scholarly journals Outcome of primary rhegmatogenous retinal detachment using microincision vitrectomy and sutureless wide-angle viewing systems

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Chun-Ting Lai ◽  
Wei-Hsun Kung ◽  
Chun-Ju Lin ◽  
Huan-Sheng Chen ◽  
Henry Bair ◽  
...  
Keyword(s):  
Rhegmatogenous Retinal Detachment ◽  
Operative Time ◽  
Operation Time ◽  
Visual Outcome ◽  
Multivariate Logistic Regression ◽  
Corrected Visual Acuity ◽  
Multiple Breaks ◽  
Anatomical Success ◽  
Anatomical Outcome ◽  
Anatomical Success Rate

Abstract Background To evaluate the efficacy of micro-incision vitrectomy surgery (MIVS) using Lumera and Resight non-contact sutureless wide-angle viewing systems (WAVS) for primary rhegmatogenous retinal detachment (RRD), and to analyze the anatomical and visual outcomes. Methods The retrospective, non-comparative, interventional case series reported here was conducted from June 2014 through November 2016. Enrolled patients presented with primary RRD and received MIVS with/without cryopexy by one surgeon using the Lumera and Resight non-contact sutureless WAVS. All patients were followed-up for a minimum of 12 months. Variables collected included patient demographics, best-corrected visual acuity, and macular status. The number and position of retinal break(s), and the use of cryopexy, were also recorded. Outcome measures included operative time, single-operation anatomical success rate, final anatomical success rate, recurrent rate, postoperative best-corrected visual acuity, and surgical complications. The end points were operative time, anatomical outcome, and functional outcome. Results In total, 110 eyes from 110 patients (68 men and 42 women) were treated. Of these, 103 (93%) eyes were reattached after primary vitrectomy. One hundred ten eyes (100%) reached final anatomical success. The mean operative time was 50.55 min. Multivariate analyses were performed with best model selection principle based on general linear model by Akaike Information Criteria for detecting possible factors related to operation time, and with multivariate logistic regression analysis for revealing probable clinical parameters which might influence the anatomical outcome after first operation and final visual outcome. Intraoperative cryopexy and multiple breaks increased operative time significantly. More favorable BCVA was significantly correlated with shorter operation time and the preoperative macula-on status. Multivariate logistic regression on the group of patients who have received the cataract surgery revealed that the pre-operative BCVA is a significant factor which can predict the visual outcome after MIVS. Conclusions The outcome of primary RRD repaired by MIVS using the Lumera and Resight sutureless WAVS was not inferior to any other published method. This instrument combination resulted in a relatively rapid and comfortable procedure without serious postoperative complications. Cryopexy and multiple breaks affected operative time significantly. Shorter operative times and preoperative macula-on status are associated with better final visual outcomes.

Outcomes of Rhegmatogenous Retinal Detachment Repair With Nonrestricted Postoperative Positioning

2019 ◽  
Vol 4 (2) ◽  
pp. 110-118
Author(s):  
Mohamed Kamel Soliman ◽  
Harrish Nithianandan ◽  
Heather McDonald ◽  
Alexander J. Lingley ◽  
Raman Tuli
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Success Rate ◽  
Rhegmatogenous Retinal Detachment ◽  
Scleral Buckle ◽  
Corrected Visual Acuity ◽  
Head Positioning ◽  
Anatomical Success ◽  
Best Corrected Visual Acuity ◽  
Anatomical Success Rate

Purpose: To investigate the anatomical success rate associated with rhegmatogenous retinal detachment (RRD) repair without postoperative head positioning. Methods: Data on 182 individuals undergoing pars plana vitrectomy (PPV) with or without phacoemulsification or scleral buckle for primary RRD with intraocular tamponade were retrospectively reviewed. The primary outcome was the initial anatomical success rate. Secondary outcome measures were the change in best-corrected visual acuity and the final reattachment rate. Results: A total of 122 eyes from 122 patients who underwent RRD repair without postoperative positioning were included in this study. PPV alone was performed in 39% of cases, whereas the remaining patients had PPV combined with phacoemulsification (35%), with scleral buckle (19%), or both (7%). Inferior breaks between the 4 o’clock and 8 o’clock positions were present in 47% of cases. Primary and final anatomical success was achieved in 86% and 98% of cases, respectively. The most common cause for redetachment was proliferative vitreoretinopathy. Age and combined inferior retinal and superior breaks were predictive of recurrence in the logistic regression model. The mean baseline best-corrected visual acuity improved from 1.2 (Snellen equivalent, 20/320) to 0.76 (Snellen, 20/125) logarithm of the minimum angle of resolution after retinal reattachment ( P < .001). Conclusions: PPV combined with or without phacoemulsification or scleral buckle for primary RRD in pseudophakic eyes or those rendered pseudophakic is associated with good anatomical outcomes without restricted postoperative head positioning. Retinal detachment in eyes with combined retinal inferior and superior breaks may have a lower success rate, and whether this is due to lack of postoperative positioning needs further evaluation in prospective, controlled studies.

scholarly journals Anatomical and Visual Outcome of Rhegmatogenous Retinal Detachment Managed with Scleral Buckling at a Tertiary Eye Centre in Nepal

2018 ◽  
Vol 10 (2) ◽  
pp. 151-155
Author(s):  
Roshija Khanal Rijal ◽  
Raghunandan Byanju ◽  
Araniko Pandey ◽  
Deepesh Mourya
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Care Center ◽  
Visual Outcome ◽  
Scleral Buckling ◽  
Interventional Study ◽  
Corrected Visual Acuity ◽  
Common Causes ◽  
The Common

Objective: To study the anatomical status and visual outcome of scleral buckling surgery in rhegmatogenous retinal detachment (RRD) at tertiary eye care center in Nepal. Method: This is a prospective, noncomparative, consecutive, interventional study of rhegmatogenous retinal detachment managed with scleral buckling surgery performed in Lumbini Eye Institute, Nepal. All the patients underwent surgery by a single experienced surgeon and had at least 3 months follow up. Result: A total of 50 patients (50 eyes) were operated, 38 males and 12 females, with a mean age of 39.46. Retinal reattachment was achieved in 46 (92%). Improved best corrected visual acuity (BCVA) was seen in 84%, whereas in 8% BCVA was same and deteriorated in another 8%. Conclusion: Rhegmatogenous retinal detachment is one of the common causes of visual impairment and blindness. Timely surgical management with scleral buckling surgery can give good anatomical and visual outcome.  

scholarly journals Comparison of 27-Gauge and 25-Gauge Microincision Vitrectomy Surgery for the Treatment of Vitreoretinal Disease: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Jinlan Ma ◽  
Qing Wang ◽  
Haoyu Niu
Keyword(s):  
Systematic Review ◽  
Postoperative Complications ◽  
Meta Analysis ◽  
Operation Time ◽  
Vitreoretinal Disease ◽  
Subgroup Analyses ◽  
Microincision Vitrectomy Surgery ◽  
Anatomical Success ◽  
Vitrectomy Surgery ◽  
Anatomical Success Rate

Background. We performed a systematic review and meta-analysis to evaluate the safety and effectiveness of 27-gauge (27-G) microincision vitrectomy surgery (MIVS) compared with 25-guage (25-G) MIVS for the treatment of vitreoretinal disease. Methods. A systematic electronic search was conducted in March 2020 in PubMed, Embase, and the Cochrane library. Eligible criteria for including studies were controlled trials comparing 27-G vitrectomy with 25-G vitrectomy in patients with vitreoretinal disease. The main outcomes included operation time; best corrected visual acuity (BCVA) in logMAR; postoperative intraocular pressure (IOP); primary anatomical success rate for rhegmatogenous retinal detachment (RRD) cases and postoperative central macular thickness (CMT) for idiopathic epiretinal membrane (ERM) cases; intraoperative/postoperative complications. Odds ratio (OR) and mean difference (MD) were synthesized under fixed or random effects models. Results. Eleven studies enrolling 940 eyes were identified. Among those 11 studies, six studies were on the treatment of RRD and five studies were on the treatment of ERM, so subgroup analyses were conducted. The total pooled results indicated that 27-G surgery system had obvious advantages in improving BCVA at six months after the vitrectomy (P = 0.004) and reducing intraoperative/postoperative complications (P = 0.03). However, the mean operation time was significantly longer by three minutes for 27-G compared with 25-G vitrectomy (P = 0.002). In subgroup analyses, for the treatment of ERM cases, 27-G group was associated with less complications and longer operation time. However, for the treatment of RRD cases, 27-G groups and 25-G groups were comparable in operation time, postoperative BCVA, postoperative IOP, and primary anatomical success rate. Conclusions. This meta-analysis confirmed that 27-G MIVS was an effective and safe surgical system compared with 25-G MIVS for the treatment of RRD and ERM cases, even though 27-G system needs a longer surgical time.

scholarly journals Vitrectomy with Air Endotamponade for Traumatic Cyclodialysis

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Anan Wang ◽  
Zhenquan Zhao
Keyword(s):  
Surgical Approach ◽  
Ultrasound Biomicroscopy ◽  
Success Rates ◽  
Corrected Visual Acuity ◽  
Pars Plana ◽  
The Difference ◽  
Anatomical Success ◽  
Anatomical Success Rate ◽  
Cyclodialysis Cleft

Background. Various techniques have been described for repairing cyclodialysis clefts, but there is no consensus regarding the optimal treatment. This study investigated the clinical efficacy of a novel surgical approach that is used to manage traumatic cyclodialysis. Methods. We prospectively enrolled 7 patients (7 eyes) with traumatic cyclodialysis of the concomitant lens and other vitreous diseases. Ultrasound biomicroscopy was used to diagnose cyclodialysis, and all eyes underwent pars plana vitrectomy with air endotamponade. The main outcome measures were postoperative anatomical success rates, best-corrected visual acuity (BCVA), and intraocular pressure (IOP). Results. All patients were male, and their age ranged from 46 to 64 years (mean: 54.3 years). After the surgical intervention, the extent of the cyclodialysis cleft ranged from 1 to 4 clock hours (mean: 2.3 clock hours) and the detached ciliary body of all cases was completely restored; the anatomical success rate was 100%. The BCVA significantly increased from 1.40 ± 0.49 to 0.42 ± 0.31 (P = 0.002). The IOP increased from 8.91 ± 1.77 to 14.67 ± 6.38, but the difference was not significant (P = 0.056). The postoperative IOP of most patients was temporarily elevated or lowered after surgery. At the last follow-up, there were still two abnormal cases, including one with ocular hypertension and one with hypotony. Conclusions. This study revealed that vitrectomy with air endotamponade is an effective and minimally invasive alternative surgical approach for small traumatic cyclodialysis clefts.

scholarly journals Management of Posterior Segment Intraocular Foreign Body with Vitrectomy; Visual and Anatomical Outcome

2018 ◽  
Vol 5 (2) ◽  
pp. 45-48
Author(s):  
Ritesh Kumar Shah ◽  
Raghunandan Byanju ◽  
Sangeeta Pradhan
Keyword(s):  
Visual Acuity ◽  
Foreign Body ◽  
Visual Outcome ◽  
Posterior Segment ◽  
Intraocular Foreign Body ◽  
Medical Sciences ◽  
Hand Motion ◽  
Magnetic Metal ◽  
Anatomical Success ◽  
Anatomical Outcome

AIM: To evaluate the anatomical and visual outcome following removal of intraocular foreign body (IOFB) through pars planavitrectomy.MATERIAL & METHODS: A retrospective analysis of 11 cases of retained posterior segment foreign body that underwent pars planavitrectomy for removal of foreign body during the period of January 2013 to August 2017 was conducted. Demographics of patients, mechanism and details of injury, Snellen best corrected visual acuity, examination results at presentation and after surgery, any diagnostic imaging and surgical procedure were recorded and analysed.RESULTS: Out of eleven eyes of eleven patients (mean age= 25.4}8.6, range 22 50 years; all male) preoperative retinal detachment and endophthalmitis was seen in 27.3% and 36.4% of cases respectively. Eighty-two percent of cases presented within 17 days of sustaining injury. Foreign body size ranged from 2mm to 8 mm and all were magnetic metal. After vitrectomy and removal of foreign body, the number of eyes with vision of hand motion or worse decreased from 72.7% to 27.3%. Similarly 45.5% of eyes gained best corrected postoperative visual acuity of better than 6/60. Anatomical success could be achieved in 81.8% of eyes.CONCLUSION: Anatomical outcome following vitrectomy in eyes with retained posterior segment IOFB in terms of retinal attachment is sufficient; however, visual outcome can be affected by other collateral ocular injuries and their sequelae.Journal of Universal College of Medical Sciences, Vol. 5, No. 2, 2017, Page: 45-48 

One year outcome and predictors of treatment outcome in central serous chorioretinopathy: Multimodal imaging based analysis

2021 ◽  
pp. 112067212110550
Author(s):  
Supriya Arora ◽  
Dmitrii S. Maltsev ◽  
Sumit Singh Randhir ◽  
Niroj Kumar Sahoo ◽  
Mahima Jhingan ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Central Serous Chorioretinopathy ◽  
Multimodal Imaging ◽  
Visual Outcome ◽  
Multicentric Study ◽  
Corrected Visual Acuity ◽  
Planning Treatment ◽  
One Year ◽  
Anatomical Outcome

Purpose To evaluate the follow up and treatment outcome of central serous chorioretinopathy (CSCR) based on the new multimodal imaging-based classification and identify the predictors for anatomic and visual outcome. Methods Retrospective, multicentric study on 95 eyes diagnosed with CSCR and a follow up of at least 12 months were included. Eyes with macular neovascularization, atypical CSCR or any other disease were excluded. Results At the baseline, observation was advised to 70% eyes with simple CSCR whereas photodynamic therapy (PDT) was performed in 49% eyes with complex CSCR. Over the follow up, decrease in CMT was significantly higher in simple CSCR as compared to complex CSCR ( P = 0.008) and the recurrences were significantly more in eyes with lower CMT at baseline ( P = 0.0002). Median time of resolution of SRF was 3 months and 6 months in simple and complex CSCR respectively ( P = 0.09). For the 12 months follow up, the median fluid free period was greater ( P = 0.03) while number of interventions performed was lesser in eyes with simple CSCR as compared to complex CSCR ( P = 0.006). Multiple regression analysis showed baseline best corrected visual acuity (BCVA) and baseline persistent SRF to be significantly predictive of BCVA and persistent SRF at 12 months ( P < 0.0001, 0.04) respectively. Conclusions Complex CSCR more often required PDT, was associated with shorter fluid free interval and longer time for SRF resolution. Baseline BCVA and persistent SRF were predictive of final visual and anatomical outcome. The new multimodal imaging based classification is helpful in establishing objective criteria for planning treatment approaches for CSCR.

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%.

scholarly journals Surgical and Visual Outcome for Recurrent Retinal Detachment Surgery

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Constantin Pournaras ◽  
Chrysanthi Tsika ◽  
Catherine Brozou ◽  
Miltiadis K. Tsilimbaris
Keyword(s):  
Retinal Detachment ◽  
Functional Outcome ◽  
Visual Outcome ◽  
Snellen Chart ◽  
Anatomic Results ◽  
The Mean ◽  
Anatomical Success ◽  
Better Than ◽  
Anatomical Success Rate

Purpose. To evaluate the anatomical and functional outcome of repeated surgeries for recurrent retinal detachment.Methods. We retrospectively reviewed 70 cases with refractory retinal detachment of various etiologies that required multiple operations. Anatomical success (attached retina) or failure (totally/partially-detached retina) was assessed biomicroscopically. The BCVA was used for the evaluation of the functional outcome, at presentation and at the end of follow-up. Various pre-, intra-, and postoperative factors were associated with anatomical success or failure as well as with final functionality.Results. The mean number of surgeries was 4 (range: 2 to 10). The anatomical success rate was 80% (56 attached cases, 14 detached cases). 29% of the attached cases had a BCVA better than 20/40 (Snellen chart). The number of operations doesn’t seem to affect significantly the final visual acuity. The PVR was found to affect both the anatomical and functional outcome (P=0.014&P=0.002, respectively).Conclusions. In the present study, it is suggested that multiple operations for refractory retinal detachment may result in successful anatomic results, with a fare functional outcome at the same time. Eventually, we verified that the existence of PVR worsens the prognosis.

scholarly journals Primary rhegmatogenous retinal detachment: evaluation of a minimally restricted face-down positioning after pars plana vitrectomy and gas tamponade

2021 ◽  
Vol 14 (6) ◽  
pp. 936-939
Author(s):  
Kiichiro Kusaba ◽  
◽  
Tsuneaki Handa ◽  
Yukihiko Shiraki ◽  
Takuya Kataoka ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Retinal Detachment ◽  
Success Rate ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Gas Tamponade ◽  
Retinal Tears ◽  
Pars Plana ◽  
Anatomical Success ◽  
Anatomical Success Rate

AIM: To evaluate the safety and efficacy of a minimally restricted face-down postoperative positioning following pars plana vitrectomy (PPV) with gas tamponade for primary rhegmatogenous retinal detachment (RRD). METHODS: Patients with primary RRD treated with PPV and gas tamponade and followed up for at least 6mo were selected for the study. All phakic eyes underwent simultaneous cataract surgery. The patients were required to be in a postoperative position that prevented downward flow of retinal tears. Patients with macular detachment were positioned face-down for only a couple of hours. The patients were assessed for preoperative and postoperative best-corrected visual acuity (BCVA), anatomical retinal reattachment rate, and postoperative complications. RESULTS: In total, 40 eyes of 39 patients with primary RRD were included in the study. A single tear was present in 30 eyes (75.0%), multiple retinal tears were present in nine eyes (22.5%), and oral dialysis was present in one eye (2.5%). The anatomical success rate was 90.0% (36 cases) after the primary surgery, and the final anatomical success rate was 100%. The BCVA improved significantly (P<0.001) from 0.75 logarithm angle of resolution (logMAR) preoperatively to 0.12 logMAR at the final visit. Postoperative complications included intraocular pressure elevation (≥25 mm Hg) in 11 patients (27.5%), fibrin formation in two patients (5.0%), pupillary capture of the intraocular lens in two patients (5.0%), and posterior synechia in one patient (2.5%). CONCLUSION: A minimally restricted face-down and flexible postoperative positioning after PPV and gas tamponade for primary RRD is effective and safe.

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