scholarly journals 25-gauge vitrectomy with gas tamponade for rhegmatogenous retinal detachment: experienced vs. inexperienced surgeons

2020 ◽  
Author(s):  
Martin Pencak ◽  
Miroslav Veith ◽  
Zbynek Stranak ◽  
Jakub Dite ◽  
Jana Vranova ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Success Rate ◽  
Rhegmatogenous Retinal Detachment ◽  
Case Series ◽  
Functional Results ◽  
Complication Rates ◽  
Gas Tamponade ◽  
Single Operation ◽  
Case Series Study ◽  
The Mean

Abstract Introduction: To compare the results and complication rates of a 25-gauge pars plana vitrectomy (25g PPV) with gas tamponade for rhegmatogenous retinal detachment (RRD) between experienced and inexperienced surgeons.Materials and Methods: This is a retrospective comparative consecutive case series study of patients with uncomplicated RRD treated with 25g PPV with gas tamponade. Patients were divided into 2 groups: In Group 1 (ESG) the procedure was performed by an experienced vitreoretinal surgeon and in Group 2 (ISG) the procedure was performed by 2 inexperienced surgeons. Anatomical and functional results and complication rates were compared between the two groups.Results: 216 eyes were included in the study. In the ESG (106 eyes), the single operation success rate was 94.3%, and the final success rate was 100%. The mean best-corrected visual acuity (BCVA) improved from 0.38 decimal to 0.73 decimal. In the ISG (110 eyes), the single operation success rate was 93.6%, and the final success rate was 100.0%. The mean BCVA improved from 0.33 decimal to 0.74 decimal. The differences between groups were not statistically significant. There was no difference in complication rates between groups.Conclusions: A 25g PPV with gas tamponade for treatment of RRD yields excellent anatomical results and improvement in BCVA. With good technique and use of modern vitrectomy machines and instruments, even inexperienced surgeons can achieve high single operation success rate, suggesting a short learning curve. The complication rate is comparable between experienced and inexperienced surgeons.

scholarly journals 25-gauge vitrectomy with gas tamponade for rhegmatogenous retinal detachment: experienced vs. inexperienced surgeons

2020 ◽  
Author(s):  
Martin Pencak ◽  
Miroslav Veith ◽  
Zbynek Stranak ◽  
Jakub Dite ◽  
Jana Vranova ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Success Rate ◽  
Rhegmatogenous Retinal Detachment ◽  
Case Series ◽  
Functional Results ◽  
Complication Rates ◽  
Gas Tamponade ◽  
Single Operation ◽  
Case Series Study ◽  
The Mean

Abstract Background: To compare the results and complication rates of a 25-gauge pars plana vitrectomy (25 g PPV) with gas tamponade for rhegmatogenous retinal detachment (RRD) between experienced and inexperienced surgeons.Methods: This is a retrospective comparative consecutive case series study of patients with uncomplicated RRD treated with 25 g PPV with gas tamponade. Patients were divided into 2 groups: In Group 1 (ESG) the procedure was performed by an experienced vitreoretinal surgeon and in Group 2 (ISG) the procedure was performed by 2 inexperienced surgeons. Anatomical and functional results and complication rates were compared between the two groups.Results: 216 eyes were included in the study. In the ESG (106 eyes), the single operation success rate was 94.3%, and the final success rate was 100%. The mean best-corrected visual acuity (BCVA) improved from 0.38 decimal to 0.73 decimal. In the ISG (110 eyes), the single operation success rate was 93.6%, and the final success rate was 100.0%. The mean BCVA improved from 0.33 decimal to 0.74 decimal. The differences between groups were not statistically significant. There was no difference in complication rates between groups.Conclusions: A 25 g PPV with gas tamponade for uncomplicated RRD renders excellent functional and anatomical results even when performed by an inexperienced surgeon. The complication rate was comparable between experienced and inexperienced surgeons.

scholarly journals 25-gauge vitrectomy with gas tamponade for rhegmatogenous retinal detachment: experienced vs. inexperienced surgeons

2020 ◽  
Author(s):  
Martin Pencak ◽  
Miroslav Veith ◽  
Zbynek Stranak ◽  
Jakub Dite ◽  
Jana Vranova ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Success Rate ◽  
Rhegmatogenous Retinal Detachment ◽  
Case Series ◽  
Functional Results ◽  
Complication Rates ◽  
Gas Tamponade ◽  
Single Operation ◽  
Case Series Study ◽  
The Difference

Abstract Introduction: To compare the results and complication rates of a 25-gauge pars plana vitrectomy (PPV) with gas tamponade for rhegmatogenous retinal detachment (RRD) between experienced and inexperienced surgeons.Materials and Methods: This is a retrospective comparative consecutive case series study of patients with uncomplicated RRD treated with 25g PPV with gas tamponade. Patients were divided into 2 groups: In experienced surgeon group (ESG) the procedure was performed by an experienced vitreoretinal surgeon and in inexperienced surgeon group (ISG) the procedure was performed by 2 inexperienced surgeons. Anatomical and functional results and complication rates were compared between the two groups.Results: 216 eyes were included in the study. In the ESG (106 eyes), the single operation success rate was 94.3%, and the final success rate was 100%. In the ISG (110 eyes), the single operation success rate was 93.6%, and the final success rate was 100.0%. The difference in single surgery success rate between groups was not statistically significant (P = 0.828). The mean postoperative BCVA improvement was 0.348 decimal in ESG and 0.405 decimal in ISG (P = 0.234). The difference in complication rates between groups was not significant.Conclusions: A 25g PPV with gas tamponade for treatment of RRD yields excellent anatomical results and improvement in BCVA. With good technique and use of modern vitrectomy machines and instruments, even inexperienced surgeons can achieve high single operation success rate, suggesting a short learning curve. The complication rate is comparable between experienced and inexperienced surgeons.

scholarly journals Drain Fluid Cryo-Explant Technique for Treatment of Superior Bullous Rhegmatogenous Retinal Detachment

2019 ◽  
Author(s):  
Kamal Solaiman ◽  
Mahmoud A Alaswad ◽  
Ashraf Mahrous ◽  
Khaled Salah ◽  
Hesham A Enany ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Case Series ◽  
Subretinal Fluid ◽  
Secondary Outcome ◽  
Retinal Break ◽  
Retinal Breaks ◽  
Case Series Study ◽  
Drain Fluid ◽  
The Mean

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).

Application of Proximal Lateral Leg Perforator Flaps for Head and Neck Reconstructions

2014 ◽  
Vol 151 (5) ◽  
pp. 791-796 ◽  
Author(s):  
Honda Hsu ◽  
Peir-Rong Chen ◽  
Sou-Hsin Chien ◽  
Jiunn-Tat Lee
Keyword(s):  
Head And Neck ◽  
Donor Site ◽  
Tertiary Care ◽  
Case Series ◽  
Functional Results ◽  
Donor Site Morbidity ◽  
Head And Neck Reconstruction ◽  
Complication Rates ◽  
Recipient Site ◽  
The Mean

Objective Analyze the reliability, complications, and donor site morbidity of the proximal lateral leg flap when applied to head and neck reconstruction. Study Design Case series and chart review. Setting Tertiary care teaching hospital. Subjects and Methods Nineteen patients who underwent reconstruction of various head and neck defects with this flap were analyzed. The patient demographics, flap characteristics, method of donor site closure, scars of the donor area, complication rates, as well as functional results at the recipient site were assessed. Results The flap size ranged from 4 × 4 cm to 11 × 8 cm. Vascular pedicle length ranged from 5 to 9 cm. The mean distance of the perforator from the fibula head was 9.2 cm. The mean thickness of this flap was 5.5 mm. All the donor wounds were closed primarily. The flap survival rate was 100%. Conclusion This flap has the advantages of thinness, short harvesting time, minimal donor site morbidity, and primary closure at the donor site when the flap width is less than 6 cm. This flap may be useful for reconstruction in selected patients with small and thin heads and neck defects.

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.

Anatomical and functional outcomes of surgery of rhegmatogenous retinal detachment

1970 ◽  
Vol 2 (2) ◽  
pp. 132-137 ◽  
Author(s):  
H Sharma ◽  
SN Joshi ◽  
JK Shrestha
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Success Rate ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Case Series ◽  
Scleral Buckling ◽  
Pars Plana ◽  
A Prospective Study ◽  
Physiological Outcome

Introduction: Rhegmatogenous retinal detachment (RRD) is a potentially blinding condition. Objective: To evaluate the anatomical and functional outcome of surgery of RRD. Materials and methods: A prospective study of interventional case series was designed including 50 consecutive patients with RRD in a tertiary level eye center in Kathmandu. The patients underwent scleral buckling (SB) or pars plana vitrectomy (PPV) according to the proliferative vitreo-retinopathy (PVR) changes. All the patients had at least 3 months of follow-up. The anatomical and physiological outcome measures were primary retinal reattachment and improvement in visual acuity respectively. The surgery was considered successful when there was attachment of retina after the first surgery. Results: The mean age of these patients at the time of presentation was 46.24 ± 19.82 years. Of 50, sixty-six percent of the patients underwent SB and 34 % underwent PPV. Primary surgical success rate was 88 %. While comparing the initial best corrected visual acuity (BCVA) with the final, 72% had an improvement, 12 % unchanged and 16 % had a deteriorated visual acuity. Conclusion: The visual acuity improves and the anatomical success rate is high in the majority of the patients after surgery for rhegmatogenous retinal detachment. Keywords: rhegmatogenous retinal detachment; scleral buckling; pars plana vitrectomy; anatomical outcome; physiological outcome DOI: 10.3126/nepjoph.v2i2.3720 Nep J Oph 2010;2(2) 132-137

scholarly journals Exclusive Use of Air as Gas Tamponade in Rhegmatogenous Retinal Detachment

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Kang Yeun Pak ◽  
Seok Jae Lee ◽  
Han Jo Kwon ◽  
Sung Who Park ◽  
Ik Soo Byon ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Primary Outcome ◽  
Rhegmatogenous Retinal Detachment ◽  
Case Series ◽  
Subretinal Fluid ◽  
Control Group ◽  
Gas Tamponade ◽  
Corrected Visual Acuity ◽  
Significant Difference ◽  
Air Tamponade

Purpose. To investigate outcomes of vitrectomy for rhegmatogenous retinal detachment (RRD) using air exclusively as the gas tamponade. Methods. This retrospective, interventional, consecutive case series involved reviewing medical records of patients that underwent vitrectomy and gas tamponade for RRD between January 2013 and December 2015. Patients whose eyes were treated exclusively with air tamponade since July 2014 were assigned to the air group, while those treated with heterogeneous gas agents before June 2014 were assigned to the control group. The primary outcome was the primary reattachment rate. Best-corrected visual acuity (BCVA) and duration to detect redetachments were assigned as the secondary outcomes. Results. The air group and the control group included 71 and 72 eyes, respectively. The primary reattachment rate was 94.4% in the air group and there was no significant difference with 94.4% in the control group (p=0.951). BCVA was significantly better in the air group at 1 month (p=0.021) but not at 3 months postoperatively (p=0.561). Redetachments were recognized earlier in the air group (9.3 ± 0.5 days) compared with those in the control group (21.3 ± 7.4 days) (p=0.041). Conclusions. In cases of simple RRD with sufficient removal of subretinal fluid, air could be considered for use as gas tamponade. This trial is registered with KCT0002358.

scholarly journals EFFECTIVITY OF PNEUMATIC RETINOPEXY PROCEDURE IN PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT (RRD

2020 ◽  
Vol 3 (2) ◽  
Author(s):  
Soefiandi Soedarman ◽  
Soedarman Sjamsoe ◽  
Waldensius Girsang ◽  
Elvioza Elvioza ◽  
Referano Agustiawan ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Secondary Procedure ◽  
Pneumatic Retinopexy ◽  
Silicon Oil ◽  
Single Procedure ◽  
Corrected Visual Acuity ◽  
Single Operation ◽  
Initial Procedure ◽  
The Mean

Aim : To evaluate the effectiveness of pneumatic retinopexy (PR) for repair of primary rhegmatogenous retinal detachment (RRD) with respect to single operation success (SOS) and best corrected visual acuity (BCVA). Method : This retrospective review comprised 8 eyes with primary rhegmatogenous retinal detachment with superior break that undergone pneumatic retinopexy as the initial procedure between 2009-2014 at Jakarta Eye Center, Indonesia. Result : The mean age of subjects was 49 ± 14.35 years. Four subjects (50%) had Single operation had only done success after 6 months of observation. The eyes that failed single procedure underwent vitrectomy and silicon oil tamponade.  Subjects that only done single procedure had better BCVA (0.01 ± 1,3 logMAR) compare to subjects that done secondary procedure (0.3 ± 0.42 logMAR) after 6 months of observation. Conclusion : Pneumatic retinopexy is still an effective procedure for primary rhegmatogenous retinal detachment with superior breaks although in our study the single operation success was 50%.

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

2017 ◽  
Vol 46 (1) ◽  
pp. 316-325 ◽  
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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