Scleral Buckling with a Noncontact Wide-Angle viewing System in the Management of Rhegmatogenous Retinal Detachment

2016 ◽  
Vol 27 (1) ◽  
pp. 98-103 ◽  
Author(s):  
Hua Yan
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Scleral Buckling ◽  
Proliferative Retinopathy ◽  
Wide Angle ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Additional Approach ◽  
Sclerotomy Site

Purpose To introduce a modified scleral buckling surgery using noncontact wide-angle viewing system and intraocular illumination in the treatment of rhegmatogenous retinal detachment (RRD) without proliferative retinopathy. Methods A modified scleral buckling surgery using noncontact wide-angle viewing system with a 25-G optic fiber through sclerotomy site was performed in 22 eyes of 22 patients with RRD. Twelve women and 10 men were included. The mean age was 49.23 ± 15.19 years. The mean refraction of myopia was -4 D (range -3 to -7 D). The mean duration of RRD was 6.64 ± 3.14 days. The preoperative best-corrected visual acuity (BCVA) ranged from 0.02 to 0.8. Mean follow-up was 9.59 ± 2.24 months. Proliferative retinopathy was grade A in 8 eyes and grade B in 14 eyes. Results This surgery was performed successfully and retinal attachment was achieved in all eyes at the final follow-up. The postoperative BCVA increased in all eyes. No complication was encountered related to this technique. Conclusions This modified scleral buckling surgery brings a panoramic and upright view and easy surgical maneuvers. It may be an additional approach for the management of RRD.

scholarly journals Anatomical and Visual Outcome of Rhegmatogenous Retinal Detachment Managed with Scleral Buckling at a Tertiary Eye Centre in Nepal

2018 ◽  
Vol 10 (2) ◽  
pp. 151-155
Author(s):  
Roshija Khanal Rijal ◽  
Raghunandan Byanju ◽  
Araniko Pandey ◽  
Deepesh Mourya
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Care Center ◽  
Visual Outcome ◽  
Scleral Buckling ◽  
Interventional Study ◽  
Corrected Visual Acuity ◽  
Common Causes ◽  
The Common

Objective: To study the anatomical status and visual outcome of scleral buckling surgery in rhegmatogenous retinal detachment (RRD) at tertiary eye care center in Nepal. Method: This is a prospective, noncomparative, consecutive, interventional study of rhegmatogenous retinal detachment managed with scleral buckling surgery performed in Lumbini Eye Institute, Nepal. All the patients underwent surgery by a single experienced surgeon and had at least 3 months follow up. Result: A total of 50 patients (50 eyes) were operated, 38 males and 12 females, with a mean age of 39.46. Retinal reattachment was achieved in 46 (92%). Improved best corrected visual acuity (BCVA) was seen in 84%, whereas in 8% BCVA was same and deteriorated in another 8%. Conclusion: Rhegmatogenous retinal detachment is one of the common causes of visual impairment and blindness. Timely surgical management with scleral buckling surgery can give good anatomical and visual outcome.  

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 Pneumatic retinopexy combined with scleral buckling in the management of relatively complicated cases of rhegmatogenous retinal detachment: A multicenter, retrospective, observational consecutive case series*

2017 ◽  
Vol 46 (1) ◽  
pp. 316-325 ◽  
Author(s):  
Chuandi Zhou ◽  
Qiurong Lin ◽  
Yuxin Wang ◽  
Qinghua Qiu
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Case Series ◽  
Subretinal Fluid ◽  
Scleral Buckling ◽  
Success Rates ◽  
Pneumatic Retinopexy ◽  
The Mean ◽  
Final Operation

Objective To evaluate the efficacy of maximal pneumatic retinopexy (PR) and subretinal fluid (SRF) drainage combined with scleral buckling (SB) in the treatment of complicated rhegmatogenous retinal detachment (RRD). Methods Patients with RRD who underwent maximal PR and SRF drainage combined with SB from June 2007 to June 2012 were included in this multicenter retrospective study. The outcome measures were the primary and final operation success rates and best-corrected visual acuity (BCVA). Results In total, 159 consecutive patients were included. The mean follow-up period was 13.76 ± 1.97 months. Primary operation success was achieved in 146/159 (91.82%) eyes. After salvage management, the final reattachment rate increased to 98.11%. All eyes had improved BCVA, with 62/159 (38.99%) attaining BCVA of ≥20/40. Conclusions Maximal PR and SRF drainage combined with SB achieved satisfactory anatomical and visual recovery in relatively complicated cases of RRD. The decreased need for vitrectomy makes this surgical approach more widely available.

scholarly journals Metamorphopsia and Morphological Changes in the Macula after Scleral Buckling Surgery for Macula-Off Rhegmatogenous Retinal Detachment

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Sisi Xu ◽  
Ling Wang ◽  
Kangjie Kong ◽  
Gang Li ◽  
Yingqin Ni
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Morphological Changes ◽  
Critical Factor ◽  
Scleral Buckling ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Time Point

Purpose. To observe the changes in metamorphopsia after scleral buckling (SB) surgery for macula-off rhegmatogenous retinal detachment (RRD) and its association with morphological changes in the macula. Methods. This prospective study included 20 eyes of 20 patients. Before surgery and 1, 3, 6, and 12 months after surgery, metamorphopsia measured by M-charts and best-corrected visual acuity (BCVA) and macular microstructures assessed using optical coherence tomography were recorded. Results. Both the vertical and horizontal M-scores improved significantly after SB surgery. BCVA also improved gradually. The mean M-score in the eyes with a continuous external limiting membrane (ELM) was smaller than that in the eyes with a disrupted ELM ( P = 0.008 ). Preoperative and postoperative BCVA did not correlate with the mean M-score at any time point. The other studied parameters, namely, the duration of RRD, the height of retinal detachment, central foveal thickness, inner nuclear layer thickness, and continuation of the ellipsoid zone, were also not relevant. Conclusions. The continuation of the ELM may be a critical factor in determining the severity of metamorphopsia after SB surgery for macula-off RRD.

scholarly journals Forced Duction Test: Is It Necessary after the Scleral Buckling Procedure?

2020 ◽  
Vol 11 (2) ◽  
pp. 282-286
Author(s):  
Mohammad Sharifi ◽  
Mohammad Reza Ansari Astaneh
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Scleral Buckling ◽  
Motility Disorder ◽  
Ocular Motility ◽  
Ocular Movement ◽  
Scleral Buckling Procedure ◽  
Movement Limitation ◽  
Restrictive Strabismus

A 14-year-old boy who had ocular motility disorder which started 2 weeks following retinal surgery (scleral buckling) secondary to rhegmatogenous retinal detachment, was referred to the strabismus clinic. He had significant ocular movement limitations in adduction and elevation under general anesthesia. The forced duction test (FDT) was positive in both adduction and elevation. After buckle removal, FDT was negative. The eye was orthotropic without ocular movement limitation at final follow-up. In conclusion, FDT at the end of the scleral buckling procedure needs to be performed. It may prevent restrictive strabismus after scleral buckling surgery.

scholarly journals Significance of outer retinal undulation on preoperative optical coherence tomography in rhegmatogenous retinal detachment

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Young Do Yeo ◽  
Yu Cheol Kim
Keyword(s):  
Optical Coherence Tomography ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Clinical Findings ◽  
Symptom Duration ◽  
Retinal Damage ◽  
Optical Coherence ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Abstract Rhegmatogenous retinal detachment (RRD) is a vision-threatening pathology. Optical coherence tomography (OCT) is useful for evaluating retinal damage and visual prognosis in patients with RRD. Outer retinal undulation (ORU) is often observed on preoperative OCT in RRD. Therefore, we evaluated the correlation between ORU seen on preoperative OCT and pre/post-operative factors in RRD. Patients with RRD (114 eyes) underwent reattachment surgery and ≥ 6 months of follow-up. According to the condition of the macula on preoperative OCT, cases were divided into macula-on RRD (65 eyes) or macula-off RRD (49 eyes). Patients were classified into acute (< 10 days), subacute (10–30 days), and chronic (> 30 days) symptom duration groups. Clinical findings, histories, and relationships with OCT findings, including ORU, were analyzed. Subacute symptom duration was significantly associated with ORU on preoperative OCT (p = 0.001) and had a higher prevalence of ORU (73.7%) than did acute (OR = 4.48) or chronic (OR = 7.467) durations. Ellipsoid zone (EZ) disruption was significantly associated with poorer best-corrected visual acuity (BCVA) than normal EZ integrity at 6 months postoperatively (p = 0.012). ORU on preoperative OCT suggests a 10–30 days morbidity duration in RRD. EZ integrity is useful for predicting postoperative BCVA in macula-off RRD.

scholarly journals Applying Sutureless Encircling Number 41 Band and Transscleral Chandelier-Assisted Laser Retinopexy for Scleral Buckling Procedure

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Amir Ramadan Gomaa ◽  
Samir Mohamed Elbaha
Keyword(s):  
Rhegmatogenous Retinal Detachment ◽  
Intervention Study ◽  
Scleral Buckling ◽  
Wide Angle ◽  
Effective Technique ◽  
Recent Onset ◽  
Retinal Reattachment ◽  
Primary Success ◽  
Scleral Buckling Procedure ◽  
The Mean

Purpose. To assess the outcome of sutureless encirlcing number 41 band and transscleral laser retinopexy in uncomplicated rhegmatogenous retinal detachment (RRD), using a wide-angle viewing system (WAVS) and chandelier endoillumination.Methods. Prospective intervention study included 30 eyes of 30 patients presenting with RRD of recent onset indicated for SB. All cases were treated by sutureless encircling number 41 band and transscleral laser retinopexy. Visualization was provided by the Resight WAVS and a single 27-gauge chandelier endoillumination. Anatomical and visual outcomes were evaluated.Results. The mean age of our group was 49.8 ± 12.3 years, and the mean duration of RD was 7 (0–50) days. Twenty-four eyes (80.0%) were phakic while the remaining 6 eyes (20%) were either pseudophakic or aphakic. The primary retinal reattachment rate was 83.3% (25 out of 30 eyes). LogMAR visual acuity improved from 1.3 (0.30–2.0) preoperatively to 1.0 (0.40–1.60) at first month (p=0.002) and to 0.70 (0.20–1.92) at third month (p<0.001).Conclusion. Sutureless encircling number 41 band with chandelier-assisted transscleral laser retinopexy is a safe and effective technique for managing uncomplicated RRD. It provides a high primary success rate while eliminating the complications of cryotherapy, sutures, and broad buckles.

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 Scleral Buckling for Primary Retinal Detachment: Outcomes of Scleral Tunnels versus Scleral Sutures

2021 ◽  
Author(s):  
Matthew R. Starr ◽  
Edwin H. Ryan ◽  
Anthony Obeid ◽  
Claire Ryan ◽  
Xinxiao Gao ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retrospective Study ◽  
Retinal Detachment ◽  
Success Rate ◽  
Rhegmatogenous Retinal Detachment ◽  
Scleral Buckling ◽  
Scleral Buckle ◽  
Scleral Tunnel ◽  
The Mean ◽  
Anatomic Success

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.

Outcomes of Combined Scleral Buckling Plus Pneumatic Retinopexy Vs. Scleral Buckling for Primary Rhegmatogenous Retinal Detachment

2021 ◽  
pp. 112067212110640
Author(s):  
Yehonatan Weinberger ◽  
Amir Sternfeld ◽  
Natalie Hadar-Cohen ◽  
Matthew T.S. Tennant ◽  
Assaf Dotan
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Medical Center ◽  
Scleral Buckling ◽  
Added Value ◽  
Scleral Buckle ◽  
Pneumatic Retinopexy ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Purpose To evaluate the outcomes and complications of scleral buckle surgery alone or combined with pneumatic retinopexy (pneumatic buckle) for the treatment of primary rhegmatogenous retinal detachment. Design Retrospective chart review. Participants Two hundred thirteen patients with rhegmatogenous retinal detachment of whom 101 underwent primary scleral buckle surgery at Rabin Medical Center in 2005–2015 (SB group) and 112 underwent pneumatic buckle surgery at Royal Alexandra Hospital in 2013–2015 (PB group). Methods All patients were followed for ≥12 months. Data on clinical and surgical parameters, outcome, and complications were collected from the medical files. Main Outcome Measures Best corrected visual acuity and anatomical outcomes. Results At 12 months, average best corrected visual acuity was 0.3 logMar in the SB group and 0.42 logMar in the PB group ( P < 0.05). Rates of anatomical reattachment were high and similar in the two groups (99% and 97%, respectively, P = 0.623). The SB group had a higher percentage of patients requiring additional laser applications (21% vs. 7%; P < 0.01) and buckle readjustment surgery (6% vs. 0; P = 0.01), and the PB group had a higher percentage of patients who required postoperative pars plana vitrectomy (30% vs. 17%; P = 0.03). Conclusion Scleral buckle surgery alone is efficient for the treatment of rhegmatogenous retinal detachment. Its combination with pneumatic retinopexy usually has no significant added value in terms of anatomical reattachment rate. Outcomes of Pneumatic buckling vs Scleral Buckling for RRD

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