Change in central corneal thickness, corneal endothelial cell density, anterior chamber depth and axial length after repair of rhegmatogenous retinal detachment

Change in axial length after vitrectomy with silicone oil tamponade for rhegmatogenous retinal detachment

Background

We aimed to explore the changes in the axial length and related factors after vitrectomy for rhegmatogenous retinal detachment (RRD).

Methods

This study retrospectively evaluated patients who underwent vitrectomy with silicone oil (SO) tamponade for RRD and subsequent silicone oil removal at our clinic. Using a Zeiss IOLMaster 700, axial length was measured before vitrectomy for RRD and SO removal. The change in axial length (ΔAL) was calculated, and multivariate binary logistic regression analysis was performed to investigate the potential correlation between ΔAL and clinical factors, such as preoperative hypotony, extreme myopia, age, macular involvement, choroidal detachment, operation duration, and operation history.

Results

In total, 213 eyes from 213 patients were included. The mean axial length changed significantly pre- and post-vitrectomy (25.98 ± 2.87 mm and 26.25 ± 3.07 mm, respectively, P < 0.001); the mean ΔAL was 0.37 ± 0.62 mm. Multivariate binary logistic regression analysis showed that preoperative hypotony and extreme myopia were significantly correlated with the ΔAL (P = 0.001 and P = 0.001, respectively). A higher proportion of hypotonic eyes had ΔAL ≥ 0.3 mm (33/76 in hypotony eyes and 32/137 in others; P = 0.003). A higher proportion of extremely myopic eyes also had a ΔAL ≥ 0.3 mm (23/46 in extremely myopic eyes and 42/167 in others; P = 0.002).

Conclusion

For patients with RRD and cataracts, as axial length changed significantly after vitrectomy in those with hypotony or extreme myopia, secondary lOL implantation should be considered.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12886-022-02433-8.

Status of corneal endothelial cells in the presence of silicone oil in the anterior chamber

To evaluate corneal endothelium damage with silicone oil (SO) presence in the anterior chamber after pars plana vitrectomy. We investigated the medical records of consecutive 54 eyes of 53 patients undergoing SO removal after pars plana vitrectomy with SO tamponade at Saitama Medical Center, Jichi Medical University, Japan. We recorded SO tamponade retention period, anterior chamber SO with gonioscope, area of SO attachment to the corneal endothelium before SO removal surgery, and the lens status. We then retrospectively investigated the correlation between SO presence in the anterior chamber and the decrease rate of corneal endothelial cell (CEC) density during SO tamponade. The average decrease rate of CEC density was 7.6 (0–38.1) %. The correlation between SO tamponade retention period and decrease rate of CEC density was high (p = 0.0001). However, there was no correlation between anterior chamber SO under gonioscope, SO attaching area, and lens status with the decrease rate of CEC density (p = 0.11, p = 0.93, p = 0.16). No correlation was observed between CEC loss and the existence of anterior chamber SO, although CEC decrease rate was relatively high after a long SO tamponade period. These findings suggest that SO presence in the anterior chamber may not directly injure CEC.

Changes in corneal thickness after vitrectomy-Implications for glaucoma practice

Purpose

To evaluate changes in central corneal thickness (CCT) following vitrectomy.

Methods

All consecutive old and new patients referred to glaucoma services for possible secondary glaucoma after vitrectomy and who had undergone corneal pachymetry between July 2013 to June 2020, were included. The eye that developed elevated intraocular pressure (IOP) and was diagnosed clinically as glaucoma after vitrectomy, was labelled as the “affected” eye. The contralateral eye of the patient with normal IOP and no history of vitrectomy was labelled as the “control” eye. The difference in CCT in the affected eye and the contralateral control eye (ΔCCT) and CCT were compared between different age groups. Correlation of CCT in the affected eye with age, diagnosis, type of surgery done, lens status and pre-existing glaucoma was done using multivariate regression analysis.

Results

Of 127 eyes of 120 patients (M:F = 85:35), the average CCT in the affected eye was significantly higher than the unaffected contralateral control eye (p<0.0001). The ΔCCT in eyes presenting at an age <25 years was higher (median 582, 497–840) than those that presented later (median 518, 384–755), p <0.0001, with maximum ΔCCT seen in eyes that had undergone vitrectomy at age<12 years. The CCT in the affected eye was significantly higher in aphakic eyes (588±81.6 microns) than in pseudophakic eyes (552±79.03 microns), p = 0.03. On multivariate analysis, age<25 years remained as a significant influencer of CCT in the affected eye (β = -1.7, p<0.001, R2 = 28.3%).

Conclusions

Young age group<25 years are more prone to corneal remodelling and CCT changes after vitrectomy.

Changes in ocular biometric measurements after vitrectomy with silicone oil tamponade for rhegmatogenous retinal detachment repair

Background

To observe the changes in ocular biometric measurements after vitrectomy with silicone oil tamponade for rhegmatogenous retinal detachment (RRD) repair.

Methods

Sixty-three phakic, macula-off RRD eyes underwent vitrectomy with silicone oil tamponade but not lens extraction were included in this retrospective study. Measurements of axial length (AL), anterior chamber depth (ACD), lens thickness (LT) using the new Zeiss IOLMaster 700 and derivative lens position (LP), relative lens position (RLP) and lens-retina distance (LRD) were compared and analyzed between preoperative and postoperative in phakic, macula-off eyes with RRD.

Results

Preoperative AL, ACD, LT, LP, RLP and LRD were 24.94 ± 1.82 mm, 3.45 ± 0.42 mm, 4.34 ± 0.16 mm, 5.55 ± 0.41 mm, 0.22 ± 0.01 and 19.52 ± 1.82 mm. After a mean 4.85-month duration of silicone oil tamponade, postoperative AL, ACD, LT, LP, RLP and LRD were 25.42 ± 2.20 mm, 3.30 ± 0.41 mm, 4.43 ± 0.21 mm, 5.46 ± 0.40 mm, 0.22 ± 0.02 and 20.17 ± 2.36 mm, respectively. The differences in all measurements are significant (all P < 0.05). Preoperative AL and LRD are positively while RLP is negatively correlated with change in LRD. Change in AL but not in LT or LP is correlated with change in LRD. Biometric measurements except LT between preoperative and postoperative were in close agreement.

Conclusion

The underestimation of AL and anterior shifting of lens in phakic, macula-off eyes with RRD after vitrectomy with silicone oil tamponade.

Changes in corneal endothelial density following scleral buckling surgery for rhegmatogenous retinal detachment: a retrospective cross-sectional study

BACKGROUND

To investigate the effect of scleral buckling (SB) on the morphology and density of human corneal endothelial cells (HCEC).

METHODS

In this retrospective cross-sectional study, 26 patients who had undergone SB due to rhegmatogenous retinal detachment were enrolled, in which 15 patients received encircling while the other 11 segment types of SB. The postoperative status of affected eye, preoperative status of affected eye, and the contralateral healthy eye was served as the study, control and contralateral groups. The images of the corneal endothelium was obtained by specular microscopy at least three months postoperatively and analyzed.

RESULTS

Postoperative best-corrected visual acuity of the study group was worse than that of another two groups (P < 0.001) while intraocular pressure and biometry data were similar. The mean cell area and standard deviation were larger in the study group while the coefficient of variation revealed no difference. The study group manifested a lower endothelial cell density than that of the control and the contralateral (P < 0.001) groups. Concerning the percentage of hexagonal cells, the study group showed a lower hexagonality than the control group (P = 0.04). No difference of the endothelial morphology was found between the segmental subgroup and the encircling subgroup, nor was a significant difference about endothelial cell loss found in the study group with different measurement interval.

CONCLUSIONS

Scleral buckling leads to short-term decreased endothelial cell density and hexagonality, while the rest of morphological features remain unchanged. Moreover, both the segmental and encircling SB procedures yield similar postoperative HCEC status.