1
|
Gisquet C, Ndiaye NC, Dubroux C, Angioi-Duprez K, Berrod JP, Conart JB. Retinal redetachment after silicone oil removal: a risk factor analysis. BMC Ophthalmol 2024; 24:346. [PMID: 39148018 PMCID: PMC11325823 DOI: 10.1186/s12886-024-03618-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 08/06/2024] [Indexed: 08/17/2024] Open
Abstract
PURPOSE To report the rate of retinal redetachment after silicone oil removal following rhegmatogenous retinal detachment surgery and to determine potential risk factors. METHODS Retrospective observational case series of 161 eyes who underwent rhegmatogenous retinal detachment surgery and subsequent silicone oil removal. Pre- and intraoperative risk factors were evaluated using univariate and multivariate logistic regression. We also evaluated the effect of tamponade duration on anatomical outcomes. RESULTS The median tamponade duration was 5.9 [4.3;7.6] months. Seventeen (10.6%) eyes underwent silicone oil removal within 3 months of surgery, with a median delay of 2.3 [2.0;2.8] months. The rate of retinal detachment after silicone oil removal was 14.9%. A history of previous unsuccessful surgery was the only significant risk factor for retinal redetachment after silicone oil removal (OR 4.8, 95%CI [1.5;19.0], p = 0.02). The use of 360° laser retinopexy and concomitant air or gas tamponade during silicone oil removal were not found to affect the redetachment rate. Eyes with silicone oil tamponade ≤ 3 months showed an increased, albeit not significant, risk of developing recurrent rhegmatogenous retinal detachment after silicone oil removal (35.3% versus 12.5%, p = 0.06). CONCLUSION A retinal redetachment occurred in 14.9% of eyes undergoing silicone oil removal following rhegmatogenous retinal detachment surgery. Previous failed surgery was associated with a 4.8-fold increased risk of developing recurrent rhegmatogenous retinal detachment after silicone oil removal. Eyes with silicone oil tamponade ≤ 3 months tended to have a higher redetachment rate. TRIAL REGISTRATION NUMBER ID NCT05647928 (12th April 2022).
Collapse
Affiliation(s)
- Clément Gisquet
- Department of Ophthalmology, University Hospital of Nancy, Rue du Morvan, Vandoeuvre-les-Nancy, 54500, France.
| | - Ndeye Coumba Ndiaye
- UMR Inserm U1256 NGERE (Nutrition-Genetics and Exposure to Environmental Risks), Université de Lorraine, Nancy, France
| | - Chloé Dubroux
- Department of Ophthalmology, University Hospital of Nancy, Rue du Morvan, Vandoeuvre-les-Nancy, 54500, France
| | - Karine Angioi-Duprez
- Department of Ophthalmology, University Hospital of Nancy, Rue du Morvan, Vandoeuvre-les-Nancy, 54500, France
| | - Jean-Paul Berrod
- Department of Ophthalmology, University Hospital of Nancy, Rue du Morvan, Vandoeuvre-les-Nancy, 54500, France
| | - Jean-Baptiste Conart
- Department of Ophthalmology, University Hospital of Nancy, Rue du Morvan, Vandoeuvre-les-Nancy, 54500, France
| |
Collapse
|
2
|
Park HW, Kim M, Kim SS, Kang HG. Prognostic Factors for Recurrent Rhegmatogenous Retinal Detachment after Silicone Oil Removal. KOREAN JOURNAL OF OPHTHALMOLOGY 2024; 38:284-295. [PMID: 38897593 PMCID: PMC11321828 DOI: 10.3341/kjo.2024.0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 06/07/2024] [Accepted: 06/15/2024] [Indexed: 06/21/2024] Open
Abstract
PURPOSE To investigate the prognostic factors for recurrent rhegmatogenous retinal detachment following silicone oil removal. METHODS This retrospective review included 147 consecutive patients with rhegmatogenous retinal detachment treated with silicone oil tamponade at a high-volume referral-based tertiary hospital between January 2012 and May 2022. All patients underwent follow-up for a minimum of 6 months after subsequent silicone oil removal. The primary outcome measure was the rate of recurrent retinal detachment following silicone oil removal, and the secondary outcome was best-corrected visual acuity after silicone oil removal. RESULTS The mean silicone oil tamponade duration was 4.7 ± 5.01 months (range, 1-38 months; median, 3 months), and the recurrent retinal detachment rate after silicone oil removal was 15.6%. Logistic regression analysis revealed that argon endolaser photocoagulation during silicone oil removal (odds ratio [OR], 0.309; 95% confidence interval [CI], 0.106-0.898; p = 0.031) was associated with a lower rate of anatomical success after silicone oil removal. Demographics, preoperative ocular characteristics, proliferative vitreoretinopathy, previous scleral encircling or buckling, previous retinectomy, concomitant phacoemulsification, duration of silicone oil tamponade, and gas tamponade after silicone oil removal were not significantly associated with recurrent retinal redetachment after silicone oil removal. Duration of silicone oil tamponade (OR, 1.226; 95% CI, 1.073-1.402; p = 0.003) and recurrent retinal detachment after silicone oil removal (OR, 3.400; 95% CI, 1.311-8.817; p = 0.012) were associated with poor visual outcomes after silicone oil removal. CONCLUSIONS Among all factors examined in this study, including the duration of silicone oil tamponade, laser retinopexy was the only significant prognostic factor for recurrent retinal detachment after silicone oil removal. A longer duration of silicone oil tamponade was associated with worse visual outcomes and a lower rate of visual improvement after silicone oil removal.
Collapse
Affiliation(s)
- Hyun Woo Park
- Department of Ophthalmology, Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, Seoul,
Korea
| | - Min Kim
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul,
Korea
| | - Sung Soo Kim
- Department of Ophthalmology, Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, Seoul,
Korea
| | - Hyun Goo Kang
- Department of Ophthalmology, Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, Seoul,
Korea
| |
Collapse
|
3
|
Younes AM, Hamza HS, Omar HA, Abdel-Kader AA, Abdelbaki AM, Elnahry AG. Intravitreal Infliximab for the Treatment of Proliferative Vitreoretinopathy (FIXER): A Randomized Controlled Phase II Trial. Ophthalmol Retina 2024:S2468-6530(24)00265-3. [PMID: 38823559 DOI: 10.1016/j.oret.2024.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 05/06/2024] [Accepted: 05/14/2024] [Indexed: 06/03/2024]
Abstract
OBJECTIVE To study the safety and efficacy of intravitreal infliximab administered at the conclusion of pars plana vitrectomy (PPV) in the treatment of proliferative vitreoretinopathy (PVR) associated with rhegmatogenous retinal detachment (RRD). DESIGN Randomized controlled phase II clinical trial. SUBJECTS Patients with primary RRD and grade C PVR, according to the updated Retina Society Classification. METHODS Sixty-six patients were randomized in a 1:1 ratio to undergo PPV and silicone oil (SO) injection with or without intravitreal injection of 1 mg/0.05 mL of infliximab in the air-filled globe before SO injection at PPV conclusion. Surgeons were masked to treatment allocation until PPV conclusion. MAIN OUTCOME MEASURES The primary outcome measure was anatomic success (defined as complete retinal reattachment without a tamponade at 6 months post SO removal). Secondary outcome measures were final best-corrected visual acuity (BCVA), single-operation success rate (SOSR), rate of recurrent detachment, central macular thickness (CMT) by macular OCT, macular function by multifocal electroretinogram, and macular vascular density (VD) by OCT angiography. RESULTS Sixty eyes of 60 patients, 30 eyes in each group, completed the study. At baseline, there were no differences regarding age, gender, history of trauma, lens status, duration of RRD, BCVA, intraocular pressure (IOP), intraocular inflammation (IOI), detachment extent in clock hours, number/size of breaks, presence of vitreous hemorrhage, axial length, or grade/extent of PVR between both groups. For the outcome measures, 30 eyes in the infliximab group achieved anatomic success vs. 29 eyes in the control group. The SOSR was higher in the infliximab group (26) vs. the control (23), but this was not statistically significant (P = 0.317). Final logarithm of the minimum angle of resolution BCVA was better in the infliximab group (mean, 0.96; standard deviation [SD], 0.4; Snellen equivalent ≈ 20/180) vs. the control (mean, 1.14; SD, 0.4); Snellen equivalent ≈ 20/280; P = 0.044). There were no differences regarding IOP, IOI, time of SO removal, macular function, CMT, or VD. CONCLUSIONS Pars plana vitrectomy with SO tamponade with or without intravitreal infliximab is effective in treating PVR-associated RRD. Infliximab may be associated with modest improvement in final visual outcomes but not anatomic outcomes. FINANCIAL DISCLOSURE(S) The authors have no proprietary or commercial interest in any materials discussed in this article.
Collapse
Affiliation(s)
- Ahmed M Younes
- Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hany S Hamza
- Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hisham A Omar
- Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed A Abdel-Kader
- Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed M Abdelbaki
- Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ayman G Elnahry
- Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt.
| |
Collapse
|
4
|
Chahar A, Sen A, Shukla D, Talwar D. THE ROLE OF INTRAVITREAL METHOTREXATE AS AN ADJUNCT TO LOCAL OR SYSTEMIC CORTICOSTEROIDS IN VITRECTOMY FOR RHEGMATOGENOUS RETINAL DETACHMENT AND CHOROIDAL DETACHMENT: A Pilot Study. Retina 2024; 44:774-781. [PMID: 38194672 DOI: 10.1097/iae.0000000000004046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
PURPOSE To evaluate the role of repeated intravitreal methotrexate as an adjunct to pars plana vitrectomy in the management of rhegmatogenous retinal detachment with choroidal detachment. METHOD The authors compared anatomical and visual outcomes of rhegmatogenous retinal detachment with choroidal detachment eyes that underwent pars plana vitrectomy with (Group B) or without repeated intravitreal methotrexate (Group A). RESULTS The study included 25 eyes of 25 patients, 16 eyes in Group A and nine in Group B. Both groups had similar baseline characteristics. In Group A, successful retinal attachment was achieved in 50% as compared with 89% in Group B; however, the difference was not statistically significant ( P = 0.08). Also, Group B had a significantly greater change in visual acuity from baseline to the last follow-up visit (1.6 + 1.5 logMAR units) compared with Group A (1.18 + 1 logMAR units) ( P = 0.05). There were no significant safety concerns with the use of intravitreal methotrexate. CONCLUSION Repeated intravitreal methotrexate after vitrectomy for rhegmatogenous retinal detachment with choroidal detachment improves outcomes without posing major safety concerns. Nonetheless, further investigation is necessary to establish the optimal intravitreal methotrexate dosage and duration to prevent recurrence effectively.
Collapse
Affiliation(s)
- Annu Chahar
- Department of Vitreo-Retina and Uvea, Sadguru Netra Chikitsalaya, Chitrakoot, India
| | - Alok Sen
- Department of Vitreo-Retina and Uvea, Sadguru Netra Chikitsalaya, Chitrakoot, India
| | - Dhananjay Shukla
- Department of Retinal and Vitreous, Ratan Jyoti Eye Hospital, Gwalior, India ; and
| | - Dinesh Talwar
- Department of Retina and Vitreous, Indraprastha Apollo Hospital, New Delhi, India
| |
Collapse
|
5
|
Ge L, Su N, Fan W, Yuan S. Risk Factors and Management of Intraocular Pressure Elevation After Vitrectomy Combined with Silicone Oil Tamponade. Int J Gen Med 2024; 17:447-456. [PMID: 38333017 PMCID: PMC10849908 DOI: 10.2147/ijgm.s446617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/24/2024] [Indexed: 02/10/2024] Open
Abstract
Silicone oil has emerged as the common option for intraocular tamponade during complicated retina vitrectomy. However, the postoperative elevation of intraocular pressure (IOP), influenced by numerous factors, remains a significant and frequently encountered complication that poses a potential threat to vision. Extensive research has been conducted to investigate the risk factors associated with elevated IOP following silicone oil tamponade, including silicone oil viscosity, preoperative high IOP, diabetes, and lens status. This comprehensive review aims to gather and summarize the current research findings regarding the risk factors contributing to IOP elevation following silicone oil tamponade, as well as the optimal management strategies for secondary glaucoma. The analysis includes the physicochemical properties of silicone oil, preoperative and intraoperative risk factors, and the effective management of secondary glaucoma. Enhancing our understanding of the primary factors associated with silicone oil-induced IOP elevation will facilitate the guidance of timely and appropriate interventions.
Collapse
Affiliation(s)
- Lexin Ge
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Na Su
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Wen Fan
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Songtao Yuan
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| |
Collapse
|
6
|
Tangpontirak K, Yospaiboon Y, Sinawat S, Sanguansak T, Bhoomibunchoo C, Ratanapakorn T, Laovirojjanakul W. Predictors for Visual Outcome After Silicone Oil Removal in Eyes with Complicated Retinal Detachment. Clin Ophthalmol 2022; 16:4335-4343. [PMID: 36601544 PMCID: PMC9807133 DOI: 10.2147/opth.s396188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 12/23/2022] [Indexed: 12/30/2022] Open
Abstract
Purpose To determine the predictors for visual outcome after silicone oil removal (SOR) in eyes with complicated retinal detachment. Patients and Methods A total of 182 eyes with complicated retinal detachment that had undergone SOR were retrospectively reviewed. Snellen best-corrected visual acuity (BCVA), intraocular pressure (IOP) and complications were recorded at baseline, 1 day, 1 month and 3 months postoperatively. Good visual outcome was defined as best-corrected visual acuity of ≥20/200 at 3 months visit. Factors predicting visual outcome were evaluated using univariate and multivariate analysis. Results After SOR, anatomical retinal reattachment was noted in 165 eyes (90.66%). Good visual outcome (VA ≥ 20/200) was achieved in 104 eyes (57.14%) at 3 months after SOR. For the eyes that remained attached after SOR, the percentage of good visual outcome was 63.03%. With univariate and multivariate analysis, visual acuity before SOR (p<0.001), circumferential peripheral retinopexy (p=0.037), additional endolaser during SOR (p=0.004), and pseudophakia status at the last follow up (p=0.021) were associated with visual outcome. Complications after SOR included redetachment (9.4%), hypotony (6.6%) and bullous keratopathy (1.7%). Conclusion While anatomically attached retina was achieved in most of the patients, the functional outcomes were still much lower. Good BCVA before SOR and pseudophakia status at the last follow up were predictors for good visual outcomes, whereas circumferential peripheral retinopexy and additional endolaser during SOR were predictors for poor visual outcomes after SOR in eyes with complicated retinal detachment.
Collapse
Affiliation(s)
- Kanpirom Tangpontirak
- KKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Yosanan Yospaiboon
- KKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Suthasinee Sinawat
- KKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Thuss Sanguansak
- KKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chavakij Bhoomibunchoo
- KKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Tanapat Ratanapakorn
- KKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Wipada Laovirojjanakul
- KKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand,Correspondence: Wipada Laovirojjanakul; Yosanan Yospaiboon, KKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, 123 Mitraparb Highway, Khon Kaen, 40002, Thailand, Tel +66-4336-3010, Fax +66-4334-8383, Email ;
| |
Collapse
|
7
|
Valentín‐Bravo FJ, García‐Onrubia L, Andrés‐Iglesias C, Valentín‐Bravo E, Martín‐Vallejo J, Pastor JC, Usategui‐Martín R, Pastor‐Idoate S. Complications associated with the use of silicone oil in vitreoretinal surgery: A systemic review and meta-analysis. Acta Ophthalmol 2022; 100:e864-e880. [PMID: 34846097 DOI: 10.1111/aos.15055] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 05/24/2021] [Accepted: 10/25/2021] [Indexed: 12/18/2022]
Abstract
Silicone oil (SO) still represents the main choice for long-term intraocular tamponade in complicated vitreoretinal surgery. This review compared the complications associated with the use of SO and other vitreous substitutes after pars plana vitrectomy in patients with different underlying diseases. Meta-analysis was conducted in accordance with PRISMA guidelines. We retrieved randomized clinical trials (RCTs), retrospective case-control and cohort studies evaluating the risk of using SO, published between 1994 and 2020, conducting a computer-based search of the following databases: PubMed, Web of Science, Scopus and Embase. Primary outcome was the rate of complications such as intraocular hypertension, retinal re-detachment, unexpected vision loss or hypotony. Secondary outcome was to compare the rate of adverse events of different SO viscosities, especially emulsification. Forty-three articles were included. There were significant differences in intraocular hypertension (p = 0.0002, OR = 1.66; 95% CI = 1.27-2.18) and the rate of retinal re-detachment (p < 0.0009, OR = 0.65; 95% CI = 0.50-0.64) between SO and other agents, including placebo. However, there were no differences in other complication rates. Silicone oil (SO)-emulsification rate was non-significantly higher in low than high SO viscosity, and results from other complications were comparable in both groups. The high quality of most of the studies included in this study is noteworthy, which provides some certainty to the conclusions. Among them is the high variability of the SO residence time. The fact that ocular hypertension and not hypotension is related to SO use. A clear relationship is not found for the so-called unexplained vision loss, which affects a significant percentage of eyes. Re-detachment cases are less if SO is used and that surprisingly there does not seem to be a relationship in the percentage of emulsification between the low- and high-viscosity silicones. All these data warrant more standardized prospective studies.
Collapse
Affiliation(s)
- Fco. Javier Valentín‐Bravo
- Department of Ophthalmology University Clinical Hospital of Valladolid Valladolid Spain
- Institute of Applied Ophthalmobiology (IOBA) University of Valladolid Valladolid Spain
| | - Luis García‐Onrubia
- Department of Ophthalmology University Clinical Hospital of Valladolid Valladolid Spain
| | | | | | - Javier Martín‐Vallejo
- Department of Statistics. Medical School University of Salamanca. Salamanca Biomedical Research Institute (IBSAL) Salamanca Spain
| | - José Carlos Pastor
- Department of Ophthalmology University Clinical Hospital of Valladolid Valladolid Spain
- Institute of Applied Ophthalmobiology (IOBA) University of Valladolid Valladolid Spain
- Medical School University of Valladolid Valladolid Spain
- Cooperative Network for Research in Ophthalmology (Oftared) Carlos III National Institute of Health, ISCIII Madrid Spain
| | - Ricardo Usategui‐Martín
- Institute of Applied Ophthalmobiology (IOBA) University of Valladolid Valladolid Spain
- Medical School University of Valladolid Valladolid Spain
- Cooperative Network for Research in Ophthalmology (Oftared) Carlos III National Institute of Health, ISCIII Madrid Spain
| | - Salvador Pastor‐Idoate
- Department of Ophthalmology University Clinical Hospital of Valladolid Valladolid Spain
- Institute of Applied Ophthalmobiology (IOBA) University of Valladolid Valladolid Spain
- Medical School University of Valladolid Valladolid Spain
- Cooperative Network for Research in Ophthalmology (Oftared) Carlos III National Institute of Health, ISCIII Madrid Spain
| |
Collapse
|
8
|
Factors affecting retinal re-detachment following silicone oil removal for rhegmatogenous retinal detachments. Retina 2022; 42:1248-1253. [PMID: 35174811 DOI: 10.1097/iae.0000000000003445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To report factors affecting retinal re-detachment rate after silicone oil removal (SOR) following rhegmatogenous retinal detachment (RRD) repair. METHODS Retrospective cohort study from December 1, 2014 to March 1, 2020 of 205 consecutive patients treated for RRD with SO tamponade and subsequent SOR with at least 6 months follow-up. Primary outcome measure was rate of retinal re-detachment following SOR. RESULTS The retinal re-detachment rate following SOR was 18.5%. Preoperative macula and lens status, PVR, previous retinectomy, RD size, concomitant phacoemulsification, previous scleral buckling, and endolaser during SOR did not affect re-detachment rate after SOR. Previous SO exchange was associated with increased re-detachment (OR 2.53, 95% CI (1.11 - 5.80), p = 0.0278). 12 months of SO tamponade had lower re-detachment rates compared to 3 months (OR 0.25, 95% CI [0.04 - 0.09], p = 0.048). Shorter SO tamponade (3 vs. 12 months) had better final visual outcomes after SOR (0.80 ± 0.61 vs 1.41 ± 0.66, p <0.0001). CONCLUSIONS No preoperative or intraoperative factors in this analysis influenced the risk of re-detachment following SOR except duration of SO tamponade and previous SO exchange. While longer SO tamponade duration may be associated with lower rates of re-detachment, visual outcomes may be worse.
Collapse
|
9
|
Arjmand P, Felfeli T, Mandelcorn ED, Mandelcorn MS. Long-Term Safety and Efficacy of Siluron2000 with Pars Plana Vitrectomy in the Treatment of Patients with Severe Vitreoretinopathy and Chronic Macular Holes. Clin Ophthalmol 2021; 15:4373-4379. [PMID: 34754177 PMCID: PMC8572115 DOI: 10.2147/opth.s338269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 10/15/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Silicone oil intraocular retinal tamponade is a useful adjunct to pars plana vitrectomy (PPV) in the treatment of complex vitreoretinal conditions. Siluron2000, a modified silicone oil product containing an additional small, high molecular weight and low viscosity, very-long-chain silicone molecule, was developed to reduce post-operative silicone oil emulsification, a non-infrequent complication that occurs with low molecular weight silicone oil. This study was designed to assess the safety and efficacy of long-term Siluron2000. PATIENTS AND METHODS This was a single-center, retrospective, observational study. All consecutive patients undergoing PPV with intravitreal Siluron2000 injection between January 2017 and September 2019 with at least 6-month follow-up were identified based on billing codes. RESULTS A total of 57 eyes of 57 consecutive patients comprising 51 cases of proliferative vitreoretinopathy and 6 cases of recurrent full thickness macular hole were included. Median follow-up was 18 months. Emulsification occurred in 9 patients (15%). Retinal re-attachment was achieved in 47 patients (82%). The median time without silicone oil emulsification was 17 months. Of the cases with residual retinal detachment (RD) despite intravitreal Siluron2000, 4 (7%) were total RDs and 6 (10%) were inferior RDs with attached macula. The most common complications were glaucoma 12 (21%), cataract 11 (19%), and epiretinal membrane 2 (3.5%). There was no association between the duration of Siluron2000 and visual outcomes. CONCLUSION Siluron2000 is an effective long-term tamponade agent in the treatment of complex vitreoretinopathy. Visual and anatomical outcomes are similar to those reported with higher mw silicone oil tamponade agents but with a lower emulsification rate.
Collapse
Affiliation(s)
- Parnian Arjmand
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Tina Felfeli
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- The Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Efrem D Mandelcorn
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Mark S Mandelcorn
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
10
|
Anatomical and Functional Outcomes of Vitrectomy with/without Intravitreal Methotrexate Infusion for Management of Proliferative Vitreoretinopathy Secondary to Rhegmatogenous Retinal Detachment. J Ophthalmol 2021; 2021:3648134. [PMID: 34336257 PMCID: PMC8315874 DOI: 10.1155/2021/3648134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/03/2021] [Accepted: 06/29/2021] [Indexed: 11/18/2022] Open
Abstract
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.
Collapse
|
11
|
[Reasons and risk factors for recurrent retinal detachment after removal of silicon oil in various vitreoretinal diseases]. Ophthalmologe 2021; 119:170-175. [PMID: 34086072 DOI: 10.1007/s00347-021-01420-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 05/03/2021] [Accepted: 05/03/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Pars plana vitrectomy (ppV) combined with silicone oil tamponade is a standard technique in the treatment of complicated retinal detachment. There are still recurrent cases of retinal detachment after silicone oil removal or redetachment with in situ oil tamponade. OBJECTIVE The aim was to identify possible risk factors for retinal redetachment and to use the knowledge for optimizing treatment. METHODS Analysis of data from patients who were treated with ppV and silicone oil tamponade in the University Department of Ophthalmology in Marburg during 2010-2015 and who had a retinal redetachment during this period. The results were divided into two groups, redetachment with oil in situ and redetachment after oil removal. RESULTS A total of 43 cases (15.6%) had a redetachment, which included 22/43 cases (50%) with a redetachment after oil removal and 21/43 cases (50%) with redetachment with oil in situ. The cause for the renewed detachment was given as proliferative vitreoretinopathy (PVR) in 90.6% (39/43) of the cases, new foramina in 20.9% (9/43) and persisting foramina in 25.5% (11/43). CONCLUSION Vitreoretinal scar formation (PVR reaction) was the main risk factor for renewed retinal detachment. Persisting foramina were also named as a frequent cause. Recurrent retinal detachment represents a significant challenge for vitreoretinal surgeons and for the patients considering the economic and emotional burden due to multiple interventions.
Collapse
|
12
|
Issa R, Xia T, Zarbin MA, Bhagat N. Silicone oil removal: post-operative complications. Eye (Lond) 2019; 34:537-543. [PMID: 31406357 DOI: 10.1038/s41433-019-0551-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 05/01/2019] [Accepted: 07/11/2019] [Indexed: 01/21/2023] Open
Abstract
PURPOSE To describe the characteristics, outcomes and complications of eyes after silicone oil removal. METHODS Retrospective case series of eyes that underwent oil removal between 2012 and 2016 at The Institute of Ophthalmology and Visual Science. Visual acuity (VA), intraocular pressure (IOP) and rates of retinal re-detachment, hypotony, ocular hypertension, corneal decompensation, cystoid macular edema (CME) and cataract progression were evaluated. RESULTS Totally, 101 eyes of 99 patients (65% male, average age 47.2 years) were identified. Oil tamponade had been used for retinal detachment (RD) repair in all eyes; 15 eyes had also undergone an open globe repair previously. The most common vitreous substitutes used after oil removal were balanced salt solution (BSS) and air in 90% of eyes. The average time of oil tamponade before removal was 9.46 months. The average logMAR VA before oil removal was 1.7 which improved to an average of 1.4 post-operatively. The average IOP pre-operatively was 16.1 mm Hg, which decreased to an average of 14.8 mm Hg post-operatively. Complications after oil removal, included retinal re-detachment (6.9%), hypotony (7.9%), ocular hypertension (12.9%), corneal decompensation (9.9%), CME (2%) and cataract progression (68%). CONCLUSION This study showed an overall improvement in VA and decrease in IOP after oil removal. Cataract progression was the most common complication.
Collapse
Affiliation(s)
- Reda Issa
- Institute of Ophthalmology and Visual Science, Rutgers-New Jersey Medical School, Newark, NJ, USA
| | - Tian Xia
- Institute of Ophthalmology and Visual Science, Rutgers-New Jersey Medical School, Newark, NJ, USA
| | - Marco A Zarbin
- Institute of Ophthalmology and Visual Science, Rutgers-New Jersey Medical School, Newark, NJ, USA
| | - Neelakshi Bhagat
- Institute of Ophthalmology and Visual Science, Rutgers-New Jersey Medical School, Newark, NJ, USA.
| |
Collapse
|
13
|
OUTCOMES OF REPEAT PARS PLANA VITRECTOMY AFTER FAILED SURGERY FOR PROLIFERATIVE VITREORETINOPATHY. Retina 2018; 38 Suppl 1:S49-S59. [PMID: 29232332 DOI: 10.1097/iae.0000000000002000] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate outcomes of repeat pars plana vitrectomy for proliferative vitreoretinopathy after previous failed pars plana vitrectomy. METHODS This is a retrospective case series including 51 eyes of 50 patients who underwent repeat surgery after failed previous pars plana vitrectomy for proliferative vitreoretinopathy from 2000 to 2015 at the Kresge Eye Institute, Detroit, MI. Patients were classified into successful and unsuccessful groups. Success was defined as retinal reattachment, silicone oil removed, and best-corrected visual acuity (BCVA) ≥5/200 at the final follow-up visit. RESULTS Forty-three eyes (84.3%) were successfully reattached at the last follow-up. Seventeen (33.3%) eyes were deemed successful and 34 (66.7%) eyes unsuccessful according to our criteria. Compared with the successful group, eyes in the unsuccessful group had more eyes with preoperative BCVA <5/200 (P < 0.001), preoperative BCVA of hand motion or worse (P = 0.002), preoperative flare ≥Grade 2+ (P = 0.03), preoperative posterior breaks (P = 0.02), previous retinectomy (P = 0.04), and final postoperative hypotony (intraocular pressure ≤ 5 mmHg) (P = 0.005). Eyes with silicone oil removed were more likely to have BCVA ≥5/200 (P < 0.001) at the final follow-up visit. Location of patients >100 miles (P = 0.04) from Detroit and preoperative BCVA of hand motion or worse (P = 0.01) were significantly associated with failure in the logistic regression analysis. CONCLUSION Success after repeat surgery for proliferative vitreoretinopathy should include ambulatory vision, retinal reattachment, and silicone oil removal. We identified several preoperative and perioperative factors that were associated with success in the bivariate and logistic analyses. The decision to perform surgical reoperation in these patients should be based on multiple factors, most importantly preoperative BCVA.
Collapse
|
14
|
He Y, Zeng S, Zhang Y, Zhang J. Risk Factors for Retinal Redetachment After Silicone Oil Removal: A Systematic Review and Meta-Analysis. Ophthalmic Surg Lasers Imaging Retina 2018; 49:416-424. [PMID: 29927469 DOI: 10.3928/23258160-20180601-06] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 02/27/2018] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND OBJECTIVE This systematic review and meta-analysis was made to measure risk factors for retinal redetachment (re-RD) after silicone oil removal (SOR) in a quantitative method. PATIENTS AND METHODS A comprehensive literature review relating to risk factors for re-RD after SOR was conducted before March 2017. Odds ratio (OR) with 95% confidence interval (CI) was calculated after data combination. RESULTS Sixteen studies were included, and risk factors with significant differences found between the re-RD and control groups are as follows: aphakic eye (OR = 1.50), high myopia (OR = 2.47), previous failed retinal surgery (OR = 1.71), and ocular trauma (OR = 3.52). Peripheral 360° laser retinopexy (OR = 0.40) and scleral encircling band (OR = 0.58) were found to be protective factors of re-RD after SOR. CONCLUSION Aphakic eye, high myopia, previous failed retinal surgery, ocular trauma, lack of 360° laser, and scleral encircling band were possible risk factors relating to the occurrence of re-RD after SOR. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:416-424.].
Collapse
|
15
|
Rhatigan M, McElnea E, Murtagh P, Stephenson K, Harris E, Connell P, Keegan D. Final anatomic and visual outcomes appear independent of duration of silicone oil intraocular tamponade in complex retinal detachment surgery. Int J Ophthalmol 2018; 11:83-88. [PMID: 29375996 DOI: 10.18240/ijo.2018.01.15] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 09/04/2017] [Indexed: 11/23/2022] Open
Abstract
AIM To report anatomic and visual outcomes following silicone oil removal in a cohort of patients with complex retinal detachment, to determine association between duration of tamponade and outcomes and to compare patients with oil removed and those with oil in situ in terms of demographic, surgical and visual factors. METHODS We reported a four years retrospective case series of 143 patients with complex retinal detachments who underwent intraocular silicone oil tamponade. Analysis between anatomic and visual outcomes, baseline demographics, duration of tamponade and number of surgical procedures were carried out using Fisher's exact test and unpaired two-tailed t-test. RESULTS One hundred and six patients (76.2%) had undergone silicone oil removal at the time of review with 96 patients (90.6%) showing retinal reattachment following oil removal. Duration of tamponade was not associated with final reattachment rate or with a deterioration in best corrected visual acuity (BCVA). Patients with oil removed had a significantly better baseline and final BCVA compared to those under oil tamponade (P=0.0001, <0.0001 respectively). CONCLUSION Anatomic and visual outcomes in this cohort are in keeping with those reported in the literature. Favorable outcomes were seen with oil removal but duration of oil tamponade does not affect final attachment rate with modern surgical techniques and should be managed on a case by case basis.
Collapse
Affiliation(s)
- Maedbh Rhatigan
- Department of Ophthalmology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, D07 KH4C, Ireland
| | - Elizabeth McElnea
- Department of Ophthalmology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, D07 KH4C, Ireland
| | - Patrick Murtagh
- Department of Ophthalmology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, D07 KH4C, Ireland
| | - Kirk Stephenson
- Department of Ophthalmology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, D07 KH4C, Ireland
| | - Elaine Harris
- Department of Ophthalmology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, D07 KH4C, Ireland
| | - Paul Connell
- Department of Ophthalmology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, D07 KH4C, Ireland
| | - David Keegan
- Department of Ophthalmology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, D07 KH4C, Ireland
| |
Collapse
|
16
|
Ambiya V, Rani PK, Narayanan R, Balakrishnan D, Chhablani J, Jalali S, Tyagi M, Pappuru RR. Outcomes of Recurrent Retinal Detachment Surgery following Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment. Semin Ophthalmol 2017; 33:657-663. [PMID: 29125779 DOI: 10.1080/08820538.2017.1395893] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIM To study the anatomical and functional outcomes of recurrent retinal detachment (RD) surgery following pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment. METHODS Retrospective analysis of 133 consecutive cases of recurrent RD. INCLUSION CRITERIA age ≥18 years, recurrent RD following PPV ± encircling band for rhegmatogenous RD. EXCLUSION CRITERIA age <18 years, post-endophthalmitis/tractional/exudative/combined RD, post-scleral buckle, primary surgery done at another institute. The final anatomical and functional outcomes, and their association with clinico-surgical factors, were analyzed. RESULTS Proliferative vitreoretinopathy (PVR) ≥ Grade C in re-detached retina (OR, 2.49; 95% CI, 1.02-6.09; P = 0.045) and need for multiple resurgeries (OR, 6.48; 95% CI, 2.51-16.69; P < 0.0001) were significant risk factors for the final anatomical failure. Eyes with PVR ≥ Grade C (OR, 0.31, 95% CI, 0.12-0.80; P = 0.013) in primary RD, and with multiple breaks (OR, 0.24; 95% CI, 0.06-0.96; P = 0.044) at the time of recurrent RD, were less likely to have final BCVA ≥20/200. The visual acuity at the time of recurrent RD had a moderately positive correlation (r = 0.454, P < 0.001), and the delay in recurrence of RD had a weakly positive correlation (r = 0.214, P = 0.046) with the final BCVA. CONCLUSIONS PVR ≥ Grade C and multiple resurgeries are associated with higher incidence of anatomical failure in recurrent RD surgery. Multiple breaks are associated with a poorer visual outcome, whereas a better baseline visual acuity and delayed recurrence of RD after primary repair are associated with a better visual outcome.
Collapse
Affiliation(s)
- Vikas Ambiya
- a Smt Kannuri Santhamma Centre for Vitreoretinal Diseases , L.V. Prasad Eye institute , Hyderabad , India
| | - Padmaja Kumari Rani
- a Smt Kannuri Santhamma Centre for Vitreoretinal Diseases , L.V. Prasad Eye institute , Hyderabad , India
| | - Raja Narayanan
- a Smt Kannuri Santhamma Centre for Vitreoretinal Diseases , L.V. Prasad Eye institute , Hyderabad , India
| | - Divya Balakrishnan
- a Smt Kannuri Santhamma Centre for Vitreoretinal Diseases , L.V. Prasad Eye institute , Hyderabad , India
| | - Jay Chhablani
- a Smt Kannuri Santhamma Centre for Vitreoretinal Diseases , L.V. Prasad Eye institute , Hyderabad , India
| | - Subhadra Jalali
- a Smt Kannuri Santhamma Centre for Vitreoretinal Diseases , L.V. Prasad Eye institute , Hyderabad , India
| | - Mudit Tyagi
- a Smt Kannuri Santhamma Centre for Vitreoretinal Diseases , L.V. Prasad Eye institute , Hyderabad , India
| | - Rajeev Reddy Pappuru
- a Smt Kannuri Santhamma Centre for Vitreoretinal Diseases , L.V. Prasad Eye institute , Hyderabad , India
| |
Collapse
|
17
|
Deuchler S, Ackermann H, Singh P, Kohnen T, Wagner C, Koch F. Key Factors to Improve the Outcome of Retinal Reattachment Surgery in Proliferative Vitreoretinopathy and Proliferative Diabetic Retinopathy. J Ophthalmol 2017; 2017:2323897. [PMID: 28770107 PMCID: PMC5523461 DOI: 10.1155/2017/2323897] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 05/07/2017] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION For management of complicated retinal detachments, a pars plana vitrectomy with temporary silicone oil (SO) fill is the method of choice. According to literature, the retinal redetachment rate varies between <10% and >70% with around 36% in our own group (retrospective data analysis, n = 119 eyes). METHODS The main goal was to reduce the retinal redetachment rate. Standard operating procedures (SOPs) and evaluation protocols (EVALPs) were developed to prospectively analyse risk factors. Lab analysis of SO was performed, and the role of surgical experience was evaluated and investigated with Eyesi®. RESULTS We achieved a significant reduction of the retinal redetachment rate (to 6.80%, n = 101, p = 0.002). After surgery with SO injection, neither further membrane peeling (in 16.5%) nor retinal laser coagulation (in 100%) during revision surgery had a significant effect on the reattachment rate (p = 0.167, p = 0.23), while extensive additional laser coagulation reduced visual acuity (p = 0.01). A 3-port approach had to be set up to complete SO removal. A difference in success rate depending on surgical experience was confirmed, and the performance in Eyesi correlated with that in the patients' eye. CONCLUSIONS A SOP- and EVALP-based management and new strategies to secure the surgical performance seem to be essential for successful surgery.
Collapse
Affiliation(s)
- Svenja Deuchler
- Vitreoretinal Unit, Department of Ophthalmology, Goethe University, Frankfurt am Main, Germany
| | - Hanns Ackermann
- Institute of Biostatistics and Mathematical Modelling, University Hospital, 60590 Frankfurt am Main, Hessen, Germany
| | - Pankaj Singh
- Vitreoretinal Unit, Department of Ophthalmology, Goethe University, Frankfurt am Main, Germany
| | - Thomas Kohnen
- Department of Ophthalmology, Goethe University, Frankfurt am Main, Germany
| | - Clemens Wagner
- VRmagic GmbH, 68167 Mannheim, Baden-Württemberg, Germany
| | - Frank Koch
- Vitreoretinal Unit, Department of Ophthalmology, Goethe University, Frankfurt am Main, Germany
| |
Collapse
|
18
|
STAINING-ASSISTED REMOVAL OF SILICONE OIL FOR THE IDENTIFICATION OF SUBCLINICAL PROLIFERATIVE VITREORETINOPATHY. Retina 2017; 37:2118-2123. [PMID: 28045788 DOI: 10.1097/iae.0000000000001441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Retinal detachment is a frequent complication after removal of silicone oil (ROSO). A retrospective study was conducted to determine whether staining-assisted removal of silicone oil (st-ROSO) allowed better identification and removal of proliferative vitreoretinopathy (PVR) processes compared with a conventional removal of silicone oil technique. METHODS All individuals underwent pars plana vitrectomy (PPV) and silicone oil fill-in for complicated retinal detachments. In conventional removal of silicone oil (Group 1), no staining was used. In staining-assisted removal of silicone oil (Group 2), a mixture of trypan blue and brilliant blue G dyes was used to identify proliferative vitreoretinopathy and subclinical epiretinal membrane. RESULTS After the first 3-month follow-up, 15.9% of patients (N = 608) developed a retinal detachment. Retinal detachment occurred in 22.8% of patients in Group 1 (n = 284) and 9.8% of patients in Group 2 (n = 324; P < 0.001). In Group 2, proliferative vitreoretinopathy removal was performed in 153 eyes (47.2%). CONCLUSION The incidence of retinal redetachment was significantly lower after staining-assisted removal of silicone oil compared with a conventional technique. Staining-assisted removal of silicone oil allowed better identification and removal of proliferative vitreoretinopathy processes.
Collapse
|
19
|
Lumi X, Lužnik Z, Petrovski G, Petrovski BÉ, Hawlina M. Anatomical success rate of pars plana vitrectomy for treatment of complex rhegmatogenous retinal detachment. BMC Ophthalmol 2016; 16:216. [PMID: 27938367 PMCID: PMC5148843 DOI: 10.1186/s12886-016-0390-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 11/24/2016] [Indexed: 11/25/2022] Open
Abstract
Background Pars plana vitrectomy (PPV) is preferred surgical procedure for the management of complex rhegmatogenous retinal detachment (RRD). The purpose of this study was to evaluate the anatomical results of primary PPV for the treatment of primary complex RRD and to determine the influence of lens status, tamponading agent, preoperative proliferative vitreoretinopathy (PVR) and axial length (AL) of the eye upon the anatomical outcome. Methods A retrospective consecutive chart analysis was performed on 117 eyes from 117 patients with complex RRD managed with PPV. Fifty-nine eyes were phakic and 58 pseudophakic eyes. All patients had a minimum follow-up period of 12 months. Eyes were classified into groups using independent variables (first classification based upon lens status and tamponade used, second classification based upon lens and PVR status and third classification based upon AL of the eye). The groups were compared for anatomical outcomes (dependent variables) using nonparametric- or, in case of normally distributed data, parametric- statistical tests. Results Retinal reattachment rate in phakic eyes was 94.9% compared to 93.1% in pseudophakic, with no statistically significant difference between the two. The overall retinal reattachment rate with single surgery was 94.0%. Final reattachment rate was 97.4%. In case of established PVR ≥ C1, the reattachment rate was not statistically different (92.6%) from eyes with no PVR (91.1%) irrespective of lens status. A statistically significant difference was found between redetachment rates only between phakic eyes with gas tamponade compared to silicon oil (SO) (p = 0.001). Reattachment rate proved to be similar in both AL groups (≤24 mm and > 24 mm). Conclusions High anatomical success rate of primary vitrectomy for complex RRD with either gas or SO tamponade was achieved in phakic as well as pseudophakic eyes irrespective of AL of the eye.
Collapse
Affiliation(s)
- Xhevat Lumi
- Eye Hospital, University Medical Centre Ljubljana, Grablovičeva 46, 1000, Ljubljana, Slovenia.
| | - Zala Lužnik
- Eye Hospital, University Medical Centre Ljubljana, Grablovičeva 46, 1000, Ljubljana, Slovenia
| | - Goran Petrovski
- Department of Ophthalmology, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, Korányi fasor 10-11, 6720, Szeged, Hungary.,Centre of Eye Research, Department of Ophthalmology, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - Beáta Éva Petrovski
- Department of Public Health, Faculty of Medicine, University of Szeged, Dóm tér 10, 6720, Szeged, Hungary.,Health Services Research Centre, Akershus University Hospital, 1478 Lørenskog, Norway, Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway
| | - Marko Hawlina
- Eye Hospital, University Medical Centre Ljubljana, Grablovičeva 46, 1000, Ljubljana, Slovenia
| |
Collapse
|
20
|
Dhalla K, Kapesa I, Odouard C. Incidence and risk factors associated with retinal redetachment after silicone oil removal in the African population. Int Ophthalmol 2016; 37:583-589. [PMID: 27492730 DOI: 10.1007/s10792-016-0309-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 07/27/2016] [Indexed: 12/11/2022]
Abstract
The purpose of this study was to investigate the incidence and risk factors associated with retinal redetachment after silicone oil (SO) removal in the African population. A retrospective cohort study was performed on patients undergoing SO removal over a period of 4 years. The risk factors assessed were (1) characteristics of the retinal detachments including type of retinal detachment, type, number and location of the retinal tears, and proliferative vitreoretinopathy (PVR) score, and (2) surgical factors including type of silicone oil used, use of laser prior to SO removal, and location of the laser (360° or around the tear only). SO was removed either through a pars plana approach or transpupillary approach and anterior limbal incision. Ninety-nine eyes met the inclusion criteria during the study period. Twelve patients (12 %) had retinal redetachment after SO removal. Factors associated with redetachment were a preexisting macular hole, PVR grade B or worse, and no intraoperative endolaser photocoagulation. The incidence of redetachment in African population is similar to that reported from developed countries and other advanced vitreoretinal centers. Redetachment occurred at higher rates in patients with preexisting macular holes and tears who did not receive intraoperative endolaser photocoagulation and patients with a severe grade of PVR.
Collapse
Affiliation(s)
- Kazim Dhalla
- Department of Ophthalmology, Comprehensive Community Based Rehabilitation in Tanzania (CCBRT) Hospital, Dar Es Salaam, Tanzania
| | - Imani Kapesa
- Department of Ophthalmology, Comprehensive Community Based Rehabilitation in Tanzania (CCBRT) Hospital, Dar Es Salaam, Tanzania
| | - Capucine Odouard
- Department of Ophthalmology, Bankstown Hospital, Eldridge Road, Bankstown, Sydney, NSW, 2200, Australia.
| |
Collapse
|
21
|
Timing and outcomes after silicone oil removal in proliferative vitreoretinopathy: a retrospective clinical series. Int J Retina Vitreous 2015; 1:2. [PMID: 27847595 PMCID: PMC5066514 DOI: 10.1186/s40942-015-0002-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 02/12/2015] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To evaluate anatomical and functional outcomes after silicone oil extraction in patients with retinal detachment and proliferative vitreoretinopathy in an eye care referral center in Joinville, SC, southern Brazil. METHODS Retrospective, noncomparative study of patients with retinal detachment and posterior proliferative vitreoretinopathy followed up after silicone oil removal. Prophylactic 360-degree peripheral laser photocoagulation was performed one to three months before silicone oil extraction. Patients with cataract underwent a combined clear corneal phacoemulsification with intraocular lens implantation in the same procedure. Anatomical outcomes were related to the duration of silicone oil tamponade and the surgical procedure performed. Functional outcomes were divided into three categories (stability, worsening, or improvement) according to visual acuity variation before the surgery and at the last follow-up visit. RESULTS Fifty-three patients were followed up for a mean period of 1,262 days. Fourteen eyes (26.4%) underwent cataract surgery combined with silicone oil extraction. Forty-eight eyes (90.5%) had attached retina at the last follow-up examination. Time of intraocular tamponade and association of phacoemulsification with silicone oil extraction were not considered as risk factors for retinal redetachment. Twenty-three cases (43.4%) showed visual acuity improvement, whereas 11 cases (20.8%) were stable and 19 cases (35.8%) showed visual acuity worsening. Five patients with attached retina had unexplained optic disc atrophy. CONCLUSION Most patients had good anatomical and visual outcomes after silicone oil extraction. Prophylactic 360-degree laser retinopexy may have led to favorable outcomes. Benefits of silicone oil extraction and the associated risks of complications due to a new surgical procedure must be carefully evaluated before surgical indication.
Collapse
|
22
|
Boscher C, Kuhn F. Endoscopic Evaluation and Dissection of the Anterior Vitreous Base. Ophthalmic Res 2015; 53:90-9. [DOI: 10.1159/000370032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Accepted: 11/17/2014] [Indexed: 11/19/2022]
|
23
|
SURGICAL OUTCOMES AND INCIDENCE OF RETINAL REDETACHMENT IN CASES WITH COMPLICATED RETINAL DETACHMENT AFTER SILICONE OIL REMOVAL. Retina 2014; 34:1926-38. [DOI: 10.1097/iae.0000000000000204] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
24
|
Surgical and visual outcome for recurrent retinal detachment surgery. J Ophthalmol 2014; 2014:810609. [PMID: 25177496 PMCID: PMC4142744 DOI: 10.1155/2014/810609] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Revised: 07/14/2014] [Accepted: 07/21/2014] [Indexed: 11/18/2022] Open
Abstract
Purpose. To evaluate the anatomical and functional outcome of repeated surgeries for recurrent retinal detachment. Methods. We retrospectively reviewed 70 cases with refractory retinal detachment of various etiologies that required multiple operations. Anatomical success (attached retina) or failure (totally/partially-detached retina) was assessed biomicroscopically. The BCVA was used for the evaluation of the functional outcome, at presentation and at the end of follow-up. Various pre-, intra-, and postoperative factors were associated with anatomical success or failure as well as with final functionality. Results. The mean number of surgeries was 4 (range: 2 to 10). The anatomical success rate was 80% (56 attached cases, 14 detached cases). 29% of the attached cases had a BCVA better than 20/40 (Snellen chart). The number of operations doesn't seem to affect significantly the final visual acuity. The PVR was found to affect both the anatomical and functional outcome (P = 0.014 & P = 0.002, respectively). Conclusions. In the present study, it is suggested that multiple operations for refractory retinal detachment may result in successful anatomic results, with a fare functional outcome at the same time. Eventually, we verified that the existence of PVR worsens the prognosis.
Collapse
|
25
|
Comparison of retinal detachment surgery outcome among patients undergoing pars plana vitrectomy with and without relaxing retinotomy. Graefes Arch Clin Exp Ophthalmol 2014; 253:855-64. [PMID: 25142375 DOI: 10.1007/s00417-014-2778-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 08/05/2014] [Accepted: 08/11/2014] [Indexed: 02/05/2023] Open
Abstract
The purpose of this four year retrospective study was to compare the anatomical and functional outcomes of complicated retinal detachment (RD) surgery by pars plana vitrectomy (PPV) with and without retinotomy. The main outcome measures were primary anatomical success (defined as retinal re-attachment at the final follow-up after a single operation, with or without silicone in situ), final anatomical success, final best-corrected visual acuity (BCVA) and postoperative complications. Baseline characteristics did not differ between the groups, although there was a borderline significant trend for the retinotomy group to be associated with worse pre-surgical ocular pathology. With a mean follow-up of 18 (± 7.8) months, primary anatomical success was achieved in 76.7% (33 of 43) of the retinotomy group eyes vs. 67.8% (40 of 59) of the eyes in the group without retinotomy. Final anatomical success rates for the retinotomy group and no retinotomy group were 100 and 93.2% respectively. The final BCVA was 1.57 LogMAR with retinotomy and 1.38 without retinotomy, an improvement in both groups. The incidence of postoperative complications was similar in the two groups, while the frequency of macular holes was higher in the retinotomy group. A similar degree of improvement in BCVA following both surgeries indicates their similar efficacy and justifies their performance even in complicated eyes in order to improve the patients' quality of life. With neither approach superior to the other, the choice of method should be left to the surgeon.
Collapse
|
26
|
Boscher C, Kuhn F. An endoscopic overview of the anterior vitreous base in retinal detachment and anterior proliferative vitreoretinopathy. Acta Ophthalmol 2014; 92:e298-304. [PMID: 24428936 DOI: 10.1111/aos.12303] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2012] [Accepted: 10/02/2013] [Indexed: 01/10/2023]
Abstract
PURPOSE Anterior proliferative vitreoretinopathy (PVR) is an important cause of persistent or recurrent retinal detachment (RD). Endoscopy provides 360° panoramic viewing of the vitreous cavity and high-magnification viewing of the anterior vitreous base (AVB). This study describes the 'in vivo' anatomy and pathoanatomy of the AVB using an ocular endoscope in RD and anterior PVR. METHODS An intraoperative analysis of over 2000 consecutive eyes undergoing vitrectomy for RD operated with endoscopy-assisted vitrectomy was performed. It was recorded in notes dictated during surgery and in standardized operative reports. Around 1500 surgical videotapes, with the exclusion of diabetic retinopathy and trauma, selected by reviewing the OR reports and notes were retrospectively reviewed. RESULTS Seven endoscopic criteria associated with anterior PVR complicating RD are described: 'en bloc' stiff anterior vitreous retraction, ciliary detachment, seeding of the AVB by abundant pigmented and/or white granulations, anterior tissue displacement, stiff 'wrinkling' at the vitreoretinal juncture, persistent shallow ciliary/RD under perfluorocarbon liquids and traction-related retinal surface haemorrhages. Causes responsible for failure of conventional vitrectomy for RD are highlighted. Findings in case of hypotony and cyclitic membranes are described. CONCLUSIONS Endoscopy is a significant adjunct to our understanding of the development of anterior loop traction by obviating the two constitutive parts of the AVB, anterior and posterior, their interconnections and their respective connections to the anterior segment and to the retina. It provides a unique evaluation and thorough eradication of the anterior vitreous cortex as a scaffold for anterior PVR. It might be an adjunct to the prevention of anterior PVR.
Collapse
Affiliation(s)
| | - Ferenc Kuhn
- Milos Klinica; Belgrade Serbia
- Zagorskiego Eye Hospital; Naleczow Poland
- Helen Keller Foundation for Research and Education; Birmingham AL USA
| |
Collapse
|
27
|
Visual and anatomical outcomes after silicone oil removal in patients with complex retinal detachment. Int Ophthalmol 2013; 34:549-56. [DOI: 10.1007/s10792-013-9857-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 09/14/2013] [Indexed: 10/26/2022]
|
28
|
Abstract
PURPOSE To evaluate the incidence of retinal redetachment after the removal of silicone oil endotamponade for complicated retinal detachment and identify possible factors affecting outcome. METHODS This is a retrospective review of 173 patients who underwent pars plana vitrectomy with silicone oil tamponade for complex retinal detachment and subsequent removal of silicone oil (ROSO). The outcome factors studied included anatomical success, best-corrected visual acuity and intraocular pressure pre- and post-ROSO. RESULTS Anatomical success was achieved in 167 of the 173 eyes (96.5%) after ROSO. The mean duration of silicone oil tamponade was 70 ± 48 weeks (median, 56 weeks; mode, 48 weeks). The cause for primary retinal detachment was proliferative diabetic retinopathy in 36 (20.8%) and proliferative vitreoretinopathy in 137 of 173 cases (79.2%). Best-corrected visual acuity of greater than 20/100 was achieved in 83 cases (49.4%) at 3 months after ROSO. Levene's test for equality of variances was used to determine the association between previous unsuccessful retinal surgeries and redetachment (P = 0.523) and between duration of endotamponade and anatomical success (P = 0.451). CONCLUSION The incidence of retinal redetachment after ROSO in our study was 3.46%. Aggressive removal of the vitreous base, performing retinotomies, ensuring complete silicone oil filling for adequate tamponade, and argon retinopexy can lead to low complication rates and improved outcomes.
Collapse
|
29
|
Constable IJ, Nagpal M. Proliferative Vitreoretinopathy. Retina 2013. [DOI: 10.1016/b978-1-4557-0737-9.00107-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
30
|
García-Arumí J, Martínez-Castillo V, Boixadera A, Blasco H, Marticorena J, Zapata MÁ, Macià C, Badal J, Distéfano L, Rafart JM, Berrocal M, Zambrano A, Ruíz-Moreno JM, Figueroa MS. Rhegmatogenous retinal detachment treatment guidelines. ACTA ACUST UNITED AC 2012; 88:11-35. [PMID: 23414946 DOI: 10.1016/j.oftal.2011.10.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Accepted: 10/10/2011] [Indexed: 11/15/2022]
Abstract
This paper outlines general guidelines following the initial diagnosis of rhegmatogenous retinal detachment. These include preoperative evaluation, treatment, possible intra- and post-operative complications, retinal re-detachment, and all therapeutic options available for each case. Treatment of the traumatic retinal detachment is also described, due to its importance and peculiarities. Treatment or prophylactic guidelines are suggested for the different types of retinal detachment described. These are based on both the experience of the ophthalmologists that have participated in preparing the guidelines, and also on evidence-based grading linked to bibliographical sources. However, these guidelines should not be interpreted as being mandatory. Given that there is a wide spectrum of options for treatment of retinal detachment, the surgeons' experience with one or other surgical technique will be of utmost importance in obtaining the best surgical result. As guidelines, they are intended as an additional aid to the surgeon during the decision-making process, with the expectation that the final choice will still be left to the surgeon's judgment and past experience.
Collapse
Affiliation(s)
- J García-Arumí
- Departamento de Oftalmología, Universidad Autónoma de Barcelona, Barcelona, Spain.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Steele KA, Sisler S, Gerding PA. Outcome of retinal reattachment surgery in dogs: a retrospective study of 145 cases. Vet Ophthalmol 2012; 15 Suppl 2:35-40. [DOI: 10.1111/j.1463-5224.2012.01009.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
32
|
Silicone oil removal after rhegmatogenous retinal detachment: comparing techniques. Eye (Lond) 2011; 26:444-7. [PMID: 22157918 DOI: 10.1038/eye.2011.319] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To assess the outcome of silicone oil removal after rhegmatogenous retinal detachment (RRD) surgery, and to compare results of a two-port (infusion-extraction) versus a three-port (full vitrectomy) approach. METHODS Primary outcome measure was the rate of redetachment. Secondary outcome measures were visual acuity, rate of intraoperative and postoperative epiretinal membrane removal and complications. RESULTS We included 147 consecutive cases. There were 15 cases of giant retinal tear, 26 cases of RRD without proliferative vitreoretinopathy (PVR) and 106 cases of RRD with PVR. The overall redetachment rate after silicone oil removal was 17.7%. In the group treated with the two-port technique (n=95), the retina redetached in 16 cases (16.8%), and in the group treated with the three-port technique (n=52), redetachment occurred in 10 cases (19.2%). This difference was not statistically significant (P=0.717; χ (2)-test). There was a significantly higher redetachment rate in cases with a short oil tamponade duration of <2 months. CONCLUSION We reconfirm a relatively high redetachment rate after silicone oil removal. The risk of redetachment is not lower with the three-port compared with the two-port approach.
Collapse
|
33
|
Velikay-Parel M, Kiss CG, Ivastinovic D, Richter-Mueksch S. Encircling band, laser retinopexy and lens removal as standard procedure in complicated retinal detachment shows a good clinical outcome. Acta Ophthalmol 2011; 89:629-33. [PMID: 20156201 DOI: 10.1111/j.1755-3768.2009.01763.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate vitrectomy in conjunction with the use of perfluorocarbon, cerclage, laser retinopexy, lens removal and silicone oil as surgical treatment of proliferative vitreoretinopathy associated with retinal detachment. METHODS Sixty-two eyes of 62 patients were treated for complicated retinal detachment following failed prior scleral buckling. Outcome measures were; retinal reattachment rate 6 months after silicone oil removal, status of the retina, visual acuity (VA), duration of silicone tamponade and frequency of reoperations. RESULTS The final reattachment rate was 95%. Reoperations had to be performed in 25% of patients. Eighty-one per cent of these patients received one and 19% two or more operations following silicone oil implantation. The mean time to reoperation was 1.8 ± 1.4 months. Silicone oil was removed after 5.6 ± 4.1 months following the last vitreoretinal procedure in 90%, respectively, 95% with attached retina. Five per cent experienced retinal detachment after silicone oil removal. At the end of follow-up, the mean VA was 0.13 ± 0.26 Snellen. Seventy per cent of patients achieved a vision of 20/200 or better (mean 0.25 ± 0.27). CONCLUSION Our study demonstrates good final outcomes when a rigorous surgical approach was used. Furthermore, this standard procedure reduces the need for reoperations and consequently improves the functional outcome.
Collapse
|
34
|
Zhang R, Wang T, Xie C, Lin X, Jiang Z, Wang Z, Liu Y, Luo Y, Long C, He L, Wang P, Gao Q. Evaluation of supporting role of a foldable capsular vitreous body with magnetic resonance imaging in the treatment of severe retinal detachment in human eyes. Eye (Lond) 2011; 25:794-802. [PMID: 21423138 DOI: 10.1038/eye.2011.61] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To determine the supporting role of a novel foldable capsular vitreous body (FCVB) with magnetic resonance imaging (MRI) in the treatment of severe retinal detachment in human eyes. METHODS The study examined nine eyes of nine patients. Among the nine eyes, five had suffered penetrating injuries while four had suffered contusions of the eyeball involving large defects of the retina or choroids. A standard three-port pars plana vitrectomy was performed, FCVB was triple-folded and sent into the vitreous cavity; balanced salt solution (BSS) was injected into the capsule to support the retina. Three cardinal axes of nine eyes were examined using MRI at baseline and at the 3-month follow up. RESULTS MRI revealed that the signal intensity of the FCVB was similar to the normal vitreous body, with low-signal intensity on T1-weighted image and high-signal intensity on T2-weighted image. In three pre-operative silicone oil- or heavy silicone oil-filled eyes, FCVBs were not fully inflated, and eyeball deformation was observed in one eye. Shifts of three cardinal axes of three eyes (horizontal, anteroposterior, and vertical) according to MRI, were -4.33, -4.67, and -2.67 mm. In the remaining six eyes, FCVBs were well distributed in the vitreous cavity and evenly supported the retina; the cardinal axes of the eyes were similar to pre-operation. Shifts of three cardinal axes of six eyes were -0.34, -0.34, and -0.34 mm. In a total of nine eyes, shifts of three cardinal axes were -1.67, -1.77, and -1.11 mm. Statistically significant difference showed only between the horizontal axis of nine eyes pre-operatively and post-operatively (P1=0.041, P2=0.058, P3=0.123). CONCLUSION This study demonstrated the effectiveness of MRI to monitor the supporting role of an FCVB in the treatment of severe retinal detachment in human eyes.
Collapse
Affiliation(s)
- R Zhang
- State Key Laboratory of Oncology in Southern China, Department of Medical Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou, China
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Falkner-Radler CI, Smretschnig E, Graf A, Binder S. Outcome after silicone oil removal and simultaneous 360° endolaser treatment. Acta Ophthalmol 2011; 89:e46-51. [PMID: 21155983 DOI: 10.1111/j.1755-3768.2010.02059.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the outcome after silicone oil removal combined with a 360° endolaser treatment in complex retinal detachment (RD) cases and to assess prognostic factors. METHODS This is a retrospective, consecutive interventional study in Vienna, Austria with data from 111 patients following silicone oil removal and simultaneous 360° endolaser treatment for at least 6 months. Stepwise regression analysis between anatomic and visual outcome, baseline demographics, and type and number of RD procedures was performed. RESULTS One hundred and one patients (91%) showed a retinal reattachment after silicone oil removal, which was associated with a low overall number of RD procedures (p = 0.01) and male gender (p < 0.03). Sixty-five patients (59%) showed an improvement (two or more lines) of best-corrected visual acuity (BCVA) at the final follow-up visit. Improvement of BCVA and a better BCVA after silicone oil removal were associated with a better BCVA before silicone oil removal (p < 0.01) and a low overall number of RD procedures (p < 0.01). CONCLUSION The overall number of RD procedures can be used to predict the anatomic and visual outcome after silicone oil removal. Adding a simultaneous 360° endolaser therapy to silicone oil removal is associated with a high anatomic success rate and an excellent visual outcome.
Collapse
Affiliation(s)
- Christiane I Falkner-Radler
- The Ludwig Boltzmann Institute of Retinology and Biomicroscopic Lasersurgery, Department of Ophthalmology, Rudolf Foundation Clinic, Vienna, Austria.
| | | | | | | |
Collapse
|
36
|
Liu Y, Jiang Z, Gao Q, Ge J, Chen J, Cao X, Shen Q, Ma P. Technical Standards of a Foldable Capsular Vitreous Body in Terms of Mechanical, Optical, and Biocompatible Properties. Artif Organs 2010; 34:836-45. [DOI: 10.1111/j.1525-1594.2010.01006.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
37
|
Lam RF, Cheung BT, Yuen CY, Wong D, Lam DS, Lai WW. Reply. Am J Ophthalmol 2008. [DOI: 10.1016/j.ajo.2008.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
38
|
Retinal redetachment after silicone oil removal in proliferative vitreoretinopathy: a prognostic factor analysis. Am J Ophthalmol 2008; 146:145; author reply 145. [PMID: 18573359 DOI: 10.1016/j.ajo.2008.03.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2008] [Accepted: 03/17/2008] [Indexed: 11/21/2022]
|