scholarly journals Double Retinal Tamponade for Treatment of Rhegmatogenous Retinal Detachment with Proliferative Vitreoretinopathy and Inferior Breaks

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Mohamed Farouk Abdelkader ◽  
Shaaban Abd-Elhamid Mehany Elwan ◽  
Ahmed Shawkat Abdelhalim
Keyword(s):  
Retinal Detachment ◽  
Proliferative Vitreoretinopathy ◽  
Rhegmatogenous Retinal Detachment ◽  
Case Series ◽  
Short Term ◽  
Retinal Breaks ◽  
Case Series Study ◽  
Retinal Reattachment ◽  
Simultaneous Use ◽  
One Year

Purpose. To evaluate the efficacy and safety of the simultaneous use of short-term perfluoro-n-octane (PFO) with perfluoropropane (C3F8) gas to achieve retinal reattachment in eyes with rhegmatogenous retinal detachment (RRD) with proliferative vitreoretinopathy (PVR) grade C and multiple retinal breaks including inferior breaks. Design. This is a prospective interventional case series study. Patients and Methods. The study was a prospective noncomparative interventional study. It included 30 eyes of 30 patients who had RRD with PVR grade C and multiple retinal breaks including inferior tears attending the vitreoretinal unit of Minia University Hospital, Egypt. The mean age was 50.2 ± 10.63 years; 18 patients were females and 12 were males. Combined phacoemulsification and 23 G pars plana vitrectomy (PPV) with double retinal tamponade by C3F8 and PFO were done, and PFO was removed in 10–14 days. The patients were followed up for one year. The primary outcome was to achieve successful retinal reattachment, and the secondary outcomes were visual improvement and occurrence of complications. Results. Successful retinal reattachment was obtained in 28 eyes out of 30 (93.3%), and 2 eyes (6.7%) had recurrent RD. Best-corrected distance visual acuity (BCDVA) in logMAR was significantly improved from baseline 1.74 ± 0.05 to 0.93 ± 0.04, 0.82 ± 0.05, 0.80 ± 0.07, and 0.73 ± 0.055 at follow-up visits 3, 6, and 9 months and one year, respectively ( P ≤ 0.001 ). There were no serious ocular complications recorded. Conclusions. The results of this study indicated that primary vitrectomy with simultaneous use of both C3F8 and short-term PFO as retinal tamponades was effective and safe in the management of complex cases of RRD with PVR grade C and inferior breaks. This trial is registered with NCT04168255.

scholarly journals The Risk Factors of the Progression of Rhegmatogenous Retinal Detachment on Patients with the Fourteen-day Quarantine in the Early Period of COVID-19 Outbreak

2021 ◽  
Author(s):  
Meng Zhao ◽  
Jipeng Li ◽  
Haicheng She ◽  
Ningpu Liu
Keyword(s):  
Risk Factors ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Proportional Hazards Model ◽  
Case Series ◽  
Early Period ◽  
Cox Proportional Hazards Model ◽  
Choroidal Detachment ◽  
Retinal Breaks ◽  
Case Series Study

Abstract Backgrounds: The COVID-19 pandemic has great impact on hospitals and patients. The fourteen-day quarantine caused surgery of RRD postponed. To explore the risk factors of rhegmatogenous retinal detachment (RRD) progression in a group of patients whose surgery was postponed during the top-level emergency response of COVID-19.Methods: Retrospective case series study. The information on RRD patients who received surgeries in Beijing Tongren Hospital's retina service from February 16, 2020, to April 30, 2020 has been collected retrospectively. The history, manifestation on presentation and admission, and progression of RRD were recorded. RRD progression was defined as the presence of either choroidal detachment (CD) or proliferative vitreoretinopathy (PVR) progression during the quarantine period. Risk factors were analyzed using the Cox proportional hazards model, survival analysis, and logistic regression.Results: There were 79 cases enrolled in this study. The median time from the patients' presentation at the clinic to admission for surgery was 14 days (3–61 days). There were 70 cases (88.6%) who did not present to the hospital within one week of the onset of visual symptoms. There were 69 (87.3%) macular-off cases at the presentation. There were 27 (34.2%) cases combined with choroidal detachment. There were 49 (62.0%) cases with PVR B, 22 (27.8%) cases with PVR C, 4 (5.1%) cases with PVR D, and 4 (5.1%) cases with PVR A. After the 14-day quarantine, 21 (26.6%) cases showed RRD progression, and 9 cases showed RD regression at the time of surgery. Neither the time of onset of the visual symptom (p=0.46) nor the time between presentation and admission (p=0.31) was significantly different between the patients with RRD progression and patients without RRD progression. The combination of CD (3.61, 1.86-6.99, p=0.001) and retinal breaks located posterior to the equator (3.78, 1.25-11.45, p=0.02) were factors related to the progression of RRD. Conclusions: In the cases enrolled in our study during the COVID-19 outbreak period, the RRD progression risk factors included a combination of CD and retinal breaks posterior to the equator. Ophthalmologists should schedule the surgeries for RRD patients with these signs as soon as possible.

scholarly journals Using Surgical Microscope for Sclera Buckling and Transscleral Cryopexy: An Alternative Procedure of Treatment for Rhegmatogenous Retinal Detachment

2014 ◽  
Vol 2014 ◽  
pp. 1-7
Author(s):  
Liu-xue-ying Zhong ◽  
Yi Du ◽  
Wen Liu ◽  
Su-Ying Huang ◽  
Shao-chong Zhang
Keyword(s):  
Retinal Detachment ◽  
Proliferative Vitreoretinopathy ◽  
Rhegmatogenous Retinal Detachment ◽  
Scleral Buckling ◽  
Surgical Microscope ◽  
Initial Surgery ◽  
Retinal Breaks ◽  
Retinal Reattachment ◽  
Indirect Ophthalmoscope

Purpose.To observe the long-term effectiveness of scleral buckling and transscleral cryopexy conducted under a surgical microscope in the treatment of uncomplicated rhegmatogenous retinal detachment.Methods.This was a retrospective analysis in a total of 227 consecutive patients (244 eyes) with uncomplicated rhegmatogenous retinal detachment (proliferative vitreoretinopathy ≤ C2). All patients underwent scleral buckling and transscleral cryopexy under a surgical microscope without using a binocular indirect ophthalmoscope or a contact lens.Results.After initial surgery, complete retinal reattachment was achieved in 226 eyes (92.6%), and retinal redetachment developed in 18 eyes (7.4%). The causes of retinal redetachment included presence of new breaks in eight eyes (44%), failure to completely seal the breaks in five eyes (28%), missed retinal breaks in four eyes (22%), and iatrogenic retinal breaks in one eye (6%). Scleral buckling surgery was performed again in 12 eyes (66%). Four eyes (22%) developed proliferative vitreoretinopathy and then were treated by vitrectomy. The sealing of retinal breaks and complete retinal reattachment were achieved in 241 eyes (98.8%).Conclusion.Probably because of clear visualization of retinal breaks and being controllable under a surgical microscope, the microsurgery of scleral buckling and transscleral cryopexy for uncomplicated retinal detachment exhibits advisable effectiveness.

scholarly journals Drain Fluid Cryo-Explant Technique for Treatment of Superior Bullous Rhegmatogenous Retinal Detachment

2019 ◽  
Author(s):  
Kamal Solaiman ◽  
Mahmoud A Alaswad ◽  
Ashraf Mahrous ◽  
Khaled Salah ◽  
Hesham A Enany ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Case Series ◽  
Subretinal Fluid ◽  
Secondary Outcome ◽  
Retinal Break ◽  
Retinal Breaks ◽  
Case Series Study ◽  
Drain Fluid ◽  
The Mean

Abstract Background: Evaluation of the safety and efficacy of the Drain Fluid Cryo-Explant (DFCE) technique for management of uncomplicated superior bullous rhegmatogenous retinal detachment (RRD). Methods: A retrospective interventional case series study that included eyes with uncomplicated superior bullous RRD and a duration less than one month. The DFCE technique which involved sequential drainage of subretinal fluid (SRF), intravitreal fluid injection, cryotherapy and placement of a scleral explant(s). The primary outcome measure was the anatomical reposition of the retina after a single surgery. Secondary outcome measures included improvement in visual acuity and any reported complication related to the procedure. Results: The study included 52 eyes (52 patients) with a mean duration of retinal detachment 19.7±6.4 days. A single retinal break was found in 31 eyes (59.6%) and more than one break were found in 21 eyes (40.4%). The mean detached area per eye was 6.3±2.8 clock hours, and the macula was detached in 23 eyes (44.2%). The mean number of breaks per eye was 1.72±1.04. Flattening of the retina and closure of all retinal breaks were achieved in all eyes. Late recurrence of RD occurred in 2 eyes (3.9%) due to PVR. No retinal incarceration or retinal folding were reported. Conclusions: DFCE is an economic technique that could be effectively used for treatment of uncomplicated superior bullous RRD. It provides good visualization during surgery that allows accurate localization of all retinal breaks, proper placement of a relatively low buckle and precise application of cryotherapy to all margins of the retinal break(s).

scholarly journals Internal Limiting Membrane Flap in the Management of Retinal Detachment due to Paracentral Retinal Breaks

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Yen-Chih Chen ◽  
Chung-May Yang ◽  
San-Ni Chen
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Structural Changes ◽  
Rhegmatogenous Retinal Detachment ◽  
Case Series ◽  
Major Complication ◽  
Internal Limiting Membrane ◽  
Fluid Exchange ◽  
Membrane Peeling ◽  
Retinal Breaks

Purpose. To describe the technique and outcomes of using either inverted or free internal limiting membrane flap in the management of retinal detachment due to paracentral retinal breaks. Methods. This retrospective observational case series includes nine patients who received surgery for retinal detachment due to paracentral retinal breaks developed either from primary rhegmatogenous origin, or secondary iatrogenic retinal breaks after prior membrane peeling, or during surgery for tractional retinal detachment. Either inverted or free internal limiting membrane flaps were inserted in the identified breaks, followed by air fluid exchange and gas tamponade. Visual acuity and structural changes were evaluated. Results. Nine eyes were included. One had primary rhegmatogenous retinal detachment, one had highly myopic eye with peripapillary atrophic hole, three had secondary retinal detachment after membrane peeling for foveoschisis or macular pucker, one had recurrent retinal detachment due to proliferative vitreoretinopathy, one had combination of tractional and rhegmatogenous retinal detachment, and two had iatrogenic breaks during surgery. The retinal breaks of all eyes were sealed with retina attached postoperatively. Visual acuity in logarithm of minimal angle of resolution improved from 1.18 ± 0.55 preoperatively to 0.74 ± 0.47 postoperatively (p=0.04). Conclusion. Internal limiting membrane flap technique can be a surgical approach selectively for retinal detachment due to paracentral retinal breaks with difficulty for laser application. The retina can be attached successfully and achieve good visual outcome without major complication. This trial is registered with NCT03707015.

scholarly journals 25-gauge vitrectomy with gas tamponade for rhegmatogenous retinal detachment: experienced vs. inexperienced surgeons

2020 ◽  
Author(s):  
Martin Pencak ◽  
Miroslav Veith ◽  
Zbynek Stranak ◽  
Jakub Dite ◽  
Jana Vranova ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Success Rate ◽  
Rhegmatogenous Retinal Detachment ◽  
Case Series ◽  
Functional Results ◽  
Complication Rates ◽  
Gas Tamponade ◽  
Single Operation ◽  
Case Series Study ◽  
The Mean

Abstract Introduction: To compare the results and complication rates of a 25-gauge pars plana vitrectomy (25g PPV) with gas tamponade for rhegmatogenous retinal detachment (RRD) between experienced and inexperienced surgeons.Materials and Methods: This is a retrospective comparative consecutive case series study of patients with uncomplicated RRD treated with 25g PPV with gas tamponade. Patients were divided into 2 groups: In Group 1 (ESG) the procedure was performed by an experienced vitreoretinal surgeon and in Group 2 (ISG) the procedure was performed by 2 inexperienced surgeons. Anatomical and functional results and complication rates were compared between the two groups.Results: 216 eyes were included in the study. In the ESG (106 eyes), the single operation success rate was 94.3%, and the final success rate was 100%. The mean best-corrected visual acuity (BCVA) improved from 0.38 decimal to 0.73 decimal. In the ISG (110 eyes), the single operation success rate was 93.6%, and the final success rate was 100.0%. The mean BCVA improved from 0.33 decimal to 0.74 decimal. The differences between groups were not statistically significant. There was no difference in complication rates between groups.Conclusions: A 25g PPV with gas tamponade for treatment of RRD yields excellent anatomical results and improvement in BCVA. With good technique and use of modern vitrectomy machines and instruments, even inexperienced surgeons can achieve high single operation success rate, suggesting a short learning curve. The complication rate is comparable between experienced and inexperienced surgeons.

scholarly journals The risk factors of the progression of rhegmatogenous retinal detachment on patients with the fourteen-day quarantine in the early period of COVID-19 outbreak

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Meng Zhao ◽  
Jipeng Li ◽  
Haicheng She ◽  
Ningpu Liu
Keyword(s):  
Risk Factors ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Proportional Hazards Model ◽  
Clinical Signs ◽  
Case Series ◽  
Early Period ◽  
Cox Proportional Hazards Model ◽  
Choroidal Detachment ◽  
Retinal Breaks

Abstract Backgrounds The COVID-19 Pandemic has a great impact on hospitals and patients. The 14-day quarantine caused surgery of rhegmatogenous retinal detachment (RRD) postponed. We aimed to explore the risk factors of RRD progression in a group of patients whose surgery was postponed during the top-level emergency response of COVID-19. Methods A retrospective case series. Medical records of all consecutive patients with a diagnosis of RRD who underwent a surgical treatment at Beijing Tongren Hospital’s retina service from February 16, 2020, to April 30, 2020 have been reviewed retrospectively. Medical history, symptoms, and clinical signs of progression of RRD were recorded. RRD progression was defined as the presence of either choroidal detachment or proliferative vitreoretinopathy (PVR) progression during the quarantine period. Risk factors were analyzed using the Cox proportional hazards model, survival analysis, and logistic regression. Results Seventy-nine eyes of 79 patients met the inclusion criteria and were included in the study. The median time from the patients’ presentation at the clinic to admission for surgery was 14 days (3–61 days). There were 70 cases (88.6%) who did not present to the hospital within 1 week of the onset of visual symptoms. There were 69 (87.3%) macular-off cases at the presentation and 27 (34.2%) cases combined with choroidal detachment. There were 49 (62.0%) cases with PVR B, 22 (27.8%) cases with PVR C, 4 (5.1%) cases with PVR D, and 4 (5.1%) cases with anterior PVR. After the 14-day quarantine, 21 (26.6%) cases showed RRD progression, and 9 cases showed RRD regression at the time of surgery. Neither the time of onset of the visual symptom (p = 0.46) nor the time between presentation and admission (p = 0.31) was significantly different between the patients with RRD progression and patients without RRD progression. The combination of choroidal detachment (3.07, 1.68-5.60, p<0.001) and retinal breaks located posterior to the equator (3.79, 1.21-11.80, p=0.02) were factors related to the progression of RRD. Conclusions In our study during the COVID-19 outbreak, the RRD progression risk factors included a combination of choroidal detachment and retinal breaks posterior to the equator. Ophthalmologists should schedule the surgeries for RRD patients with these signs as soon as possible.

scholarly journals Human amniotic membrane grafts for retinal breaks in diabetic tractional retinal detachment and combined tractional and rhegmatogenous retinal detachment

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yen-Chih Chen ◽  
San-Ni Chen
Keyword(s):  
Retinal Detachment ◽  
Tissue Regeneration ◽  
Amniotic Membrane ◽  
Rhegmatogenous Retinal Detachment ◽  
Case Series ◽  
Control Group ◽  
Human Amniotic Membrane ◽  
Ellipsoid Zone ◽  
Retinal Breaks ◽  
Additional Surgery

AbstractTo describe the surgical outcomes of using human amniotic membrane (hAM) grafts in the management of retinal breaks in diabetic tractional detachment (TRD) and combined tractional and rhegmatogenous retinal detachment (CTRRD). A retrospective case series of 10 eyes with TRD or CTRRD receiving pars plana vitrectomy with hAM grafts implantation, compared with 13 controls receiving the same surgery without hAM grafts. Best-corrected visual acuity (BCVA) and re-detachment rate were compared between two groups. Postoperatively, all eyes in the hAM group had retina attachment without recurrence, while 9 eyes in the control group had retina re-detachment and required additional surgery (0% vs 69.2%, p = 0.003). The BCVA significantly improved in the hAM group (from 1.96 ± 0.95 to 1.44 ± 0.77 in log MAR, p = 0.03), but not improved in control group (p = 0.20). Postoperative optical coherence tomography of the eyes receiving hAM grafts demonstrated glial tissue regeneration and restoration of ellipsoid zone. In diabetic TRD or CTRRD, hAM grafts could be an effective method, with promising outcome. Compared to standard surgery, it could result in higher retina reattachment rate and significant visual improvement. Moreover, it may offer the adjunctive benefit in tissue regeneration and fasten ellipsoid zone restoration.

scholarly journals Surgical outcomes of minimally invasive vitrectomy surgery in Eales’ disease

2013 ◽  
Vol 5 (2) ◽  
pp. 182-189
Author(s):  
S Khanduja ◽  
S Gupta ◽  
S Sinha ◽  
Pradeep Venkatesh ◽  
R Vohra ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Surgical Outcomes ◽  
Case Series ◽  
Vitreous Hemorrhage ◽  
Neovascular Glaucoma ◽  
Retinal Breaks ◽  
Eales Disease ◽  
23 Gauge ◽  
One Year

Introduction: The results of surgical outcomes of 20 gauge pars plana vitrectomy in Eales’ disease are available in the scientific literature. However, all these studies have been done using the 20 gauge vitrectomy systems and most studies have been conducted in a retrospective manner. Objective: To evaluate the outcomes and safety of 23 gauge vitrectomy in complications of Eales’ disease. Materials and methods: Study design: Consecutive interventional case series. Participants: Seventy-six eyes of 72 nonconsecutive patients undergoing 23-gauge vitrectomy for complications of Eales’ disease were enrolled. The participants were followed up for a minimum of one year. Intervention: The participants underwent a complete demographic, medical and ophthalmic evaluation. A 23-gauge vitrectomy was performed. Endotamponade was used when necessary. Perioperative and postoperative events were recorded. Primary outcome measures were visual acuity and complications arising due to surgery. Results: Indication for surgery was non-clearing vitreous hemorrhage in 89.4% (68/76) and secondary retinal detachment in 10.6% (8). Visual acuity improved from Log Mar 1.80 ± 0.19 units preoperatively to Log Mar 0.47±0.59. Best-corrected visual acuity equivalent to Snellen 6/9 was achieved in 77. 6% of eyes. . Surgical failure was seen in 6.5% cases. Four cases were lost due to progression to neovascular glaucoma and 1 case was lost to severe residual retinal detachment. Iatrogenic portside retinal breaks occurred in 3.9% (3), post-vitrectomy retinal detachment 2.6% ( 2), hypotony 1.3% (1) and cataract in 38.1% (28) cases. Conclusion: 23-gauge sutureless vitrectomy in patients with Eales’ disease is a safe and effective technique with acceptable level of risk and complications. Nepal J Ophthalmol 2013; 5(10): 182-189 DOI: http://dx.doi.org/10.3126/nepjoph.v5i2.8710

Sign in / Sign up

Export Citation Format

Share Document