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

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

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Tomoaki Tatsumi ◽  
Takayuki Baba ◽  
Takehito Iwase ◽  
Tomohiro Nizawa ◽  
Gen Miura ◽  
...  

Purpose. To investigate the outcomes of pars plana vitrectomy (PPV) combined with scleral buckling (SB) in treating eyes with an early recurrent rhegmatogenous retinal detachment (rRRD). Methods. This was a retrospective, interventional case series of 21 eyes with an early rRRD treated by PPV combined with SB. The significance of the associations between the variants before the surgeries and the final best-corrected visual acuity (BCVA) was determined. Results. The average age of the patients was 61.0 ± 9.6 years. A retinal reattachment was observed in 20 of 21 eyes (95.2%) after a single reoperation. The BCVA was 0.91 ± 0.90 logMAR units before the initial surgery and 0.94 ± 0.94 logMAR units before the reoperations, and it improved significantly to 0.49 ± 0.50 logMAR units after the reoperation ( P  = 0.016, P  = 0.002, respectively). The preoperative BCVA was significantly correlated with the final BCVA ( P  = 0.043, r = 0.445 before the primary surgery; P  < 0.001, r = 0.885 before reoperation). Conclusions. The reattachment of an early recurrent retinal detachment by PPV with SB is effective.


2007 ◽  
Vol 17 (4) ◽  
pp. 677-679 ◽  
Author(s):  
M.N. Demir ◽  
N. Ünlü ◽  
Z. Yalniz ◽  
M.A. Acar ◽  
F. Örnek

Purpose To report case of retinitis pigmentosa in association with rhegmatogenous retinal detachment. Methods An eight year old boy complained of a sudden visual loss. The patient had night blindness, bone spicule-like hyperpigmentation, pale optic disc in both eyes, and the retina was totally detached in the right eye. Results He was initially treated with conventional scleral buckling surgery, then pars plana vitrectomy with silicone tamponade was performed and retinal reattachment was established. After the phacoemulsification combined with silicone oil removal the final visual acuity of counting fingers was obtained. Conclusions The association of retinitis pigmentosa and rhegmatogenous retinal detachment is uncommon in young patients.


2013 ◽  
Vol 06 (02) ◽  
pp. 135 ◽  
Author(s):  
Eric W Schneider ◽  
Mark W Johnson ◽  
◽  

With the development of pars plana vitrectomy in the 1970s and pneumatic retinopexy in the 1980s, the primacy of scleral buckling for repair of rhegmatogenous retinal detachment (RRD) came under challenge. While a degree of consensus exists for certain forms of complex RRD, there remains little agreement concerning the optimal treatment of primary noncomplex RRD. This debate is further muddied by application of adjuvant procedures to supplement the primary surgical approach. This article aims to present the current evidence regarding repair of primary noncomplex RRD. A brief summary of primary surgical approaches—pneumatic retinopexy, scleral buckling, and pars plana vitrectomy—will be presented along with a short discussion on potential adjuvant procedures. The remainder of the article focuses on reported outcomes for the different treatment modalities for primary noncomplex RRD.


2013 ◽  
Vol 72 (2) ◽  
pp. 95-98 ◽  
Author(s):  
Alexandre Achille Grandinetti ◽  
Janaína Dias ◽  
Ana Carolina Trautwein ◽  
Natasha Iskorostenski ◽  
Luciane Moreira ◽  
...  

Author(s):  
Matthew R. Starr ◽  
Edwin H. Ryan ◽  
Anthony Obeid ◽  
Claire Ryan ◽  
Xinxiao Gao ◽  
...  

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.


2020 ◽  
Author(s):  
Yan Fu ◽  
Yue-ling Zhang ◽  
Zhaohui Gu ◽  
Ren-Fei Geng ◽  
Xin-Yu Yuan

Abstract Background The recurrence of retinal detachment (RD) following rhegmatogenous retinal detachment (RRD) is a relatively common complication that threatens vision and needs further surgery. The purpose of this study is to investigate the risk factors and visual outcomes of recurrent RD following pars plana vitrectomy (PPV) for primary RRD.Methods This was a retrospective follow-up of 343 eyes that underwent initial PPV surgery for primary RRD. Patients were divided into a recurrence group and a reattachment group. The main outcome measures included the causative factors, visual outcomes of RD recurrence, and the perioperative factors most affecting the recurrence of RD.Results After retinal reattachment, we observed recurrence of RD after PPV for primary RRD in 42 out of 343 eyes (12.2%) during the follow-up period. Most recurrence (69%) occurred within 6 months after surgery. Univariate analysis showed that the primary risk factor significantly associated with recurrent RD was the presence of proliferative vitreoretinopathy (PVR) ≥ Grade C ( P = 0.003). Logistic regression analysis showed that a PVR ≥ Grade C (odds ration [OR]: 9.421, 95% confidence interval [CI]: 2.432 - 56.39; P =0.020) was a significant predictor for the development of recurrent RD. The recurrence of RD resulted in a significant decline in best-corrected visual acuity (BCVA) at the last follow-up visit compared with the reattachment group ( P =0.000). Eyes with PVR prior to primary surgery or at the diagnosis of re-detachment showed a worse final BCVA.Conclusions The presence of PVR ≥ Grade C was the predominant risk factor for the recurrence of RD. PVR prior to primary surgery, or at the diagnosis of re-detachment, limited the recovery of final visual acuity.


2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Yasser Helmy Mohamed ◽  
Kozue Ono ◽  
Hirofumi Kinoshita ◽  
Masafumi Uematsu ◽  
Eiko Tsuiki ◽  
...  

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%.


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