scholarly journals Efficacy and Safety of Vitrectomy without Using Perfluorocarbon Liquids and Drainage Retinotomy Associated with Postoperative Positioning Based on Residual Subretinal Fluid for Rhegmatogenous Retinal Detachment

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Paolo Chelazzi ◽  
Claudia Azzolini ◽  
Claudia Bellina ◽  
Francesca Cappelli ◽  
Ilaria Del Genovese ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Surgical Procedure ◽  
Rhegmatogenous Retinal Detachment ◽  
Intraoperative Complications ◽  
Subretinal Fluid ◽  
Vitreoretinal Surgery ◽  
Perfluorocarbon Liquids ◽  
Secondary Endpoints ◽  
Encircling Band ◽  
Pars Plana

Medical records of 75 eyes from 75 consecutive patients with uncomplicated rhegmatogenous retinal detachment (RRD) who underwent pars plana vitrectomy (PPV) were analyzed. Inclusion criteria were patients with RRD who underwent primary 23- or 25-gauge PPV with air, gas, or SiO tamponade and performed by a single surgeon, no use of perfluorocarbon liquids (PFCL) and drainage retinotomy, and follow-up ≥ six months. Exclusion criteria were patients who underwent previous vitreoretinal surgery, proliferative vitreoretinopathy (PVR) more than grade B, giant tears, and encircling band associated with PPV. The main endpoint was the anatomical retinal reattachment rate after a single surgical procedure. Secondary endpoints were best-corrected visual acuity (BCVA), postoperative retinal displacement, and intraoperative and/or postoperative complications. Primary anatomical success was achieved in 97.3% of cases using this modified surgical procedure. Retinal slippage occurred only in 28.2% of patients and it was not observed in all cases of macula-on RRD. The mean logMAR of the BCVA significantly improved in 92% of patients and no intraoperative complications were observed. The results suggest that complete subretinal liquid drainage is not mandatory for all RRD cases treated with PPV and that using PFCL and performing a drainage retinotomy are not essential in eyes with primary RRD and PVR less than grade B. Postoperative positioning after PPV for uncomplicated RRD based on the presence or absence of residual subretinal fluid at the end of surgery could limit the occurrence of postoperative retinal displacement, while promoting patient compliance.

Our Experience with Perfluorohexyloctane (F6H8) as a Temporary Endotamponade in Vitreoretinal Surgery

2002 ◽  
Vol 12 (6) ◽  
pp. 518-522 ◽  
Author(s):  
M.I. Stefaniotou ◽  
M.V. Aspiotis ◽  
G.D. Kitsos ◽  
CHR.D. Kalogeropoulos ◽  
I.C. Asproudis ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Vitreoretinal Surgery ◽  
Additional Surgery ◽  
Special Cases ◽  
Perfluorocarbon Liquids ◽  
Pars Plana ◽  
Oil Injection ◽  
Anatomical Success

Purpose To evaluate the use of F6H8 as a temporary endotamponade for complicated and special cases of retinal detachment instead of silicone oil. Methods We have used F6H8 with 14 patients since February 1999. Eight suffered from rhegmatogenous retinal detachment (RRD) with multiple tears located inferiorly. Three presented inferior traction retinal detachment (TRD) under silicone oil, two suffered from ocular trauma with inferior TRD, and one had idiopathic macular hole. The substance was introduced into the eye after pars plana vitrectomy and membrane peeling if needed, and we tried to introduce as much as possible. Results With F6H8 the retina was easily reattached in all cases, like with perfluorocarbon liquids. The postoperative view was very good. F6H8 was removed in all cases after 3–8 weeks. Anatomical success was achieved in 12 out of 14 eyes. Two eyes presented severe PVR. F6H8 entered the anterior chamber in 4 cases, but no corneal complications occurred. In one case there was a marked IOP rise due to an anterior block, treated with superior iridotomy. In two cases retinal detachment (RD) occurred in the upper part and was treated with additional surgery, F6H8 removal and silicone oil injection. Conclusions F6H8 seems to be a promising tamponade agent for special cases of RD.

Properties of Gases Used in Vitrectomy Surgery in Rhegmatogenous Retinal Detachment

2019 ◽  
pp. 172-175
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Visual Loss ◽  
Rhegmatogenous Retinal Detachment ◽  
Vitreoretinal Surgery ◽  
Scleral Buckle ◽  
Pneumatic Retinopexy ◽  
The World ◽  
Pars Plana ◽  
Vitrectomy Surgery

Despite improvements in vitreoretinal surgery techniques, rhegmatogenous retinal detachment is still one of the major causes of visual loss in the world. Pneumatic retinopexy (PR), scleral buckle, and pars plana vitrectomy (PPV) are the modalities that are used in the treatment of retinal detachment. Intraocular gases, which are frequently used in PR and PPV, are indispensable molecules due to their tamponade effects. In order to get favorable postoperative outcomes, the proper type of gas selection should be made by considering the properties of the gases, indications, potential complications, and findings of the patients together.

Iatrogenic Subretinal Triamcinolone During Primary Surgical Repair of a Retinal Detachment With a Giant Retinal Tear

2020 ◽  
pp. 247412642097455
Author(s):  
Kunyong Xu ◽  
Eric K. Chin ◽  
David R.P. Almeida
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Surgical Repair ◽  
Vitreoretinal Surgery ◽  
Subretinal Space ◽  
Perfluorocarbon Liquid ◽  
Retinal Tear ◽  
Giant Retinal Tear ◽  
Mechanical Removal ◽  
Pars Plana

Purpose: We describe the outcome of a 23-year-old man undergoing vitreoretinal surgery for a macula-off rhegmatogenous retinal detachment secondary to a giant retinal tear. Methods: Patient underwent combined 25- gauge 3-port pars plana vitrectomy with scleral buckle, perfluorocarbon liquid, and perfluoropropane gas tamponade. During surgery, triamcinolone inadvertently entered the subretinal space and was retained. Results: The subretinal triamcinolone deposits spontaneously absorbed over a 2-month period. No adverse sequelae were associated with this complication. Conclusion: This may support avoiding aggressive mechanical removal of iatrogenic subretinal triamcinolone in the context of retinal detachment repair.

scholarly journals Sympathetic ophthalmia after vitreoretinal surgery: a report of two cases

2021 ◽  
Vol 49 (8) ◽  
pp. 030006052110327
Author(s):  
Junhui Shen ◽  
Zheng Zhang ◽  
Dian Ye ◽  
Zuohui Wen ◽  
Xupeng Shu ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Vitreoretinal Surgery ◽  
Sympathetic Ophthalmia ◽  
Positive Outcomes ◽  
Dexamethasone Intravitreal Implant ◽  
Intravitreal Implant ◽  
Pars Plana ◽  
23 Gauge

Sympathetic ophthalmia (SO) is a panuveitis that usually occurs after trauma to one eye. We describe two cases of SO occurring after 23-gauge vitrectomy. Case 1 involved a 66-year-old woman who underwent pars plana vitrectomy (PPV) for a rhegmatogenous retinal detachment. Two months later, she presented with decreased visual acuity (VA) and bilateral uveitis. Case 2 involved a 43-year-old woman who underwent a second PPV for recurrent retinal detachment. Two months later, she presented with bilateral panuveitis. Both patients were diagnosed with SO and were treated with methylprednisolone and cyclosporine. The first patient was further treated with a dexamethasone intravitreal implant (Ozurdex®) owing to the side effects of methylprednisolone. The VA and symptoms improved significantly after treatment in both patients. Bilateral granulomatous panuveitis following PPV should alert surgeons to consider SO. Appropriate interventions for SO can produce positive outcomes.

Posterior Retinotomy vs Perfluorocarbon Liquid to Aid Drainage of Subretinal Fluid During Primary Rhegmatogenous Retinal Detachment Repair (PRO Study Report No. 10)

2020 ◽  
Vol 4 (6) ◽  
pp. 494-498
Author(s):  
Loi V. Vo ◽  
Edwin H. Ryan ◽  
Claire M. Ryan ◽  
Gaurav K. Shah ◽  
Omesh P. Gupta ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Surgical Procedures ◽  
Subgroup Analysis ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Subretinal Fluid ◽  
Postoperative Outcomes ◽  
Perfluorocarbon Liquid ◽  
Pars Plana ◽  
Retrospective Comparative Study

Purpose: This work compares posterior retinotomy vs perfluorocarbon liquid (PFCL) for subretinal fluid (SRF) drainage during pars plana vitrectomy for primary rhegmatogenous retinal detachment (RRD). Methods: In this large, multicenter, retrospective comparative study, 2620 patients underwent pars plana vitrectomy (with or without scleral buckle) for uncomplicated RRD. Patients for whom SRF was drained via the primary break without retinotomy or PFCL were excluded; those who required both retinotomy and PFCL were similarly excluded. Remaining patients were separated into “retinotomy” and “PFCL” cohorts. Subgroup analysis was conducted for macula-on and macula-off subgroups. Postoperative outcomes were analyzed and compared. Results: A total of 760 eyes (82.7%) had retinotomy and 159 eyes (17.3%) had PFCL for drainage of SRF, and baseline characteristics between the 2 groups were similar. Postoperative analysis showed similar outcomes between the retinotomy and PFCL cohorts, including final visual acuity ( P = .19), redetachment rate ( P = .30), anatomic success ( P = .28), presence of postoperative epiretinal membrane ( P = .75), and other macular pathologies ( P > .99). Subgroup analysis yielded similar outcomes for macula-on and macula-off subgroups. Postoperative presence of retained PFCL was 2.4%, possibly a factor in the slightly higher number of subsequent surgical procedures ( P = .03) in the PFCL cohort. Conclusions: Postoperative outcomes for retinotomy vs PFCL during RRD repair are comparable, aside from slightly greater number of subsequent surgical procedures needed in the PFCL cohort. Our analysis suggests both techniques are reasonable tools in the repair of macula-on or macula-off RRD.

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.

scholarly journals The surgical experience in recurrent retinal detachments after episcleral procedures

2014 ◽  
Vol 7 (4) ◽  
pp. 22-26
Author(s):  
Abdul-Gamid Davudovich Aliev ◽  
Dzhenet Nabievna Sharipova ◽  
Akhmed Gamidovich Aliev ◽  
Maysarat Tinamagomedovna Mikailova
Keyword(s):  
Retinal Detachment ◽  
Complex Disease ◽  
Rhegmatogenous Retinal Detachment ◽  
Gas Injection ◽  
Subretinal Fluid ◽  
Vitreoretinal Surgery ◽  
Surgical Experience ◽  
Surgical Tactics ◽  
Surgical Treatments ◽  
Flap Tear

The two major surgical treatments of retinal detachments are episcleral and intravitreal procedures. There is no general consensus as to which procedure is the most appropriate for this complex disease. The aim of the study was to define differentiated surgical tactics, and to look at five year results of extrascleral surgical procedures based upon clinical and statistical analysis. . The results showed that primary rhegmatogenous retinal detachment with proliferative vitreoretinopathy (PVR) stage A is an indication for episcleral buckling if tears are located in the retinal periphery. If there are multiple tears, a concomitant macular hole or a large flap tear, the surgery may also include drainage of subretinal fluid, intravitreal air or gas injection, and avoidance of the use of cryotherapy. The causes for 19 recurrences that required subsequent vitreoretinal surgery are: PVR progression after surgery and as a consequence of it a retinal detachment recurrence, epiretinal fibrosis, subretinal proliferation.

scholarly journals Outcome of Scleral Buckling With or Without Gas Tamponade for Recurrent Retinal Detachment in Post-vitrectomy Eyes

2020 ◽  
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 first 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. The re-RD involved the fovea in 7 (50%) eyes. There was no break detected in 2 eyes, suspected break in 5 eyes, 1 break in 4 eyes, 2 breaks in 2 eyes, and 3 breaks in 1 eye. 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.

Sign in / Sign up

Export Citation Format

Share Document