New therapeutic opportunities for increase functional results of endovitreal surgery of rheumatogenic retinal detachment

Aim: To assess long-term anatomic and functional outcomes of early lens-sparing vitrectomy (LSV) for stage 4A retinopathy of prematurity (ROP) in infants with aggressive-posterior ROP (AP-ROP) which progressed to retinal detachment despite laser treatment. Methods: Chart review of infants who underwent early 25-gage LSV for stage 4A ROP. Outcomes were anatomic success, mean visual acuity (VA), development of postoperative complications, and refractive changes. Follow-up examinations were performed at 1, 3, 6, 12, and then every 6 months. Results: Ten eyes of seven preterm infants who underwent LSV were included. Mean follow-up was 36 ± 13.4 months and mean postmenstrual age (PMA) at last follow-up was 37 ± 13.7 months. Mean gestational age (GA) and weight at birth was 26 ± 1.4 weeks and 639 ± 180 g. Two eyes had vitreous hemorrhage 4 and 14 days after surgery, respectively. At last follow-up anatomic success was 100%, mean VA was 20/80 and eight eyes (80%) had high myopic refractive correction (mean spherical equivalent –11.25 D). Conclusion: Early LSV for stage 4A ROP with AP-ROP and progression to retinal detachment is efficacious in terms of anatomic and functional outcomes. Anatomic success is associated with visual improvement despite possible myopic refraction changes during follow-up.

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

10.21203/rs.3.rs-53301/v2 ◽

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.

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The role of pars plana vitrectomy in the management of fungal endogenous endophthalmitis

European Journal of Ophthalmology ◽

10.1177/1120672118815105 ◽

2018 ◽

Vol 30 (1) ◽

pp. 88-93 ◽

Cited By ~ 2

Author(s):

Hande Celiker ◽

Haluk Kazokoglu

Keyword(s):

Retinal Detachment ◽

Pars Plana Vitrectomy ◽

Functional Results ◽

Endogenous Endophthalmitis ◽

Causative Microorganism ◽

Clinical Presentations ◽

Phthisis Bulbi ◽

Pars Plana ◽

Treatment Of Infection

Purpose: To identify the causative microorganism of fungal endogenous endophthalmitis in our tertiary referral uveitis center and review the therapeutic role of pars plana vitrectomy in patients with fungal endogenous endophthalmitis. Methods: Seven eyes of six cases were identified as fungal endogenous endophthalmitis through positive cultures of ocular fluids and clinical presentations. The final anatomical and functional results were evaluated. Results: Four women (66.7%) and two men (33.3%) underwent vitrectomy. Control of infection was achieved early on in all cases. Candida (71.4%) and Aspergillus (28.6%) species were identified as causative fungi in patients with fungal endogenous endophthalmitis. Two patients were reoperated due to reinfection and retinal detachment, respectively. Visual acuity improved in six eyes (85.7%) and worsened in one eye (14.3%). At the final examination, the retina was flat in all cases. No eye developed phthisis bulbi. Conclusion: Candida species are the most common causative organisms of fungal endogenous endophthalmitis in this study. Pars plana vitrectomy in fungal endogenous endophthalmitis may enhance the treatment of infection by removing fungal elements in the vitreous and aid in diagnosis. Vitrectomy may also be an important tool in the management of vision-threatening post-infectious sequelae such as retinal detachment and reinfections.

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Prognostic Factor Analysis of Visual Outcome after Vitrectomy for Rhegmatogenous Retinal Detachment

Journal of Clinical Medicine ◽

10.3390/jcm9103251 ◽

2020 ◽

Vol 9 (10) ◽

pp. 3251

Author(s):

Polona Zaletel Benda ◽

Bor Vratanar ◽

Goran Petrovski ◽

Ana Uršula Gavrić ◽

Katja Matović ◽

...

Keyword(s):

Retinal Detachment ◽

Rhegmatogenous Retinal Detachment ◽

Visual Outcome ◽

Functional Results ◽

Significant Negative Correlation ◽

Swept Source ◽

Duration Of Symptoms ◽

Swept Source Oct ◽

The Impact ◽

Preoperative Factors

Pars plana vitrectomy (PPV) is a surgical approach mainly chosen for complex rhegmatogenous retinal detachment (RRD) repair with highly variable functional results. The aim of this analysis was to evaluate the impact of preoperative factors and postoperative optical coherence tomography (OCT) macular findings on the functional outcome of patients undergoing primary PPV for RRD. A retrospective analysis was performed on 88 eyes of 88 patients with complex RRD managed by PPV. A swept source OCT was used to obtain images at the postoperative visit at least 6 months after PPV. Hierarchical linear regression model was used to evaluate the influence of preoperative factors related to patient, ocular clinical and postoperative OCT macular findings on functional outcomes of PPV for RRD. Duration of symptoms (p = 0.031) and discontinuity of the ellipsoid zone (EZ) on OCT (p = 0.024) showed statistically significant negative correlation, while preoperative best-corrected visual acuity (BCVA; p < 0.001) showed statistically significant positive correlation to postoperative BCVA. Preoperative BCVA and duration of symptoms can be used as prognostic factors for visual outcome in patients undergoing PPV for RRD. Discontinuity of the EZ was the only postoperative OCT variable related to worse postoperative visual outcome.

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On functional results of treatment of recurrent rhegmatogenous retinal detachment after multiple endovitreal interventions

Ophthalmology journal ◽

10.17816/ov201925-10 ◽

2019 ◽

Vol 12 (2) ◽

pp. 5-10

Author(s):

Andrei D. Shchukin

Keyword(s):

Retinal Detachment ◽

Rhegmatogenous Retinal Detachment ◽

Present Report ◽

Vitreoretinal Surgery ◽

Functional Results ◽

Scleral Buckling ◽

City Hospital ◽

Results Of Treatment ◽

The City ◽

Retinal Photocoagulation

The present report is an extension of the study, in which on a large clinical material, the ratio of procedures used at this time for retinal detachment was shown, and the frequency of relapses after extrascleral and endovitreal surgeries was analyzed. The purpose of the study is to determine the terms of relapse occurrence, and to estimate visual function after multiple endovitreal procedures. Materials and methods. The study was carried out in the Ophthalmological Center of the City Hospital No. 2 of St. Petersburg. The data of 116 case histories of 23 patients (28 eyes) repeatedly admitted to the department of vitreoretinal surgery of the center and operated (2 to 7 times) for recurrent rhematogenous retinal detachment in 2015-2016 were analyzed. Results. Multistage endovitreal surgery in patients with recurrent retinal detachment in most cases (78.6%) leads to significant decrease of visual functions; in incomplete retinal adherence in the lower segments after extrascleral surgery, additional scleral buckling or barrier laser retinal photocoagulation can be used.

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Optical coherence tomography can be used in evaluation of morphological and functional results after successful rhegmatogenous retinal detachment surgery with different tamponade agents

Ophthalmology journal ◽

10.17816/ov201515-11 ◽

2015 ◽

Vol 8 (1) ◽

pp. 5-11

Author(s):

Tat'yana Andreevna Avanesova

Keyword(s):

Optical Coherence Tomography ◽

Retinal Detachment ◽

Rhegmatogenous Retinal Detachment ◽

Silicone Oil ◽

Strong Association ◽

Functional Results ◽

Optical Coherence ◽

Retinal Detachment Surgery ◽

Group I ◽

Group Ii

Background: Optical coherence tomography (OCT) findings are helpful in assessing the cause of reduced visual acuity (VA) after successful rhegmatogenous retinal detachment (RRD) surgery. Objective: To study anatomical and functional results after successful RRD surgery with gas-air mixture or silicone oil (SO) tamponade using OCT. Materials and methods. 70 patients were divided into 2 groups: group I (n = 34) - gas-air mixture tamponade; group II (n = 36) - SO tamponade. At baseline, were no significant differences by gender, age and VA between the groups. Follow-up was 12 months after the surgery. OCT was performed with the Cirrus HD-OCT 4000, CARL ZEISS MEDITEC, USA. Results: VA increased significantly in both groups. Regression analysis showed lower VA in group II and statistically significant association between VA and IS/OS and ELM defects. Сonclusions. There is a strong association of disruption of the IS/OS and ELM with reduced vision after successful retinal detachment surgery. Gas-air mixture tamponade showed some benefits in comparison with SO tamponade.

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Surgical treatment of retinal detachment with inferior break using combined gas-air tamponade with viscoelastic

Fyodorov journal of ophthalmic surgery ◽

10.25276/0235-4160-2021-4-52-56 ◽

2021 ◽

pp. 52-56

Author(s):

I.M. Gorshkov ◽

◽

D.O. Shkvorchenko ◽

A.V. Yukhananova ◽

A.A. Shpak ◽

...

Keyword(s):

Intraocular Pressure ◽

Surgical Treatment ◽

Retinal Detachment ◽

Rhegmatogenous Retinal Detachment ◽

Clinical Observation ◽

Sodium Hyaluronate ◽

Functional Results ◽

Air Tamponade ◽

New Surgical Technique

Surgical treatment of rhegmatogenous retinal detachment with an inferior break remains a challenge for ophthalmic surgeons. When using silicone tamponade, complications can develop, such as increased intraocular pressure and emulsification of silicone. In recent years, tamponade of the vitreous cavity with a gas-air mixture has been actively used, however, not all patients can observe the forced position face down, and the tamponade itself is not long-term. Purpose. The authors proposed a method for the treatment of rhegmatogenous retinal detachment with an inferior break using a combined tamponade with a gas-air mixture and viscoelastic based on sodium hyaluronate. Material and methods. A clinical observation of a patient successfully operated on with the use of the specified combined tamponade is presented. A detailed description of a new surgical technique is presented, which allows achieving a higher anatomical and functional results. Conclusion. To confirm the effectiveness and safety of the proposed method, further studies on a group of patients are needed. Key words: rhegmatogenous retinal detachment, inferior break, gas-air tamponade, tamponade with viscoelastic, sodium hyalur onate

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Successful Surgical Treatment of Traumatic Macular Hole With Total Rhegmatogenous Retinal Detachment in a Child- a Case Report

10.21203/rs.3.rs-506882/v1 ◽

2021 ◽

Author(s):

Sławomir Cisiecki ◽

Karolina Boninska ◽

Maciej Bednarski

Keyword(s):

Retinal Detachment ◽

Macular Hole ◽

Rhegmatogenous Retinal Detachment ◽

Functional Results ◽

Scleral Buckling ◽

Case Presentation ◽

Hand Motion ◽

Silicon Oil ◽

Flap Technique ◽

Morphologic Characteristics

Abstract Background: To investigate the surgical results and morphologic characteristics of pediatric traumatic macular hole with total rhegmatogenous retinal detachment.Case presentation: The 4-year-old-male patient underwent scleral buckling surgery combined with vitrectomy with the inverted ILM flap technique and silicon oil tamponade for five months. Complete ophthalmic examination was performed preoperatively and 7 days, 1, 3, 6, 9 and 12 months after surgery. Successful retinal reattachment was achieved and the macular hole was successfully closed. Visual acuity improved from Hand Motion at the initial visit to 20/80 (0.6 LogMAR) postoperatively.Conclusions: Scleral buckling surgery and vitrectomy with the inverted ILM flap technique appeared to give effective anatomical and functional results in this case.

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