Corneal Complications During and After Vitrectomy for Retinal Detachment in Photorefractive Keratectomy Treated Eyes

Performance of Bandage Contact Lens in Patients Post-ocular Surgeries: A Systematic Literature Review

ABSTRACT

This study systematically reviewed the performance of bandage contact lenses (BCL) such as lotrafilcon A, lotrafilcon B, senofilcon A, balafilcon A, and comfilcon A as postoperative treatment in different ocular surgeries. A systematic search of English and Chinese databases (from inception to December 2021) was conducted for studies reporting the efficacy of BCLs after ocular surgeries. Postoperative symptoms, corneal healing, and visual outcomes were studied. Overall, 38 studies were identified. Bandage contact lens was applied as a postoperative aid in corneal refractive, cataract, and vitrectomy surgeries. Most studies were on photorefractive keratectomy. Reduced postoperative symptoms were observed within 4 hr to 3 days, whereas re-epithelization of the cornea and healing was complete within 3 to 7 days after ocular surgeries except for vitrectomy. In a vitrectomy, greater comfort and improved corneal epithelium were observed on the seventh day after surgery. An improvement in dry eye symptoms was observed at 7 days with considerable benefits observed after 1 month of cataract surgery. These findings indicate that BCLs are effective for improving postoperative symptoms and facilitation of early visual rehabilitation with a wear time of 8 hr to 7 days depending on the type of ocular surgery.

Return to the Operating Room After Repair of Rhegmatogenous Retinal Detachment

Purpose

To report the rate of all-cause returns to the operating room (OR) after surgery for rhegmatogenous retinal detachment (RRD).

Patients and Methods

This was a retrospective consecutive case series; 1278 eyes underwent RRD repair from 1/1/2014 to 12/31/2016 at a tertiary care center. A total of 507 eyes returned to the OR. Surgical indication, procedure, number of reoperations, and final vision were recorded.

Results

At least one secondary procedure was performed in 24.9% at 6 months, 34.7% at 1 year, and 39.7% as of last follow-up. The most common indications for reoperation were cataract (43.9%) and recurrent RRD (12.8%). Cornea, glaucoma, and oculoplastic issues were rare (each <1.1%). There was no association between final visual outcome and number of reoperations (p > 0.05). SB/PPV had the highest rate of return to OR (p < 0.001) but lowest rate of recurrent RRD (p = 0.007).

Conclusion

To our knowledge, there are no other large studies that examine all-cause returns to the OR after primary RRD repair. This study provides important risk-benefit and prognostic information to patients undergoing RRD repair.

Endothelial corneal cell damage after pars plana vitrectomy: analogy of different intraocular tamponade agents

A reduction in the corneal endothelial cells multitude after anterior pole intervention is well established in numerous researches, but there are few articles that follow the impact of vitreoretinal interventions on the cornea, especially when endotamponade agents are used. The assessment of the endothelial corneal cells is needed since it facilitates the personal evaluation of the functional endothelial stock. Specular microscopy investigation offers a scale of the functional strength of the endothelium of cornea, which is vital before all intraocular interventions.

Endotamponade agents are very suitable and important tools in the surgical treatment of retinal detachment, but their use must be differentiated depending on the uniqueness of each patient. This research shows corneal endothelial damages caused by intraocular tamponade agents of different types in the case of pars plana vitrectomy for cases of multitude retinal detachments. The purpose of the research was to determine the changes that appear in the endothelium of the cornea and to deal with the results when different tamponade agents are used in the surgical cure for retinal detachment. Specular endothelial corneal microscopy records were achieved and the modifications of the following parameters revealed corneal implication: mean endothelial cell densities, average cell area, coefficient of variation, hexagonality and corneal center thickness. On the first day and at three months postoperatively, a statistically significant reduction was observed for the CV, MCD, and HEX parameters (p 0.001), but no statistically significant difference of the two endotamponade agents (for MCD, p=0.15; for CV, p=0.63; for HEX, p=0.93) was noticed. AVG parameter had a statistically significant decrease (p 0.001) and there was also a statistically significant difference of the two endotamponade agents (p=0.03), patients with gas tamponade presenting a superior result. On the first day and at three months postoperatively, the corneal center thickness presented a statistically significant increase (p 0.001) and there was a statistically significant difference between the two endotamponade agents (p=0.03), patients with gas endotamponade presenting a superior result. In conclusion, using the intraocular tamponade agents helps reestablish the functional-anatomical recovery of the retina after surgery, but their special indication must be well-established for each case of retinal detachment.