scholarly journals Preoperative, Intraoperative and Postoperative Corticosteroid Use as an Adjunctive Treatment for Rhegmatogenous Retinal Detachment

2020 ◽  
Vol 9 (5) ◽  
pp. 1556
Author(s):  
Vincenza Bonfiglio ◽  
Michele Reibaldi ◽  
Iacopo Macchi ◽  
Matteo Fallico ◽  
Corrado Pizzo ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Oral Prednisone ◽  
Scleral Buckling ◽  
Adjunctive Treatment ◽  
Large Randomized Clinical Trial ◽  
Inflammatory Processes ◽  
Pars Plana

The treatment for rhegmatogenous retinal detachment (RRD) is surgery, including pars plana vitrectomy (PPV) and scleral buckling (SB). Despite surgical advances, degeneration of the photoreceptors and post-operative complications, such as proliferative vitreoretinopathy (PVR), often occurs as the result of inflammation, preventing complete visual recovery or causing RRD recurrence. There is increasing evidence that in the presence of RRD, the activation of inflammatory processes occurs and the surgery itself induces an inflammatory response. This comprehensive review focuses on the use of different formulations of corticosteroids (CCS), as an adjunctive treatment to surgery, either PPV or SB, for RRD repair. The purpose was to review the efficacy and safety of CCS in improving functional and anatomical outcomes and in preventing postoperative complications. This review is organized according to the timing of CCS administration: preoperative, intraoperative, and postoperative. The evidence reviewed supported the role of the pre-operative use of CCS in the treatment of combined RRD and choroidal detachment (CD), reducing CD height. No solid consensus exists on intraoperative and postoperative use of CCS to treat and prevent postoperative complications. However, a large randomized clinical trial including more than 200 eyes suggested that oral prednisone after surgery decreases the rate of postoperative grade B PVR.

A Case of Retinal Detachment in Retinitis Pigmentosa

2007 ◽  
Vol 17 (4) ◽  
pp. 677-679 ◽  
Author(s):  
M.N. Demir ◽  
N. Ünlü ◽  
Z. Yalniz ◽  
M.A. Acar ◽  
F. Örnek
Keyword(s):  
Retinal Detachment ◽  
Retinitis Pigmentosa ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Young Patients ◽  
Scleral Buckling ◽  
Oil Removal ◽  
Pars Plana ◽  
The Right

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.

Repair of Primary Noncomplex Rhegmatagenous Retinal Detachment

2013 ◽  
Vol 06 (02) ◽  
pp. 135 ◽  
Author(s):  
Eric W Schneider ◽  
Mark W Johnson ◽  
◽  
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Scleral Buckling ◽  
Treatment Modalities ◽  
Current Evidence ◽  
Surgical Approaches ◽  
Short Discussion ◽  
Pneumatic Retinopexy ◽  
Pars Plana

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.

scholarly journals Repair of Traumatic Rhegmatogenous Retinal Detachment Combined with Congenital Falciform Retinal Detachment

2018 ◽  
Vol 9 (1) ◽  
pp. 55-59
Author(s):  
Fukutaro Mano ◽  
Kuo-Chung Chang ◽  
Tomiya Mano
Keyword(s):  
Retinal Detachment ◽  
Patient Outcomes ◽  
Rhegmatogenous Retinal Detachment ◽  
Scleral Buckling ◽  
Retrospective Case ◽  
Hand Motion ◽  
Corrected Visual Acuity ◽  
Pars Plana Lensectomy ◽  
Pars Plana

Purpose: To report a case of surgical repair of traumatic rhegmatogenous retinal detachment combined with congenital falciform retinal detachment (FRD). Methods: A retrospective case report. Results: A 36-year-old man with traumatic rhegmatogenous retinal detachment complicating a previously known FRD was successfully treated despite residual FRD following pars plana lensectomy, vitrectomy, and encircling scleral buckling. His best corrected visual acuity improved from hand motion at 50 cm to 20/1,000. Conclusion: We concluded that the root of the FRD is susceptible to trauma because of the contraction of fibrovascular tissue. The early intervention of modern vitrectomy to traumatic rhegmatogenous retinal detachment complicating a previously known FRD is an important consideration for enhanced quality of care and optimal patient outcomes.

scholarly journals Corneal topographic changes after 20-gauge pars plana vitrectomy associated with scleral buckling for the treatment of rhegmatogenous retinal detachment

2013 ◽  
Vol 72 (2) ◽  
pp. 95-98 ◽  
Author(s):  
Alexandre Achille Grandinetti ◽  
Janaína Dias ◽  
Ana Carolina Trautwein ◽  
Natasha Iskorostenski ◽  
Luciane Moreira ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Scleral Buckling ◽  
Pars Plana

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

Visual outcomes after surgery for primary rhegmatogenous retinal detachment in era of microincision vitrectomy: Japan-Retinal Detachment Registry Report IV

2020 ◽  
pp. bjophthalmol-2020-315945
Author(s):  
Takayuki Baba ◽  
Ryo Kawasaki ◽  
Keita Yamakiri ◽  
Takashi Koto ◽  
Koichi Nishitsuka ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Cataract Surgery ◽  
Rhegmatogenous Retinal Detachment ◽  
Scleral Buckling ◽  
Study Data ◽  
Giant Retinal Tear ◽  
Retinal Breaks ◽  
Surgical Methods ◽  
Pars Plana ◽  
Registry Report

Background/AimTo determine the preoperative ocular factors and surgical methods that led to best-corrected visual acuity (BCVA) after pars plana vitrectomy (PPV) or scleral buckling (SB) for rhegmatogenous retinal detachment (RRD).MethodsThis was a prospective, nationwide, multicentre, observational study. Data from the Japanese Retina and Vitreous Society registry from 2016 to 2017 were used to determine the association between preoperative clinical factors, surgical procedures and postoperative BCVA at 6 months. Japanese individuals >40 years of age were included. Eyes with proliferative vitreoretinopathy were included. The primary outcome was the percentage of eyes that achieved 20/25 vision.ResultsOf the 3219 registered cases, 2192 met the inclusion criteria (344 SB, 1738 PPV, 110 PPV+SB). Cases with preoperative BCVA (≤0 logarithm of the minimum angle of resolution (logMAR) units) had good postoperative BCVA (OR=3.97, CI 2.87 to 5.51). Older age (>70 years), low intraocular pressure (<10 mm Hg), high myopia (<−5 dioptres), multiple retinal breaks (>4), giant retinal tear (>90°), wide retinal detachment (>3 quadrants) and macula-off detachment were associated with less probability of postoperative 20/25 vision (OR=0.39, 0.64, 0.62, 0.60, 0.12, 0.51 and 0.36, respectively). Postoperative BCVA was 0.03±0.23 and 0.10±0.32 logMAR units after SB and PPV, respectively. The percentage of cases that achieved 20/25 vision was not significantly different after PPV or SB if cases that had concurrent cataract surgery were excluded (p=0.251).ConclusionsBetter BCVA in patients with RRD who had undergone PPV was observed. However, if concurrent cataract surgery is not performed, BCVA will be comparable with either PPV or SB.

Pneumatic Retinopexy; Indications and Techniques

2019 ◽  
pp. 181-186
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Invasive Procedure ◽  
Scleral Buckling ◽  
Minimally Invasive Procedure ◽  
Postoperative Rehabilitation ◽  
Pneumatic Retinopexy ◽  
Indirect Ophthalmoscopy ◽  
Pars Plana

Pneumatic retinopexy is a minimally invasive procedure for repairing rhegmatogenous retinal detachment. PR is an excellent option in carefully selected patients, but skillful use of indirect ophthalmoscopy and more preoperative time is required for examination and to prepare and educate patients. Although it is associated with reduced morbidity, reduced cost, and faster postoperative rehabilitation compared to pars plana vitrectomy and scleral buckling, it is currently underutilized.

scholarly journals Outcome of scleral buckling with or without gas tamponade for recurrent retinal detachment in post-vitrectomy eyes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jun-Xing Bai ◽  
Xiao-Jian Zhang ◽  
An-Li Duan ◽  
Xiao-Yan Peng
Keyword(s):  
Retinal Detachment ◽  
Functional Outcomes ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Intraoperative Complications ◽  
Scleral Buckling ◽  
Gas Tamponade ◽  
Pars Plana ◽  
Air Tamponade

Abstract Background Treatment of recurrent retinal detachment (re-RD) following vitrectomy (post-gas/air tamponade and post-silicone oil removal) is challenging. Previously reported treatment is commonly revision pars plana vitrectomy (PPV) combined with tamponade, which is invasive and a burden both economically and emotionally when compared with scleral buckling (SB). The purpose of this study is to report anatomical and functional outcomes of SB with or without gas tamponade in eyes with recurrent retinal detachment (re-RD) that previously underwent PPV at least once. Methods We retrospectively reviewed the medical records of 14 patients (14 eyes) who underwent PPV at least once and were treated with SB after re-RD. Preoperative characteristics, intraoperative complications, and postoperative data were assessed. The final anatomical and functional outcomes were analyzed. Results The original PPV was performed for primary rhegmatogenous retinal detachment in 11 eyes, macular hole retinal detachment in 2 eyes, and myopic foveoschisis in 1 eye. Previously, 3 eyes underwent one PPV with gas tamponade, and the remaining 11 (79%) eyes underwent 2–5 operations. Seven eyes underwent the procedure with gas injection. At the last follow-up, 13 eyes achieved total retinal attachment and 1 eye had re-RD. The postoperative intraocular pressure was within the normal range, except in 1 eye (6 mmHg). The finest postoperative best-corrected visual acuity (BCVA) was 20/25. There was a significant improvement in BCVA from 20/160 ± 20/63 at baseline to 20/80 ± 20/50 at the last visit in the 13 successfully treated eyes (P = 0.025). Conclusions SB can be effective for re-RD after PPV in specific cases.

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