scholarly journals Anatomic and functional outcomes of 25-gauge vitrectomy for repair of eyes with rhegmatogenous retinal detachment complicated by proliferative vitreoretinopathy

2013 ◽  
pp. 2043 ◽  
Author(s):  
Tatsuhiko Sato ◽  
Chiharu Iwahashi-shima ◽  
Hajime Bando ◽  
Toshihide Ikeda ◽  
Kazuyuki Emi
Keyword(s):  
Retinal Detachment ◽  
Proliferative Vitreoretinopathy ◽  
Functional Outcomes ◽  
Rhegmatogenous Retinal Detachment ◽  
25 Gauge Vitrectomy

scholarly journals Anatomical and Functional Outcomes of Vitrectomy with/without Intravitreal Methotrexate Infusion for Management of Proliferative Vitreoretinopathy Secondary to Rhegmatogenous Retinal Detachment

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Samir El Baha ◽  
Mahmoud Leila ◽  
Ahmed Amr ◽  
Mohamed M. A. Lolah
Keyword(s):  
Retinal Detachment ◽  
Proliferative Vitreoretinopathy ◽  
Functional Outcomes ◽  
Rhegmatogenous Retinal Detachment ◽  
Visual Outcome ◽  
Rank Test ◽  
Control Groups ◽  
Retinal Reattachment ◽  
The Difference

Purpose. To assess the anatomical and functional outcomes of intravitreal infusion of methotrexate (MTX) during pars plana vitrectomy (PPV) for proliferative vitreoretinopathy (PVR) associated with rhegmatogenous retinal detachment (RRD). Methods. Comparative interventional nonrandomized study including consecutive patients who had vitrectomy for RRD. The study included six groups. Groups I (established PVR), II (high risk of PVR), and III (no risk of PVR) comprised prospectively recruited study eyes, which received PPV and adjuvant intravitreal MTX infusion equivalent to 400 μg/0.1 mL. Groups IA, IIA, and IIIA comprised retrospectively recruited control groups. Main outcome measures were retinal reattachment at the end of 6 months, visual outcome, and complications. Chi-square test or Fisher’s exact test analyzed categorical variables. ANOVA test and Kruskal–Wallis test analyzed quantitative variables. Mann–Whitney U-test and independent t-test evaluated the difference between each group and its control. Comparison between two paired groups was done by Wilcoxon Rank test. The Kaplan–Meier method was used for survival analysis and the log-rank test estimated differences in event-free survival across the groups. P was significant at <0.05. Results. The study included 190 eyes of 188 patients. Study Groups I, II, and III included 42, 35, and 24 eyes, respectively. Mean age was 45 years. Male gender constituted 70% of patients. Mean follow-up period was 6 months. Control Groups IA, IIA, and IIIA included 30, 30, and 29 eyes, respectively. Mean age was 50 years. Male gender constituted 50%. Mean follow-up period was 7 months. Median rate of retinal reattachment was 82% in the study eyes versus 86% in the control eyes. The difference in the retinal reattachment rates between each study group and its respective control was not statistically significant, Group I-IA p =   0. 2 , Group II-IIA p = 0.07 , and Group III-IIIA p = 0.07 . BCVA improved by a mean of 4 lines in the study eyes versus 3 lines in the control eyes. The difference in visual outcome between each study group and its respective control was statistically significant between Groups II-IIA and III-IIIA, p = 0.03 , but not between Groups I-IA, p = 0.07 . We did not detect complications attributed to MTX use in the study eyes. Conclusion. Intravitreal infusion of MTX during PPV is a safe adjuvant therapy in RRD patients with and without PVR. MTX yields superior functional outcomes in patients at high risk of PVR and in patients with no risk of PVR compared to PPV without MTX, but not in cases with established PVR. MTX did not confer an additional advantage in terms of retinal reattachment rate. Summary. Proliferative vitreoretinopathy is a major cause of failure in surgery for rhegmatogenous retinal detachment. Methotrexate as an adjuvant therapy blocks essential drivers in the pathogenetic cascade leading to PVR. Intravitreal infusion has the advantage of blocking the pathology in its nascence and obviates the need for repeated intravitreal injections of the drug.

ANTERIOR CHAMBER AQUEOUS FLARE IS A STRONG PREDICTOR FOR PROLIFERATIVE VITREORETINOPATHY IN PATIENTS WITH RHEGMATOGENOUS RETINAL DETACHMENT

Retina ◽  
2012 ◽  
Vol 32 (1) ◽  
pp. 38-42 ◽  
Author(s):  
Sabine Schröder ◽  
Philipp S Muether ◽  
Albert Caramoy ◽  
Moritz Hahn ◽  
Medhat Abdel-Salam ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Anterior Chamber ◽  
Proliferative Vitreoretinopathy ◽  
Rhegmatogenous Retinal Detachment ◽  
Strong Predictor ◽  
Aqueous Flare

Cryopexy in primary rhegmatogenous retinal detachment: a risk factor for postoperative proliferative vitreoretinopathy?

1996 ◽  
Vol 234 (12) ◽  
pp. 739-743 ◽  
Author(s):  
Mireille Bonnet ◽  
Jacque Fleury ◽  
Sylvie Guenoun ◽  
Atés Yaniali ◽  
Christine Dumas ◽  
...  
Keyword(s):  
Risk Factor ◽  
Retinal Detachment ◽  
Proliferative Vitreoretinopathy ◽  
Rhegmatogenous Retinal Detachment

Outcomes of Primary Rhegmatogenous Retinal Detachment Repair in Eyes With Preoperative Grade B or C Proliferative Vitreoretinopathy

2021 ◽  
pp. 247412642110467
Author(s):  
Travis J. Peck ◽  
Matthew R. Starr ◽  
Yoshihiro Yonekawa ◽  
M. Ali Khan ◽  
Anthony Obeid ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Approach ◽  
Proliferative Vitreoretinopathy ◽  
Functional Outcomes ◽  
Rhegmatogenous Retinal Detachment ◽  
Primary Grade ◽  
Success Rates ◽  
Surgical Success ◽  
Intraoperative Management ◽  
Anatomic Success

Purpose: This work evaluates the anatomic and functional outcomes of primary rhegmatogenous retinal detachments (RRDs) with preoperative grade B and C proliferative vitreoretinopathy (PVR) vs eyes without PVR. Methods: As a multi-institutional, interventional, retrospective study of all patients undergoing primary RRD surgical procedures from January 1, 2015, through December 31, 2015, this study evaluated the visual acuity (VA) outcomes and single-surgery anatomic success rates (SSAS) of patients with primary grade B and C PVR at the time of RRD repair. Results: A total of 2486 eyes underwent primary RD surgery during the study period, of which 153 eyes (6.2%) had documented preoperative PVR grade B or C. Eyes without PVR had better SSAS compared with eyes with grade B or C PVR (87% vs 83% vs 75%, respectively, P < .0001). Eyes without PVR also had better final mean (SD) logMAR VA (0.35 [0.47]; 20/45 Snellen equivalent) than eyes with PVR of grade B (0.50 [0.56]; 20/63 Snellen equivalent) or grade C ( P < .0001). In only eyes with preoperative PVR, there were no significant differences in final VA or SSAS on multivariate analysis based on surgical approach or use of retinectomy or membrane peeling alone in the intraoperative management of PVR. Conclusions: Eyes with primary preoperative grade B and C PVR appear to have significantly worse VA outcomes and lower surgical success rates. Surgical approach and management of PVR membranes did not appear to affect VA or success rates, indicating that preoperative PVR severity may dictate these outcomes.

Vitreoschisis and retinal detachment: New insight in proliferative vitreoretinopathy

2021 ◽  
pp. 112067212110576
Author(s):  
Stanislao Rizzo ◽  
Lorenzo de Angelis ◽  
Francesco Barca ◽  
Daniela Bacherini ◽  
Lorenzo Vannozzi ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Proliferative Vitreoretinopathy ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Vitreous Cortex ◽  
Group A ◽  
Pars Plana ◽  
Group B ◽  
Removal Group ◽  
Anatomical Success

Purpose To assess the occurrence of peripheral vitreoschisis-induced vitreous cortex remnants (p-VCRs) in primary rhegmatogenous retinal detachment (RD) and investigate whether the presence of p-VCRs results in a greater risk of RD recurrence, secondary to Proliferative Vitreoretinopathy (PVR) development after pars plana vitrectomy (PPV). Methods Patients who underwent PPV for primary rhegmatogenous RD between January 2016 and December 2018 were included. The presence of residual p-VCRs was confirmed intraoperatively using triamcinolone acetonide (TA). Patients with p-VCRs were divided into two groups: Group A comprised of patients who underwent PPV without p-VCR removal, while Group B included patients who underwent PPV with p-VCR removal. Results Four hundred-thirteen eyes with evidence of p-VCR were analyzed. Two-hundred-twenty-three eyes underwent PPV without VCR removal (Group A), while 190 eyes underwent PPV with p-VCR removal (Group B). Primary anatomical success was 91.5% in the Group A and 95.4% in the group B. Retinal re-detachment due to PVR occurred in 17 (7.6%) eyes in Group A and in four (2.1%) eyes in Group B within the first 3 months (p  =  0.01). Among group A, in 11 eyes, there was a diffuse posterior PVR grade C, while six eyes were focal PVR grade C. In Group B, we observed four retinal re-detachment due to focal PVR grade C. Conclusion The presence of p-VCRs seems to be associated with a higher incidence of PVR development and might also result in more complex RD recurrence, this suggests the need for more aggressive VCRs removal during the first surgery.

Comparison of 20- and 25-Gauge Vitrectomy for Primary Repair of Rhegmatogenous Retinal Detachment

2010 ◽  
Vol 41 (5) ◽  
pp. 550-554 ◽  
Author(s):  
Satoshi Kobayashi ◽  
Shimpei Sato ◽  
Maiko Inoue ◽  
Shin Yamane ◽  
Yoichiro Watanabe ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Primary Repair ◽  
25 Gauge Vitrectomy
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