Retrospective analysis of the results of episcleral filling in the surgical treatment of primary rhegmatogenous retinal detachment

2021 ◽  
pp. 171-174
Author(s):  
A.V. Tereshchenko ◽  
◽  
N.N. Yudina ◽  
Y.A. Sidorova ◽  
O.S. Kulikov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Retinal Detachment ◽  
Key Words ◽  
Retrospective Analysis ◽  
Rhegmatogenous Retinal Detachment ◽  
Vitreoretinal Surgery ◽  
State Institution ◽  
Federal State

Purpose – to conduct a retrospective analysis of the results of episcleral filling in the surgical treatment of primary rhegmatogenous retinal detachment. Material and methods. Patients diagnosed with rhegmatogenous retinal detachment whom were undergone episcleral filling from 2015 to 2020 at the S. Fyodorov Eye Microsurgery Federal State Institution, the Kaluga Branch, were performed to a detailed retrospective analysis. Additionally, cases were analyzed when, after episcleral filling, the retina did not attach and later vitreoretinal surgery was performed. Results. Episcleral surgery was performed to the 486 eyes, repeated interventions were required to 126 eyes (26%). The presence of peripheral chorioretinal dystrophy of the retina (PCHDR) in paired eyes was found in only 45% of patients. In these patients’ retinal attachment was achieved with only one episcleral filling. In cases of lack of retinal attachment after episcleral surgery, the proportion of the presence of PCHDR in the paired eye was 84%. The superior and temporal segments were the most frequent places of localization of retinal rupture. At the same time, there were retinal ruptures in the upper segment in 30% of patients. The proportion of rupture in the external segment was 32%. The retinal rupture was localized in the upper external segment at 18% of cases. At 20% of cases, retinal ruptures were localized in the lower external and lower segments. Conclusion. The success of episcleral surgery depends on the thoroughness of the diagnosis, the detection of all existing retinal ruptures and their blocking during the surgical treatment. Key words: rhegmatogenous retinal detachment, episcleral filling, intravitreal surgery.

Rhegmatogenous Retinal Detachment in Children

2020 ◽  
pp. 29-35
Author(s):  
O.V. Diskalenko ◽  
◽  
O.A. Konikova ◽  
V.V. Brzheskiy ◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Retinal Detachment ◽  
Treatment Efficacy ◽  
Rhegmatogenous Retinal Detachment ◽  
Clinical Course ◽  
Vitreoretinal Surgery ◽  
Scleral Buckling ◽  
Stickler Syndrome ◽  
Pediatric Practice

Purpose. To study the etiological structure of rhegmatogenous retinal detachment, the efficacy and outcomes of its surgical treatment in pediatric practice. Material and Methods. A retrospective series of cases in one vitreoretinal center in 2015–2019 was presented. The age of the children with rhegmatogenous retinal detachment (57 patients / 66 eyes) was from 0 to 18. Surgical treatment included vitreoretinal and scleral buckling techniques. Results. Rhegmatogenous retinal detachment in 30.3% of cases developed against the background of ROP, in 24.2% – against the background of Stickler‘s syndrome, in 12.1% – against the background of myopia, in 12.1% – against the background of trauma, and in 21.3 % – against the background of other reasons. On average, the anatomical treatment efficacy was 77.4%. The leading factors of an unfavorable outcome of treatment were the duration of presence of retinal detachment (OR 21.44; CI 3.76– 122.16) and 3–5 stages ROP (OR 2.56; CI 0.76–8.44). Visual acuity exceeding the blindness threshold (Vis > 0.02) was maintained or achieved in 72% of cases. Conclusions. The specificity of the clinical course and adherence to surgical treatment of children with rhegmatogenous retinal detachment is determined by its etiology. Key words: retinal detachment in children, Stickler syndrome, retinopathy of prematurity, scleral buckling, vitreoretinal surgery.

Extrascleral Filling Using Endoillumination the First Experiencethe

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.

scholarly journals Effect of COVID-19-related lockdown on ophthalmic practice in Italy: A report from 39 institutional centers

2021 ◽  
pp. 112067212110024
Author(s):  
Roberto dell’Omo ◽  
Mariaelena Filippelli ◽  
Gianni Virgili ◽  
Francesco Bandello ◽  
Giuseppe Querques ◽  
...  
Keyword(s):  
Quantitative Analysis ◽  
Retinal Detachment ◽  
Retrospective Analysis ◽  
Surgical Procedures ◽  
Public Transportation ◽  
Rhegmatogenous Retinal Detachment ◽  
Intravitreal Injections ◽  
P Value ◽  
Academic Hospitals ◽  
Rate Ratios

Background/objectives: To compare the number of eye surgical procedures performed in Italy in the 2 months following the beginning of lockdown (study period) because of COVID-19 epidemic with those performed in the two earlier months of the same year (intra-year control) and in the period of 2019 corresponding to the lockdown (inter-year control). Methods: Retrospective analysis of surgical procedures carried out at 39 Academic hospitals. A distinction was made between elective and urgent procedures. Intravitreal injections were also considered. Percentages for all surgical procedures and incidence rate ratios (IRR) for rhegmatogenous retinal detachment (RRD) events were calculated. A p value <0.05 was considered significant. Results: A total of 20,886 versus 55,259 and 56,640 patients underwent surgery during the lockdown versus intra-and inter-year control periods, respectively. During the lockdown, only 70% of patients for whom an operation/intravitreal injection was recommended, finally underwent surgery; the remaining patients did not attend because afraid of getting infected at the hospital (23%), taking public transportation (6.5%), or unavailable swabs (0.5%). Elective surgeries were reduced by 96.2% and 96.4%, urgent surgeries by 49.7% and 50.2%, and intravitreal injections by 48.5% and 48.6% in the lockdown period in comparison to intra-year and inter-year control periods, respectively. IRRs for RRDs during lockdown dropped significantly in comparison with intra- and inter-year control periods (CI: 0.65–0.80 and 0.61–0.75, respectively, p < 0.001 for both). Conclusion: This study provides a quantitative analysis of the reduction of eye surgical procedures performed in Italy because of the COVID-19 epidemic.

The urgency of surgical treatment for rhegmatogenous retinal detachment

2021 ◽  
Author(s):  
Nicolas Feltgen ◽  
Josep Callizo ◽  
Lars-Olof Hattenbach ◽  
Hans Hoerauf
Keyword(s):  
Surgical Treatment ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment

Postoperative endophthalmitis

2021 ◽  
pp. 185-187
Author(s):  
I.A. Frolychev ◽  
◽  
N.A. Pozdeyeva ◽  
◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Silicone Oil ◽  
Angiogenesis Inhibitor ◽  
Cataract Extraction ◽  
State Institution ◽  
Federal State ◽  
Postoperative Endophthalmitis ◽  
Ophthalmic Surgery ◽  
Corrected Visual Acuity

Surgical treatment of postoperative endophthalmitis is an urgent problem of ophthalmic surgery. Purpose.The aim of the study was to analyze the results of treatment of patients with postoperative endophthalmitis using perfluorodecalin and antibiotic solutions for vitreal cavity tamponade. Materials and methods. For the period 2016-2020, 35 patients (35 eyes) were operated in the Cheboksary branch of the S. Fyodorov Eye Microsurgery Federal State Institution. In 26 patients, this complication occurred after cataract extraction, in 7 after vitreoretinal operations, in 2 after intravitreal administration of an angiogenesis inhibitor. Visual acuity before treatment of endophthalmitis in 3 patients was to 0.02– 0.08, in 16 – counting of fingers in the face, in 13 – pr.l.certa, in 3-pr. l. incerta. All patients underwent vitrectomy with perfluorodecalin tamponade of the vitreal cavity for up to 14 days and intravitreal administration of vancomycin 1 mg and ceftazidime 2.25 mg at the end of the operation. On day 2-3, all patients underwent additional intravitreal administration of antibiotics, depending on the detected pathogen. Further, in 22 patients, the removal of perfluorodecalin and the remaining preretinal and peripherally located exudate was performed, in 13 patients - tamponade of the vitreal cavity with silicone oil. Results. As a result of the treatment according to the developed method, it was possible to preserve visual functions in 32 patients (91%) out of 35. At discharge, the corrected visual acuity was from 0.1 to 0.7 (0.28±0.2). After 6 months, the corrected visual acuity in 32 patients was from 0.1 to 0.9 (0.36±0.2). Visual acuity (above 0.3) was achieved in 26 cases (74.3%). Conclusion. Clinical results demonstrate the effectiveness of the developed method of surgical treatment of endophthalmitis. Key words: postoperative endophthalmitis, perfluorodecalin, intravitreal administration of vancomycin and ceftazidime.

Experience in surgical treatment of idiopathic macular ruptures in Orenburg branch of The S. Fyodorov Eye Microsurgery Federal State Institution

2021 ◽  
pp. 97-100
Author(s):  
A.S. Firsov ◽  
◽  
A.D. Chuprov ◽  
V.A. Trubnikov ◽  
A.E. Voronina ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Silicone Oil ◽  
Platelet Rich Plasma ◽  
Functional Results ◽  
State Institution ◽  
Federal State ◽  
Rate Of Increase ◽  
Surgical Methods ◽  
Medical Effectiveness ◽  
Group 5

Purpose. To study the anatomical and functional results of various methods of surgical treatment of idiopathic macular rupture. Material and methods. In the course of this study, 50 medical records of patients with a diagnosis of macular rupture were randomly selected from the total number of those, who underwent the surgery at the Orenburg branch of The S. Fyodorov Eye Microsurgery Federal State Institution for 2020 year. Patients were divided into 3 groups. In the first group (38 eyes), the macular rupture was closed using ACP and PRP, in the second group (7 eyes) – using an inverted flap of the internal border membrane, in the third group (5 eyes) – by mechanical convergence of the edges of the rupture followed by tamponade of the vitreous cavity with silicone oil. Results. To assess the medical efficiency of the studied methods of surgical treatment of idiopathic macular rupture, the rate of increase in the maximum corrected visual acuity (MCVA) was calculated for each patient. Conclusion. The calculated indicator of the dynamics of vision improvement «the rate of BCVA growth» as a whole reflects the positive dynamics of the treatment of idiopathic macular rupture by surgical methods and can be used to assess the medical effectiveness of methods of treating patients with eye diseases initially with different values of the BCVA parameter. In the course of the analysis, no significant differences were found between the influence of various methods of surgical treatment of macular rupture on the rate of BCVA growth or rupture closure. Correlation analysis did not establish a statistically significant dependence of the growth rate of BCVA on the initial size of the rupture. Key words: macular rupture, inverted flap, platelet-rich plasma (PRP), autologous conditioned plasma (ACP).

Primary Vitrectomy Surgery in Rhegmatogenous Retinal Detachment; Indications and Techniques

2019 ◽  
pp. 197-200
Keyword(s):  
Retinal Detachment ◽  
Visual Loss ◽  
Rhegmatogenous Retinal Detachment ◽  
Vitreoretinal Surgery ◽  
Scleral Buckling ◽  
Primary Vitrectomy ◽  
Advantages And Disadvantages ◽  
Instruments And Techniques ◽  
Vitrectomy Surgery ◽  
State Of Art

Retinal detachment is one of the most important causes of visual loss. Scleral buckling, pneumatic retinopexy, or primary vitrectomy techniques are the state of art treatment approaches for retinal detachment. Novel improvements in instruments and techniques of vitreoretinal surgery have led primary vitrectomy to be more preferable for retinal detachment surgery. Performing primary vitrectomy in selected patients, considering the advantages and disadvantages has a significant impact in terms of prognosis.

Properties of Gases Used in Vitrectomy Surgery in Rhegmatogenous Retinal Detachment

2019 ◽  
pp. 172-175
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Visual Loss ◽  
Rhegmatogenous Retinal Detachment ◽  
Vitreoretinal Surgery ◽  
Scleral Buckle ◽  
Pneumatic Retinopexy ◽  
The World ◽  
Pars Plana ◽  
Vitrectomy Surgery

Despite improvements in vitreoretinal surgery techniques, rhegmatogenous retinal detachment is still one of the major causes of visual loss in the world. Pneumatic retinopexy (PR), scleral buckle, and pars plana vitrectomy (PPV) are the modalities that are used in the treatment of retinal detachment. Intraocular gases, which are frequently used in PR and PPV, are indispensable molecules due to their tamponade effects. In order to get favorable postoperative outcomes, the proper type of gas selection should be made by considering the properties of the gases, indications, potential complications, and findings of the patients together.

Iatrogenic Subretinal Triamcinolone During Primary Surgical Repair of a Retinal Detachment With a Giant Retinal Tear

2020 ◽  
pp. 247412642097455
Author(s):  
Kunyong Xu ◽  
Eric K. Chin ◽  
David R.P. Almeida
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Surgical Repair ◽  
Vitreoretinal Surgery ◽  
Subretinal Space ◽  
Perfluorocarbon Liquid ◽  
Retinal Tear ◽  
Giant Retinal Tear ◽  
Mechanical Removal ◽  
Pars Plana

Purpose: We describe the outcome of a 23-year-old man undergoing vitreoretinal surgery for a macula-off rhegmatogenous retinal detachment secondary to a giant retinal tear. Methods: Patient underwent combined 25- gauge 3-port pars plana vitrectomy with scleral buckle, perfluorocarbon liquid, and perfluoropropane gas tamponade. During surgery, triamcinolone inadvertently entered the subretinal space and was retained. Results: The subretinal triamcinolone deposits spontaneously absorbed over a 2-month period. No adverse sequelae were associated with this complication. Conclusion: This may support avoiding aggressive mechanical removal of iatrogenic subretinal triamcinolone in the context of retinal detachment repair.

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