treatment is an effective method of surgical treatment of patients with RRD. In our study, the successful anatomical outcome after the first operation was recorded in 82% of patients, which correlates with the data of the authors who also used this method (83–92%). Surgeons who performed surgical treatment using this technique in our study note improved workplace ergonomics when visualizing the fundus using an operating microscope and endoillumination compared with indirect ophthalmoscopy. Other teams of authors came to this conclusion as well. In our study, there were no complications associated with the introduction of a light pipe into the vitreous cavity (iatrogenic crystalline lens injury, endophthalmitis), which indicates the safety of this type of surgical treatment.

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