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PubMed1993

Retinal detachment as a complication of neodymium: yttrium aluminum garnet laser cyclophotocoagulation.

We report a traction retinal detachment that developed within one month of transscleral neodymium: yttrium aluminum garnet (Nd:YAG) laser cyclophotocoagulation, a previously unreported complication of the new cyclodestructive procedure. A 17-year-old boy was referred to our department with uncontrolled aphakic glaucoma OD after having undergone cyclocryotherapy twice. Three treatments with transscleral Nd:YAG cyclophotocoagulation were done over nine months to lower his intraocular pressure. Hypotony and traction retinal detachment occurred after the third laser treatment and was managed successfully by vitrectomy with a fluid-gas exchange. Thus, the possibility of this additional complication should be remembered when doing transscleral Nd:YAG cyclophotocoagulation.

Adolescent↗

PubMed1977

Ultrasound in the differential diagnosis of juvenile retinal detachment.

495 ultrasonograms were performed on children with intraocular pathology. In this report 66 eyes with juvenile retinal detachment are reviewed and exemplary cases are presented. The most common indications for ultrasound in eyes with juvenile retinal detachment were opaque media due to trauma first and leucocoria second.

Adolescent↗

PubMed1989

Prognosis of foveal splitting rhegmatogenous retinal detachments.

Retrospectively reviewing 4,966 patients with rhegmatogenous retinal detachments, we identified 21 patients with foveal split detachments who had no coexisting macular disease and who had been followed at least 6 months postoperatively. All detached retinas were anatomically reattached with one operation. The average preoperative and postoperative visual acuity was 20/50. Because eyes with foveal split detachments have a good visual prognosis when the retinas are anatomically reattached, we recommend that they be treated urgently, as if they had a macular-spared detachment.

Adolescent↗

PubMed1993

[Long-term prognosis of cystoid macular edema after microsurgery of rhegmatogenous retinal detachment].

We reviewed 25 eyes of 24 patients who had undergone successful repair of rhegmatogenous retinal detachment and who showed cystoid macular edema disclosed by routine fluorescein angiography performed 10-12 weeks postoperatively. The follow-up ranged from 18 months to 10 years (average: 60 months). Angiographic CME spontaneously disappeared in 19 eyes (76%). Complete disappearance of CME occurred less than 2 years postoperatively in all eyes. No late recurrence was observed. The final visual acuity was 20/40 or better in 15 eyes (78.9%). The final near reading visual acuity was normal in 16 eyes (84.2%). Angiographic CME was still present in 6 eyes (24%) 2 years postoperatively. It remained unchanged during the follow-up period (average 64 months) in all eyes. Cystoid macular degeneration developed in only 1 of the 6 eyes with chronic angiographic CME. Five of the 6 eyes with chronic CME retained useful near reading visual acuity during the follow-up period. The long-term prognosis of angiographic CME after microsurgical repair of rhegmatogenous retinal detachment appears to be good in most cases.

Fluorescein Angiography↗

PubMed1983

Advances in intraocular techniques in the treatment of retinal detachments arising from holes of the posterior pole.

Two groups of retinal detachments arising from macular holes were compared. The first group consisted of 27 consecutive cases operated upon during the years 1972-7 by various techniques (encircling and hemi-encircling procedures, scleral resection, scleral pocket, and silver clip). The second group consisted of 18 consecutive cases operated upon in the years 1978-81 by pars plana vitrectomy to release vitreous traction or make intraocular manoeuvres possible. In all cases of the second group an intraocular gas bubble was used to tamponade the macular hole, and the hole was coagulated only if necessary. There was not only a significantly better anatomical result in the second group, but the functional results were more favourable. Two-thirds of the eyes of the second group reached a visual acuity between 6/12 and 6/48, while in the first group none of the eyes gained a better vision than 6/60. The reading vision in 2/3 of the first group was negligible, while nearly half of the cases in the second group reached useful acuity between Jaeger 3 and 10.

Female↗

PubMed1989

Retinal detachment after neodymium:YAG laser posterior capsulotomy.

We reviewed the records of 397 patients who had undergone Nd:YAG laser posterior capsulotomy between July 1983 and August 1988. Of the 366 eyes that had been followed up for three months or more, 13 (3.6%) developed a retinal detachment after capsulotomy; of these 13 detachments, 11 (84.6%) occurred within the first year. The combination of male gender with axial myopia (greater than or equal to 25.00 mm), a history of lattice degeneration, or a history of retinal detachment in the fellow eye was a significant risk factor for the development of retinal detachment after YAG capsulotomy.

Cataract Extraction↗

PubMed2006

Incidence of fellow eye retinal detachment resulting from macular hole.

PURPOSE: To determine the incidence of retinal detachment resulting from macular hole (MHRD) in fellow eyes. DESIGN: Observational case series. METHODS: The medical records of 59 normal fellow eyes of cases with MHRD diagnosed between 1994 and 2004 at Osaka Rosai Hospital were retrospectively reviewed. Thirty-nine of the 59 fellow eyes were highly myopic. The average follow-up period was 42 months with a range of seven to 132 months. The incidence of MHRD in fellow eyes, and the interval between the onset of MHRD in the first eye and the fellow eye were determined. The Kaplan-Meier method was used to estimate the probability of the fellow eye developing MHRD at 18 months and five years, and the probability of high myopia in the development of MHRD with log-rank test. RESULTS: Five eyes (8.5%) developed MHRD during the follow-up period. All affected eyes were highly myopic, and the incidence of MHRD among the highly myopic fellow eyes was 12.8%. The average interval was 51 months. The Kaplan-Meier estimated probability of the fellow eye developing MHRD was 3.7% (0% to 8.7% for 95% confidence interval [CI]) at 18 months and 8.0% (0% to 17.7% for 95% CI) at five years. The probability of the fellow eyes with high myopia developing MHRD was significantly higher than that of eyes without high myopia (P = .0304). CONCLUSIONS: The high incidence of MHRD developing in the fellow eye indicates that the fellow eyes should be examined and followed carefully.

Aged↗

PubMed1986

Experimental study on drug therapy of "traction retinal detachment" after posterior penetrating eye injury in the rabbit.

In an experimental study on rabbits, a standardized eye injury was created by using the "pars-plana incision model." Subsequently, the effect of intravenous application of dexamethasone and penicillamine on traction retinal detachment was investigated. The two drugs were applied in varying concentrations and combinations (single and combined use in varying intervals), followed by a 3-month control period without medication. Clinical and histological findings showed that intravitreal instillation of 1.2 mg dexamethasone reduces the incidence of retinal detachment from 46% to 27%. Higher concentrations of dexamethasone, as well as the use of penicillamine or a combination of both substances, proved to enhance traction retinal detachment.

Animals↗

PubMed1999

The choroidal circulation after retinal detachment surgery.

PURPOSE: to assess the effects on choroidal perfusion of scleral buckling and vitrectomy procedures for retinal detachment. METHODS: 17 patients were included in the study: 7 underwent scleral buckling and 10 vitrectomy, for rhegmatogenous retinal detachment. pOBF Langham system evaluation was performed before and after surgery (the fellow eye served as control). Statistical analysis was based on paired t-test. RESULTS: in the scleral buckling group was found a mean change (SD) of 470 (355.32) microl/min; in the vitrectomy group the mean difference (SD) was 254.2 (132.53) microl/min. In both groups a statistically significant difference with the control was found. CONCLUSIONS: our results show that both surgical procedures affect choroidal perfusion and could impair optic nerve head feeding.

Adult↗

PubMed1982

Microsurgical management of retinal detachment in eyes with pupillary membranes.

A one-stage approach to the combined problem of retinal detachment and pupillary membranes, aided by fiberoptic endoillumination and microscopic viewing through a corneal contact lens, permits simultaneous removal of the pupillary membrane and cortical vitreous along with microsurgical examination of the peripheral retina and closure of all breaks. Four cases of complicated retinal detachment that were treated in this manner are presented. In two, the presence of pupillary membranes was further complicated by vitreoretinal traction. Although it is a departure from traditional techniques of retinal attachment, such a microsurgical approach is surely an additional, and perhaps an advantageous, way in which to perform these complicated surgical procedures.

Aged↗

PubMed2026

Postoperative hypotony after retinectomy in rhegmatogenous retinal detachment surgery: A systematic review and meta-analysis.

We estimate the incidence of postoperative hypotony after retinectomy performed during rhegmatogenous retinal detachment surgery and explore clinical, surgical, and methodological factors associated with hypotony risk. We include human clinical studies reporting postoperative intraocular pressure (IOP) outcomes after retinectomy or retinotomy for retinal detachment. Postoperative hypotony was defined as IOP ≤ 6 mmHg, with alternative thresholds (≤5 or ≤3 mmHg) retained for sensitivity analyses. A random-effects meta-analysis was used to pool hypotony incidence, with prespecified subgroup and sensitivity analyses according to retinectomy extent, tamponade strategy, hypotony definition, assessment timepoint, and vitrectomy gauge size. Study-level associations with visual outcomes and proliferative vitreoretinopathy (PVR) severity were also explored. Thirty-three studies comprising 2673 eyes were included. The pooled incidence of postoperative hypotony was 13.71% (95% CI, 10.40-17.40), with substantial heterogeneity (I² = 83.2%). Hypotony incidence did not increase linearly with retinectomy extent, and similar rates were observed for extents of 180°-269° and ≥ 270°. Stricter hypotony definitions and later postoperative assessment timepoints were associated with a higher reported incidence. A significant negative association was observed between hypotony incidence and visual improvement rates (Spearman ρ = -0.47, p = 0.03). In contrast, no significant study-level difference in hypotony incidence was observed according to PVR severity grouping or vitrectomy gauge size. Postoperative hypotony after retinectomy is a frequent and clinically relevant complication, moderately associated with poorer visual outcomes and influenced by methodological factors rather than retinectomy extent alone.

Humans↗

PubMed1988

[Retinal detachment following implantation of a posterior chamber lens].

In a series of 6000 cases of pseudophakia following extracapsular cataract extraction and implantation of Simcoe-type posterior chamber lenses, observed for a minimum of 20 months, the incidence of retinal detachment was 21 cases (0.33%). Significant risk factors include male sex (18/21, 82%), high myopia (axial length, over 25 mm in men), intraoperative rupture and late discussion of the posterior capsule. The frequency of retinal detachment following intracapsular cataract extraction without lens implantation was four times greater than that after extracapsular cataract extraction with implantation of a posterior chamber lens. After intracapsular cataract extraction and implantation of an iris-fixation lens it was eight times greater. Horseshoe tears, most of which were located in the peripheral superior quadrants, were seen in 14 eyes (76%). In three eyes no holes were detected. Reattachment was less successful in eyes with posterior chamber implants than in phakic eyes with retinal detachments.

Aged↗

PubMed1985

D-ACE surgical sequence for selected bullous retinal detachments.

Forty-five out of 50 selected retinal detachments were successfully reattached by the D-ACE surgical sequence, that is, initial drainage of subretinal fluid followed by air injection into the vitreous, transcleral cryopexy, and definitive scleral buckling. The D-ACE sequence is recommended for difficult bullous detachments as a simple, safe, and effective alternative to non-drainage techniques.

Air↗

PubMedDate not supplied

Perifoveal traction retinal detachment following successful optic disc pit surgery.

A 25-year-old male presented 8 years after a successful vitreoretinal operation for a left optic disc pit (ODP). On presentation his visual acuity had reduced from 6/5 (20/15) to 6/12 (20/40) in his operated eye. On examination an annular serous retinal detachment possibly secondary to tangential traction by either the internal limiting membrane (ILM) or residual lamellar vitreous cortex or both around the peripheral macular area was seen. The central fovea was flat. Following an uncomplicated vitrectomy and ILM peel, visual acuity improved to 6/6 (20/20) postoperatively. The author suggests that traction forces are responsible for the development of the serous detachment in eyes with ODP. Epiretinal membranes together with the ILM should be removed in all patients undergoing therapy for a retinal detachment associated with ODP in an effort to initially achieve a further relief of all forces and to try to avoid the late retinal detachment associated with epiretinal membrane or ILM contraction.

Adult↗

PubMed1999

Retinal detachment in Olmsted County, Minnesota, 1976 through 1995.

OBJECTIVE: To estimate the incidence of rhegmatogenous retinal detachment (RD) in a geographically defined population and to compare the probability of RD in residents after cataract extraction with the probability of RD in residents who did not have cataract extraction. DESIGN: Rochester Epidemiology Project databases were used to perform a retrospective population-based incidence study of RD diagnosed between 1976 and 1995 with cohort analyses of the influence of risk factors on the occurrence of RD. PARTICIPANTS: The population of Olmsted County, Minnesota, participated. MAIN OUTCOME MEASURE: Incidence rates of RD adjusted to the age and gender distribution of the 1990 U.S. white population were measured. RESULTS: Three hundred eleven incident cases of rhegmatogenous RD were identified. The mean annual age- and gender-adjusted incidence rate of rhegmatogenous RD was 17.9 per 100,000 persons (95% confidence interval [CI], 15.9-19.9). For idiopathic rhegmatogenous RD alone, the mean annual age- and gender-adjusted incidence rate was 12.6 (95% CI, 10.9-14.3) per 100,000 persons. Ten years after phacoemulsification and extracapsular cataract extraction, the estimated cumulative probability of RD was 5.5 (95% CI, 3.4-7.6) times as high as would have been expected in a similar group of county residents not undergoing cataract surgery. CONCLUSIONS: Cataract surgery is associated with a significantly elevated long-term cumulative probability of retinal detachment.

Adolescent↗

PubMed1977

Retinal detachment surgery. Buckling procedures and drainage of subretinal fluid.

The encircling procedure, while still an important part of succesful retinal detachment surgery, has been found to be unnecessary in a wide variety of retinal detachments which can be more simply treated by local buckles. A much more important aspect of the detachment procedure, however, is the avoidance where possible of drainage of subretinal fluid.

Drainage↗

PubMed1977

[Aphakic retinal detachment as a function of the technic and course of cataract extraction].

Myopic patients, in particular, should be carefully observed by contactglass examination prior to and after cataract surgery, in order to be able to perform prophylactic photocoagulation. In cases of vitreous loss, the risk of having an aphakic retinal detachment will be 20 times as high; that is to say, in one of every five cases cataract extraction with vitreous loss can be expected to produce a retinal detachment. It can be said, therefore, that the best cataract procedure- as far as aphakic retinal detachment is concerned-will be that in which we can expect the lowest rate of vitreous loss. Whether an extensive anterior vitrectomy will reduce the number of aphakic detachments, we cannot yet say defintely, because in these cases we have only routinely performed vitrectomy during the past 2 years.

Aged↗

PubMed1997

Complex retinal detachment treated with silicone oil or sulfur hexafluoride gas: a randomized clinical trial.

BACKGROUND AND OBJECTIVE: To determine if either silicone oil or sulfur hexafluoride gas (SF6) is superior to the other in the treatment of complex retinal detachment after previously failed vitreous surgery. PATIENTS AND METHODS: In this randomized clinical trial, 18 patients received treatment with silicone oil and 16 patients received SF6. The primary outcome was defined as successful anatomic attachment of the retina. Secondary outcomes included the time to retinal detachment, visual acuity, anatomic macular attachment, and any complications of surgery. RESULTS: The odds of successful reattachment with silicone oil were 50% greater than they were with SF6, but this difference was not statistically significant. There were no differences between the two groups in any of the secondary outcomes. CONCLUSIONS: This study did not have enough statistical power to detect a small but clinically important difference between the two treatment groups. Physicians must use their clinical judgment to select a vitreal substitute for complex retinal detachment when clinical trials are inconclusive. Data pooling is one method of overcoming the limitation of clinical trials with small sample sizes.

Adolescent↗