scholarly journals Surgical Management of a Case of a 360-Degree Giant Retinal Break

2016 ◽  
Vol 235 (4) ◽  
pp. 241-241
Author(s):  
Ahmed Elshewy
Keyword(s):  
Retinal Detachment ◽  
Ocular Trauma ◽  
Silicone Oil ◽  
University Hospital ◽  
Anterior Leaflet ◽  
Retinal Break ◽  
Traumatic Cataract ◽  
Epiretinal Membranes ◽  
Posterior Hyaloid ◽  
Retinal Slippage

Purpose: The aim is to describe tools and techniques that can be used to deal with total retinal detachment (open funnel) and associated proliferative vitreoretinopathy due to a 360-degree giant retinal break following ocular trauma. Setting/Venue: The video (available at www. karger.com/doi/10.1159/000444811) was created at the Ophthalmology Department, Faculty of Medicine Kasr Al Ainy, Cairo University Hospital, Cairo, Egypt. Methods: A 16-year-old female patient presented to the Cairo University Hospital after blunt ocular trauma. She had traumatic cataract, and ultrasound examination showed total retinal detachment. She was scheduled for surgery at the Cairo University Hospital. Phacoemulsification of traumatic cataract was done after insertion of the 3-port 23-gauge trocar system. The 25-gauge chandelier illumination system was used to assist the peeling of adherent posterior hyaloid and epiretinal membranes, allowing bimanual work using an end-gripping forceps and a diamond-dusted retinal scrapper. Removal of the vitreous surrounding the retinal funnel was performed, and a small perfluorocarbon (PFC) bubble was used to support the posterior pole. This was followed by refreshing the rolled edges of the retinal break and shaving the vitreous base and anterior leaflet of the giant break by surgeon-assisted scleral indentation. The eye was completely filled with PFC, and Argon laser retinopexy was performed. Direct PFC-silicone oil exchange was done to avoid retinal slippage (silicone oil 5,000 cSt was used). Results: Retinal attachment was successfully achieved at the end of the surgery. The silicone oil was removed 5 months after the initial surgery. The patient's uncorrected visual acuity 1 month after removal of the silicone was 0.4. Conclusions: The chandelier-assisted bimanual technique is an effective method for dealing with adherent posterior hyaloid and epiretinal membranes in a detached retina, particularly in cases of complex open-funnel retinal detachment. Proper shaving of the anterior leaflet and refreshing the edges of the retinal break helps decrease postoperative PVR formation. Direct PFC-silicone oil exchange in giant retinal breaks helps minimize the risk of retinal slippage occurrence.

Limitation of computed tomography scan in ocular trauma in diagnosing posterior globe rupture and retinal detachment

Trauma ◽  
2016 ◽  
Vol 20 (1) ◽  
pp. 72-76
Author(s):  
AR Munirah ◽  
MK Safinaz ◽  
ZMZ Aida ◽  
A Malisa ◽  
MI Hazlita
Keyword(s):  
Computed Tomography ◽  
Retinal Detachment ◽  
Ocular Trauma ◽  
Silicone Oil ◽  
Primary Repair ◽  
Computed Tomography Scan ◽  
Penetrating Eye Injury ◽  
Globe Rupture ◽  
Open Globe ◽  
Tomography Scan

Ocular trauma with penetrating eye injury or globe rupture is an ophthalmic emergency. Immediate but gentle ocular assessment is mandatory to diagnose the extent of the injury. Imaging modalities are valuable in aiding diagnosis and management in open globe injury due to the difficulty of full eye assessment in the presence of multiple head and facial injuries. This report presents a case of an elderly man with ocular trauma of the left only seeing eye where computed tomography scan showed anterior globe rupture and the possibility of posterior globe rupture due to discontinuity of the posterior sclera. Primary repair and exploration of the left eye revealed no posterior globe rupture. Post-operative B-scan revealed a total retinal detachment with intact posterior globe. Vision of the left eye after pars planar vitrectomy and tamponade of the retina detachment with heavy silicone oil improved to 1/60. Computed tomography scan in ocular trauma has limitations especially in diagnosing retinal detachment and posterior globe rupture.

scholarly journals PROLIFERATIVE VITREORETINOPATHY

2006 ◽  
Vol 13 (01) ◽  
pp. 42-46
Author(s):  
SYED ABID HASSAN NAQVI ◽  
SOHAIL SHEHZAD ◽  
OMAR ZAFAR
Keyword(s):  
Retinal Detachment ◽  
Proliferative Vitreoretinopathy ◽  
Rhegmatogenous Retinal Detachment ◽  
Ocular Trauma ◽  
Silicone Oil ◽  
Military Hospital ◽  
Globe Rupture ◽  
Department Of Ophthalmology ◽  
Anatomical Success ◽  
Blunt Ocular Trauma

Objective: The objective of study to assess the success of pars planavitrectomy with use of silicone Oil for internal tamponade in traumatic rhegmatogenous R D with severe PVR. Setting& Period: This study was carried out in department of Ophthalmology Military Hospital Rawalpindi. Material &Methods: Fifteen cases with severe proliferative vitreoretinopathy (PVR Grade C, according to up dated retina SocietyClassification of 1991) was included in study. All the patients had traumatic rhegmatogenous retinal detachment withhistory of blunt ocular trauma, without globe rupture, outcome of the treatment was assessed by post operativeanatomical and physiological success. Results: Anatomical success was encouraging in-spite of advance disease andtechnically difficult and complicated intra-ocular maneuvers.

scholarly journals Study on the effectiveness and safety of Foldable Capsular Vitreous Body implantation

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Xiangyang Zhang ◽  
Xuemin Tian ◽  
Baike Zhang ◽  
Lisa Guo ◽  
Xiaodan Li ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Ocular Trauma ◽  
Silicone Oil ◽  
Vitreous Body ◽  
Fundus Photography ◽  
Specular Microscopy ◽  
Applanation Tonometer ◽  
Before And After ◽  
Fellow Eyes

Abstract Background Foldable capsular vitreous body (FCVB) was designed to treat severe retinal detachment. The aim of this study was to evaluate the efficacy and safety of the implantation of foldable capsular vitreous body in 1-year follow-up. Methods A retrospective analysis was conducted for 20 patients with severe ocular trauma or silicone oil (SO) dependent eyes underwent vitrectomy and FCVB implantation in a 1-year follow-up. All treated eyes were peformed clinical examinations involved the visual acuity (VA) examination, Goldmann applanation tonometer, noncontact specular microscopy, fundus photography, B-Scan examination and optical coherence tomography (OCT). The groups were compared with t-test and the McNemar - Bowker test. Results In 1-year follow-up, 20 eyes were evaluated in the study. FCVB well supported the vitreous retina in all treated eyes, and 6 treated eyes achieved retinal reattachment 12 months after FCVB implantation. There were no significant differences in VA before and after FCVB implantation (P = 1.000). In addition, the postoperative IOP markedly elevated from the preoperative IOP of 12.90 ± 7.06 mmHg to 15.15 ± 3.36 mmHg (P = 0.000017). The intraocular pressure (IOP) of 10 eyes maintained at a normal level after surgeries. The other 10 eyes showed slightly lower IOP within the acceptable level. Though two patients developed keratopathy and ocular inflammation respectively, other treated eyes were symmetric with fellow eyes showing satisfactory appearance. Moreover, there was no SO emulsification or leakage happened in the observation. Conclusions FCVB implantation was an effective and safe treatment in the eyes with severe retinal detachment.

Macular optical coherence tomography findings after vitreoretinal surgery for rhegmatogenous retinal detachment

2020 ◽  
Vol 30 (4) ◽  
pp. 805-816
Author(s):  
Michele Coppola ◽  
Alessandro Marchese ◽  
Maria Vittoria Cicinelli ◽  
Alessandro Rabiolo ◽  
Chiara Giuffrè ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Subretinal Fluid ◽  
Vitreoretinal Surgery ◽  
Optical Coherence ◽  
Cross Sectional ◽  
Epiretinal Membranes ◽  
Funduscopic Examination

The primary aim of this study was to summarize and illustrate the main structural cross-sectional optical coherence tomography findings encountered after vitreoretinal surgery for rhegmatogenous retinal detachment. This was a non-systematic review of literature on structural cross-sectional optical coherence tomography findings after vitreoretinal surgery for rhegmatogenous retinal detachment. Adequate illustrations of the main findings described were found after a retrospective analysis of imaging and charts of patients operated at the department where this study was performed. The main structural cross-sectional optical coherence tomography findings after vitreoretinal surgery for rhegmatogenous retinal detachment included persistent subretinal fluid, subretinal blebs, retinal folds, subretinal perfluorocarbon liquids, macular alterations related to silicone oil, epiretinal membranes, proliferative vitreoretinopathy, cystoid macular edema, macular holes, and recurrent retinal detachment. In conclusion, optical coherence tomography was a useful tool after vitreoretinal surgery for rhegmatogenous retinal detachment. Some optical coherence tomography findings may not be evident on fundus examination, and optical coherence tomography can reveal essential details for the clinical management and the visual prognosis. Other findings, despite being visible on funduscopic examination, may be better assessed with the aid of optical coherence tomography. All these elements contribute to support the importance of tomographic assessment in the follow-up of eyes treated for vitreoretinal conditions.

scholarly journals Successful Management in a Case of Traumatic Retinal Detachment due to Open Globe Injury Using Microincisional Vitrectomy

2016 ◽  
Vol 7 (3) ◽  
pp. 476-480 ◽  
Author(s):  
Wei-Yu Lai ◽  
Tsung-Tien Wu
Keyword(s):  
Retinal Detachment ◽  
Ocular Trauma ◽  
Silicone Oil ◽  
Medical Center ◽  
Primary Repair ◽  
Surgical Techniques ◽  
Open Globe Injury ◽  
Open Globe ◽  
Silicone Oil Tamponade

Background: Retinal detachment (RD) following ocular trauma often results in guarded visual prognosis and sometimes leads to loss of the eye. With the advent of microincisional vitrectomy surgery and the development of surgical techniques, the management of ocular trauma has been transformed. Case Presentation: A 34-year-old man sustained an open globe injury from fragmented glass at work. He received primary repair and another follow-up surgery 9 days later, including vitrectomy, silicone oil tamponade, and lensectomy for RD and traumatic cataract at another medical center. However, his retina was totally detached and completely curled up in a roll with choroid on display when he was seen by us 1 month later. He was managed with vigilant and patient peeling and unfolding of the retina using a 23-gauge forceps and silicone oil tamponade, and achieved anatomical success and preservation of his eye at 6-month follow-up. Conclusions: This report demonstrates that even in cases which appear to be hopeless at presentation, the surgeon’s perseverance and surgical technique can salvage an eye that may otherwise be phthisical. It also encourages retinal surgeons to use microincisional vitrectomy to manage severe traumatic RD.

Effect of prophylactic laser during small-gauge vitrectomy for epiretinal membranes

2021 ◽  
pp. 112067212199294
Author(s):  
Edward F Linton ◽  
Stephen J Kim ◽  
Shriji N Patel
Keyword(s):  
Retinal Detachment ◽  
Epiretinal Membrane ◽  
Medical Center ◽  
Statistical Significance ◽  
Demographic Data ◽  
Surgical Techniques ◽  
Final Analysis ◽  
Outcome Data ◽  
Retinal Break ◽  
Epiretinal Membranes

Purpose: To determine the rate of post-operative retinal detachment after elective pars plana vitrectomy for epiretinal membrane, and to test for the mitigating effect of prophylactic endolaser. Methods: We identified 459 eyes of 411 patients undergoing vitrectomy for epiretinal membrane at Vanderbilt University Medical Center between January 2010 and May 2017. Patients who underwent concurrent endolaser without any identified retinal break were included in the exposure cohort. Patients who underwent no prophylactic retinopexy or ablation were included in the unexposed cohort. Exposure data, demographic data, and outcome data were tabulated for comparison. Results: The final analysis included 343 eyes of 343 patients. Approximately 7% of eyes undergoing ERM surgery were found to have a full-thickness retinal break which was not seen preoperatively. The overall rate of postoperative RD was 2.04%. Postoperative retinal detachment occurred in 0 of the 34 eyes exposed to prophylactic laser, and in 7 of the 309 control eyes. Odds ratio was found to be 0.60 ( p = 0.598 (95%CI 0.0327–10.7), p = 0.72), indicated the results were not statistically significant. Discussion: Looking at patients undergoing routine vitrectomy surgery for epiretinal membrane, no retinal detachments occurred in the group receiving prophylactic treatment, though this association did not reach statistical significance. With modern surgical techniques, post-operative retinal detachment remains relatively rare after vitrectomy for ERM though a thorough intraoperative exam is critical to identify occult retinal breaks.

scholarly journals Cataract Progression Following Lens-Sparing Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment

2021 ◽  
Author(s):  
Carlo Bellucci ◽  
Lucia Benatti ◽  
Maurizio Rossi ◽  
Salvatore Antonio Tedesco ◽  
Arturo Carta ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Cataract Extraction ◽  
University Hospital ◽  
Pars Plana ◽  
Cataract Development ◽  
Silicone Oil Tamponade

Abstract Purpose: Lens-sparing pars plana vitrectomy (PPV) is often followed by cataract development. However, there have been few prospective studies evaluating the timing of cataract progression and potential associated factors.Methods: This was an observational study conducted at the Ophthalmology Unit of the University Hospital of Parma (Parma, Italy). Patients presenting with rhegmatogenous retinal detachment (RRD), who underwent PPV with preservation of the lens, were examined according to a scheduled follow-up (3, 6 and 12 months after PPV) and then preoperatively when cataract extraction surgery (CES) was indicated, or at the end of the study follow-up period (May 2021). The primary outcome was the interval between PPV and CES indication (based on predefined refractive criteria).Results: A total of 36 eyes of 36 patients (mean age: 52 ± 10 years) were included in the study. Nineteen eyes (53%) were indicated for CES a median of 14.5 months (IQR: 12.0–24.8) after PPV. The nuclear and posterior subcapsular forms of cataract progressed significantly starting at 6 months after PPV. Older age at the time of PPV, silicone oil tamponade and RRD without macular involvement were significantly and independently associated with an earlier indication for CES. Conclusions: Patient age and the use of silicone oil tamponade must be taken into consideration when evaluating the risk of cataract development after PPV.

Biomedical Materials to Repair Retinal Detachments

1985 ◽  
Vol 55 ◽  
Author(s):  
Miguel F. Refojo
Keyword(s):  
Retinal Detachment ◽  
Silicone Rubber ◽  
Methyl Acrylate ◽  
Silicone Oil ◽  
Vitreous Body ◽  
Light Sensitivity ◽  
Scleral Buckling ◽  
Intraocular Injection ◽  
Other Substances

ABSTRACTImplants are essential for the repair of retinal detachments. The implant buckles the wall of the eye and apposes the detached retina with the choroid, thus restoring light sensitivity to the retina. The scleral buckling also relieves traction on the retina from a shrinking vitreous body. The implant materials most commonly used are solid silicone rubber and silicone sponges, but both types have some disadvantages. A poly(hydroxyethyl acrylate-co-methyl acrylate) hydrogel implant with improved properties of softness and antibiotic absorption is also available for retinal detachment surgery. Proliferative vitreoretinopathy involves various conditions of retinal detachment complicated by vitreous fibrosis, which, after vitrectomy, may be treated with intraocular injection of fluids that support the retina against the choroid. For conditions requiring a long-term implant, silicone oil although controversial is the material of choice. Many other substances have been investigated but none better has yet been found.

Extrascleral Filling Using Endoillumination the First Experiencethe

2020 ◽  
pp. 43-49
Author(s):  
V.Y. Markevich ◽  
◽  
T.A. Imshenetskaya ◽  
O.A. Yarmak ◽  
◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Subretinal Fluid ◽  
Crystalline Lens ◽  
Vitreous Cavity ◽  
Macular Area ◽  
General Group ◽  
Anatomical Outcome

Purpose. To study the effectiveness of extrascleral filling (ESF) using endoillumination in the surgical treatment of patients with primary rhegmatogenous retinal detachment (RRD). Material and methods. The material for the study was the data of a comprehensive clinical examination and surgical treatment by ESF method using endoillumination in 17 patients (17 eyes) with RRD. In 7 cases (41%), the macular area was involved in the detachment process. In 5 cases (29.4%), local scleral filling was performed. In the remaining 12 cases (70.6%), the local ESF was supplemented with a circling silicone element. Surgical intervention was supplemented by transscleral drainage of subretinal fluid (SRF) in 10 cases (59%) and pneumatic retinopexy with SF6 gas 50% in 8 cases (48%). Results. In the general group of patients, best corrected visual acuity (BCVA) increased from 0.35 to 0.46. In the subgroup of patients with a detached macular area, the positive dynamics is more pronounced, BCVA increased from 0.1 to 0.28. The progression of proliferative vitreoretinopathy caused the recurrence of retinal detachment in two patients (11.8%). Recurrences were diagnosed after 3 and 5 months, respectively. In both cases, a vitrectomy with tamponade of the vitreous cavity with silicone oil 5000 Cst was performed. The percentage of successful anatomical outcome after the first operation in our study was 82%. The percentage of successful achievement of the final anatomical result was 94%. In two cases, additional injection of SF6 gas into the vitreous cavity was required. Conclusion. This type of surgical treatment is an effective method of surgical treatment of patients with RRD. In our study, the successful anatomical outcome after the first operation was recorded in 82% of patients, which correlates with the data of the authors who also used this method (83–92%). Surgeons who performed surgical treatment using this technique in our study note improved workplace ergonomics when visualizing the fundus using an operating microscope and endoillumination compared with indirect ophthalmoscopy. Other teams of authors came to this conclusion as well. In our study, there were no complications associated with the introduction of a light pipe into the vitreous cavity (iatrogenic crystalline lens injury, endophthalmitis), which indicates the safety of this type of surgical treatment.

scholarly journals Refractory Myopic Retinal Detachment and Macular Hole Closure with Autologous Neurosensory Retinal Free Flap

2019 ◽  
Vol 10 (2) ◽  
pp. 160-164 ◽  
Author(s):  
Filipe Sousa Neves ◽  
Joana Braga ◽  
Paula Sepúlveda ◽  
Miguel Bilhoto
Keyword(s):  
Retinal Detachment ◽  
Macular Hole ◽  
Free Flap ◽  
Vision Loss ◽  
Silicone Oil ◽  
Modified Technique ◽  
Alternative Approach ◽  
Retinal Atrophy ◽  
One Year ◽  
Hole Closure

The purpose of this case report is to describe a modified technique involving the use of an autologous neurosensory retinal free flap for closure of a macular hole (MH) during retinal detachment (RD) surgery. A 50-year-old female presented with sudden vision loss (light perception only) and a recurrent myopic RD associated with an MH. An autologous neurosensory retinal free flap was obtained and moved toward the MH. Silicone oil was used as an endotamponade and removed after 6 months. Two months after oil removal visual acuity improved to 20/400 and remained stable thereafter; however, the patient developed central retinal atrophy. One year after surgery the MH was closed and the retina attached. This modified technique with the use of an autologous neurosensory retinal flap provides an alternative approach for recurrent MH in RD procedures.

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