scholarly journals Pars plana vitrectomy with/without encircling scleral band for treatment of retinal detachment associated with buphthalmos

Author(s):  
Hammouda Hamdy Ghoraba ◽  
Sameh Mohamed El Gouhary ◽  
Ali Ahmed Ali Ghali ◽  
Mohamed Ahmed Abdelhafez ◽  
Adel Galal Zaky ◽  
...  

Abstract Background To evaluate the results of pars plana vitrectomy (PPV) and silicone oil (SO) tamponade with or without encircling scleral band for repair of rhegmatogenous retinal detachment (RRD) in children with buphthalmos. Patients and methods Retrospective comparative nonrandomized interventional case series including consecutive patients who underwent PPV with or without encircling band and SO tamponade for RRD associated with buphthalmos. Results The study included 19 eyes of 19 children. Mean age was 8 years, range 3–16 years. Mean follow-up period was 28 months, range 19–63 months. Globe survival has been achieved in 15 out of 19 eyes (79%). Phthisis bulbi was reported in four cases (22%). Eight patients (42%) achieved ambulatory vision. Most eyes initially achieved anatomical success. Conclusion Despite the poor visual and anatomical results of RRD repair in eyes with buphthalmos, globe survival might be the rationale for surgery in such cases. Globe preservation could avoid the psychological and social consequences of phthisis bulbi in non-operated children.


2018 ◽  
Vol 103 (8) ◽  
pp. 1133-1136 ◽  
Author(s):  
Tommaso Rossi ◽  
Tomaso Caporossi ◽  
Stanislao Rizzo ◽  
Carlandrea Trillo ◽  
Serena Telani ◽  
...  

PurposeTo review a series of highly myopic eyes with retinal detachment undergoing pars plana vitrectomy with autologous internal limiting membrane (ILM) flap placed over posterior retinal breaks located in areas of choroidal atrophy.MethodsRetrospective review of 13 consecutive patients receiving pars plana vitrectomy with ILM flap over causative breaks, compared with 19 controls receiving the same surgery with ILM peeling but no ILM flap. Main outcome measures included anatomical success rate, visual acuity, number of surgeries and the rate of silicone oil removal.ResultsPatients in the ILM group required 2.08±0.37 interventions versus 2.58±0.75 in the control group (p=0.037). One (1/13; 7.6%) patient in the ILM group required additional unplanned surgery versus 8/19 (42.10%) in the control group (p=0.038). Final anatomical success rate defined as attached retina after silicone oil (SiO) removal was 13/13 in the I-ILM group and 14/19 (73.6%) in the control group (p=0.052). No patients (0/13) in the I-ILM group retained SiO at the end of follow-up versus 4/19 (21.1%) patients in the control group (p=0.061). Best-corrected visual acuity at the end of follow-up was logMAR 0.65±0.36 (20/91 Snellen) in the ILM group and logMAR 0.89±0.44 (20/158 Snellen) in the control group (p=0.20).ConclusionAutologous ILM may help seal posterior retinal breaks and improve the surgical prognosis of retinal detachment due to breaks located over areas of choroidal atrophy within the myopic staphyloma.



2014 ◽  
Vol 142 (11-12) ◽  
pp. 717-720 ◽  
Author(s):  
Dragan Vukovic ◽  
Sanja Petrovic-Pajic ◽  
Predrag Paovic

Introduction. Choroidal coloboma is a congenital defect caused by an inadequate closure of embryonic fissure. About 40% of the eyes with the choroidal coloboma (CHC) develop the retinal detachment (RD). It is extremely difficult to manage these cases due to the lack of pigmentation at the site of choroidal coloboma. Outline of Cases. This is a case series of five patients with CHC and RD who were successfully operated using one of two different surgical techniques: pars plana vitrectomy (PPV) + silicone oil internal tamponade and/or scleral buckle with encircling band with laser photocoagulation (SB+EB+LPC) around the coloboma. The purpose of this paper is to present how to successfully handle patients with CHC, who have concurrent retinal detachment in the same eye and to compare two different techniques and indications for the predominant use of one of them in a specific case. Conclusion. Both surgical techniques can be applied with equal success in the operation of retinal detachment in eyes with the chorioidal coloboma. Which one will be used depends only of the posterior segment of eye findings. We use scleral buckling in cases with RD accompanied by CHC when the peripheral break is evident and there are no breaks in the coloboma itself. We also perform, 2-3 days after surgery, laser burns around the coloboma, which is our modification of this technique. In all other cases it is indicated to perform PPV+silicon oil internal tamponade.



2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Mohamed Abou Shousha ◽  
Taher Eleiwa ◽  
Allister Gibbons ◽  
Christopher Smith ◽  
Sean Edelstein ◽  
...  

Purpose. To identify the incidence of endophthalmitis and visual outcomes in eyes with Boston type 1 keratoprosthesis combined with pars plana vitrectomy and silicone oil insertion (KPro + PPV + SOI) as compared to eyes receiving Boston type 1 keratoprosthesis (KPro) alone. Patients and Methods. Retrospective chart review of 29 eyes of 27 patients with KPro having at least 12-month follow-up. Thirteen of these eyes had hypotony and/or retinal detachment in addition to corneal pathology and thus received KPro + PPV + SOI. Polymyxin-trimethoprim with a quinolone was used as chronic topical antibiotic prophylaxis in both groups after the first postoperative month. Outcome measures recorded at the 1-, 3-, 6-, 12-, and 24-month follow-up visits included best-corrected visual acuity (BCVA) and rates of postoperative complications. Results. All the patients had completed 24-month follow-up except one case in the KPro group who lost to follow-up after 12-month visit. In the KPro + PPV + SOI group, no eyes had developed endophthalmitis by the 24-month follow-up visit versus 5 eyes of 5 patients in the uncombined KPro group (P=0.048). The 2-year cumulative endophthalmitis incidence was 31.2% in the KPro group versus zero in the KPro + PPV + SOI group (P=0.030). Four of these 5 eyes had vitreous taps with positive cultures; 2 were positive with Staphylococcus aureus, 1 with coagulase-negative staphylococci, and 1 with Streptococcus pneumoniae. Other complications included KPro extrusion (1 in each group), retinal detachment (2 in the KPro and 1 in the KPro + PPV + SOI group), newly developed glaucoma (2 in each group), and retroprosthetic membrane (9 in the KPro and 5 in the KPro + PPV + SOI group). The KPro group had better average preoperative BCVA compared to those of the KPro + PPV + SOI group (−2.29 ± 0.72 LogMAR, versus −2.95 ± 0.30 LogMAR; P=0.004). No statistically significant difference in BCVA was noted in subsequent follow-up visits. Conclusion. The addition of PPV and SOI to the KPro implantation in the eyes with corneal pathology, as well as hypotony and/or retinal detachment, is a safe and effective procedure for visual rehabilitation. Pars plana vitrectomy and silicone oil insertion may have a protective effect against the development of postoperative endophthalmitis in eyes receiving KPro.



2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Gian Marco Tosi ◽  
Davide Marigliani ◽  
Tommaso Bacci ◽  
Napoleone Romeo ◽  
Angelo Balestrazzi ◽  
...  

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.



2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
S Z M Hussain ◽  
M A Awan ◽  
M A R Siddiqui

Abstract Aim To evaluate the primary anatomical success and visual outcomes in patients with rhegmatogenous retinal detachment (RRD) undergoing 25-gauge pars plana vitrectomy (25g PPV) surgery in Pakistan. Method This is a five-year retrospective, interventional cohort study of 418 consecutive patients with RRD who underwent 25g PPV. Surgeries were performed by two experienced surgeons at tertiary care hospitals in Pakistan. Consecutive patients, who underwent 25 g PPV surgery as treatment for RRD between October 2013-October 2018 were included. We excluded patients who had a history of previous retinal surgery or who did not complete the 4-8 weeks primary outcome visit. Data was collected from the patient’s files by using a pro forma. SPSS version 23.0 (IBM SPSS Statistics, Armonk, NY) was used. A p-value of < 0.5 was considered significant. Results We identified 452 patients through coding system of hospitals who underwent 25g PPV surgery between October 2013-October 2018. Secondary retinal surgery and incomplete follow up cases were excluded. A total of 441 patients’ files were reviewed for the study, out of which 418 patients met the criteria for final analysis. Males were in a higher number 284 (67.9 %). The average age was 49±15.8. In our study, 186 (44.4%) patients were phakic at the time of presentation. At 2 months follow up, the primary anatomical success rate was 87.1 %. Conclusions Surgical outcomes of RRD with 25g PPV surgery in our study were similar to the outcomes reported in the developed world. We propose a prospective multicenter national study to prospectively evaluate the risk factors for RRD surgical failure in the Pakistani population.



2021 ◽  
Vol 20 (4) ◽  
pp. 150-157
Author(s):  
Min Jin Kim ◽  
Sung Jin Lee ◽  
Kyung Seek Choi

Purpose: To compare long-term clinical outcomes of pars plana vitrectomy (PPV) combined with intraoperative 360° laserpexy and pars plana vitrectomy combined with scleral encircling for the treatment of primary rhegmatogenous retinal detachment (RRD).Methods: This retrospective, comparative case study included 70 patients who had at least 1 year of follow-up after vitrectomy for primary uncomplicated RRD from 2015 to 2019. The patients were divided into two groups. Group I included 34 patients who underwent PPV + 360° laserpexy (LP), while group II included 36 patients who underwent PPV + scleral encircling (SE). Main outcome measures were the anatomical success rate, the functional success rate, final best-corrected visual acuity (BCVA), and the incidence of post-operative complications. We also examined the long-term changes in axial length, corneal curvature, and refractive error before and after surgery.Results: LP and SE groups showed no significant differences with respect to the primary anatomical success rate (97.05% and 94.44%, respectively; p = 0.592) or the functional success rate (BCVA ≥ 20/40 at final follow-up; 82.35% and 77.78%, respectively; p = 0.635). Detachment reoccurred in three cases (one in the LP group and two in the SE group) because of proliferative vitreoretinopathy; both cases in the SE group had successful anatomical re-attachment after repeating the PPV procedure. Complications included post-operative epiretinal membrane and cystic macular edema, as well as increased intraocular pressure.Conclusions: Primary vitrectomy combined with 360° laserpexy has effectiveness similar to vitrectomy combined with scleral encircling in patients with RRD in long-term clinical outcomes.



2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Keiko Otsuka ◽  
Hisanori Imai ◽  
Ayaka Fujii ◽  
Akiko Miki ◽  
Mizuki Tagami ◽  
...  

Aim. To compare the anatomic and visual outcomes of 25-gauge (25G), and 27-gauge (27G) transconjunctival sutureless pars plana vitrectomy (TSV) for the management of primary rhegmatogeneous retinal detachment (RRD).Design. A retrospective nonrandomized clinical trial.Methods. A retrospective comparative analysis of 62 consecutive eyes from 62 patients with 6 months of follow-up was performed.Results. Thirty-two patients underwent 25G TSV, and 30 patients underwent 27G TSV for the treatment of primary RRD. There was no significant difference in baseline demographic and preoperative ocular characteristics between the two groups. The initial and final anatomical success rates were 93.8% and 100% in 25G TSV and 96.7% and 100% in 27G TSV, respectively (p=1andp=1, resp.). Preoperative best-corrected visual acuity (BCVA) (logMAR) was 0.44 ± 0.69 and 0.38 ± 0.61 for 25G and 27G TSV, respectively (p=0.73). The final follow-up BCVA was 0.07 ± 0.25 and −0.02 ± 0.17 for 25G and 27G TSV, respectively (p=0.16). The final BCVA was significantly better than the preoperative BCVA in both groups (p=0.02andp=0.002, resp.). Preoperative intraocular pressure (IOP) (mmHg) was 13.0 ± 3.5 in 25G TSV and 14.3 ± 2.8 in 27G TSV (p=0.11). IOP did not statistically significantly change in both groups during the follow-up period (p=0.63andp=0.21, resp.).Conclusion. The 27G TSV system is safe and useful for RRD treatment as 25G TSV.



2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Robert Rejdak ◽  
Dominika Nowakowska ◽  
Katarzyna Wrona ◽  
Ryszard Maciejewski ◽  
Anselm G. Junemann ◽  
...  

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.



2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Sidrah Riaz ◽  
Muhammad Tariq Khan ◽  
Khurram Azam Mirza

Purpose:  To study demographic characteristics and treatment outcomes of Rhegmatogenous retinal detachment in a private Vitreo-retinal setup of Lahore. Study Design:  Cross sectional Observational study. Place and Duration of Study:  Private Vitreo-retinal setup, from March 2017 to April 2019. Methods:  Total 102 patients with Rhegmatogenous retinal detachment (RRD) were included. Patients with retinal detachment other than RRD were excluded. Detailed history and ocular examination was performed. Type of break, procedure adopted for RRD repair and type of endo-tamponade were also recorded. These patients had either 23 G pars plana vitrectomy (PPV) or scleral buckling (SB) procedures or combined sclera buckling with PPV. Patients were followed-up for six months. Results:  Out of 102 total RRD cases, 63.70% were males and 36.30%were females. Mean age was 47.44 ± 18.44. Macula was on in 48% and off in 52%. Phakic patients were 46.50%, pseudophakic 48.50% and 5.10% were aphakic. Position of break in RRD was superotemporal in 39.2%, inferotemporal in 30.4% and inferonasal in 2.9%. Total RD was observed in 27.5% patients. One or more breaks were identified in 82.4% patients and giant tear in 4.9%. Three ports 23 G PPV was done in 64.7%, PPV with IOL in 18.6%, scleral buckling in 10.8% and combined PPV + SB in 5.9% patients. The anatomical success rate was observed in 96.07%, 3.9% needed second surgery to get anatomical success in six months follow-up. Conclusion:  Anatomical success rates in retinal attachment surgeries in experienced hands is comparable with more developed retinal centers of the world. Key Words:  Rhegmatogenous retinal detachment, Pars plana vitrectomy, Scleral buckling, Silicon oil.



2021 ◽  
Author(s):  
Carlo Bellucci ◽  
Lucia Benatti ◽  
Maurizio Rossi ◽  
Salvatore Antonio Tedesco ◽  
Arturo Carta ◽  
...  

Abstract Purpose: Lens-sparing pars plana vitrectomy (PPV) is often followed by cataract development. However, there have been few prospective studies evaluating the timing of cataract progression and potential associated factors.Methods: This was an observational study conducted at the Ophthalmology Unit of the University Hospital of Parma (Parma, Italy). Patients presenting with rhegmatogenous retinal detachment (RRD), who underwent PPV with preservation of the lens, were examined according to a scheduled follow-up (3, 6 and 12 months after PPV) and then preoperatively when cataract extraction surgery (CES) was indicated, or at the end of the study follow-up period (May 2021). The primary outcome was the interval between PPV and CES indication (based on predefined refractive criteria).Results: A total of 36 eyes of 36 patients (mean age: 52 ± 10 years) were included in the study. Nineteen eyes (53%) were indicated for CES a median of 14.5 months (IQR: 12.0–24.8) after PPV. The nuclear and posterior subcapsular forms of cataract progressed significantly starting at 6 months after PPV. Older age at the time of PPV, silicone oil tamponade and RRD without macular involvement were significantly and independently associated with an earlier indication for CES. Conclusions: Patient age and the use of silicone oil tamponade must be taken into consideration when evaluating the risk of cataract development after PPV.



Sign in / Sign up

Export Citation Format

Share Document