scholarly journals Predictive Risk Factors for Retinal Redetachment Following Uncomplicated Pars Plana Vitrectomy for Primary Rhegmatogenous Retinal Detachment

2020 ◽  
Vol 9 (12) ◽  
pp. 4037
Author(s):  
Josef Guber ◽  
Maico Bentivoglio ◽  
Christophe Valmaggia ◽  
Corina Lang ◽  
Ivo Guber

Purpose: To investigate clinical and surgical factors influencing the outcome after primary rhegmatogenous retinal detachment surgery. Methods: A retrospective, single-centre, case-control study of 1017 eyes of 1017 consecutive patients with primary rhegmatogenous retinal detachment (RRD) who underwent pars plana vitrectomy (PPV), were included in the study. Analysed surgical factors were: combined procedure with phacoemulsification, type of retinopexy (cryocoagulation, endolaser, combined), type of tamponade (gas, silicone oil), and anatomical factors: primary proliferative vitreoretinopathy (PVR) and macular detachment at the time of surgery. Results: Overall retinal re-detachment rate was 10.1%. The main reason for re-detachment was an insufficient retinopexy in 53.6%, followed by PVR (37.3%), and retinal detachment occurred at a different location caused by another break in 9.1%. No significant difference in the rate of re-detachment was found if a phacoemulsification with simultaneous IOL implantation was performed (p = 0.641). No significant difference between the various retinopexy techniques was found (p = 0.309). Risk factors re-detachment were primary PVR (p = 0.0003), silicone oil as initial tamponade (p = 0.0001) as well as macula off detachments (p = 0.034). Conclusions: The present study showed no significant difference between the types of retinopexy and if additional phacoemulsification was performed or not. Factors associated with a higher risk for re-detachment were detached macula at surgery, primary PVR and primary oil-filling.

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.


2020 ◽  
pp. 112067212091303 ◽  
Author(s):  
Katharina Eibenberger ◽  
Stefan Sacu ◽  
Sandra Rezar-Dreindl ◽  
Ursula Schmidt-Erfurth ◽  
Eva Stifter ◽  
...  

Objective: The aim of this study was to evaluate and compare the underlying pathologies, demographic and retinal detachment characteristics in pediatric and early adulthood retinal detachment. Methods: Patients with rhegmatogenous, serous, or tractional retinal detachment aged 0–26 years were retrospectively reviewed. The preschool group (n = 4) comprised children aged 0–6 years, the pediatric group (n = 19) comprised children aged 7–16 years, and the early adulthood group (n = 13) aged 17–26 years. Demographic information and retinal detachment characteristics, type of surgery, and intraocular tamponade were analyzed. Postoperatively, the functional outcome, anatomic success, and ocular adverse events were evaluated. Due to the low patient number in the preschool group, statistical analysis was performed for pediatric group and early adulthood group only. Results: All causes of retinal detachment were present in the pediatric group, but only rhegmatogenous retinal detachment in the early adulthood group. In both groups, the main type of surgical intervention was pars plana vitrectomy (pediatric group: 52%, early adulthood group: 38%; p = 0.36). The type of intraocular tamponade varied statistically significantly between the groups (p = 0.014). Silicone oil was the main intraocular tamponade in the pediatric group (48%), whereas no tamponade (54%) followed by gas tamponade (46%) in the early adulthood group. Final attachment rate was similar in both groups (pediatric group: 89%, early adulthood group: 100%; p = 0.35). Re-detachment occurred significantly sooner in the pediatric group (1.3 ± 0.3 months) than in the early adulthood group (4.3 ± 1.4 months; p = 0.03). Conclusion: In pediatric and early adulthood retinal detachment, pars plana vitrectomy appeared as a successful surgical intervention. Re-attachment rate and re-treatment were similar in both groups with a better functional outcome observed in cases of retinal detachment in early adulthood and poorer results in young children.


2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Bing Lu ◽  
Pengfei Zhang ◽  
Haiyun Liu ◽  
Huixun Jia ◽  
Yang Yu ◽  
...  

Purpose. To investigate the vascular density of the optic nerve head (ONH) and macula using optical coherence tomography angiography (OCTA) in patients undergoing vitrectomy for rhegmatogenous retinal detachment (RRD) and to evaluate associations with visual outcomes. Methods. Patients with RRD, successfully treated with a pars plana vitrectomy (PPV) and a minimum three-month follow-up were included in this study. The vessel density (VD) of the ONH and peripapillary regions, foveal avascular zone (FAZ), foveal flow density (FFD), and parafoveal flow density (PFD) were evaluated using OCTA and compared to the fellow eye. Multivariate linear regression analysis was performed to determine correlations with visual outcomes. Results. Thirty-one patients with macula-off RRD were included in the study. Compared with the fellow eyes, eyes after RRD surgery had a lower peripapillary VD ( P < 0.01 ). No significant difference in superficial and deep FFD, PFD, and FAZ area was found compared to the fellow eyes. Postoperative peripapillary VD and baseline BCVA were significantly associated with BCVA three months after PPV ( P < 0.05 ). Conclusion. Rhegmatogenous retinal detachment eyes successfully treated with PPV had lower peripapillary vessel density than fellow healthy eyes. Postoperative BCVA was related to postoperative peripapillary VD.


2021 ◽  
Vol 8 ◽  
Author(s):  
Jinguo Yu ◽  
Xingxing Hu ◽  
Jiangkai Zhang ◽  
Han Han ◽  
Bo Huang ◽  
...  

Objective: To observe the characteristics and evaluate the efficacy and safety of the chronic total rhegmatogenous retinal detachment (RRD) treatment by the 23-gauge pars plana vitrectomy (PPV) in young adults and to analyze the related factors.Methods: A retrospective chart review was performed for the young adults who underwent the 23-gauge PPV for the chronic total RRD at the Tianjin Medical University General Hospital from 2011 to 2018. A total of 54 eyes of 48 patients were included in this study. The preoperative vision ranged from 2.00 to 1.00. The mean duration of RRD was 9 ± 0.6 months with a range from 4 to 18 months. The proliferative vitreoretinopathy (PVR) grade D1 and grade D2 was diagnosed in 48 eyes and 6 eyes, respectively. About 37 eyes were filled with C3F8 and 17 eyes were filled with silicone oil tamponade. The follow-up ranged from 9 to 78 months with a mean of 23 ± 2.2 months.Results: The postoperative visual acuity increased in all the eyes at the final observation. The retinal attachment was achieved in 49 eyes (90.7%) in the primary PPV. Five eyes (9.3%) with the failed retinal attachment finally achieved the attachment after the second procedure. The postoperative complications mainly included temporary intraocular pressure (IOP) elevation, hyphema, and retinal redetachment.Conclusion: Chronic total RRD can be treated via the 23-gauge PPV with a great anatomical and visual prognosis in the young adult. The successful treatment of the chronic total RRD in young adults is mainly associated with the complete dissection of the severe vitreoretinopathy, especially for the epiretinal membrane at the retinal breaks and degenerations and the subretinal proliferation during surgery.


2020 ◽  
Author(s):  
Yifan Zhou ◽  
Siqi Zhang ◽  
Min Gao ◽  
Hao Zhou ◽  
Haiyun Liu ◽  
...  

Abstract Purpose: To investigate different fundus vasculature and structure changes after single pars plana vitrectomy (PPV) following silicone oil (SO) or sterilized air in macular-off rhegmatogenous retinal detachment (RRD) patients. Method: 39 eyes (39 patients) with macular-off RRD underwent standard three-port 23-gauge PPV and intraocular SO or gas tamponade. Optical Coherence Tomography (OCT) and angiography were used to evaluate fundus structure and vasculature including retinal layers thicknesses and vessel density (VD) changes throughout observation for 12 weeks. Retinal layers were segmented into: NFL, GCL+IPL, INL, OPL, ONL+IS, OS+RPE and BRM. Fundus vasculature was segmented into superficial and deep capillary plexus (SCP, DCP), and choriocapillaris plexus (CCP). Result: For fundus vasculature, SO tamponade led to significant decrease in both SCPVD and DCPVD, while only SCPVD was found significantly decreased in gas tamponade eyes. For specific retinal layer, SO led to significant decrease in NFL and INL thicknesses. OPL, ONL+IS and OS+RPE thicknesses had significant increase in both SO tamponade and gas tamponade eyes. Conclusion: Different intraocular tamponades could have various impacts on retinal vasculature and structure. Compared to sterilized air, silicone oil tamponade could have relatively more negative effects on retinal vasculature and specific retinal layer thickness change.


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