Conventional Detachment Surgery in Rhegmatogenous Retinal Detachment; Indications and Techniques

2019 ◽  
pp. 187-196
Keyword(s):  
Retinal Detachment ◽  
Complication Rate ◽  
Rhegmatogenous Retinal Detachment ◽  
Subretinal Fluid ◽  
Scleral Buckling ◽  
Conventional Surgery ◽  
Surgical Method ◽  
Retinal Detachment Surgery ◽  
Lower Complication ◽  
Lower Complication Rate

Conventional surgery with a lower complication rate is recommended in cases of rhegmatogenous retinal detachment. Conventional retinal detachment surgery is still an appropriate technique for the treatment of most of the cases with rhegmatogenous retinal detachment even today. The main steps of the conventional retinal detachment surgeries are cryopexy, scleral buckling, encircling, and removal of subretinal fluid. Successful results have been reported in this surgical method in uncomplicated cases. This review mentions about the conventional detachment surgery in the main aspects.

Standardized scleral buckling approach in the management of noncomplex primary rhegmatogenous retinal detachment

2020 ◽  
pp. 112067212094020
Author(s):  
Paolo Radice ◽  
Elisa Carini ◽  
Patrizio Seidenari ◽  
Andrea Govetto
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Vision Loss ◽  
Case Series ◽  
Subretinal Fluid ◽  
Scleral Buckling ◽  
Full Thickness Macular Hole ◽  
Air Tamponade ◽  
Subretinal Fluid Drainage ◽  
Anatomical Success

Purpose: To analyze the anatomical and functional outcomes of a standardized scleral buckling approach in patients with noncomplex primary rhegmatogenous retinal detachment (RRD). Methods: Retrospective institutional case series of 135 eyes of 131 patients diagnosed with noncomplex primary RRD. All patients underwent scleral buckling surgery with the placement of an encircling 5 mm oval sponge at 15 ± 2 mm posteriorly from the limbus, cryopexy, subretinal fluid drainage, and air tamponade. Results: Final anatomical success at 12 months was achieved in all 135 eyes (100%). Primary anatomical surgical success was obtained in 127 out of 135 eyes (94%), while re-detachment occurred in eight out of 135 cases (6%). Primary anatomical success was significantly lower in pseudophakic eyes ( p < 0.001). At the end of the follow-up period, no vision loss was observed in any patient and both sphere and cylinder refraction shift was mild. There was a low rate of postoperative complications. Nine out of 135 eyes (6.6%) developed full thickness macular hole, whether in 24 out of 135 eyes (17.8%) epiretinal membrane development was noticed. Conclusion: A standardized scleral buckling approach for primary noncomplex RRD may be effective. The technique is reproducible, easier, and quicker to perform if compared to classic scleral buckling procedures, suggesting that it may represent a valuable surgical option. Special care is needed in the management of pseudophakic RRD due to higher risk of RRD recurrence.

PERSISTENT LOCULATED SUBRETINAL FLUID AFTER RHEGMATOGENOUS RETINAL DETACHMENT SURGERY

Retina ◽  
2020 ◽  
Vol 40 (6) ◽  
pp. 1153-1159
Author(s):  
Michael Mimouni ◽  
Tareq Jaouni ◽  
Mor Ben-Yair ◽  
Shiran Almus ◽  
Laura Derman ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Subretinal Fluid ◽  
Retinal Detachment Surgery

Persistent Subretinal Fluid Mimicking Central Serous Retinopathy after Scleral Buckling Surgery: Possible Vortex Vein Compression Role

2017 ◽  
Vol 27 (2) ◽  
pp. e54-e56 ◽  
Author(s):  
Chiara Giuffrè ◽  
Adriano Carnevali ◽  
Marco Codenotti ◽  
Eleonora Corbelli ◽  
Luigi A. De Vitis ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Indocyanine Green Angiography ◽  
Serous Retinal Detachment ◽  
Subretinal Fluid ◽  
Scleral Buckling ◽  
Central Serous Retinopathy ◽  
Retinal Detachment Surgery ◽  
Encircling Band ◽  
Vortex Vein ◽  
Sd Oct

Purpose To describe the case of a woman who developed persistent subretinal fluid in the macular region after the placement of encircling band for retinal detachment surgery, possibly due to vortex vein compression. Methods Case report. Results A 66-year-old woman diagnosed with central serous retinopathy presented with poor vision and metamorphopsia in the left eye (LE). Her visual acuity had deteriorated to 20/100 in LE after retinal detachment surgery with scleral buckling 8 months before. Multimodal imaging including fundus autofluorescence and fluorescein angiography disclosed a gravitational hyperfluorescent area involving the macular region that appeared to originate from the superotemporal quadrant in correspondence with the buckling. This area corresponded to a serous retinal detachment on structural spectral-domain optical coherence tomography (SD-OCT). Interestingly, on indocyanine green angiography, the encircling band of the scleral buckling appeared located at the emergence of the superotemporal vortex vein. Based on these findings, the patient was diagnosed with gravitational serous retinal detachment secondary to vortex vein compression. Successful rapid visual recovery and decrease of retinal fluid on SD-OCT was achieved with prompt surgery of scleral buckling removal, confirming the diagnosis. Conclusions Choroidal veins can be obliterated during retinal detachment surgery, especially when retinal breaks are posterior to the equator. Indocyanine green angiography is the gold standard to study choroidal circulation and in our case allowed us to visualize the compression of the superotemporal vortex vein at the site of scleral buckling.

scholarly journals A COMPARATIVE ANALYSIS OF THE RESULTS OF SCLERAL BUCKLING WITH ALLOPLANT BIOMATERIAL VERSUS SILICONE SPONGE

2013 ◽  
Vol 6 (1) ◽  
pp. 16-21
Author(s):  
Larisa Konstantinovna Moshetova ◽  
Aysylu Bulatovna Galimova
Keyword(s):  
Comparative Analysis ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Scleral Buckling ◽  
Surgical Method ◽  
Visual Improvement ◽  
Post Operative Period ◽  
Technical Simplicity

A surgical method of rhegmatogenous retinal detachment repair with Alloplant biomaterial is effective and allows to provide a significant visual improvement. Technical simplicity, favorable course of early post-operative period, and lack of complications specific to the majority of episcleral procedures (implant contamination and/or extrusion, buckle displacement, dystrophic scleral changes in the buckling area) are the undoubted advantages of the proposed method, which make it preferable for using in rhegmatogenous retinal detachment.

scholarly journals Endoillumination aided scleral buckling combined with intravitreal injection of hyaluronate for treatment of rhegmatogenous retinal detachment

2019 ◽  
Author(s):  
Tong Zhao ◽  
Zhijun Wang
Keyword(s):  
Intraocular Pressure ◽  
Retinal Detachment ◽  
Intravitreal Injection ◽  
Rhegmatogenous Retinal Detachment ◽  
Subretinal Fluid ◽  
Scleral Buckling ◽  
Wide Angle ◽  
Corrected Visual Acuity ◽  
Significant Difference ◽  
Subretinal Fluid Drainage

Abstract Background: To evaluate the efficiency and safety of 25-gauge illumination aided scleral buckling surgery combined with intravitreal injection of hyaluronate for treatment of rhegmatogenous retinal detachment Methods: This study was undertaken in a prospective, nonrandomized, and uncontrolled manner. Patients of rhegmatogenous retinal detachment were performed scleral buckling surgery with the aid of intraocular illumination and noncontact wide-angle viewing system. Hyaluronate was injected into the vitreous cavity to maintain intraocular pressure stable after subretinal fluid drainage through the external sclerotomy when necessary. Best corrected visual acuity(BCVA), intraocular pressure, fundus examination and complications were observed and recorded. Results: Twenty-eight consecutive patients (28 eyes) were enrolled. Subretinal fluid drainage and hyaluronate injection was performed in 12 eyes. The final reattachment ratio was 100%. BCVA increased after operation (P<0.001) and no significant difference was observed between preoperative and postoperative intraocular pressure (P=0.149). No iatrogenic retinal break, choroidal hemorrhage or endophthalmitis were observed. Conclusions: Endoillumination aided buckling surgery combined with intravitreal injection of hyaluronate could be an option for treatment of rhegmatogenous retinal detachment especially for the cases of highly elevated retina. Trial registration: ChiCTR1800020055. Retrospectively registered on December 12, 2018. Key words: Rhegmatogenous retinal detachment, scleral buckling, noncontact wide-angle viewing system, endoillumination, intravitreal injection of hyaluronate.

scholarly journals The Impact of the Covid-19 Pandemic on Rhegmatogenous Retinal Detachment Treatment Patterns

2021 ◽  
Author(s):  
Jipeng Li ◽  
Meng Zhao ◽  
Haicheng She
Keyword(s):  
Retinal Detachment ◽  
Surgical Procedures ◽  
Rhegmatogenous Retinal Detachment ◽  
Subretinal Fluid ◽  
Scleral Buckling ◽  
Retinal Breaks ◽  
Surgery Outcomes ◽  
Potential Factors ◽  
Subretinal Fluid Drainage ◽  
The Impact

Abstract Background: To describe changes in rhegmatogenous retinal detachment (RRD) surgical procedures in Beijing during the COVID-19 pandemic. Material and Methods:A retrospective cohort of RRD patients was analyzed. Patients were divided into the COVID-19 pandemic group and pre-COVID-19 group according to their presentation. The presurgery characteristics, surgical procedures, and surgery outcomes were collected. The potential factors related to the choice of pars plana vitrectomy (PPV) or scleral buckling (SB) were analyzed using logistic regression. The differences in the procedure choice under specific conditions were compared. Surgery outcomes were compared between the two groups.Results:In the COVID-19 pandemic group, less patients received SB (27.8%, 41.3%, p=0.02) while more patients received PPV (72.2%, 58.6%, p=0.02); in patients who received SB, fewer patients received subretinal fluid drainage (45.4%,75.7%, p=0.01); in patients who received PPV, fewer patients received phacovitrectomy (7.0%, 21.0%, p=0.02). The choice of PPV was related to older age (1.03, p=0.005), the presence of RRD with choroidal detachment (RRD-CD) (2.92, p=0.03), pseudophakia (5.0, p=0.002), retinal breaks located posterior to the equator(4.87, p<0.001), macular holes (9.76, p=0.005), and a presurgery visual acuity (VA) less than 0.02 (0.44 , p=0.03). Fewer phakia patients with retinal breaks located posterior to the equator (1/28, 11/30, p=0.01) and fewer patients with chronic RRD and subretinal strand (1/9, 9/16, p=0.03) received SB in the COVID-19 pandemic group. More patients with improved VA (55.7%, 40.2%, p=0.03) in the COVID-19 pandemic group. The overall single-surgery retinal attachment rate was similar in the two groups (94.9%, 94.5%, p=0.99).Conclusions:During the COVID-19 pandemic, the main reason for the increased number of PPV in RRD treatment was that more complicated cases were presented. However, the surgeons were conservative in procedure choice in specific cases. The adjustments on RRD treatments leads to comparable surgery outcomes.

Premacular membrane formation after scleral buckling for primary rhegmatogenous retinal detachment: prospective study and pathophysiological insights

2018 ◽  
Vol 103 (4) ◽  
pp. 481-487 ◽  
Author(s):  
Viviana Cacioppo ◽  
Andrea Govetto ◽  
Paolo Radice ◽  
Gianni Virgili ◽  
Antonio Scialdone
Keyword(s):  
Risk Factors ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Case Series ◽  
Subretinal Fluid ◽  
Scleral Buckling ◽  
Key Factor ◽  
Subretinal Fluid Drainage ◽  
Functional Deterioration

PurposeTo investigate the incidence, clinical features and risk factors of premacular membrane (PMM) formation after primary rhegmatogenous retinal detachment (RRD) repair with scleral buckling (SB) alone.MethodsThis institutional, prospective and consecutive case series included phakic eyes with RRD, treated with SB alone within 7 days from the occurrence of symptoms, with a follow-up of 6 months. Spectral-domain optical coherence tomography images were reviewed. The association of PMM development and morphology with preoperative and intraoperative RRD features was analysed.ResultsNinety-two patients with a mean age of 56±13 years completed the 6 months follow-up period. Postoperatively, eyes with any PMM stage were 30 out of 92 (32.6%) at 1 month and 47 out of 92 (51,1%) at both 3 months and 6 months. Over the follow-up period, 17 out of 47 PMMs (36.2%) progressed to later stages. Progression of PMMs to later stages were observed only in RRDs involving the macular region (17 out of 35 eyes, 48.5%), while none of the PMMs in macula-sparing detachments progressed to later stages (p=0.020). The risk factors significantly associated with postoperative new onset of PMM were preoperative RRDs involving the macular region (p=0.001), cryopexy time (p=0.045), presence of horseshoe tears (p=0.003), worse preoperative visual acuity (p=0.004) and subretinal fluid drainage (p=0.047).ConclusionThe incidence of postoperative PMM formation after RRD repair with SB alone was high. In retinal detachments involving the macular region PMM were more severe, tending to anatomical progression and functional deterioration. Activation of foveal Müller cell in detachments involving the macula may be a key factor in PMM progression.

scholarly journals The impact of the COVID-19 Pandemic on rhegmatogenous retinal detachment treatment patterns

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jipeng Li ◽  
Meng Zhao ◽  
Haicheng She
Keyword(s):  
Retinal Detachment ◽  
Surgical Procedures ◽  
Rhegmatogenous Retinal Detachment ◽  
Subretinal Fluid ◽  
Scleral Buckling ◽  
Retinal Breaks ◽  
Surgery Outcomes ◽  
Potential Factors ◽  
Subretinal Fluid Drainage ◽  
The Impact

Abstract Backgrounds To describe changes in rhegmatogenous retinal detachment (RRD) surgical procedures in Beijing during the COVID-19 Pandemic. Methods A retrospective cohort of RRD patients was analyzed. Patients were divided into the COVID-19 pandemic group and pre-COVID-19 group according to their presentation. The presurgery characteristics, surgical procedures, and surgery outcomes were collected. The potential factors related to the choice of pars plana vitrectomy (PPV) or scleral buckling (SB) were analyzed using logistic regression. The differences in the procedure choice under specific conditions were compared. Surgery outcomes were compared between the two groups. Results In the COVID-19 pandemic group, less patients received SB (27.8, 41.3%, p = 0.02) while more patients received PPV (72.2, 58.6%, p = 0.02); in patients who received SB, fewer patients received subretinal fluid drainage (45.4,75.7%, p = 0.01); in patients who received PPV, fewer patients received phacovitrectomy (7.0, 21.0%, p = 0.02). The choice of PPV was related to older age (1.03, p = 0.005), the presence of RRD with choroidal detachment (RRD-CD) (2.92, p = 0.03), pseudophakia (5.0, p = 0.002), retinal breaks located posterior to the equator (4.87, p < 0.001), macular holes (9.76, p = 0.005), and a presurgery visual acuity (VA) less than 0.02 (0.44, p = 0.03). Fewer phakia patients with retinal breaks located posterior to the equator (1/28, 11/30, p = 0.01) and fewer patients with chronic RRD and subretinal strand (1/9, 9/16, p = 0.03) received SB in the COVID-19 pandemic group. There were more patients with improved VA (55.7, 40.2%, p = 0.03) in the COVID-19 pandemic group. The overall single-surgery retinal attachment rate was similar in the two groups (94.9, 94.5%, p = 0.99). Conclusions During the COVID-19 Pandemic, the main reason for the increased number of PPV in RRD treatment was that more complicated cases were presented. However, the surgeons were conservative in procedure choice in specific cases. The adjustments on RRD treatments lead to comparable surgery outcomes.

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