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Motloch K, Soler V, Delyfer MN, Vasseur V, Wolff B, Issa M, Dot C, Massé H, Weber M, Comet A, Hitzl W, Matonti F, Creuzot-Garcher C, Tadayoni R, Kodjikian L, Couturier A. Efficacy and Safety of 0.19-mg Fluocinolone Acetonide Implant in Postoperative Cystoid Macular Edema after Pars Plana Vitrectomy: the ILUCYD study. Ophthalmol Retina 2024:S2468-6530(24)00327-0. [PMID: 39004282 DOI: 10.1016/j.oret.2024.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 06/23/2024] [Accepted: 07/08/2024] [Indexed: 07/16/2024]
Abstract
PURPOSE To assess the efficacy and safety of 0.19-mg fluocinolone acetonide (FAc) intravitreal implant (Iluvien®) in treating chronic postoperative cystoid macular edema (PCME) after pars plana vitrectomy. DESIGN Retrospective multicentric case series in clinical settings. SUBJECTS Patients with chronic PCME who underwent vitrectomy in tertiary care centers in France. All eyes had a documented good response to the DEX implant prior to FAc implantation. METHODS Review of charts and OCT scans of patients treated with a FAc intravitreal implant. MAIN OUTCOME MEASURES The primary endpoints were the best-corrected visual acuity (BCVA) and central retinal thickness (CRT). Secondary endpoints were the intraocular pressure (IOP); proportion of patients maintaining a BCVA ≥20/40; need for additional non-study treatment; differences between eyes that underwent a single and multiple surgeries and OCT biomarkers of better BCVA. RESULTS Forty-nine eyes of 49 patients with a mean follow-up of 24.5 ± 3.9 months were included. The mean BCVA increased from 0.40 ± 0.26 logMAR at baseline to 0.32 ± 0.24 logMAR at month 24 (M24) (p=0.0035). The mean CRT decreased from 409.37 ± 139.43 μm at baseline to 340 ± 91 μm at M24 (p=0.0001). The mean IOP was 14.0 ± 4 mmHg at baseline and remained stable at 14.03 ± 4.1 mmHg at M24 (p=0.99). During the follow-up, the IOP exceeded 21 mmHg in 9 eyes. The IOP rise was controlled with topical therapy in all eyes except one, which required cyclophotocoagulation. The BCVA was ≥20/40 in 47% of eyes (95% CI: 34%-61%) at baseline and in 58% of eyes at M24 (95% CI: 41%-73%). At M18, the likelihood of achieving a BCVA ≥20/40 was higher in eyes with intact external limiting membrane and ellipsoid zone. Additional dexamethasone implant (DEXi) was injected in 14 eyes (28.57%). The treatment burden of 2.45 ± 1.35 DEXi/year was decreased to 0.57 ± 0.60 DEXi/year after FAc implantation (p=0.001). CONCLUSION FAc implant improved the BCVA and reduced the CRT in eyes with chronic PCME after vitrectomy. The IOP rise could be anticipated by the previous response to corticosteroids. FAc implant in eyes with chronic PCME also allowed reducing the treatment burden.
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Affiliation(s)
- Karolina Motloch
- Department of Ophthalmology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany; Université Paris Cité, Ophthalmology Department, AP-HP, Lariboisière Hospital-Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Vincent Soler
- Department of Ophthalmology, Hôpital CHU Purpan Toulouse, France
| | | | - Vivien Vasseur
- Rothschild Foundation Hospital, Paris, France; Maison Rouge Ophthalmologic Center, Strasbourg, France
| | | | - Mohamad Issa
- Université Paris Cité, Ophthalmology Department, AP-HP, Lariboisière Hospital-Assistance Publique-Hôpitaux de Paris, Paris, France; Rothschild Foundation Hospital, Paris, France
| | - Corinne Dot
- Department of Ophthalmology, E. Herriot University Hospital, Lyon, French military Academy of Val de Grâce, Paris, France
| | - Hélène Massé
- Department of Ophthalmology, Hotel Dieu University Hospital, Nantes, France
| | - Michel Weber
- Department of Ophthalmology, Hotel Dieu University Hospital, Nantes, France
| | - Alban Comet
- Department of Ophthalmology, Aix-Marseille University, Hôpital Nord, Marseille, France; Centre Monticelli Paradis, Marseille, France; Groupe Almaviva Santé, Clinique Juge, Marseille, France
| | - Wolfgang Hitzl
- Department of Ophthalmology and Optometry, Paracelsus Medical University Salzburg, Austria; Research Program Experimental Ophthalmology and Glaucoma Research, Paracelsus Medical University, Salzburg, Austria; Biostatistics and Publication of Clinical Trial Studies, Research and Innovation Management (RIM), Paracelsus Medical University,Salzburg, Austria
| | - Frederic Matonti
- Department of Ophthalmology, Nord Hospital, Aix Marseille University, Institut de Neurosciences de la Timone, Marseille, France
| | - Catherine Creuzot-Garcher
- Department of Ophthalmology, University Hospital Dijon, Eye and Nutrition Research Group, INRAe, Dijon, France
| | - Ramin Tadayoni
- Université Paris Cité, Ophthalmology Department, AP-HP, Lariboisière Hospital-Assistance Publique-Hôpitaux de Paris, Paris, France; Rothschild Foundation Hospital, Paris, France
| | - Laurent Kodjikian
- Department of Ophthalmology, Hopital de la Croix-Rousse, Hospices Civils de Lyon, 96004 Lyon, France; Université Claude Bernard Lyon 1, Lyon, France; Laboratoire MATEIS, UMR-CNRS 5510, INSA, Université Lyon 1, 69100 Villeurbanne, France
| | - Aude Couturier
- Université Paris Cité, Ophthalmology Department, AP-HP, Lariboisière Hospital-Assistance Publique-Hôpitaux de Paris, Paris, France.
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Cakir B, Peacker BL, Zeng R, Tracy JH, Feng Y, Miller JB. Extensive Endolaser During Vitrectomy for Primary Rhegmatogenous Retinal Detachment Is Associated With Epiretinal Membrane Formation. Ophthalmic Surg Lasers Imaging Retina 2024; 55:326-333. [PMID: 38531000 DOI: 10.3928/23258160-20240131-02] [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: 03/28/2024]
Abstract
BACKGROUND AND OBJECTIVE Epiretinal membrane (ERM) formation, a common complication following pars plana vitrectomy (PPV) for primary rhegmatogenous retinal detachment (RRD) repair, is associated with vision loss and metamorphopsias. Although laser retinopexy is generally associated with ERM formation, the correlation between the extent of laser treatment and ERM formation during PPV is not well established. The aim of this study was to identify risk factors associated with ERM formation including extend of endolaser retinopexy after PPV for primary RRD. PATIENTS AND METHODS A retrospective, observational case series of 181 consecutive patients (185 eyes) who underwent PPV for primary RRD repair by a single surgeon was performed. Charts were reviewed by two independent reviewers, and de-identified data including patient characteristics and intraoperative findings such as number of laser spots placed were recorded. RESULTS Postoperative ERM formation occurred in 75 eyes (40.5%) of which 68 (90.6%) were Stage 1, two (2.6%) were Stage 2, three (4%) were Stage 3, and two (2.6%) were Stage 4. Only one patient required secondary PPV for visually significant ERM. Patients with ERM had significantly more laser spots compared with patients with no ERM, with a mean of 807 and 519 laser spots respectively (95% CI: 387.6 to -187.3; P < 0.0001). Univariable analysis identified ≥750 endolaser spots (odds ratio [OR] = 4.0, 95% CI: 2.0 to 8.4; P < 0.0001), ≥4 retinal tears (OR = 2.8, 95%: CI 1.4 to 6.4; P = 0.005), and female sex (OR = 2.0, 95% CI: 1.1 to 3.7; P = 0.02) as significantly associated factors. After adjusting for potential confounding factors (ie, age, sex, macula status, lattice degeneration, length of symptoms, vitreous hemorrhage, number of endolaser spots, number of retinal tears) in multivariable logistic regression, ≥ 750 endolaser spots (OR = 2.4; P = 0.04) and female sex (OR = 2.4; P = 0.03) persisted as significant independent factors. CONCLUSIONS Our study identified ≥ 750 laser spots and female sex as independent risk factors for ERM formation following PPV for RRD with an OR of 2.4 each. Although the incidence of ERM formation was generally high (40.5%), only one case required secondary PPV with ERM peeling, and visual outcomes were comparable between patients with and without ERM at final follow up. While endolaser photocoagulation is critical for successful RRD repair, consideration of the risk of ERM formation with extensive laser exposure is warranted. [Ophthalmic Surg Lasers Imaging Retina 2024;55:326-333.].
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Shah YS, Abidi M, Ahmed I, Arsiwala-Scheppach LT, Ong SS, Wu D, Handa JT. Risk Factors Associated with Cystoid Macular Edema among Patients Undergoing Primary Repair of Rhegmatogenous Retinal Detachment. Ophthalmol Retina 2024; 8:456-464. [PMID: 38036083 PMCID: PMC11070291 DOI: 10.1016/j.oret.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 11/14/2023] [Accepted: 11/17/2023] [Indexed: 12/02/2023]
Abstract
PURPOSE To investigate predictors of the development and resolution of cystoid macular edema (CME) after rhegmatogenous retinal detachment (RRD) repair. DESIGN Retrospective cross sectional study. SUBJECTS Patients who underwent primary repair of uncomplicated RRD. METHODS Demographics, ophthalmic history, visual acuity, RRD features, time to development/resolution of CME, OCT characteristics of CME/epiretinal membrane (ERM), type of surgery, and treatments were collected. Logistic regressions were used to identify predictors of CME development and resolution. MAIN OUTCOME MEASURES Predictors of CME development and resolution. RESULTS A total of 708 eyes were included, of which 55 (7.8%) developed CME. Factors associated with an increased risk of CME development included total number of retinal detachment surgeries (odds ratio [OR] 1.66 [1.24-2.23], P < 0.001), prior intraocular surgery (OR 4.43 [1.19-16.51], P = 0.03), and presence of ERM after surgery (OR 4.49 [2.30-8.74], P < 0.001). Patients undergoing pars plana vitrectomy (PPV) were more likely to develop CME compared with patients undergoing scleral buckling (SB; OR 3.09 [1.18-8.10], P = 0.02). A longer average time to CME detection was associated with lower CME resolution (OR 0.94 [0.89-0.998], P = 0.04). In patients who developed an ERM postsurgically, those who developed CME after ERM had a lower rate of resolution compared with those who developed CME before ERM (P = 0.03). CONCLUSIONS Cystoid macular edema may be more likely to develop in patients undergoing PPV than SB, those who underwent more surgeries for RRD repair, those who had prior intraocular surgery, or those who developed an ERM after RRD repair. Resolution of CME may be affected by the time to detection of CME and ERM development. 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)
- Yesha S Shah
- Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland
| | | | - Ishrat Ahmed
- Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland; Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts
| | - Lubaina T Arsiwala-Scheppach
- Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland; Wilmer Biostatistics Center, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Sally S Ong
- Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland; Department of Ophthalmology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - David Wu
- Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland; Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts
| | - James T Handa
- Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland.
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Bernabei F, Marcireau I, Frongia F, Azan F, Vagge A, Peiretti E, Guerrier G, Rothschild PR. Risk Factors of Cystoid Macular Edema After Pars Plana Vitrectomy for Pseudophakic Retinal Detachment. Ophthalmol Ther 2023; 12:1737-1745. [PMID: 37029838 PMCID: PMC10164198 DOI: 10.1007/s40123-023-00705-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 03/21/2023] [Indexed: 04/09/2023] Open
Abstract
INTRODUCTION This study aimed to investigate the prevalence of cystoid macular edema after pars plana vitrectomy for the treatment of pseudophakic rhegmatogenous retinal detachment and identify possible related risk factors. METHODS A retrospective monocentric study was conducted within a cohort of pseudophakic patients undergoing vitrectomy for rhegmatogenous retinal detachment between January 2019 and December 2022. Demographic data, initial and intraoperative characteristics of rhegmatogenous retinal detachment, and postoperative data were analyzed. Cystoid macular edema was defined on optical coherence tomography exclusively. RESULTS A total of 164 eyes of 164 patients were included for analysis. The mean age of the patients at surgery was 65.7 ± 12.0 years. The mean best-corrected visual acuity was 2.1 ± 1.0 logMAR preoperatively and 1.0 ± 0.7 logMAR postoperatively. The mean follow-up was 13.4 ± 7.7 months. The prevalence of cystoid macular edema was 17.1% [9.8-26.4]. In multivariate analysis, severe proliferative vitreoretinopathy (relative risk 3.6 [1.3-9.7]) and laser retinopexy (relative risk 8.4 [1.1-64.7]) were independently and significantly associated with cystoid macular edema. CONCLUSION The prevalence of cystoid macular edema in pseudophakic rhegmatogenous retinal detachment after pars plana vitrectomy was 17.1%. Severe proliferative vitreoretinopathy stage and the use of endolaser retinopexy were independent risk factors for development of cystoid macular edema.
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Affiliation(s)
- Federico Bernabei
- Department of Ophthalmology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France.
- Service d'ophtalmologie, 8 Rue Mechain, 75014, Paris, France.
| | - Ianis Marcireau
- Department of Ophthalmology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Francesca Frongia
- Department of Ophthalmology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
- Eye Clinic, Department of Surgical Sciences, University of Cagliari, 09124, Cagliari, Italy
| | - Frederic Azan
- Department of Ophthalmology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Aldo Vagge
- IRCCS Ospedale Policlinico San Martino, University Eye Clinic of Genoa, Genoa, Italy
- Dipartimento di Neuroscienze, riabilitazione, oftalmologia, genetica e scienze materno-infantili (DINOGMI), Università di Genova, Genoa, Italy
| | - Enrico Peiretti
- Eye Clinic, Department of Surgical Sciences, University of Cagliari, 09124, Cagliari, Italy
| | - Gilles Guerrier
- Anaesthetic and Intensive Care Department, Hôpital Cochin, Paris Descartes University, 75014, Paris, France
- Université Paris Cité, Centre de Recherche des Cordeliers, INSERM, UMR_1138, 75006, Paris, France
| | - Pierre-Raphaël Rothschild
- Department of Ophthalmology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
- Université Paris Cité, Centre de Recherche des Cordeliers, INSERM, UMR_1138, 75006, Paris, France
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A Simple New Technique to Peel Epiretinal Membrane Without Removing Silicone Oil. Retina 2023; 43:529-530. [PMID: 32516226 DOI: 10.1097/iae.0000000000002838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To introduce a new surgical technique that can keep constant intraocular pressure of the eyeball during peeling epiretinal membrane under silicone oil status. METHODS A viscoelastic agent was injected into the air pump of the constellation system via the metal tip. This procedure offers a buffer zone to keep constant pressure within the eyeball without disturbing the surgical field by an air bubble. RESULTS Three cases were performed efficiently (15 ± 5 minutes) under this technique with improvement in anatomical feature and visual function after the surgery. CONCLUSION Using this simple yet important technique can provide us the constant intraocular pressure without hypotony and avoid the traditional complicated procedures.
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Szigiato AA, Antaki F, Javidi S, Touma S, Duval R, Cordahi G, Olivier S, Rezende FA. Risk factors for epiretinal membrane formation and peeling following pars plana vitrectomy for primary rhegmatogenous retinal detachment, an OCT guided analysis. Int J Retina Vitreous 2022; 8:70. [PMID: 36180942 PMCID: PMC9524009 DOI: 10.1186/s40942-022-00418-9] [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: 08/09/2022] [Accepted: 09/08/2022] [Indexed: 11/23/2022] Open
Abstract
Background To evaluate the rate and risk factors of epiretinal membrane (ERM) formation and need for ERM peeling after pars plana vitrectomy (PPV) for uncomplicated primary rhegmatogenous retinal detachment (RRD). Methods Retrospective, single-center, cohort study of 119 consecutive patients (119 eyes) that underwent RRD repair using PPV. The primary outcomes were ERM formation, classified using an optical coherence tomography grading system, and the rate of ERM peeling. Visual acuity, postoperative complications, and risk factors for ERM formation and peeling were also identified. Results Postoperative ERM formation occurred in 69 eyes (58.0%); 56 (47.1%) were stage 1, 9 (7.6%) stage 2, 3 (2.5%) stage 3, and 1 (0.8%) stage 4. Only 6 (5.0%) eyes required secondary PPV for a visually significant ERM, with a mean time to reoperation of 488 ± 351 days. Risk factors for ERM formation included intraoperative cryotherapy, more than 1000 laser shots, 360° laser photocoagulation, and choroidal detachment (p < 0.01). Eyes with more than 3 tears had a trend towards increased ERM surgery (p = 0.10). Conclusions Visually significant ERM formation following PPV for primary RRD was uncommon in this cohort (5%). Half of the ERMs were detected after the first post-operative year, indicating that this complication may be underreported in studies with only 1-year follow-up.
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Affiliation(s)
| | - Fares Antaki
- Department of Ophthalmology, Hôpital Maisonneuve Rosemont, Montreal, Québec, Canada
| | - Simon Javidi
- Department of Ophthalmology, Hôpital Maisonneuve Rosemont, Montreal, Québec, Canada
| | - Samir Touma
- Department of Ophthalmology, Hôpital Maisonneuve Rosemont, Montreal, Québec, Canada
| | - Renaud Duval
- Department of Ophthalmology, Hôpital Maisonneuve Rosemont, Montreal, Québec, Canada
| | - Ghassan Cordahi
- Department of Ophthalmology, Hôpital Maisonneuve Rosemont, Montreal, Québec, Canada
| | - Sebastien Olivier
- Department of Ophthalmology, Hôpital Maisonneuve Rosemont, Montreal, Québec, Canada
| | - Flavio A Rezende
- Department of Ophthalmology, Hôpital Maisonneuve Rosemont, Montreal, Québec, Canada.
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Chronopoulos A, Chronopoulos P, Hattenbach LO, Ashurov A, Schutz JS, Pfeiffer N, Korb C. Intravitreal fluocinolone acetonide implant for chronic postoperative cystoid macular edema - two years results. Eur J Ophthalmol 2022; 33:11206721221124688. [PMID: 36062617 DOI: 10.1177/11206721221124688] [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: 11/15/2022]
Abstract
PURPOSE We report visual and anatomical outcomes of chronic postoperative macular edema treated with a fluocinolone acetonide intravitreal implant. METHOD Retrospective study of chronic, post-surgical CME treated with a fluocinolone acetonide intravitreal implant. Best registered visual acuity (BRVA), central retinal thickness (CRT), and Goldmann tonometry intraocular pressure (IOP) were assessed over 24 months. The need for IOP lowering treatment, top-up therapy during follow-up, and complications were also assessed. RESULTS We analyzed 16 consecutive eyes of 16 patients with chronic, post-surgical CME treated with fluocinolone acetonide intravitreal implant. Surgical indications included cataract surgery, vitrectomy plus membrane peeling and combined phaco-vitrectomy. Baseline mean BRVA of 0.8 ± 0.65 logMAR improved to 0.60 ± 0.4 logMAR (p = 0.02) at 12 months and to 0.7 ± 0.5 logMAR (p = 0.32) at 24 months. At month 12, BRVA improved in 11 eyes, stabilized in 4 eyes, and decreased in 1 eye. At month 24, VA remained improved in 5 eyes, remained stabilized in 5 eyes, and decreased in 1 eye. Mean CRT decreased from 524 ± 132 μm at baseline to 389 μm at month 3, 347 μm at month 6, 355 ± 106 μm (p = 0.0003) at month 12, and 313 ± 83 μm (p = 0.0001) at month 24. At 12 months, CRT improved in 13 eyes and remained unchanged in 2 eyes. At 24 months, CRT improved further in 8 eyes, and stabilized in 3 eyes. Increased IOP (≥21 mmHg) was observed only in 4 eyes, all successfully managed with topical medication. No further side effects were observed in any patient. CONCLUSION Visual and anatomic improvements were achieved by a single fluocinolone acetonide implant with few side effects up to 24 months in CME eyes with a long and heavy prior treatment history.
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Affiliation(s)
- Argyrios Chronopoulos
- Department of Ophthalmology, 9209Ludwigshafen Hospital, Ludwigshafen am Rhein, Germany
| | - Panagiotis Chronopoulos
- Department of Ophthalmology, 39068University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - L O Hattenbach
- Department of Ophthalmology, 9209Ludwigshafen Hospital, Ludwigshafen am Rhein, Germany
| | - Agharza Ashurov
- Department of Ophthalmology, 9209Ludwigshafen Hospital, Ludwigshafen am Rhein, Germany
| | - James S Schutz
- Department of Ophthalmology, 9209Ludwigshafen Hospital, Ludwigshafen am Rhein, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, 39068University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Christina Korb
- Department of Ophthalmology, 39068University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
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Merad M, Vérité F, Baudin F, Ghezala IB, Meillon C, Bron AM, Arnould L, Eid P, Creuzot-Garcher C, Gabrielle PH. Cystoid Macular Edema after Rhegmatogenous Retinal Detachment Repair with Pars Plana Vitrectomy: Rate, Risk Factors, and Outcomes. J Clin Med 2022; 11:jcm11164914. [PMID: 36013153 PMCID: PMC9410086 DOI: 10.3390/jcm11164914] [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: 07/01/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 11/26/2022] Open
Abstract
(1) Background: The aim was to describe the rate and outcomes of cystoid macular edema (CME) after pars plana vitrectomy (PPV) for primary rhegmatogenous retinal detachment (RRD) and to identify risk factors and imaging characteristics. (2) Methods: A retrospective consecutive case study was conducted over a 5-year period among adult patients who underwent PPV for primary RRD repair. The main outcome measure was the rate of CME at 12 months following PPV. (3) Results: Overall, 493 eyes were included. The CME rate was 28% (93 patients) at 12 months. In multivariate analysis, eyes with worse presenting visual acuity (VA) (odds ratio [OR], 1.55; 95% CI, 1.07–2.25; p = 0.02) and grade C proliferative vitreoretinopathy (PVR) (OR, 2.88; 95% CI, 1.04–8.16; p = 0.04) were more at risk of developing CME 1 year after PPV. Endolaser retinopexy was associated with a greater risk of CME than cryotherapy retinopexy (OR, 3.06; 95% CI, 1.33–7.84; p = 0.01). Eyes undergoing cataract surgery within 6 months of the initial RRD repair were more likely to develop CME at 12 months (OR, 1.96; 95% CI, 1.06–3.63; p = 0.03). (4) Conclusions: CME is a common complication after PPV for primary RRD repair. Eyes with worse presenting VA, severe PVR at initial presentation, endolaser retinopexy, and cataract surgery within 6 months of initial RRD repair were risk factors for postoperative CME at 12 months.
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Affiliation(s)
- Malik Merad
- Department of Ophthalmology, Dijon University Hospital, 21000 Dijon, France
| | - Fabien Vérité
- Agathe Group INSERM U 1150, UMR 7222 CNRS, ISIR (Institute of Intelligent Systems and Robotics), Sorbonne Université, 75005 Paris, France
| | - Florian Baudin
- Department of Ophthalmology, Dijon University Hospital, 21000 Dijon, France
| | - Inès Ben Ghezala
- Department of Ophthalmology, Dijon University Hospital, 21000 Dijon, France
| | - Cyril Meillon
- Department of Ophthalmology, Dijon University Hospital, 21000 Dijon, France
| | - Alain Marie Bron
- Department of Ophthalmology, Dijon University Hospital, 21000 Dijon, France
- Eye and Nutrition Research Group, Centre des Sciences du Goût et de l’Alimentation, AgroSup Dijon, CNRS, INRAE, Université de Bourgogne Franche-Comté, 21000 Dijon, France
| | - Louis Arnould
- Department of Ophthalmology, Dijon University Hospital, 21000 Dijon, France
| | - Pétra Eid
- Department of Ophthalmology, Dijon University Hospital, 21000 Dijon, France
| | - Catherine Creuzot-Garcher
- Department of Ophthalmology, Dijon University Hospital, 21000 Dijon, France
- Eye and Nutrition Research Group, Centre des Sciences du Goût et de l’Alimentation, AgroSup Dijon, CNRS, INRAE, Université de Bourgogne Franche-Comté, 21000 Dijon, France
| | - Pierre-Henry Gabrielle
- Department of Ophthalmology, Dijon University Hospital, 21000 Dijon, France
- Eye and Nutrition Research Group, Centre des Sciences du Goût et de l’Alimentation, AgroSup Dijon, CNRS, INRAE, Université de Bourgogne Franche-Comté, 21000 Dijon, France
- Correspondence: ; Tel.: +33-380-293-031
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Gharbiya M, Visioli G, Iannetti L, Iannaccone A, Tamburrelli AC, Marenco M, Albanese GM. COMPARISON BETWEEN SCLERAL BUCKLING AND VITRECTOMY IN THE ONSET OF CYSTOID MACULAR EDEMA AND EPIRETINAL MEMBRANE AFTER RHEGMATOGENOUS RETINAL DETACHMENT REPAIR. Retina 2022; 42:1268-1276. [PMID: 35316255 PMCID: PMC9205297 DOI: 10.1097/iae.0000000000003475] [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] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate the incidence and risk factors for the main complications in patients with rhegmatogenous retinal detachment treated with scleral buckling (SB) or pars plana vitrectomy (PPV). METHODS A retrospective, comparative, observational study was conducted. The medical records of 107 patients with primary rhegmatogenous retinal detachment who were managed with SB (n = 57) or PPV (n = 50) were reviewed. Scleral buckling was performed using scleral encircling solid silicone band and circumferential solid silicone exoplant to support the break. Pars plana vitrectomy was combined with phacoemulsification in phakic eyes and with scleral encircling in inferior detachments. Follow-ups, including spectral-domain optical coherence tomography examination, were scheduled at 1, 3, and 12 months after surgery. Propensity score matching was used to adjust for potential preoperative selection bias. RESULTS The overall incidence of postoperative cystoid macular edema (CME) and epiretinal membrane was 14.95% and 30.84%, respectively. Compared with SB, CME was more frequent in the PPV (P = 0.021) and in the PPV pseudophakic eyes (P = 0.027). Postoperative CME was an early, predominantly transient complication and regressed in 67% of SB and in 77% of PPV eyes within 12 months after surgery. No differences were observed regarding epiretinal membrane development. Except for the surgical technique, no preoperative factors associated with CME were identified. A correlation between epiretinal membrane and patients' age was found (P = 0.028). CONCLUSION The incidence of CME after rhegmatogenous retinal detachment repair was higher in patients who underwent PPV, either alone or combined with phacoemulsification, than in those treated with SB. Epiretinal membrane development was correlated to older age, regardless of the surgical procedure.
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Affiliation(s)
- Magda Gharbiya
- Department of Sense Organs, Sapienza University of Rome, Policlinico Umberto I University Hospital, Head and Neck Department, Rome, Italy
| | - Giacomo Visioli
- Department of Sense Organs, Sapienza University of Rome, Policlinico Umberto I University Hospital, Head and Neck Department, Rome, Italy
| | - Ludovico Iannetti
- Department of Sense Organs, Sapienza University of Rome, Policlinico Umberto I University Hospital, Head and Neck Department, Rome, Italy
| | - Andrea Iannaccone
- Department of Sense Organs, Sapienza University of Rome, Policlinico Umberto I University Hospital, Head and Neck Department, Rome, Italy
| | - Anna Clara Tamburrelli
- Department of Sense Organs, Sapienza University of Rome, Policlinico Umberto I University Hospital, Head and Neck Department, Rome, Italy
| | - Marco Marenco
- Department of Sense Organs, Sapienza University of Rome, Policlinico Umberto I University Hospital, Head and Neck Department, Rome, Italy
| | - Giuseppe Maria Albanese
- Department of Sense Organs, Sapienza University of Rome, Policlinico Umberto I University Hospital, Head and Neck Department, Rome, Italy
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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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Awan MA, Hussain SZM, Shaheen F, Humayun MB, Zeb NT, Ayub B, Siddiqui MAR. Efficacy and Safety Profile of 25-Gauge Pars Plana Vitrectomy in Rhegmatogenous Retinal Detachment in Pakistan: A Multicenter Retrospective Study. Cureus 2022; 14:e23437. [PMID: 35494950 PMCID: PMC9038210 DOI: 10.7759/cureus.23437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2022] [Indexed: 11/05/2022] Open
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Belin PJ, Mundae R, Tzu JH, Chang E, Parke DW. EXTERNAL DRAINAGE OF SUBRETINAL FLUID DURING RHEGMATOGENOUS RETINAL DETACHMENT REPAIR. Retina 2021; 41:1828-1832. [PMID: 33512898 DOI: 10.1097/iae.0000000000003136] [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: 11/25/2022]
Abstract
PURPOSE To describe the safety and efficacy of rhegmatogenous retinal detachment (RRD) repair with external drainage of subretinal fluid using a 28-gauge External Drainage and Depression device (Vortex Surgical, Chesterfield, MO). METHODS Retrospective review of patients who underwent primary rhegmatogenous retinal detachment repair with scleral buckle, pars plana vitrectomy, or scleral buckle/pars plana vitrectomy using the drainage device from August 2018 through March 2020, performed by four surgeons at two vitreoretinal practices. RESULTS Eighty-three eyes of 83 patients were included. At presentation, 28% had proliferative vitreoretinopathy. Surgery included 65% scleral buckle/pars plana vitrectomy, 33% pars plana vitrectomy, and 2% scleral buckle. There were no cases of retinal incarceration and two subretinal hemorrhages at the drainage site (both < 2 DD), 2 cases of recurrent RD with proliferative vitreoretinopathy (1 had proliferative vitreoretinopathy at presentation), and 6 (10%) new epiretinal membranes (3 were mild). There were no other complications. Mean follow-up was 274 days. Single operation success rate for those with ≥ 6-month follow-up was 97% (57/59). CONCLUSION External drainage of subretinal fluid during rhegmatogenous retinal detachment repair demonstrated a favorable safety profile with a high single operation success rate. Further study of the role of external drainage in rhegmatogenous retinal detachment repair is warranted.
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Affiliation(s)
| | - Rusdeep Mundae
- Department of Ophthalmology, University of Minnesota, Minneapolis, Minnesota; and
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13
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Keller J, Govetto A, Ramasamy P, Liyanage SE. Comparison of Perfluorodecalin and Silicone Oil as Initial Tamponade for Giant Retinal Tear-Associated Retinal Detachment. Ophthalmologica 2021; 244:218-222. [PMID: 33915541 DOI: 10.1159/000516520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 04/07/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION To compare visual outcomes and complication rates of giant retinal tear-associated retinal detachment (GRT-RD) cases treated with short-term perfluorodecalin (PFD) tamponade versus silicone oil (SiO). METHODS Database analysis of patients with GRT-RD operated on in the period from 1 January 2014 to 31 December 2019. RESULTS Forty-five patients were operated for GRT-RD using PFD or SiO during this period. Two children, 7 patients receiving gas tamponade, and 2 lost to follow-up were excluded. Eighteen eyes (40%) received PFD and 27 (60%) received SiO. There were 15/18 (83%) macula-sparing cases in the PFD group and 18/27 (67%) in the SiO group (p = 0.13). The mean duration of oil tamponade was 91 days for SiO and 7.6 days for PFD (p < 0.0001). The mean length of follow-up was 274.5 days for PFD and 668.9 days for SiO. The mean BCVA was 6/18 (63.4 ± 26.0 ETDRS letters) for SiO and 6/12 (72.9 ± 12.7 ETDRS letters) for PFD (p = 0.42). Analysing macula-sparing pseudophakic eyes, the BCVA was 6/12 (67.4 ± 25.9 letters, n = 18) for SiO eyes and 6/9 (76.8 ± 9.9 letters, n = 11) for PFD eyes (p = 0.54). The recurrence rate was 22% (6/27) for SiO and 6% (1/18) for PFD (p = 0.12). The rate of cystoid macular oedema (CMO) was 22% for SiO and 22% for PFD. Epiretinal membrane (ERM) was found in 26% of SiO cases and 22% of PFD cases. Loss of vision after oil removal was not observed. Seven eyes (26%) receiving SiO and none receiving PFD developed chronic ocular hypertension (OHT) (p = 0.02). CONCLUSIONS Short-term tamponade with PFD for GRT-RD appears similar to tamponade with SiO in terms of the visual outcomes and complication rates.
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Affiliation(s)
- Johannes Keller
- Bristol Eye Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | - Andrea Govetto
- Bristol Eye Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | - Pathma Ramasamy
- Bristol Eye Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | - Sidath E Liyanage
- Bristol Eye Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
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14
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Intravitreal Dexamethasone Implant for Postoperative Macular Oedema Secondary to Vitrectomy for Epiretinal Membrane and Retinal Detachment: A Systematic Review and Meta-Analysis. J Ophthalmol 2021; 2021:6627677. [PMID: 33953965 PMCID: PMC8064798 DOI: 10.1155/2021/6627677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/06/2021] [Accepted: 04/05/2021] [Indexed: 01/01/2023] Open
Abstract
Purpose To evaluate the efficacy of intravitreal dexamethasone implant (DEX) for the treatment of macular oedema secondary to vitrectomy for epiretinal membrane (ERM) and retinal detachment (RD) by conducting a systematic review with meta-analysis of published studies. Methods Studies reporting clinical outcomes of DEX use for the treatment of macular oedema secondary to ERM and RD vitrectomy were searched on PubMed and Embase databases. The primary outcome was best-corrected visual acuity (BCVA) change between baseline and post-DEX treatment, reported as mean difference (MD) with 95% confidence interval (CI). Mean central macular thickness (CMT) change was assessed as a secondary outcome. Postimplant adverse events, including intraocular pressure rise and cataract development, were reported as well. Results Five uncontrolled studies, 1 nonrandomized controlled study, and 1 randomized controlled study were included, with a total of 5 cohorts and 3 cohorts in the ERM group and RD group, respectively. Considering the last available follow-up, a significant improvement in postimplant BCVA was found in the overall population, irrespective of the indication for vitrectomy (MD = −0.28, 95% CI = −0.37, −0.20; p < 0.001), but with significant heterogeneity. In either group, mean BCVA significantly improved following the implant (in the ERM group, MD = −0.31, 95% CI = −0.40, −0.22; in the RD group, MD = −0.22, 95% CI = −0.41, −0.03), with no difference between the two groups (p=0.41). However, there was significant heterogeneity in both groups. Considering the last available follow-up, a significant CMT reduction was found in the overall population, irrespective of the indication for vitrectomy (MD = −129.75, 95% CI = −157.49, −102.01; p < 0.001). In the ERM group, a significant CMT reduction was shown following DEX (MD = −133.41, 95% CI = −155.37, −111.45; p < 0.001), with no heterogeneity. In the RD group, mean CMT reduction was borderline significant (MD = −128.37, 95% CI = −253.57, −3.18; p=0.040), with significant heterogeneity. No difference in CMT improvement was found between the two groups (p=0.94). Conclusion This meta-analysis showed that DEX yielded a significant improvement in visual and anatomical outcomes, even if limited by significant heterogeneity. Dexamethasone implant represents an effective treatment for postoperative macular oedema secondary to ERM and RD vitrectomy.
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15
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Sultan ZN, Agorogiannis EI, Iannetta D, Steel D, Sandinha T. Rhegmatogenous retinal detachment: a review of current practice in diagnosis and management. BMJ Open Ophthalmol 2020; 5:e000474. [PMID: 33083551 PMCID: PMC7549457 DOI: 10.1136/bmjophth-2020-000474] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/17/2020] [Accepted: 07/20/2020] [Indexed: 11/04/2022] Open
Abstract
Rhegmatogenous retinal detachment (RRD) is a common condition with an increasing incidence, related to the ageing demographics of many populations and the rising global prevalence of myopia, both well known risk factors. Previously untreatable, RRD now achieves primary surgical success rates of over 80%-90% with complex cases also amenable to treatment. The optimal management for RRD attracts much debate with the main options of pneumatic retinopexy, scleral buckling and vitrectomy all having their proponents based on surgeon experience and preference, case mix and equipment availability. The aim of this review is to provide an overview for the non-retina specialist that will aid and inform their understanding and discussions with patients. We review the incidence and pathogenesis of RRD, present a systematic approach to diagnosis and treatment with special consideration to managing the fellow eye and summarise surgical success and visual recovery following different surgical options.
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Affiliation(s)
- Ziyaad Nabil Sultan
- Ophthalmology, Royal Liverpool and Broadgreen Hospitals NHS Trust, Liverpool, UK
| | | | - Danilo Iannetta
- Ophthalmology, Royal Liverpool and Broadgreen Hospitals NHS Trust, Liverpool, UK.,UOSD Glaucoma, Arcispedale S Maria Nuova, Reggio Emilia, Emilia-Romagna, Italy
| | - David Steel
- Ophthalmology, Sunderland Eye Infirmary, Sunderland, Sunderland, UK
| | - Teresa Sandinha
- St Paul's Eye Unit, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, Liverpool, UK
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16
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Dzhaber D, Mustafa OM, Tian J, Cox JT, Daoud YJ. Outcomes and complications of iris-fixated intraocular lenses in cases with inadequate capsular support and complex ophthalmic history. Eye (Lond) 2020; 34:1875-1882. [PMID: 31900437 PMCID: PMC7609302 DOI: 10.1038/s41433-019-0759-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 12/17/2019] [Accepted: 12/19/2019] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND To report the indications, visual outcomes, and intra-operative and post-operative complications of iris-sutured posterior chamber intraocular lens (IOL) in eyes with inadequate capsular support and complex ocular history. METHODS A chart review and data analysis of eyes that underwent iris fixation of posterior chamber (PC) IOL for correction of aphakia, dislocated and subluxed IOLs, ectopia lentis, and IOL exchange. Data included clinical risk factors, associated eye conditions, previous surgeries, and concomitant procedures. The pre-operative and post-operative vision, manifest refraction, endothelial cell density, intraocular pressure (IOP), as well as intra-operative and post-operative complications were also recorded. RESULTS One hundred and seventeen eyes from 114 patients were examined with a mean follow-up of 22.4 months. The most common identifiable predisposing risk factor was high myopia in 23 eyes. A significant improvement in uncorrected and best corrected visual acuity compared with baseline was observed. The most common post-operative complications included recurrent IOL subluxation in 16 (13.7%) eyes, IOP spike in 7 (5.9%) eyes, cystoid macular oedema in 5 (4.3%) eyes, and epiretinal membrane formation in 4 (3.4%) eyes. There was one (0.85%) case of sterile endophthalmitis. CONCLUSIONS Iris suture fixation of PC IOLs is a good treatment option for eyes with inadequate capsular support and complex ocular history.
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Affiliation(s)
- Daliya Dzhaber
- Cornea, Cataract, and External Diseases Division, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Osama M Mustafa
- Cornea, Cataract, and External Diseases Division, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jing Tian
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jacob T Cox
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yassine J Daoud
- Cornea, Cataract, and External Diseases Division, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Busquets MA, Lutz CT, Zhao T. Management of Cystoid Macular Edema After Vitrectomy for Proliferative Vitreoretinopathy. Ophthalmic Surg Lasers Imaging Retina 2020; 51:436-443. [PMID: 32818275 DOI: 10.3928/23258160-20200804-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 07/01/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To assess therapies for cystoid macular edema (CME) following pars plana vitrectomy for proliferative vitreoretinopathy (PVR). PATIENTS AND METHODS Retrospective analysis of 42 eyes developing CME after PVR surgery. Treatments included topical therapy, sub-Tenon's triamcinolone acetonide (STTA), intravitreal bevacizumab and combinations thereof. Best-corrected visual acuity (BCVA) as well as central subfield thickness (CST) were tracked. RESULTS Mean Snellen BCVA improved from 20/598 to 20/297 (logMAR change -0.21; confidence interval [CI], -0.39 to -0.03; P = .03). Mean CST improved from 448 µm to 260 µm (CI, -248.70 to -126.06; P < 0.01). There was no difference in efficacy between treatment subgroups (analysis of variance, P = 0.16, 0.43), but STTA yielded statistically significant improvement in both categories (CI, -0.79 to -0.11; P = 0.01; and CI, -333.74 to 166.51; P < .01). CONCLUSIONS Treatment of CME following PVR surgery is possible with a variety of different options. STTA appears to yield anatomical and visual improvement. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:436-443.].
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Kuberappa RG, Surve A, Azad SV, Kumar V. Cystoid macular oedema following pars plana vitrectomy for macula on rhegmatogenous retinal detachment. Clin Exp Optom 2020; 104:253-254. [PMID: 32458541 DOI: 10.1111/cxo.13097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Ranjitha G Kuberappa
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Abhidnya Surve
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Shorya V Azad
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Vinod Kumar
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Coppola M, Marchese A, Cicinelli MV, Rabiolo A, Giuffrè C, Gomarasca S, Querques G, Bandello F. Macular optical coherence tomography findings after vitreoretinal surgery for rhegmatogenous retinal detachment. Eur J Ophthalmol 2020; 30:805-816. [DOI: 10.1177/1120672120911334] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The primary aim of this study was to summarize and illustrate the main structural cross-sectional optical coherence tomography findings encountered after vitreoretinal surgery for rhegmatogenous retinal detachment. This was a non-systematic review of literature on structural cross-sectional optical coherence tomography findings after vitreoretinal surgery for rhegmatogenous retinal detachment. Adequate illustrations of the main findings described were found after a retrospective analysis of imaging and charts of patients operated at the department where this study was performed. The main structural cross-sectional optical coherence tomography findings after vitreoretinal surgery for rhegmatogenous retinal detachment included persistent subretinal fluid, subretinal blebs, retinal folds, subretinal perfluorocarbon liquids, macular alterations related to silicone oil, epiretinal membranes, proliferative vitreoretinopathy, cystoid macular edema, macular holes, and recurrent retinal detachment. In conclusion, optical coherence tomography was a useful tool after vitreoretinal surgery for rhegmatogenous retinal detachment. Some optical coherence tomography findings may not be evident on fundus examination, and optical coherence tomography can reveal essential details for the clinical management and the visual prognosis. Other findings, despite being visible on funduscopic examination, may be better assessed with the aid of optical coherence tomography. All these elements contribute to support the importance of tomographic assessment in the follow-up of eyes treated for vitreoretinal conditions.
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Affiliation(s)
- Michele Coppola
- Department of Ophthalmology, San Gerardo Hospital, Monza, Italy
| | - Alessandro Marchese
- Department of Ophthalmology, San Gerardo Hospital, Monza, Italy
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Maria Vittoria Cicinelli
- Department of Ophthalmology, San Gerardo Hospital, Monza, Italy
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Alessandro Rabiolo
- Department of Ophthalmology, San Gerardo Hospital, Monza, Italy
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Chiara Giuffrè
- Department of Ophthalmology, San Gerardo Hospital, Monza, Italy
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | | | - Giuseppe Querques
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Francesco Bandello
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
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de Carlo T, Lim JI. Macular Vitelliform-Like Lesion in an Eye With Chronic Retinal Detachment. JAMA Ophthalmol 2018; 136:1303-1304. [PMID: 30193326 DOI: 10.1001/jamaophthalmol.2018.1379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Talisa de Carlo
- Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago
| | - Jennifer I Lim
- Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago.,Associate Deputy Editor
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RESIDUAL VITREOUS CORTEX AT THE FOVEA DURING VITRECTOMY FOR PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT REPAIR. Retina 2018; 38:1549-1555. [DOI: 10.1097/iae.0000000000001734] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Papastefanou VP, Dooley I, Zambarakji H. Management of macular edema in vitrectomized patients with diabetes. EXPERT REVIEW OF OPHTHALMOLOGY 2018. [DOI: 10.1080/17469899.2018.1465819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Vasilios P. Papastefanou
- Ophthalmology Service, Whipps Cross University Hospital, Barts Health NHS Trust, E1 1NR, London, UK
| | - Ian Dooley
- Ophthalmology Service, Whipps Cross University Hospital, Barts Health NHS Trust, E1 1NR, London, UK
| | - Hadi Zambarakji
- Ophthalmology Service, Whipps Cross University Hospital, Barts Health NHS Trust, E1 1NR, London, UK
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Preexisting epiretinal membrane is associated with pseudophakic cystoid macular edema. Graefes Arch Clin Exp Ophthalmol 2018; 256:909-917. [DOI: 10.1007/s00417-018-3954-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 02/14/2018] [Accepted: 03/02/2018] [Indexed: 11/26/2022] Open
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THE ASSOCIATION OF EPIRETINAL MEMBRANE WITH MACULAR HOLE FORMATION AFTER RHEGMATOGENOUS RETINAL DETACHMENT REPAIR. Retina 2017; 37:1073-1078. [DOI: 10.1097/iae.0000000000001307] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Correspondence. Retina 2015; 36:e2-3. [PMID: 26630318 DOI: 10.1097/iae.0000000000000905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Reply. Retina 2015; 36:e3-4. [PMID: 26630320 DOI: 10.1097/iae.0000000000000906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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