Case series: Two cases of severe retinal cicatricial contraction after vitrectomy for open-globe injury in patients with skin keloid

Purpose

To report two cases of severe retinal cicatricial contraction after vitrectomy for open-globe injury in patients with skin keloid.

Observations

One was a 33-year-old male patient who developed severe retinal cicatricial contraction 6.5 months post-operatively, and his skin wound was observed with keloid simultaneously. The second case was a 36-year-old male patient who developed recurrent retinal detachment 1 week after the two operations, and keloid was also found on his skin.

Conclusions and Importance

Retinal detachment is a vision-threatening complication of open-globe injury. Besides most of the already known factors, skin keloid should be concerned.

Retinal Displacement Following Rhegmatogenous Retinal Detachment: A Systematic Review and Meta-Analysis

Retinal displacement following rhegmatogenous retinal detachment (RRD) repair is an important consideration when assessing the integrity of reattachment, with potential implications on functional outcomes. There are limited data comparing various surgical techniques. We conducted a review of retinal displacement following RRD repair through October 2021, finding twenty-one studies encompassing 1258 unique eyes. Outcome measures included the frequency of retinal displacement, visual acuity, metamorphopsia, and displacement direction. A meta-analysis was performed with data reported as risk ratios or mean difference and 95% confidence intervals. Retinal displacement was found in 35±20% of RRD repairs. Scleral buckle (SB) without tamponade had the lowest rate of retinal displacement (9.60 [2.01-45.95], p=0.005), followed by pneumatic retinopexy (PnR) and finally pars plana vitrectomy (PPV). Silicone oil may reduce risk of displacement following PPV compared to gas (2.16 [1.22-3.83], p=0.009), as may immediate face-down positioning for 2 hours. Retinal displacement following PPV occurred in the downward direction in 92±14% of cases and does not appear to significantly impact visual acuity (0.05 [-0.21-0.31 p=0.70), although it may increase distortion. SB, PnR, PPV with silicone oil, and immediate face-down positioning are likely associated with less retinal displacement. Additional prospective studies are required to increase the certainty of these findings.

Retinal detachment repair with perfluoro-N-octane endotamponade in an infant with juvenile X-linked retinoschisis

Purpose

We present a case of successful surgical management of an infant with X-linked retinoschisis with a giant retinal tear and retinal detachment of the right eye.

Observations

A 10-month-old male presented with retinoschisis of both eyes and a retinal detachment of the right eye. The patient underwent two-stage pars plana vitrectomy utilizing perfluoro-N-octane to stabilize the detached retina and facilitate posterior hyaloid separation. Retained perfluoro-N-octane tamponade was later exchanged with silicone oil. The retina remained attached at last follow up.

Conclusions and Importance

Retinal detachment repair in infants presents unique challenges. This is a safe and effective strategy for complex retinal detachment repair in the infant population.

Central retinal artery occlusion on postoperative day one after vitreoretinal surgery

Purpose

To report two cases of central retinal artery occlusion (CRAO) associated with vitreoretinal surgery.

Observations

Two patients underwent vitreoretinal surgery and were diagnosed with CRAO on postoperative day one. Both had received retrobulbar anesthetic blocks, followed by pars plana vitrectomy in one patient and scleral buckling in the other patient. Best-corrected visual acuity at last follow-up was 20/40 and 20/400.

Conclusions/Importance

CRAO is a rare but serious adverse event after vitreoretinal surgery. The causative mechanism is not known in these patients.