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Ciavarra BM, Stenz EC, Barke MR, Gross AW, Chuang AZ, Crowell EL. Mechanism and outcomes of recreational and sports-related open globe injuries. Injury 2024; 55:111504. [PMID: 38508982 DOI: 10.1016/j.injury.2024.111504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 02/14/2024] [Accepted: 03/11/2024] [Indexed: 03/22/2024]
Abstract
OBJECTIVES To describe the mechanisms and visual outcomes of recreational and sports-related open globe injuries (OGIs). METHODS A retrospective case series of eyes experiencing OGI secondary to recreational and sports-related activities at Memorial Hermann Hospital - Texas Medical Center (MHH-TMC) from January 1st, 2010 through March 31st, 2015 was conducted. Exclusionary criteria included no documented ophthalmologic examination upon presentation and repairs performed by services other than ophthalmology. A two-tailed t-test and Fisher's exact test were utilized to assess for statistical significance (p < 0.05). RESULTS A total of 20 eyes from 20 patients experiencing OGIs secondary to recreational and sports-related activities were included. Thirteen eyes (65 %) presented with OGIs from penetrating objects while seven eyes (35 %) had injuries from blunt injuries. Males comprised most of the total study group (17 of 20 patients), and zone 3 injuries were the most common location of OGI. While eyes with OGIs from blunt trauma underwent evisceration/enucleation procedures more frequently than OGIs from penetrating mechanisms (71% vs 23 %) (p = 0.10), the final visual outcomes were similarly poor between groups. Only three eyes in this series experienced an improvement from baseline VA; all three eyes had lacked initial findings consistent with severe injury. CONCLUSIONS Recreational and sports related OGIs most commonly occur in zone 3 and in young males, regardless of injury type. OGIs due to both penetrating and blunt trauma mechanisms implicate poor functional outcomes, but the absence of certain presenting injury features may indicate possibility of eventual visual recovery.
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Affiliation(s)
- Bronson M Ciavarra
- Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at the University of Texas Health Science Center at Houston, 6400 Fannin Street, Suite 1800, Houston, TX 77030, United States
| | - Emma C Stenz
- Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at the University of Texas Health Science Center at Houston, 6400 Fannin Street, Suite 1800, Houston, TX 77030, United States
| | - Matthew R Barke
- Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at the University of Texas Health Science Center at Houston, 6400 Fannin Street, Suite 1800, Houston, TX 77030, United States
| | - Andrew W Gross
- Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at the University of Texas Health Science Center at Houston, 6400 Fannin Street, Suite 1800, Houston, TX 77030, United States
| | - Alice Z Chuang
- Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at the University of Texas Health Science Center at Houston, 6400 Fannin Street, Suite 1800, Houston, TX 77030, United States
| | - Eric L Crowell
- Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at the University of Texas Health Science Center at Houston, 6400 Fannin Street, Suite 1800, Houston, TX 77030, United States.
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Momenaei B, Wakabayashi T, Kazan AS, Oh GJ, Kozarsky S, Vander JF, Gupta OP, Yonekawa Y, Hsu J. Incidence and Outcomes of Recurrent Retinal Detachment after Cataract Surgery in Eyes with Prior Retinal Detachment Repair. Ophthalmol Retina 2024; 8:447-455. [PMID: 37989465 DOI: 10.1016/j.oret.2023.11.005] [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: 10/07/2023] [Revised: 11/03/2023] [Accepted: 11/14/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVE To investigate the incidence and outcomes of recurrent retinal detachment (RD) after cataract extraction (CE). DESIGN Retrospective case series. SUBJECTS Phakic eyes with RD that were successfully repaired with pneumatic retinopexy (PR), scleral buckle (SB), pars plana vitrectomy (PPV), or combined PPV/SB and subsequently underwent cataract surgery. METHODS A retrospective review of phakic eyes that underwent successful RD repair followed by subsequent cataract surgery between April 2012 and January 2023 was performed. Patients with multiple RD surgeries before CE and those with silicone oil tamponade before cataract surgery were excluded. Eyes that redetached were matched 1:2 with eyes that did not redetach after cataract surgery. MAIN OUTCOME MEASURES Incidence of redetachment after cataract surgery as well as visual and anatomic outcomes at 6 months after first redetachment and at the final visit. RESULTS Of 4833 phakic eyes at the time of initial RD, 1893 patients (39.2%) underwent cataract surgery. After applying exclusion criteria, 763 patients were included. The mean (standard deviation) duration of follow-up was 48.4 (29.1) months. The overall incidence of retinal redetachment after cataract surgery was 2.5% (19/763 eyes). The rate of redetachment based on the type of initial RD repair was 9.1% (1/11), 5.3% (2/38), 2.8% (9/317), and 1.8% (7/397) for PR, SB, PPV, and combined PPV/SB, respectively (P = 0.24). The median (interquartile range [IQR]; range) duration between the cataract surgery and first redetachment was 301 (104-1222; 8-2760) days. Single surgery anatomic success for the RD repair after cataract surgery was achieved in 17 eyes (89.5%) at 3 months and 14 eyes (73.7%) at 6 months and at the final visit. Final anatomic success rate for reattachment was 100% (19/19). The median (IQR) logarithm of the minimal angle of resolution visual acuity (VA) at the final visit was 1.00 (0.18-2.00, Snellen equivalent, 20/200) with significant worsening compared with vision after cataract surgery (0.18 [0.10-0.48], 20/30) (P = 0.001). CONCLUSION Recurrent RD was not uncommon in patients with a prior history of RD repair after CE. Reoperation resulted in relatively favorable anatomic success but there were declines in VA. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Bita Momenaei
- The Retina Service of Wills Eye Hospital, Wills Eye Physicians-Mid Atlantic Retina, Philadelphia, Pennsylvania
| | - Taku Wakabayashi
- The Retina Service of Wills Eye Hospital, Wills Eye Physicians-Mid Atlantic Retina, Philadelphia, Pennsylvania
| | - Adina S Kazan
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Glenn J Oh
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Scott Kozarsky
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - James F Vander
- The Retina Service of Wills Eye Hospital, Wills Eye Physicians-Mid Atlantic Retina, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Omesh P Gupta
- The Retina Service of Wills Eye Hospital, Wills Eye Physicians-Mid Atlantic Retina, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Yoshihiro Yonekawa
- The Retina Service of Wills Eye Hospital, Wills Eye Physicians-Mid Atlantic Retina, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jason Hsu
- The Retina Service of Wills Eye Hospital, Wills Eye Physicians-Mid Atlantic Retina, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
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Catania F, Chapron T, Crincoli E, Miere A, Abdelmassih Y, Beaumont W, Chehaibou I, Metge F, Bruneau S, Bonnin S, Souied EH, Caputo G. Deep Learning for prediction of late recurrence of retinal detachment using preoperative and postoperative ultra-wide field imaging. Acta Ophthalmol 2024. [PMID: 38682863 DOI: 10.1111/aos.16693] [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: 01/20/2024] [Accepted: 04/08/2024] [Indexed: 05/01/2024]
Abstract
PURPOSE To elaborate a deep learning (DL) model for automatic prediction of late recurrence (LR) of rhegmatogenous retinal detachment (RRD) using pseudocolor and fundus autofluorescence (AF) ultra-wide field (UWF) images obtained preoperatively and postoperatively. MATERIALS AND METHODS We retrospectively included patients >18 years who underwent either scleral buckling (SB) or pars plana vitrectomy (PPV) for primary or recurrent RRD with a post-operative follow-up >2 years. Records of RRD recurrence between 6 weeks and 2 years after surgery served as a ground truth for the training of the deep learning (DL) models. Four separate DL models were trained to predict LR within the 2 postoperative years (binary outputs) using, respectively, UWF preoperative and postoperative pseudocolor images and UWF preoperative and postoperative AF images. RESULTS A total of 412 eyes were included in the study (332 eyes treated with PPV and 80 eyes with SB). The mean follow-up was 4.0 ± 2.1 years. The DL models based on preoperative and postoperative pseudocolor UWF imaging predicted recurrence with 85.6% (sensitivity 86.7%, specificity 85.4%) and 90.2% accuracy (sensitivity 87.0%, specificity 90.8%) in PPV-treated eyes, and 87.0% (sensitivity 86.7%, specificity 87.0%) and 91.1% (sensitivity 88.2%, specificity 91.9%) in SB-treated eyes, respectively. The DL models using preoperative and postoperative AF-UWF imaging predicted recurrence with 87.6% (sensitivity 84.0% and specificity 88.3%) and 91.0% (sensitivity 88.9%, specificity 91.5%) accuracy in PPV eyes, and 86.5% (sensitivity 87.5%; specificity 86.2%) and 90.6% (sensitivity 90.0%, specificity 90.7%) in SB eyes, respectively. Among the risk factors detected with visualisation methods, potential novel ones were extensive laser retinopexy and asymmetric staphyloma. CONCLUSIONS DL can accurately predict the LR of RRD based on UWF images (especially postoperative ones), which can help refine follow-up strategies. Saliency maps might provide further insight into the dynamics of RRD recurrence.
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Affiliation(s)
- Fiammetta Catania
- Ophthalmology Department, Rothschild Foundation Hospital, Paris, France
- Humanitas University, Department of Biomedical Sciences, Milan, Italy
| | - Thibaut Chapron
- Ophthalmology Department, Rothschild Foundation Hospital, Paris, France
- Université Paris Cité, CRESS, Obstetrical Perinatal and Paediatric Epidemiology Research Team, Paris, France
| | - Emanuele Crincoli
- Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli IRCCS", Catholic University "Sacro Cuore", Rome, Italy
| | - Alexandra Miere
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | | | - William Beaumont
- Ophthalmology Department, Rothschild Foundation Hospital, Paris, France
| | - Ismael Chehaibou
- Ophthalmology Department, Rothschild Foundation Hospital, Paris, France
| | - Florence Metge
- Ophthalmology Department, Rothschild Foundation Hospital, Paris, France
| | - Sebastien Bruneau
- Ophthalmology Department, Rothschild Foundation Hospital, Paris, France
| | - Sophie Bonnin
- Ophthalmology Department, Rothschild Foundation Hospital, Paris, France
| | - Eric H Souied
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Georges Caputo
- Ophthalmology Department, Rothschild Foundation Hospital, Paris, France
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Li P, Li L, Wu J. The Effect of Steroid Intervention before Vitrectomy for Rhegmatogenous Retinal Detachment Associated with Choroidal Detachment: A Meta-Analysis and Systematic Review. Curr Eye Res 2024:1-7. [PMID: 38679916 DOI: 10.1080/02713683.2024.2343333] [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: 11/03/2023] [Accepted: 04/09/2024] [Indexed: 05/01/2024]
Abstract
PURPOSE This meta-analysis discusses the effectiveness of steroid intervention before vitrectomy in patients with rhegmatogenous retinal detachment associated with choroidal detachment. METHODS We searched PubMed, MEDLINE, EMBASE, and the Cochrane Library for randomized controlled trials and observational studies published until August 2023. We included studies involving: patients with rhegmatogenous retinal detachment associated with choroidal detachment with proliferative vitreoretinopathy; an experimental group that was not administered steroids and a control group that was administered steroids; and assessment of visual acuity, retinal reattachment rate, and complications. The heterogeneity, publication bias, and sensitivity analysis were performed to ensure the statistical power and reliability of the analysis. RESULTS Two randomized controlled trials and four case-control studies involving 490 eyes were included in the meta-analysis. There were no significant differences in the primary and final retinal reattachment rates after surgery between the steroid and non-steroid groups (primary retinal reattachment rate: odds ratio = 1.01, 95% confidence interval = 0.63-1.63, p = .41; final retinal reattachment rate: odds ratio = 0.82, 95% confidence interval = 0.43-1.59, p = .33). There was no statistically significant difference in postoperative visual acuity improvement between the two groups (odds ratio = 1.19, confidence interval = 0.63-2.25, p = .69). In addition, subgroup analyses of different types of steroids showed that systemic and local administration of steroids had similar results for retinal reattachment rate and visual acuity improvement. CONCLUSION Patients with rhegmatogenous retinal detachment associated with choroidal detachment who did not receive preoperative steroids achieved the same effect as patients with rhegmatogenous retinal detachment associated with choroidal detachment who did receive preoperative steroids in terms of retinal reattachment rate and visual acuity. It is recommended that patients with rhegmatogenous retinal detachment associated with choroidal detachment undergo surgery as promptly as possible.
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Affiliation(s)
- Pingping Li
- AIER Eye Hospital of Wuhan University, Wuhan, China
| | - Lu Li
- Eye Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jianhua Wu
- AIER Eye Hospital of Wuhan University, Wuhan, China
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Quiroz-Reyes MA, Babar ZUD, Hussain R, Loh ZC, Quiroz-Gonzalez EA, Quiroz-Gonzalez MA, Lima-Gomez V. Management, risk factors and treatment outcomes of rhegmatogenous retinal detachment associated with giant retinal tears: scoping review. Int J Retina Vitreous 2024; 10:35. [PMID: 38654369 PMCID: PMC11036595 DOI: 10.1186/s40942-024-00552-6] [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: 02/22/2024] [Accepted: 03/27/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Rhegmatogenous retinal detachment (RRD) is a serious condition that occurs when the retina detaches from its underlying retinal pigment epithelium. RRDs associated with giant retinal tears (GRTs) are caused by retinal tears at least 90° or one-quarter of the circumferential extent. This scoping review systematically identifies and summarizes clinical studies evaluating surgical techniques for the management of GRT-related RRDs, discusses functional and visual outcomes and the risk factors affecting treatment outcomes. METHODS This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Scopus, Google Scholar, and Springer Link databases were searched for relevant papers (from January 2001 to March 2023). Studies that were published in the English language and reported the risk factors, management, and treatment outcomes of GRT-related RRDs were included in the review. The outcome measures included anatomic success rates, changes in BCVA (logMAR) from baseline to the final follow-up, and adverse events. RESULTS A total of 11,982 articles were identified. After the title and abstract review, 71 studies were deemed eligible for full-text review. Thirty-six studies that met the eligibility criteria were included in the final review. Four surgical techniques were identified: pars plana vitrectomy (PPV), combined PPV and scleral buckling, scleral buckling alone, and pneumatic retinopexy. Various types of tamponades, including gas, silicone oil, and air, have been used. PPV was the most commonly used surgical technique in 33.1-100% of patients. Among the 20 studies that used PPV alone, 17 were associated with preoperative PVR. In addition, scleral buckling alone or in combination with PPV was reported as a treatment option in 10 studies, with 2-100% of patients experiencing scleral buckling alone and 13.6-100% experiencing combined PPV and complementary scleral buckling. Primary anatomic success (PAS) was achieved with retinal reattachment via a single operation with no residual tamponade, whereas final anatomic success (FAS) was achieved via more than one operation with no residual tamponade. Reported single surgery anatomic success (SSAS) rates range from 65.51 to 100%. The preoperative best-corrected visual acuity (BCVA) ranged from 0.067 to 2.47 logMAR, whereas the postoperative BCVA ranged from 0.08 to 2.3 logMAR. An improvement in visual acuity was observed in 29 studies. Cataracts (3.9-28.3%) were the most common postoperative complication, followed by high IOP (0.01-51.2%) and PVR (0.8-31.57%). CONCLUSION PPV is the most common surgical technique, and currently microincision vitrectomy surgery (MIVS) systems are commonly employed. Silicone oil is the most frequently used tamponade in RRD repair. Risk factors for GRT-related RRD include age, sex, lens status, high myopia status, proliferative vitreoretinopathy (PVR), presenting visual acuity, the extent of the GRT and retinal detachment, and macular involvement. Future research areas include guidelines to reduce variability in the reporting of surgical methodology, choice of tamponades, and reporting of functional and visual outcomes to inform the best therapeutic interventions in GRT-related RRD.
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Affiliation(s)
- Miguel A Quiroz-Reyes
- Retina Department of Oftalmologia Integral ABC (Nonprofit Medical and Surgical Organization, National Autonomous University of Mexico, Av. Paseo de las Palmas 735 Suite 303, 11000, Lomas de Chapultepec, Mexico City, Mexico.
| | - Zaheer-Ud-Din Babar
- Department of Pharmacy, University of Huddersfield, HD1 3DH, Queensgate, Huddersfield, UK
| | - Rabia Hussain
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Gelugor, Pulau Pinang, Malaysia
| | - Zhe Chi Loh
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Gelugor, Pulau Pinang, Malaysia
| | - Erick A Quiroz-Gonzalez
- Retina Department of Oftalmologia Integral ABC (Nonprofit Medical and Surgical Organization, National Autonomous University of Mexico, Av. Paseo de las Palmas 735 Suite 303, 11000, Lomas de Chapultepec, Mexico City, Mexico
- Institute of Ophthalmology, National Autonomous University of Mexico, Av. Chimalpopoca 14. Col. Obrera, 06800, Mexico City, Mexico
| | - Miguel A Quiroz-Gonzalez
- Retina Department of Oftalmologia Integral ABC (Nonprofit Medical and Surgical Organization, National Autonomous University of Mexico, Av. Paseo de las Palmas 735 Suite 303, 11000, Lomas de Chapultepec, Mexico City, Mexico
| | - Virgilio Lima-Gomez
- Juarez Hospital, Public Assistance Institution, Av. Politecnico Nacional 5160, Colonia Magdalena de las Salinas, 07760, Mexico City, Mexico
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Wu SL, Chen YQ, Shen LJ, Mao JB, Lin L, Tao JW, Chen H, Zhang SA, Yu JF, Wang CX. Non-contact wide-field viewing system-assisted scleral buckling surgery for retinal detachment in silicone oil-filled eyes. Int J Ophthalmol 2024; 17:761-766. [PMID: 38638243 PMCID: PMC10988081 DOI: 10.18240/ijo.2024.04.21] [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: 03/23/2023] [Accepted: 11/20/2023] [Indexed: 04/20/2024] Open
Abstract
AIM To evaluate scleral buckling (SB) surgery using a non-contact wide-field viewing system and 23-gauge intraocular illumination for the treatment of rhegmatogenous retinal detachment in silicone oil (SO)-filled eyes. METHODS Totally 9 patients (9 eyes) with retinal detachment in SO-filled eyes were retrospectively analyzed. All patients underwent non-contact wide-field viewing system-assisted buckling surgery with 23-gauge intraocular illumination. SO was removed at an appropriate time based on recovery. The patients were followed up for at least 3mo after SO removal. Retinal reattachment, complications, visual acuity and intraocular pressure (IOP) before and after surgery were observed. RESULTS Patients were followed up for a mean of 8.22mo (3-22mo) after SO removal. All patients had retinal reattachment. At the final follow-up, visual acuity showed improvement for 8 patients, and no change for 1 patient. The IOP was high in 3 patients before surgery, but it stabilized after treatment; it was not affected in the other patients. None of the patients had infections, hemorrhage, anterior ischemia, or any other complication. CONCLUSION This new non-contact wide-field viewing system-assisted SB surgery with 23-gauge intraocular illumination is effective and safe for retinal detachment in SO-filled eyes.
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Affiliation(s)
- Su-Lan Wu
- Center for Rehabilitation Medicine, Department of Ophthalmology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310000, Zhejiang Province, China
| | - Yi-Qi Chen
- Center for Rehabilitation Medicine, Department of Ophthalmology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310000, Zhejiang Province, China
| | - Li-Jun Shen
- Center for Rehabilitation Medicine, Department of Ophthalmology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310000, Zhejiang Province, China
| | - Jian-Bo Mao
- Center for Rehabilitation Medicine, Department of Ophthalmology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310000, Zhejiang Province, China
| | - Li Lin
- The Affiliated Eye Hospital of Wenzhou Medical University in Hangzhou, Hangzhou 310000, Zhejiang Province, China
| | - Ji-Wei Tao
- The Affiliated Eye Hospital of Wenzhou Medical University in Hangzhou, Hangzhou 310000, Zhejiang Province, China
| | - Huan Chen
- Center for Rehabilitation Medicine, Department of Ophthalmology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310000, Zhejiang Province, China
| | - Shi-An Zhang
- Center for Rehabilitation Medicine, Department of Ophthalmology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310000, Zhejiang Province, China
| | - Jia-Feng Yu
- Center for Rehabilitation Medicine, Department of Ophthalmology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310000, Zhejiang Province, China
| | - Chen-Xi Wang
- Center for Rehabilitation Medicine, Department of Ophthalmology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310000, Zhejiang Province, China
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Harju N, Hytti M, Kolari O, Nisula H, Loukovaara S, Kauppinen A. Anti-inflammatory potential of simvastatin and amfenac in ARPE-19 cells; insights in preventing re-detachment and proliferative vitreoretinopathy after rhegmatogenous retinal detachment surgery. Int Ophthalmol 2024; 44:158. [PMID: 38530532 DOI: 10.1007/s10792-024-03067-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 02/16/2024] [Indexed: 03/28/2024]
Abstract
PURPOSE Rhegmatogenous retinal detachment is a severe vision-threatening complication that can result into proliferative vitreoretinopathy (PVR) and re-detachment of the retina if recovery from surgery fails. Inflammation and changes in retinal pigment epithelial (RPE) cells are important contributors to the disease. Here, we studied the effects of simvastatin and amfenac on ARPE-19 cells under inflammatory conditions. METHODS ARPE-19 cells were pre-treated with simvastatin and/or amfenac for 24 h after which interleukin (IL)-1α or IL-1β was added for another 24 h. After treatments, lactate dehydrogenase release, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) processing, nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) activity, prostaglandin E2 (PGE2) level, and extracellular levels of IL-6, IL-8, monocytic chemoattractant protein (MCP-1), vascular endothelial growth factor (VEGF), and pigment epithelium-derived factor, as well as the production of reactive oxygen species (ROS) were determined. RESULTS Pre-treatment of human ARPE-19 cells with simvastatin reduced the production of IL-6, IL-8, and MCP-1 cytokines, PGE2 levels, as well as NF-κB activity upon inflammation, whereas amfenac reduced IL-8 and MCP-1 release but increased ROS production. Together, simvastatin and amfenac reduced the release of IL-6, IL-8, and MCP-1 cytokines as well as NF-κB activity but increased the VEGF release upon inflammation in ARPE-19 cells. CONCLUSION Our present study supports the anti-inflammatory capacity of simvastatin as pre-treatment against inflammation in human RPE cells, and the addition of amfenac complements the effect. The early modulation of local conditions in the retina can prevent inflammation induced PVR formation and subsequent retinal re-detachment.
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Affiliation(s)
- Niina Harju
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
- Head and Neck Center, Ophthalmology Research Unit, Helsinki University Central Hospital, Helsinki, Finland.
| | - Maria Hytti
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Department of Ophthalmology, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Onni Kolari
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Hilkka Nisula
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Sirpa Loukovaara
- Department of Ophthalmology, Unit of Vitreoretinal Surgery, and Individualized Drug Therapy Research Program, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Anu Kauppinen
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
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Jung JJ, Lim SY, Chan X, Yee Yeoh CH, Smolyar K, Oribello A, Dizon AG, Hoang QV. ULTRA-WIDEFIELD IMAGING DETECTION RATE IN IDENTIFYING PERIPHERAL RETINAL TEARS IN SINGLE VERSUS MONTAGE OF PERIPHERAL STEERING. Retina 2024; 44:406-413. [PMID: 37976437 DOI: 10.1097/iae.0000000000003979] [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: 11/19/2023]
Abstract
PURPOSE To compare the detection rate of orthogonal, directed peripheral steering, and automontaged images with ultra-widefield imaging and the factors influencing the ability to identify retinal breaks. DESIGN Retrospective cohort study. METHODS Three hundred and seventy-six treatment-naive eyes (349 patients) that underwent laser retinopexy for retinal breaks between 2015 and 2021 were included. Pretreatment ultra-widefield orthogonal, peripheral steering, and automontage were cross-referenced to scleral-depressed examination to determine whether images successfully visualized all retinal breaks. Total relative retinal area (RRA) visualized was divided by its optic disk area (pixels) to calculate relative retinal area. Potential associations were assessed by linear regression analysis. RESULTS One hundred and sixty two eyes (154 patients) met inclusion criteria. Orthogonal, peripheral steering, and automontage images showed detection rates of 47.5%, 90.7%, and 80.0%, respectively. Relative retinal area increased from orthogonal versus montage by 34.7% ± 26.5% (mean ± SD), which increased the detection rate by 90.8% ( P = 0.006). In linear probability models, vertical meridian tears decreased probability of identification in orthogonal, peripheral steering, and automontage by -26.6%, -86.2%, and -68.7%, respectively ( P < 0.001), and horizontal meridian tears increased the probability by 62.2%, 92.9%, and 85.5%, respectively, ( P < 0.001). Tears posterior to the equator in orthogonal images increased the probability (91.4%, P < 0.001). Artifacts such as lids/lashes, reflection, and face guard decreased the probability in directed peripheral steering by -28.6%, -50.0%, and -66.7%, respectively, ( P = 0.020, P = 0.049, and P = 0.016). CONCLUSION Using directed peripheral steering and automontage increases RRA and detection rate of identifying peripheral retinal breaks. Tears in horizontal meridians or posterior to the equator increase the probability of identification. Common ultra-widefield imaging artifacts can significantly limit the probability of identifying retinal tears.
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Affiliation(s)
- Jesse J Jung
- East Bay Retina Consultants, Inc, Oakland, CA
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California
| | - Shen Yi Lim
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, Singapore
| | - Xavier Chan
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, Singapore
| | | | | | | | | | - Quan V Hoang
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore; and
- Department of Ophthalmology, Columbia University College of Physicians and Surgeons, New York, New York
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Qian T, Gong Q, Shu Y, Shen H, Wu X, Wang W, Zhang Z, Cao H, Xu X. The Efficacy and Safety of Diazepam for Intraoperative Blood Pressure Stabilization in Hypertensive Patients Undergoing Vitrectomy Under Nerve Block Anesthesia: A Prospective, Single-Center, Double-Blind, Randomized, Controlled Trial. Ther Clin Risk Manag 2024; 20:9-18. [PMID: 38230372 PMCID: PMC10790667 DOI: 10.2147/tcrm.s441152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/18/2023] [Indexed: 01/18/2024] Open
Abstract
Purpose To evaluate the effectiveness and safety of diazepam in maintaining stable intraoperative blood pressure (BP) in hypertensive patients undergoing vitrectomy under nerve block anesthesia. Methods A total of 180 hypertensive patients undergoing vitrectomy with nerve block anesthesia were randomized into two groups. The intervention group was given oral diazepam 60 min before operation, while the control group was given oral placebo 60 min before operation. The primary outcome is the effective rate of intraoperative BP control, defined as systolic blood pressure (SBP) during the operation maintained < 160 mmHg at all timepoints. The logistic regression model will be performed to analyze the compare risk factors for ineffective BP control. Results The effective rate of intraoperative SBP control in the diazepam group was significant higher than that in the placebo group from 15 min to 70 min of the surgery (P < 0.05). The proportion of patients with SBP ≥180 mmHg at any timepoint from operation to 1 h postoperation was higher in the placebo group (12.22%) than in the diazepam group (2.22%) (P = 0.0096). We observed that the change in SBP from baseline consistently remained higher in the placebo group than in the diazepam group. In the logistic regression analysis, age, years of diagnosed hypertension and SBP 1h before surgery were significant risk factors for ineffective BP control. Conclusion This study provides robust evidence supporting the effectiveness of oral diazepam as a pre-surgery intervention in maintaining stable blood pressure during vitrectomy in hypertensive patients. Trial Registration Chinese Clinical Trial Registry (ChiCTR), ChiCTR2100041772.
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Affiliation(s)
- Tianwei Qian
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
- National Clinical Research Center for Eye Diseases, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, People’s Republic of China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, People’s Republic of China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, People’s Republic of China
| | - Qiaoyun Gong
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
- National Clinical Research Center for Eye Diseases, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, People’s Republic of China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, People’s Republic of China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, People’s Republic of China
| | - Yiyang Shu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
- National Clinical Research Center for Eye Diseases, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, People’s Republic of China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, People’s Republic of China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, People’s Republic of China
| | - Hangqi Shen
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
- National Clinical Research Center for Eye Diseases, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, People’s Republic of China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, People’s Republic of China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, People’s Republic of China
| | - Xia Wu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
- National Clinical Research Center for Eye Diseases, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, People’s Republic of China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, People’s Republic of China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, People’s Republic of China
| | - Weijun Wang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
- National Clinical Research Center for Eye Diseases, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, People’s Republic of China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, People’s Republic of China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, People’s Republic of China
| | - Zhihua Zhang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
- National Clinical Research Center for Eye Diseases, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, People’s Republic of China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, People’s Republic of China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, People’s Republic of China
| | - Hui Cao
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
- National Clinical Research Center for Eye Diseases, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, People’s Republic of China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, People’s Republic of China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, People’s Republic of China
| | - Xun Xu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
- National Clinical Research Center for Eye Diseases, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, People’s Republic of China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, People’s Republic of China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, People’s Republic of China
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10
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Bahrani HM, Alhasseny KF. Vitrectomy Results for Stages 4 and 5 Retinopathy of Prematurity in Iraq. Clin Ophthalmol 2023; 17:4033-4041. [PMID: 38170100 PMCID: PMC10759917 DOI: 10.2147/opth.s443810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024] Open
Abstract
Background Stage 4 and 5 retinopathy of prematurity (ROP) is a serious condition that may require surgical intervention at some point. Timely intervention is a key element and, with the peculiarity of eyes among this group that necessities a certain level of surgical standards, operations cannot be undertaken in any surgical eye center. Aim of the Study To recognize the outcomes of vitrectomy in Iraqi preterm babies with stage 4 and 5 ROP, and to study factors that might increase the risk of re-detachment in operated eyes. Methods A prospective cohort study undertaken from November 2020 to June 2023 for Iraqi preterm babies presenting with stage 4 and 5 ROP requiring surgical intervention. Each patient had a follow-up duration of 9 months. The primary follow-up outcome was anatomical success rate (flat versus detached), and the secondary outcome was to identify the postoperative complications. Results This study enrolled 19 children; 11 males and eight females (number of eyes operated on was was 31), with a mean gestational age of 29.4±2.1 weeks. There were six (19.4%) eyes that did not develop any complications, five (16.1%) eyes developed postoperative vitreous hemorrhage, five (16.1%) eyes developed cataract, three (9.7%) eyes underwent a second vitrectomy, and seven (22.6%) eyes developed secondary glaucoma. The surgical success rates were 90.9% for stage 4a, 57.1% for stage 4b, and 33.3% for stage 5a. Conclusion This study presented the first surgical experience for vitrectomy in children with retinopathy of prematurity in our country, and the results were encouraging with an overall surgical success rate of 64.5%, and 19.4% of eyes did not develop any complication until the 1-year of follow-up.
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11
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Treviño-Herrera AB, Gonzalez-Cortes JH, Gonzalez-Cantu JE, Garza-Chavarria JA, Martinez-Pacheco VA, Bilgic A. Suprachoroidal silicone oil as an intraoperative complication during Pars Plana Vitrectomy: A case report. Int J Surg Case Rep 2023; 108:108441. [PMID: 37393679 PMCID: PMC10382846 DOI: 10.1016/j.ijscr.2023.108441] [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: 05/28/2023] [Revised: 06/13/2023] [Accepted: 06/27/2023] [Indexed: 07/04/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Complications related to silicone oil tamponade are frequent. There are reports of events related to silicone oil (SO) injection during Pars Plana Vitrectomy (PPV). This case presents the unexpected injection of SO in the suprachoroidal space. The proper management of this complication along with the preventive measures are discussed. CASE PRESENTATION A 38-year-old male presented with a one-week history of decreased vision in his right eye (OD). His visual acuity was hand motion (HM). A late-onset retinal detachment recurrence with proliferative vitreoretinopathy (PVR) in his OD was diagnosed. Cataract surgery and PPV were scheduled. During PPV, a choroidal detachment (CD) secondary to the suprachoroidal injection of silicone oil (SO) was noted. Suprachoroidal SO was identified timely and was managed with external drainage through a posterior sclerotomy. CLINICAL DISCUSSION Suprachoroidal silicone oil injection is a potential complication during PPV. For the management of this complication, the drainage of the silicone oil from the suprachoroidal space through a posterior sclerotomy may be considered as an option. This complication may be avoided by periodically checking the correct position of the infusion cannula during the PPV, by injecting the SO into the vitreous cavity under direct visualization and by using automated injection systems. CONCLUSION Suprachoroidal silicone oil injection is an intraoperative complication that might be avoided by cross-checking the correct position of the infusion cannula and by injecting SO under direct visualization.
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Affiliation(s)
- Alan Baltazar Treviño-Herrera
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León (UANL), Monterrey 64460, Mexico
| | - Jesus Hernan Gonzalez-Cortes
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León (UANL), Monterrey 64460, Mexico; Department of Retina and Vitreous, Especialistas en Retina Medica y Quirurgica ERVOS, ISSSTE Constitucion, UNAM, Monterrey, Nuevo Leon, Mexico.
| | - Jesus Emiliano Gonzalez-Cantu
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León (UANL), Monterrey 64460, Mexico
| | - Javier Alan Garza-Chavarria
- Department of Retina and Vitreous, Especialistas en Retina Medica y Quirurgica ERVOS, ISSSTE Constitucion, UNAM, Monterrey, Nuevo Leon, Mexico
| | | | - Alper Bilgic
- Department of Retina and Vitreous, Especialistas en Retina Medica y Quirurgica ERVOS, ISSSTE Constitucion, UNAM, Monterrey, Nuevo Leon, Mexico
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12
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Zhou Y, Lu Q, Chen Z, Lu P. A Prediction Nomogram for Recurrent Retinal Detachment. Risk Manag Healthc Policy 2023; 16:479-488. [PMID: 37013114 PMCID: PMC10066632 DOI: 10.2147/rmhp.s403136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 03/10/2023] [Indexed: 03/30/2023] Open
Abstract
Purpose Recurrent retinal detachment (re-RD) is one of the complications in rhegmatogenous retinal detachment patients who underwent surgical treatment. We investigated the risk factors for re-RD and developed a nomogram for estimating clinical risk. Methods Univariate and multivariable logistic regression models were performed to determine the association between variables and re-RD, and a nomogram was then developed for re-RD. The nomogram performance was assessed based on its discrimination, calibration, and clinical usefulness. Results This study analyzed 15 potential variables of re-RD in 403 rhegmatogenous retinal detachment patients who underwent initial surgical treatment. Axial length, inferior breaks, retinal break diameter, and surgical methods were independent risk factors for re-RD. A clinical nomogram incorporating these four independent risk factors was constructed. The diagnostic performance of the nomogram was excellent (area under the curve = 0.892, 95% CI: 0.831-0.953). Our study further validated this nomogram by bootstrapping for 500 repetitions. The area under the curve of the bootstrap model was 0.797 (95% CI: 0.712-0.881). This model showed good calibration curve fitting and a positive net benefit in decision curve analysis. Conclusion Axial length, inferior breaks, retinal break diameter, and surgical methods could be risk factors for re-RD. We have developed a prediction nomogram of re-RD for rhegmatogenous retinal detachment following initial surgical treatment.
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Affiliation(s)
- Yongying Zhou
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China
- Department of Ophthalmology, Children’s Hospital of Wujiang District, Suzhou, People’s Republic of China
| | - Qianyi Lu
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China
| | - Zhigang Chen
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China
| | - Peirong Lu
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China
- Correspondence: Peirong Lu, Department of Ophthalmology, the First Affiliated Hospital of Soochow University, Shizi Street 188, Suzhou, Jiangsu Province, 215006, People’s Republic of China, Email
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13
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Akbarzadeh A, Zand A, Rahimi M, Mirshahi R, Parvaresh MM, Falavarjani KG. Unplanned Reoperation following Vitreoretinal Surgery. J Curr Ophthalmol 2023; 35:56-60. [PMID: 37680287 PMCID: PMC10481975 DOI: 10.4103/joco.joco_343_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 04/10/2023] [Accepted: 04/13/2023] [Indexed: 09/09/2023] Open
Abstract
Purpose To evaluate the incidence of unplanned return to the operating room following vitreoretinal surgery and assess the reasons. Methods In this retrospective case series, medical records of all patients who underwent vitreoretinal surgery were reviewed to determine the incidence and reasons of early (<30 days postoperatively) and late (≥30 days postoperatively) unplanned reoperations after the surgery. Results A total of 488 eyes of 468 patients with a mean age of 55.84 ± 18.23 years were included. Fourteen percent (68/488) of eyes required one or more unplanned reoperation following their primary surgery. These include 3.9% (19/488) for the early and 10.0% (49/488) for the late reoperation. The most common primary reason for baseline surgery was rhegmatogenous retinal detachment (RRD) without proliferative vitreoretinopathy (PVR, 38.2%), followed by RD with PVR (23.5%), and tractional RD (TRD, 19.1%). Unplanned reoperations were most common in RD with PVR (19.3%), RRD without PVR (17.2%), and TRD (14.4%). Overall, the most common reasons of the first unplanned reoperation were repeated RD with PVR (27.9%), repeated RD (19.1%), and the presence of silicone oil (SO) in the anterior chamber (AC) (10.3%). For early unplanned reoperations, SO in AC, postoperative endophthalmitis, and persistent hyphema were the most common causes. Repeated RD with PVR was the most prevalent cause of late unplanned reoperations (34.7%). In the multivariate analysis, preoperative best-corrected visual acuity (BCVA) was significantly lower in eyes with unplanned reoperation than in eyes without (P = 0.011). Conclusions Unplanned reoperation following vitreoretinal surgery is not very common, and occurs mostly in the setting of PVR, RRD, and TRD. Lower preoperative BCVA may indicate an increased chance of future unplanned reoperation(s).
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Affiliation(s)
- Ali Akbarzadeh
- Eye Research Center, Department of Ophthalmology, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Amin Zand
- Eye Research Center, Department of Ophthalmology, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Masoud Rahimi
- Eye Research Center, Department of Ophthalmology, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Mirshahi
- Eye Research Center, Department of Ophthalmology, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mehdi Parvaresh
- Eye Research Center, Department of Ophthalmology, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Khalil Ghasemi Falavarjani
- Eye Research Center, Department of Ophthalmology, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
- Stem Cell and Regenerative Medicine Research Center, Iran University of Medical Sciences, Tehran, Iran
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14
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Yablokov MM, Fabrikantov OL, Yablokova NV. Silicone oil tamponade in surgical treatment of rhegmatogenous retinal detachment. RUSSIAN OPHTHALMOLOGICAL JOURNAL 2022. [DOI: 10.21516/2072-0076-2022-15-4-173-177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The article presents a literature review regarding the use of silicone oil tamponade (ST) in rhegmatogenous retinal detachment (RRD) treatment. Vitrectomy, which produces a stable anatomical result in most patients, is currently recognized as one of the main methods of treating RRD. In complicated retinal detachments, vitrectomy is followed by ST tamponade of the vitreous cavity (VC). Despite the many benefits of ST, it carries the risk of a number of complications arising at different times after surgery. The duration of ST presence in the vitreous cavity during RRD treatment may vary substantially. The review presents ST complications, including an unexpected and hard to explain vision deterioration after silicone oil removal, and the correlation between the complications and the duration of ST presence in the vitreous cavity.
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Affiliation(s)
| | - O. L. Fabrikantov
- S. Fyodorov Eye Microsurgery Clinic, Tambov branch; Derzhavin Tambov State University, Medical Institute
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15
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Comparison of Idiopathic Macular Hole Interventions Using Frequency Domain Optical Coherence Tomography and Optical Coherence Tomography Angiography. DISEASE MARKERS 2022; 2022:7749605. [PMID: 35996716 PMCID: PMC9392636 DOI: 10.1155/2022/7749605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 07/03/2022] [Accepted: 07/23/2022] [Indexed: 11/18/2022]
Abstract
Objective We aimed to determine the efficacy of different idiopathic macular hole treatment methods to improve recovery time and patient outcomes using Frequency Domain Optical Coherence Tomography (SD-OCT) and Optical Coherence Tomography Angiography (OCTA). Methods This retrospective study included patients with idiopathic macular hole who were admitted to our hospital between 1st January 2019 and 31st October 2021. The control group was treated with internal limiting membrane tamponade, and the study group was treated with clamshell therapy. Treatment conditions (internal limiting membrane treatment duration and hole closure rate), best corrected visual acuity (BCVA) before and after surgery, OCTA measurements, and SD-OCT were assessed. The retinal nerve fiber layer (RNFL), retinal ganglion cell layer (GCL), and retinal pigment epithelium (RPE) thicknesses were also analyzed. Results The treatment time and hole closure rate of the internal limiting membrane in the study group were higher than those in the control group. The curative effect of the study group was better than that of the control group. The postoperative DCP blood vessel density in both groups was higher than that before operation, and the study group was higher than the control group. The FAZ area and circumference were lower than those before surgery, and the study group was lower than the control group. At 3 months after operation, the thickness of DIOA, nasal temporal RNFL, and GCL were decreased in both groups, and the observed values in the study group were lower than those in the control group. At 3-month follow-up, there was no significant difference in RPE thickness between the two groups. Conclusion Flip and cover therapy is the most effective treatment. SD-OCT and OCTA provide an objective basis for clinical intervention by comparing the effects of different procedures on the retinal condition of patients.
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16
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Stenz EC, Yu HJ, Shah AR, Wong TP, Major JC, Benz MS, Wykoff CC, Patel SB. Outcomes of Eyes Undergoing Multiple Surgical Interventions after Failure of Primary Rhegmatogenous Retinal Detachment Repair. Ophthalmol Retina 2022; 6:339-346. [PMID: 35074559 DOI: 10.1016/j.oret.2022.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 06/14/2023]
Abstract
PURPOSE To assess outcomes among eyes undergoing surgery for recurrent rhegmatogenous retinal detachment (RRD) and investigate variables that correlate with visual and anatomic outcomes. DESIGN Retrospective, consecutive case series. PARTICIPANTS Eyes in which initial RRD repair failed that underwent ≥2 surgeries for RRD repair between January 1, 2016, and December 31, 2020. METHODS A retrospective analysis of eyes that underwent ≥2 RRD repairs. Eyes with etiologies of retinal detachment other than RRD, previous vitreoretinal surgery, and proliferative diabetic retinopathy were excluded. One-way analysis of variance with Tukey honestly significant difference testing and multivariate regression analyses were used to assess statistical significance. MAIN OUTCOME MEASURES Anatomic success rate and habitual best recorded visual acuity (VA) at postoperative time intervals and at final follow-up. RESULTS The single-operation success rate (SOSR) among eyes that underwent primary RRD repair over a 5-year period was 92.4% (2021 of 2187 eyes). The remaining 166 eyes (164 patients) in which primary RRD repair failed were included in this study. Although the anatomic success rates after the second and third RRD repairs were lower than the SOSR (71.7% and 68.1%, respectively), the final anatomic success rates did not significantly differ between eyes that underwent ≥2 RRD repairs (range, 90.6%-100%) (P > 0.05), and final anatomic success was achieved in 95.8% of the eyes. The average VA at both postoperative time intervals and final follow-up decreased with an increased total number of RRD repairs. Eyes that received silicone oil endotamponade during the second RRD repair were 20.3% (P = 0.03) and 38.4% (P = 0.04) less likely to require a third RRD repair compared with eyes that received octafluoropropane and sulfur hexafluoride gases, respectively. Eyes that developed a third RRD due to proliferative vitreoretinopathy (PVR) (n = 43) were 110% more likely to require a fourth RRD repair than eyes that developed a third RRD due to a new tear or failure to reattach (n = 4) (P = 0.04). CONCLUSIONS In this series, the rates of anatomic success appeared consistent after each surgery when multiple reoperations were required for RRD. The VA decreased with an increased total number of RRD repairs, and the endotamponade choice might have affected the risk of additional reoperations. Proliferative vitreoretinopathy was a significant prognostic factor for RRD recurrence.
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Affiliation(s)
- Emma C Stenz
- John P. and Kathrine G. McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas; Retina Consultants of Texas, Retina Consultants of America, Houston, Texas
| | - Hannah J Yu
- Retina Consultants of Texas, Retina Consultants of America, Houston, Texas
| | - Ankoor R Shah
- Retina Consultants of Texas, Retina Consultants of America, Houston, Texas; Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas
| | - Tien P Wong
- Retina Consultants of Texas, Retina Consultants of America, Houston, Texas; Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas
| | - James C Major
- Retina Consultants of Texas, Retina Consultants of America, Houston, Texas; Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas
| | - Matthew S Benz
- Retina Consultants of Texas, Retina Consultants of America, Houston, Texas; Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas
| | - Charles C Wykoff
- Retina Consultants of Texas, Retina Consultants of America, Houston, Texas; Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas
| | - Sagar B Patel
- Retina Consultants of Texas, Retina Consultants of America, Houston, Texas; Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas.
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17
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Peters MC, Murray-Douglass A, Park J, Cheng SSH, Sharma AK, Sharma A, Vandeleur KW, Lee LR, Moloney TP. 360-Degree laser retinopexy in primary vitrectomy for rhegmatogenous retinal detachment: factors associated with its use and impact on surgical outcomes. Int J Retina Vitreous 2022; 8:28. [PMID: 35387685 PMCID: PMC8985359 DOI: 10.1186/s40942-022-00377-1] [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: 02/10/2022] [Accepted: 03/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To determine patient and surgical factors associated with the use of 360-degree laser retinopexy during primary pars plana vitrectomy (PPV) ± scleral buckle (SB) for rhegmatogenous retinal detachment (RRD) and its impact on surgical outcomes. METHODS Patients who underwent PPV ± SB for repair of non-complex RRD at a single centre were included in this retrospective study. The primary outcome was single surgery anatomical success (SSAS). Secondary outcomes included visual acuity, epiretinal membrane formation, the presence of cystoid macular oedema, tonic pupil and corneal epithelial defects. Multiple logistic regression and multivariate regression was used. RESULTS The study included 192 cases, of which 130 received 360-degree laser. Worse preoperative logMAR visual acuity (P = 0.009), male sex (P = 0.060), higher PVR grades, supplemental SB (P = 0.0468) and silicone oil/C3F8 tamponade (P < 0.0001) were associated with 360-degree laser use. No significant associations between 360-degree laser and SSAS (P = 0.079), final logMAR visual acuity (P = 0.0623), ERM development (P = 0.8208), postoperative CMO (P = 0.5946), tonic pupil (P > 0.9999) or corneal epithelial defects (P = N/A) were found. CONCLUSIONS 360-degree laser retinopexy during primary PPV ± SB for RRD was associated with more complex cases and more extensive operations. Even when accounting for this, there was no difference in surgical outcomes or complication rates.
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Affiliation(s)
- Matthew C Peters
- Ophthalmology Department, Royal Brisbane and Women's Hospital, Level 8, Ned Hanlon Building, Butterfield Street, Herston, QLD, 4029, Australia
| | - Alexander Murray-Douglass
- Ophthalmology Department, Royal Brisbane and Women's Hospital, Level 8, Ned Hanlon Building, Butterfield Street, Herston, QLD, 4029, Australia
| | - Joseph Park
- Ophthalmology Department, Royal Brisbane and Women's Hospital, Level 8, Ned Hanlon Building, Butterfield Street, Herston, QLD, 4029, Australia
| | - Sean S H Cheng
- Ophthalmology Department, Royal Brisbane and Women's Hospital, Level 8, Ned Hanlon Building, Butterfield Street, Herston, QLD, 4029, Australia
| | - Anil K Sharma
- Ophthalmology Department, Royal Brisbane and Women's Hospital, Level 8, Ned Hanlon Building, Butterfield Street, Herston, QLD, 4029, Australia
| | - Abhishek Sharma
- Ophthalmology Department, Royal Brisbane and Women's Hospital, Level 8, Ned Hanlon Building, Butterfield Street, Herston, QLD, 4029, Australia
| | - Kevin W Vandeleur
- Ophthalmology Department, Royal Brisbane and Women's Hospital, Level 8, Ned Hanlon Building, Butterfield Street, Herston, QLD, 4029, Australia
| | - Lawrence R Lee
- Ophthalmology Department, Royal Brisbane and Women's Hospital, Level 8, Ned Hanlon Building, Butterfield Street, Herston, QLD, 4029, Australia
| | - Thomas P Moloney
- Ophthalmology Department, Royal Brisbane and Women's Hospital, Level 8, Ned Hanlon Building, Butterfield Street, Herston, QLD, 4029, Australia.
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18
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Churashov SV, Shevalova TN, Kulikov AN, Maltsev DS. Surgical outcomes in inferior recurrences of rhegmatogenous retinal detachment. Int J Ophthalmol 2021; 14:1909-1914. [PMID: 34926207 DOI: 10.18240/ijo.2021.12.15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 08/18/2021] [Indexed: 11/23/2022] Open
Abstract
AIM To analyze the anatomical and functional outcomes in the inferior recurrences of rhegmatogenous retinal detachment (RRD) depending on the surgical approach. METHODS Eighty-one eyes of 81 patients (47 males and 34 females with a mean age of 54.8±14.1y) who demonstrated at least one inferior recurrence of RRD were included in this retrospective study. All patients were categorized as having received either circular scleral buckling (SB), pars plana vitrectomy (PPV), a combination of SB and PPV (SB+PPV), PPV with retinotomy (PPV+RT), or PPV+RT and short-term postoperative perfluorocarbon liquid tamponade (PPV+RT+pPFCL). All cases were followed up until successful retinal reattachment or third recurrence. The primary outcome measures were the achievement of the surgical goal without recurrence of RRD and best-corrected visual acuity (BCVA). RESULTS After the treatment of the first recurrence, the recurrence rate in the PPV+SB group was statistically significantly lower than that of the PPV (P=0.0012), PPV+RT (P=0.028), or PPV+RT+pPFCL (P=0.047) group. There was no statistically significant difference between PPV+SB, PPV+RT, and PPV+RT+pPFCL groups in the recurrence rate after treatment of the second recurrence (42 eyes). However, there was a statistically significant (P=0.016) trend towards a decrease of recurrence rate after PPV+RT+pPFCL. There was no statistically significant improvement of BCVA in either study group (P>0.05) after both first and second recurrence surgery. The mean time follow-up was 109.0±91.0d before the first recurrence and 210.0±186.6d between previous surgery at second recurrence. CONCLUSION Patients with first inferior recurrence of RRD may benefit from SB as an adjunct to PPV. RT and short-term pPFCL tamponade in the second recurrence may allow better anatomical outcomes, however, without functional improvement.
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Affiliation(s)
- Sergey V Churashov
- Department of Ophthalmology, Military Medical Academy, St Petersburg 194044, Russia
| | - Tatiana N Shevalova
- Department of Ophthalmology, Military Medical Academy, St Petersburg 194044, Russia
| | - Alexei N Kulikov
- Department of Ophthalmology, Military Medical Academy, St Petersburg 194044, Russia
| | - Dmitrii S Maltsev
- Department of Ophthalmology, Military Medical Academy, St Petersburg 194044, Russia
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19
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Managing PVR in the Era of Small Gauge Surgery. J Ophthalmol 2021; 2021:8959153. [PMID: 34904057 PMCID: PMC8665895 DOI: 10.1155/2021/8959153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 11/08/2021] [Indexed: 11/17/2022] Open
Abstract
Proliferative vitreoretinopathy (PVR) is the leading cause of failed rhegmatogenous retinal detachment (RRD) surgery. Based upon the presence of clinical features and due to associated underlying risk factors, it is classified into various grades based upon its severity and extent of involvement. Despite excellent skills, flawless techniques, and high-end technology applied in the management of RRD, PVR still occurs in 5–10% of cases. Due to the advancements in wide angle viewing systems, advance vitrectomy machines and fluidics, early identification, use of long-term heavy silicon oil tamponades, high-speed cutters, small-gauge vitrectomies, use of perfluorocarbon liquid (PFCL), and small-gauge forceps and scissors, the success rate in the management of PVR has increased leading to improved anatomical outcomes. However, functional outcomes do not correlate well with improved anatomical outcomes. Various complications occur after RRD repair that are responsible for re-retinal detachment and recurrence of PVR. This article highlights causes, risk factors, classification, grading, diagnosis, and approach to management of PVR and post-PVR surgery complications.
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20
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Wang Y, Huang Z, Zheng D, Liu J, Huang D, Zheng J, Xie H, Lin P, Chen W. Adequate Silicone Oil Tamponade by Utilizing the Space of Anterior Segment for Complicated Retinal Detachment: Technique, Efficacy, and Safety. Asia Pac J Ophthalmol (Phila) 2021; 10:564-571. [PMID: 34608067 PMCID: PMC8673844 DOI: 10.1097/apo.0000000000000436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/06/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To evaluate the efficacy and safety of adequate silicone oil (SO) tamponade procedure in patients with complicated retinal detachment. METHODS Thirty-one eyes in 31 patients were enrolled in this prospective case series. Adequate SO tamponade was performed by injecting the SO into the vitreous cavity and the entire anterior chamber, followed by posterior capsulotomy and inferior peripheral iridotomy. Preoperative and follow-up data including retinal anatomic reattachment and SO status, best-corrected visual acuity, intraocular pressure, surgical complications and management were collected and analyzed. RESULTS Twenty-nine eyes presented with complete retinal reattachment after subsequent SO removal with a primary success rate of 93.5%. Seventeen patients (54.8%) had complete anterior chamber SO migration to the vitreous cavity within the first postoperative day. The average time for anterior chamber SO migration was 2.3 ± 1.8 days. No oil-fluid interface in the vitreous cavity was observed in all the eyes, indicating a relatively adequate SO tamponade. Acute intraocular pressure elevation occurred in 16 (51.6%) eyes and was controllable under medication (n = 16) and anterior chamber paracentesis (n = 1). Two patients developed recurrent retinal detachment and received SO removal and a secondary adequate SO tamponade. At final follow-up, all the eyes had SO removal for at least 3 months and retinas maintained completely attached. CONCLUSIONS The adequate SO tamponade procedure offers a simple, safe, and efficacious treatment alternative for complicated retinal detachment.
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Affiliation(s)
- Yifan Wang
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China
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21
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Grosinger AJ, Nicholson BP, Shah SM, Pulido JS, Barkmeier AJ, Iezzi R, Bakri SJ. Time to Unplanned Return to the Operating Room and Associated Risk Factors in Patients With Surgical Retinal Detachment Repair. Am J Ophthalmol 2021; 229:18-25. [PMID: 33626361 DOI: 10.1016/j.ajo.2021.02.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 02/12/2021] [Accepted: 02/13/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To assess the incidence of unplanned return to the operating room (ROR) at ≤45 days or ≥46 days after primary retinal detachment (RD) surgery and correlate ROR with preoperative risk factors and visual outcomes. DESIGN Retrospective cohort study. METHODS This was a retrospective review of patients with primary RD surgery to assess for unplanned ROR between January 1, 2012 and June 30, 2014, with follow-up of 90 days to 8 years (mean, 1.5 years). We assessed 268 patients receiving 270 primary rhegmatogenous RD surgeries between January 1, 2012 and June 30, 2014 in an academic tertiary referral center. RESULTS Of the 270 RD surgeries, 82 were complicated (history of proliferative vitreoretinopathy or trauma-related RDs at presentation) and 188 were uncomplicated (RD unrelated to trauma or proliferative vitreoretinopathy at presentation). The ROR rate for all surgeries was 12.2% (33/270) over the follow-up period, with 51.5% (17/33) having reoperations within 45 days. The complicated detachment group had a ROR rate of 14.6% (12/82) over the follow-up period, and 50% of those (6/12) had reoperations within 45 days. The uncomplicated detachment group had a ROR rate of 11.2% (21/188) over the follow-up period. Of those, 52.4% (11/21) had reoperations within 45 days. CONCLUSIONS Given that only 51.5% of all RORs occurred within 45 days, a 45-day ROR surgical quality metric that has been previously used may be of limited value for RD surgery. Factors such as age at presentation, number of retinal breaks, number of detached clock hours, use of silicone oil tamponade for pars plana vitrectomy, history of choroidal detachment, high myopia, ocular trauma, and open globe were associated with increasing risk of ROR. Implementing risk-adjusted metrics may provide a more accurate and useful quality improvement metric for evaluating quality of surgical care in vitreoretinal surgery. Am J Ophthalmol 2021;221:•••-•••. © 2021 Elsevier Inc. All rights reserved.
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Affiliation(s)
| | | | - Saumya M Shah
- From the Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA
| | - Jose S Pulido
- From the Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA
| | - Andrew J Barkmeier
- From the Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA
| | - Raymond Iezzi
- From the Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA
| | - Sophie J Bakri
- From the Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA.
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22
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Hocaoglu M, Karacorlu M, Giray Ersoz M, Sayman Muslubas I, Arf S. Retinotomy and retinectomy for anterior inferior proliferative vitreoretinopathy: Can visual outcome be improved? Eur J Ophthalmol 2021; 32:11206721211012848. [PMID: 33887980 DOI: 10.1177/11206721211012848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To describe the treatment outcomes and prognostic factors of retinotomy/retinectomy for rhegmatogenous retinal detachment (RD) complicated anterior inferior proliferative vitreoretinopathy (PVR). METHODS Retrospective, nonrandomized, single-center case series. The outcomes of 126 cases of retinotomy/retinectomy for RD complicated by advanced (Grade C) anterior inferior PVR managed consistently by one surgeon during a 15-year period were evaluated. RESULTS Forty-two eyes (33%) had primary RDs and 84 (67%) had recurrent RDs. The extent of retinotomy/retinectomy varied: 90° in 21 eyes (17%), >90° to <180° in 49 eyes (39%), and ⩾180° to ⩽240° in 56 eyes (44%). The retinotomy/retinectomy location was peripheral in 58 eyes (46%) and equatorial in 68 eyes (54%). The mean follow-up period was 43 ± 42 months. The silicone oil (SO) was removed from 98% of the eyes. The single-operation success rate after the primary retinectomy was 87%, and the final attachment rate was 94%. Visual acuity improved from 20/630 to 20/160 (p < 0.001). Vision ⩾20/200 was achieved in 101 eyes (80%). Good visual outcome was correlated positively with preoperative VA (p = 0.02), previous vitrectomy with gas tamponade (p = 0.007), and was negatively correlated with number of previous RD operations (p = 0.01), larger extent of RD (p = 0.02) and more extensive retinotomy/retinectomy (p = 0.04). CONCLUSIONS An appropriate and timely intervention, including vitrectomy alone, inferior relaxing retinotomy/retinectomy and standard SO tamponade provide satisfactory outcomes for RDs complicated by PVR. Lesser extension of grade C PVR at baseline, such as PVR limited to one quadrant should encourage vitreoretinal specialists to consider retinotomy/retinectomy at a milder clinical stage of PVR development.
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Affiliation(s)
| | | | - M Giray Ersoz
- Biruni University School of Medicine, Istanbul, Turkey
| | | | - Serra Arf
- Istanbul Retina Institute, Istanbul, Turkey
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23
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Baba T, Tatsumi T, Oshitari T, Yamamoto S. Four Cases of Rhegmatogenous Retinal Detachment That Recurred More than 10 Years after Initial Reattachment by Pars Plana Vitrectomy. Case Rep Ophthalmol 2021; 12:219-226. [PMID: 33976686 PMCID: PMC8077482 DOI: 10.1159/000511372] [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: 07/26/2020] [Accepted: 09/06/2020] [Indexed: 11/19/2022] Open
Abstract
Purpose The purpose of this report was to present our findings in 4 cases of rhegmatogenous retinal detachment (RRD) that recurred 10, 11, 12, and 17 years after a reattachment surgery by pars plana vitrectomy (PPV). Methods Four cases of a recurrent RRD had undergone scleral buckling surgery and vitrectomy. Patients The recurrence of the RRD was observed 10-17 years after the successful attachment by PPV. The macula was detached in all cases, and none of the eyes had severe proliferative vitreoretinopathy. The cause of the recurrence was a new retinal break in 3 eyes and a reopening of an old retinal break in the other eye. The new breaks had a punched-out shape and had neither a horseshoe tear nor an atrophic hole associated with lattice degeneration. PPV combined with scleral buckling was performed, and a reattachment was achieved in all cases. The best-corrected visual acuity (BCVA) at the last visit ranged from 20/30 to 20/25, but the BCVA in 1 eye was 20/200 because of amblyopia. Conclusions We experienced 4 rare cases of a recurrent retinal detachment 10-17 years after the primary RRD. PPV and scleral buckling were effective and the anatomical and the functional outcomes were good.
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Affiliation(s)
- Takayuki Baba
- Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Tomoaki Tatsumi
- Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Toshiyuki Oshitari
- Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, Japan.,Department of Ophthalmology, International University of Health and Welfare, Narita, Japan
| | - Shuichi Yamamoto
- Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, Japan
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24
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Bai JX, Zhang XJ, Duan AL, Peng XY. Outcome of scleral buckling with or without gas tamponade for recurrent retinal detachment in post-vitrectomy eyes. BMC Ophthalmol 2021; 21:109. [PMID: 33639899 PMCID: PMC7916288 DOI: 10.1186/s12886-021-01873-y] [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: 11/28/2020] [Accepted: 02/18/2021] [Indexed: 11/24/2022] Open
Abstract
Background Treatment of recurrent retinal detachment (re-RD) following vitrectomy (post-gas/air tamponade and post-silicone oil removal) is challenging. Previously reported treatment is commonly revision pars plana vitrectomy (PPV) combined with tamponade, which is invasive and a burden both economically and emotionally when compared with scleral buckling (SB). The purpose of this study is to report anatomical and functional outcomes of SB with or without gas tamponade in eyes with recurrent retinal detachment (re-RD) that previously underwent PPV at least once. Methods We retrospectively reviewed the medical records of 14 patients (14 eyes) who underwent PPV at least once and were treated with SB after re-RD. Preoperative characteristics, intraoperative complications, and postoperative data were assessed. The final anatomical and functional outcomes were analyzed. Results The original PPV was performed for primary rhegmatogenous retinal detachment in 11 eyes, macular hole retinal detachment in 2 eyes, and myopic foveoschisis in 1 eye. Previously, 3 eyes underwent one PPV with gas tamponade, and the remaining 11 (79%) eyes underwent 2–5 operations. Seven eyes underwent the procedure with gas injection. At the last follow-up, 13 eyes achieved total retinal attachment and 1 eye had re-RD. The postoperative intraocular pressure was within the normal range, except in 1 eye (6 mmHg). The finest postoperative best-corrected visual acuity (BCVA) was 20/25. There was a significant improvement in BCVA from 20/160 ± 20/63 at baseline to 20/80 ± 20/50 at the last visit in the 13 successfully treated eyes (P = 0.025). Conclusions SB can be effective for re-RD after PPV in specific cases.
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Affiliation(s)
- Jun-Xing Bai
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmolgy and Visual Science Key Laboratory, No.17 Hougou Lane, Chongnei Street, Beijing, 100005, People's Republic of China.,Department of Ophthalmology, Beijing Meiermu Hospital, No.65 Fuxing Road, Haidian District, Beijing, 100036, People's Republic of China
| | - Xiao-Jian Zhang
- Department of Ophthalmology, Beijing Huade Eye Hospital, No.179 North Chaoyang Road, Chaoyang District, Beijing, 100101, People's Republic of China
| | - An-Li Duan
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmolgy and Visual Science Key Laboratory, No.1 Dongjiaominxiang, Dongcheng District, Beijing, 100730, People's Republic of China.
| | - Xiao-Yan Peng
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmolgy and Visual Science Key Laboratory, No.17 Hougou Lane, Chongnei Street, Beijing, 100005, People's Republic of China.
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25
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Jia LY, Sun YX, Zhang YP, Ma K. Risk Factors of Recurrent Retinal Detachment Following Surgical Treatment for Rhegmatogenous Retinal Detachment: A Retrospective Study. Risk Manag Healthc Policy 2020; 13:3165-3171. [PMID: 33408538 PMCID: PMC7779298 DOI: 10.2147/rmhp.s288777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 12/03/2020] [Indexed: 11/23/2022] Open
Abstract
Objective To identify potential risk factors for recurrent retinal detachment after surgical treatment for rhegmatogenous retinal detachment with choroidal detachment (RRD-CD) in a Chinese population. Methods A total of 1212 patients with RRD-CD admitted to Beijing Tongren Hospital from 2004 to 2018 were reviewed retrospectively. The rate of recurrent retinal detachment was calculated, and risk factors were analyzed by logistic regression analysis. Results The average age of the patients was 48.51 years, 760 patients (62.7%) were male, and 630 patients (52.0%) had right eye disease. The recurrence rate in the same eye was 21.3%. The incidence of recurrence retinal detachment was higher in patients who were male, middle age, and with poor preoperative vision, longer axial length, and scleral buckling. Recurrence usually occurred 3 months after surgery. Conclusion Male, middle age, longer axial length, and scleral buckling could be risk factors for recurrent retinal detachment following surgical treatment in patients with RRD-CD.
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Affiliation(s)
- Li-Yun Jia
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yan-Xia Sun
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yong-Peng Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Kai Ma
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
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26
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Fei P, Jin HY, Zhang Q, Peng J, Li JK, Lyu J, Tian T, Lu ZP, Li J, Zhao PQ. Local dry vitrectomy combined with segmental scleral buckling and viscoelastic tamponade for rhegmatogenous retinal detachment with vitreous traction. Int J Ophthalmol 2020; 13:1713-1719. [PMID: 33215000 DOI: 10.18240/ijo.2020.11.05] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 08/07/2020] [Indexed: 11/23/2022] Open
Abstract
AIM To demonstrate local dry vitrectomy combined with segmental scleral buckling and viscoelastic tamponade for the treatment of partial rhegmatogenous retinal detachment (RRD) with local vitreous traction in patients at high-risk for proliferative vitreoretinopathy (PVR). METHODS Eleven eyes of 11 patients were retrospectively studied, including 5 retinal dialysis and 6 retinal detachment (RD; 5 eyes with peripheral retinal hole and 1 eye with giant tear). All patients exhibited partial RD and local vitreous traction. Combined local dry vitrectomy without conventional infusion and segmental scleral buckling was performed. Viscoelastic fluid was injected into the vitreous cavity if needed. Demographic information, preoperative and post-operative complications, and outcomes were recorded. RESULTS The mean age of the patients at presentation was 26.55±13.52y. All 11 patients obtained retinal reattachment after a single surgical intervention. Postoperative visual acuities were improved or remained stable in all patients. None of them developed complications, except for temporary mildly increased intraocular pressure in 3 cases. CONCLUSION Combined local dry vitrectomy and segmental scleral buckling are effective for patients of RRD with local vitreous traction. The technique avoids many complications associated with regular surgery and was minimally invasive to both the external and internal eye.
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Affiliation(s)
- Ping Fei
- Department of Ophthalmology, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Hai-Ying Jin
- Department of Ophthalmology, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Qi Zhang
- Department of Ophthalmology, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Jie Peng
- Department of Ophthalmology, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Jia-Kai Li
- Department of Ophthalmology, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Jiao Lyu
- Department of Ophthalmology, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Tian Tian
- Department of Ophthalmology, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Zu-Peng Lu
- Department of Ophthalmology, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Jing Li
- Department of Ophthalmology, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Pei-Quan Zhao
- Department of Ophthalmology, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
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Shroff D, Saha I, Bhatia G, Dutta R, Gupta C, Shroff CM. Tug of war: A bimanual technique for anterior circumferential proliferative vitreoretinopathy in recurrent retinal detachment. Indian J Ophthalmol 2020; 68:2155-2158. [PMID: 32971629 PMCID: PMC7727933 DOI: 10.4103/ijo.ijo_2179_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose: To describe a bimanual technique, “tug of war” for managing anterior circumferential proliferative vitreoretinopathy (PVR) in eyes with recurrent retinal detachment (RRD). Methods: We retrospectively analyzed outcomes from eyes with RRD that underwent reattachment surgery using this maneuver and had a minimum of 6 months follow-up. A chandelier light was inserted for endo-illumination and the circumferential anterior PVR was tackled with two 25-gauge forceps stretching circumferential tractional membranes in opposite direction (tug of war) till they snapped. Results: Eleven eyes of 11 patients with a mean age of 38.2 ± 19.7 years underwent surgery. All eyes had advanced PVR of Grade C A Type 4 (Circumferential). The median duration of RD from the time of first surgery was 6 months (interquartile range = 3–8 months). The tug of war maneuver was successful in relieving the anterior retinal traction leading to retinal reattachment in all eyes without the need for relaxing retinotomies or retinectomies. Small iatrogenic retina tears occurred at the time of tug of war maneuver in 3 (27%) eyes at the site of maximum traction. The mean best-corrected visual acuity (BCVA) improved from 1.87 ± 0.2 logarithm of minimum angle of resolution (logMAR) to 1.3 ± 0.4 logMAR at 6-months follow-up (P = 0.04). Conclusion: The 'tug of war' maneuver is useful for relieving circumferential anterior traction and reattaching the retina in eyes with RRD without having to resort to large relaxing retinotomies or retinectomies.
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Affiliation(s)
- Daraius Shroff
- Vitreoretinal Services, Shroff Eye Centre, New Delhi, India
| | - Indranil Saha
- Vitreoretinal Services, Shroff Eye Centre, New Delhi, India
| | - Gagan Bhatia
- Vitreoretinal Services, Shroff Eye Centre, New Delhi, India
| | - Ranjan Dutta
- Vitreoretinal Services, Shroff Eye Centre, New Delhi, India
| | - Charu Gupta
- Vitreoretinal Services, Shroff Eye Centre, New Delhi, India
| | - Cyrus M Shroff
- Vitreoretinal Services, Shroff Eye Centre, New Delhi, India
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Frisina R, Gius I, Frascogna G, Pizzolon T, Greggio A, Tozzi L, Midena E. A possible strategic role of air during pars plana vitrectomy for macula-involving rhegmatogenous retinal detachment. Int Ophthalmol 2020; 41:421-431. [PMID: 32951112 DOI: 10.1007/s10792-020-01591-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 09/04/2020] [Indexed: 01/23/2023]
Abstract
AIM To evaluate the advantages and safety of vitrectomy under air for treating macula-involving rhegmatogenous retinal detachment (RRD). METHODS Consecutive patients with macula-involving RRD who underwent vitrectomy under air were recruited. Demographic and clinical data were: age, gender, eye, lens status, best corrected visual acuity (BCVA) in logarithm of the minimum angle of resolution (logMAR), axial length, intraocular pressure (IOP). RRD parameters were: RRD extent, retinal breaks number. Surgical data were: cataract surgery, tamponade used. Postoperative parameters were: BCVA, IOP at first, third, sixth month, recurrent RD, incidence of retinal folds, subretinal fluid (SRF) persistence, macular displacement. RESULTS Seventy-one eyes (71 patients) were recruited. Cataract surgery was performed in 32 of 45 phakic patients. The tamponade used was: sulfur hexafluoride 18% (41), silicon oil (SO) (26), high-density SO (4). BCVA improved significantly from baseline (1.2 ± 0.4 logMAR) to the last control (0.8 ± 0.7 logMAR) (P = 0.03285). Recurrent RD incidence was 14.1%. Postoperative complications were: retinal folds (2), SRF persistence (3), macular displacement (2). CONCLUSION Vitrectomy under air is a safe alternative technique for treating macula-involving RRD. Vitrectomy under air allows surgeon to remove accurately the vitreous from the peripheral retina and facilitates the removal of SRF reducing the complications related to its postoperative persistence.
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Affiliation(s)
- Rino Frisina
- Department of Ophthalmology, University of Padova, via Giustiniani n. 2, 35128, Padua, Italy.
| | - Irene Gius
- Department of Ophthalmology, University of Padova, via Giustiniani n. 2, 35128, Padua, Italy
| | - Giuseppe Frascogna
- Department of Ophthalmology, University of Padova, via Giustiniani n. 2, 35128, Padua, Italy
| | - Tobia Pizzolon
- Department of Ophthalmology, University of Padova, via Giustiniani n. 2, 35128, Padua, Italy
| | - Angelo Greggio
- Department of Ophthalmology, University of Padova, via Giustiniani n. 2, 35128, Padua, Italy
| | - Luigi Tozzi
- Department of Ophthalmology, University of Padova, via Giustiniani n. 2, 35128, Padua, Italy
| | - Edoardo Midena
- Department of Ophthalmology, University of Padova, via Giustiniani n. 2, 35128, Padua, Italy
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29
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Abu-Yaghi NE, Abu Gharbieh YA, Al-Amer AM, AlRyalat SAS, Nawaiseh MB, Darweesh MJ, Alkukhun LR, Abed AM, Saleh OA, Ababneh OH. Characteristics, fates and complications of long-term silicone oil tamponade after pars plana vitrectomy. BMC Ophthalmol 2020; 20:336. [PMID: 32807120 PMCID: PMC7433146 DOI: 10.1186/s12886-020-01608-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 08/13/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Silicone oil tamponade has become a mainstay in treatment of advanced retinal detachment due to multiple etiologies. The aim of this study is to assess the characteristics, fates and complications of long-term silicone oil tamponade after par plana vitrectomy (PPV), and to compare the outcomes of different silicone oil viscosities used in a cohort of consecutive patients. METHODS This is a retrospective comparative case series of eyes undergoing vitrectomy with silicone oil tamponade for retinal detachment by a single surgeon using different oil viscosities that were followed for one year with the silicone oil in situ. Visual acuity (VA), intraocular pressure (IOP) and complications associated with the follow up period were analyzed and compared. RESULTS Eighty-five eyes of 85 patients were included in this study. Forty three patients had 1000 centistoke (cs) oil injected and 42 patients had 5000cs oil utilized. Demographic, cause of retinal detachment and preoperative ocular characteristics were similar in both groups. Long term complications in both groups included ocular hypertension (67.4% vs 66.7%), keratopathy due to silicone oil emulsification and migration to the anterior chamber (7.0% vs 11.9%), recurrent retinal detachment (4.7% vs 19%) and epiretinal membrane formation (7% vs 19%). In the 1000cs oil group, there was no significant difference between baseline IOP and any subsequent visit. There was a significant difference between baseline IOP and visits at day 1 (with IOP difference of 2.61 mmHg (±6.5)) (p = 0.028), 1 month (with IOP difference of 3.52 mmHg (±8.1)) (p = 0.026), 4 months (with IOP difference of 6.38 mmHg (±9.3)) (p = 0.005), and one year (with IOP difference of 4.24 mmHg (±11.1)) (p = 0.048), all higher in the post-operative period in the 5000cs oil group. Excluding the first post-operative day, no significant difference was found for VA between baseline visits and subsequent visits for either silicone oil groups. CONCLUSION In this cohort of patients with long-term silicone oil tamponade after PPV to treat retinal detachment, IOP increased significantly in patients who received 5000cs silicone oil. There was no significant difference between other complication rates in patients receiving either oil viscosities. Long term silicone oil tamponade remains a viable option in certain cases, and a vigilant follow up for complications is necessary to limit any adverse effects and improve visual and surgical outcomes.
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Affiliation(s)
- Nakhleh E. Abu-Yaghi
- Department of Special Surgery, Ophthalmology Division, the University of Jordan, P.O. Box 7599, Amman, 11118 Jordan
| | - Yazan A. Abu Gharbieh
- Department of Special Surgery, Ophthalmology Division, the University of Jordan, P.O. Box 7599, Amman, 11118 Jordan
| | - Ahmad M. Al-Amer
- Department of Special Surgery, Ophthalmology Division, the University of Jordan, P.O. Box 7599, Amman, 11118 Jordan
| | - Saif Aldeen S. AlRyalat
- Department of Special Surgery, Ophthalmology Division, the University of Jordan, P.O. Box 7599, Amman, 11118 Jordan
| | | | | | | | - Alaa M. Abed
- Department of Special Surgery, Ophthalmology Division, the University of Jordan, P.O. Box 7599, Amman, 11118 Jordan
| | - Omar A. Saleh
- Department of Ophthalmology, Jordan University of Science and Technology, Ar-Ramtha, Jordan
| | - Osama H. Ababneh
- Department of Special Surgery, Ophthalmology Division, the University of Jordan, P.O. Box 7599, Amman, 11118 Jordan
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Maruthupandy M, Muneeswaran T, Anand M, Quero F. Highly efficient multifunctional graphene/chitosan/magnetite nanocomposites for photocatalytic degradation of important dye molecules. Int J Biol Macromol 2020; 153:736-746. [DOI: 10.1016/j.ijbiomac.2020.03.045] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/04/2020] [Accepted: 03/06/2020] [Indexed: 12/13/2022]
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Lahham S, Ali Q, Palileo BM, Lee C, Fox JC. Role Of Point Of Care Ultrasound In The Diagnosis Of Retinal Detachment In The Emergency Department. Open Access Emerg Med 2019; 11:265-270. [PMID: 32009820 PMCID: PMC6859292 DOI: 10.2147/oaem.s219333] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 10/23/2019] [Indexed: 11/23/2022] Open
Abstract
Ocular complaints represent up to 3% of all emergency department (ED) visits. These presentations can result in permanent vision loss if not promptly diagnosed and treated. Recently, point of care ultrasound (POCUS) has been investigated for the evaluation of ocular pathology in the ED. Multiple studies have investigated the role that ultrasound may play in the early diagnosis of these patients. Ocular ultrasound can be used to visualize the structures of the eye and evaluate for pathology such as retinal detachment, vitreous hemorrhage and vitreous detachment. This comprehensive review aims to present current evidence for the efficacy and reliability of ED ocular ultrasound use in the detection of retinal detachment and additional ocular pathologies.
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Affiliation(s)
- Shadi Lahham
- University of California, Irvine, Department of Emergency Medicine, Orange, CA92868, USA
| | - Qumber Ali
- Touro University, School of Medicine, Henderson, NV89014, USA
| | - Bea Martina Palileo
- University of California, Riverside, School of Medicine, Riverside, CA92521, USA
| | - Clifton Lee
- University of California, Riverside, School of Medicine, Riverside, CA92521, USA
| | - John C Fox
- University of California, Irvine, Department of Emergency Medicine, Orange, CA92868, USA
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