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PubMed2000

[Definitive internal tamponade with silicone oil in certain cases of retinal detachment].

PURPOSE: The aim of this study was to analyze the effect of definitively maintaining silicone oil in the treatment of certain cases of retinal detachment. MATERIAL AND METHODS: Sixteen cases of retinal detachment seen from July 1995 to April 1999 were retrospectively studied. For these eyes with residual visual acuity, we voluntarily maintained silicone oil. There were 11 men and 5 women, mean age 56 (range 24 - 82). Followup ranged from 18 to 45 months. RESULTS: We analyzed visual acuity outcome, complications, and main reasons for maintaining longterm silicone oil CONCLUSION: This study provided interesting insight concerning certain clinical situations where silicone oil has to be maintained definitively. In some cases, low, but useful, visual acuity can be achieved for long periods of time. This therapeutic approach would be particularly helpful for mono-ophthalmic patients.

Adult↗
PubMed1989

[Does peripheral iridectomy increase the risk of retinal detachment in patients with aphakia or pseudophakia?].

A retrospective study of 107 cases of retinal detachment in aphakic and pseudophakic eyes showed different types of retinal break depending upon surgical method. Three techniques were studied: intracapsular extraction (ICCE), intracapsular extraction with anterior chamber lens implant (ICCE, AC-IOL), and extracapsular extraction with posterior chamber lens implant (ECCE, PC-IOL). Results were compared for each technique with and without peripheral iridectomy. Typical aphakic and pseudophakic retinal breaks were found only in eyes having undergone peripheral iridectomy: our conclusion is that peripheral iridectomy is a risk factor for typical retinal breaks.

Cataract Extraction↗
PubMed1978

Retinal detachment in renal insufficiency a report of 3 cases.

Three cases of retinal detachment associated with renal insufficiency are presented. The authors feel that dilutional hyponatremia and hypervolemia were not significant in the genesis of the detachments and that control of the blood pressure was the key factor in their cure. The importance of hypertensive retinochoroidopathy in the pathogenesis of the detachment is emphasized.

Adult↗
PubMedDate not supplied

Recurrences of retinal detachment after vitreoretinal surgery, and surgical approach.

PURPOSE: To investigate the causes and management of recurrences of complicated retinal detachment after vitreoretinal surgery. METHODS: Vitreoretinal surgery was performed in 61 patients with complicated retinal detachment who were followed up for 4-24 (mean 7) months. Liquid perfluorocarbon (PFC) was used in all 61, silicone oil in 40 and perfluoropropane (C3F8) in 18 patients. RESULTS: Retinal attachment was achieved in 58 patients (95%) during the first operation. Due to the recurrence of detachment 17 patients (29%) had to be operated for a second, 7 (12%) a third and 4 (7%) a fourth time. Anterior and posterior proliferative vitreoretinopathy, missed tear, retinal incarceration, subretinal membrane and perisilicone proliferation were the factors causing redetachment. CONCLUSIONS: The best anatomical and functional results are obtained by dissection of the anterior membranes. In order to properly remove the retinal periphery the crystalline or intraocular lens should be removed. Comparison of our results with others indicates that anatomical success depends, to a certain extent, on doing only one, radical operation on the pathology that leads to recurrence.

Adolescent↗
PubMed2001

Retinal detachment and cataract, facial dysmorphism, generalized osteoporosis, immobile spine and platyspondyly in a consanguinous kindred--a possible new syndrome.

We report on a consanguineous family with 6 children (out of 7) affected by a spondylo-ocular syndrome. Clinical features include cataract, loss of vision due to retinal detachment, facial dysmorphism, facial hypotonia, normal height with disproportional short trunk, immobile spine with thorakal kyphosis and reduced lumbal lordosis. On ophthalmological examination of the index patient, a dense cataract and complete retinal detachment could be detected on the right eye. On the left eye, an absent lens nucleus was found, but no retinal detachment. On radiological examination, there was generalized moderate osteoporosis; the spine showed marked platyspondyly and the bone age was advanced. On laboratory investigations, a normal excretion of amino acids, mucopolysaccharides and oligosaccharides could be found. The phenotypical spectrum observed in the 6 affected individuals was rather uniform. The karyotype was normal in all affected children. This hitherto undescribed combination of oculo-skeletal symptoms shows most resemblance with connective tissue disorders, suggesting a range of candidate genes for mutation analysis.

Abnormalities, Multiple↗
PubMed1999

[Evaluation of the use of intravitreal air in retinal detachment surgery].

PURPOSE: To analyse the effects and complications after the use of intravitreal air in retinal surgery. MATERIAL AND METHODS: 185 patients (89 female, 96 male, aged from 12 to 81 years) with retinal detachment treated in the Department of Ophthalmology in Bydgoszcz in the period from 1992 to 1997, in whom intravitreal air was used. Patients with breaks lying above the 5 and 7 o'clock meridians were included in the treatment with intravitreal air. Follow-up period was from 6 months to 5 years. RESULTS: In 94% of cases the treatment was successful. In 2.7% the transient rise of intraocular pressure was noted. CONCLUSION: The use of intravitreal air in retinal surgery is an effective, safe, easy to perform, cheap and commonly available method used in retinal detachment surgery.

Adolescent↗
PubMed2006

Combined removal of silicone oil plus internal search (ROSO-plus) following retinal detachment surgery.

PURPOSE: To report the rate of retinal redetachment and intervention with combined removal of silicone oil plus internal search (ROSO-plus) and to report the pathology identified. METHODS: Preoperative and peroperative findings were related to postoperative failure of the surgery defined as retinal redetachment postoperatively or silicone oil in situ at the final follow-up. RESULTS: Sixty-three patients were included in the study. Mean follow-up was 13 months. Retinopexy and further tamponade were used in 22 patients. Overall 'ROSO-plus' failed in 13 (21%) patients. Patients with subretinal fluid (SRF) in the inferior quadrants of the fundus during 'ROSO-plus' were particularly at risk of failure at 86% (six of seven patients) vs 12.5% (7/56) for the remainder (P=0.0002, relative risk=6.9, 95% confidence interval 3.2-14.6). The overall success rate at final follow-up (after any further surgery) for a flat retina without oil in situ was 83%. CONCLUSION: The 'ROSO-plus' procedure allowed identification of problems expected to result in anatomical failure. Treatment did not prevent a high rate of postoperative retinal detachment. Refinement of the treatment algorithm is required with perhaps more use of silicone oil reinsertion in high-risk eyes.

Adolescent↗
PubMed2002

[Retinal detachment due to macular hole: therapeutic problems].

UNLABELLED: To compare the success rate and the visual improvement of different surgical techniques for treating 21 retinal detachments due to macular hole in highly myopic eyes. METHODS: Twelve patients were treated by gas tamponade alone, 5 patients underwent vitrectomy with gas tamponade, 4 patients underwent vitrectomy with epiretinal membrane pealing and gas or oil silicone tamponade. RESULTS: Fifty eight % of patients were successfully treated after gas tamponade alone, and 75% after vitrectomy, epiretinal membrane pealing and gas or silicone oil tamponade. After retreatment in 7 patients, the final reattachment rate was 80%. Visual acuity was inchanged in 12 cases, improved to 1/20-1/10 in 8 case and reached 3/10 in 1 case. CONCLUSION: A therapeutic scheme is suggested according to the type of retinal detachment, macular vitreoretinal traction and pigment epithelium and chorioretinal degeneration condition.

Adult↗
PubMed1983

[Superior bullous retinal detachment: value of the intravitreous injection of sulfur hexafluoride].

15 cases of superior bullous hemi-retinal detachment were repaired during a 16-month period, with a post-operative follow-up of 3-19 months. Intravitreal injection of 0,75-1,5 cc of pure sulfur hexafluoride (SF 6) was performed in 9 cases. The indications for injection at the end of the procedure were: 1) absence of chorioretinal contact in spite of an indentation in the correct position; 2) fishmouth configuration of the retinal break; 3) presence of radial folds over an indentation parallel to the limbus. Only two out of patients required a second operation, due to the development of proliferative vitreoretinopathy. One case was unsuccessful because of a redetachment secondary to massive periretinal proliferation. No complication was observed with the injection of SF 6. In particular, ocular hypertension was avoided by controlling the amount of gas used, always inferior to 2 cc, and postoperative treatment with acetazolamide and topical timolol. The intraocular injection of SF 6 appears to be useful contribution to the surgical treatment of superior bullous hemi-retinal detachment, allowing effective and durable internal tamponade, while avoiding prolonged bedrest.

Absorption↗
PubMed1996

[The diagnoses and treatment of traumatic retinal detachment].

PURPOSE: The diagnoses and treatments of traumatic retinal detachment (RD) were studied retrospectively in this article. METHODS: A sequence of 25 eyes of traumatic RD included 12 eyes of contusion, 4 explosion and 9 perforation; PVR (Proliferative vitreoretinopathy) < or = C grade 16 eyes and D grade 9 eyes. The techniques were, one: scleral cryotherapy, silicon band buckling and circling, external drainage, which was mainly used to PVR < or = C cases; two: vitrectomy and silicon oil tamponade, which was mainly used to the cases of perforated PVR-D cases. RESULTS: Retinal reattachment rate was 91.67% in technique one and 69.23% in technique two. Improvement of visual acuity showed that partial RD was better than total RD (P < 0.01), PVR < or = C better than PVR-D (P < 0.05) and non-perforated better than perforated (P < 0.05). CONCLUSION: The patient who had a history and visual symptoms after an eye injury must be carefully examined by dilating pupil in order that the RD could be early inquired and treated. The techniques one and two must be performed in the severe perforated cases.

Adolescent↗
PubMed2002

[Traction retinal detachment, optic atrophy, apallic syndrome after shaking trauma in an infant].

INTRODUCTION: Ophthalmological examinations are important in children with suspected shaken baby and/or battered child syndrome. Retinal and epiretinal haemorrhages can indicate non-accidental injuries. We observed a case of extensive retinal hemorrhages, edema of the optic disc followed by development of optic atrophy, neovascularisation and tractional retinal detachment over the course of months. CASE REPORT: A 6-week-old infant with no history of systemic disease or trauma was admitted to the children's hospital because of a disorder of consciousness, respiratory insufficiency, taut fontanel and dilated pupils with sluggish reaction to light. A subdural haematoma was diagnosed. Ophthalmological examination showed no signs of trauma in the anterior segment. Ophthalmoscopy revealed extensive retinal haemorrhages and swollen optic nerve heads. During the next months optic atrophy, subretinal fibrosis at the posterior pole, neovascularisation at the optic disc and non-rhegmatogenous retinal detachment developed. The child is in a persistent vegetative state. DISCUSSION: Non-accidental injuries can cause direct trauma and indirect traumatic sequelae. Retinal haemorrhages, especially in conjunction with unexplained trauma or changes of consciousness should arouse suspicion of shaken baby syndrome. The ophthalmologist should emphasize this and strongly recommend further investigation if not previously undertaken.

Battered Child Syndrome↗
PubMed1989

[Microvitreous surgery combined with scleral encircling for the treatment of complex retinal detachments].

50 cases (50 eyes) of various complex retinal detachments (RD) were treated with a combination of vitrectomy, membrane peeling, intraocular air tamponade and scleral encircling. RD with opaque media, RD with proliferative vitroretinopathy, traction RD due to trauma or other factors, RD with posterior breaks, and giant tears were included. During the follow-up periods of 3-12 months, 27 cases (54%) obtained anatomic reattachment, 23 failed (46%). Of the successful case, 24 eyes achieved improvement, 2 eyes remained unchanged, and one eye became worse in their vision. The surgery complications were: retinal haemorrhage, choroidal haemorrhage, iatrogenic tears, and the development of cataract.

Adolescent↗
PubMed1986

Retinal detachment after intraocular lens implantation.

Between August 1982 and July 1985, 19 eyes were operated for pseudophakic retinal detachment (PRD) (Anterior chamber lens in 13 eyes, posterior chamber lens in 3 eyes and iris supported lens in 3 eyes). The characteristics of these pseudophakic retinal detachments were very similar to those following intracapsular cataract extractions. Retina was re-attached in 18 eyes (95%), in 14 eyes, after one buckling procedure. In 4 eyes, altogether 12 surgical procedures were needed to re-attach the retina. Problems to visualize the peripheral retina, made it necessary to remove the IOL in 3 eyes (2 iris fixated and one in the anterior chamber).

Adult↗
PubMed1982

Prophylactic argon laser photocoagulation in retinal detachment fellow eyes.

Over a two-year period (1975-76) 329 patients were operated for rhegmatogenous retinal detachment. 301 patients had unilateral detachment and in 62 of these prophylactic photocoagulation with argon laser in the fellow eye was performed. During the observation time one of these (1.6%) and 7 untreated (2.9%) fellow eyes developed retinal detachment. The indication for prophylactic photocoagulation of fellow eyes and the results are discussed.

Adult↗
PubMed1994

Effect of leukopenia on experimental post-traumatic retinal detachment.

Macrophages are invariably present in the intraocular membranes of patients with traumatic proliferative vitreoretinopathy (PVR). There are two sources from which these macrophages could be recruited: adjacent tissues and the systemic circulation. In the study described herein, the role of circulating white blood cells and monocytes in experimental, traumatic PVR was studied. The circulating white blood cells of 20 rabbits were depleted by intravenous injection of strontium-89. Posterior perforating eye injury with subsequent intravitreal injection of autologous whole blood or autologous activated macrophages was then performed on these leukopenic animals. The experiments demonstrated that severe bone marrow depression reduced significantly the incidence of retinal detachments in eyes receiving whole blood, and reduced the severity of retinal detachments in eyes injected with activated macrophages. An association between the degree of leukopenia, monocytopenia, and protection from retinal detachment was demonstrated. These results support the hypothesis that macrophage infiltration is an important component of intraocular cellular proliferation, but does not exclude the role of other types of white blood cells in the pathogenesis of PVR.

Animals↗
PubMed1978

Absorption of subretinal fluid after nondrainage retinal detachment surgery.

A total of 134 cases of retinal detachment treated with a single successful nondrainage operation were studied to assess the rate of absorption of subretinal fluid in the postoperative period. It has been found that the relationship of the tear to the buckle at the end of the operation is an indicator of the rate of absorption of subretinal fluid that can be expected in the postoperative period. The age of the detachment or the age of the patient did not appear to be significant factors in influencing absorption. In 28 cases (21%), absorption of subretinal fluid took longer than one week. This delay in absorption shows that conservatism regarding early reoperation should be urged unless a definite cause of failure (such as a missed tear) can be found.

Absorption↗
PubMed1990

[The indications for and sequence of vitrectomy and scleroplastic operations in posttraumatic retinal detachment and vitreous body pathology (1)].

The paper presents a clinical analysis of surgical treatment of 378 patients (426 operations) with posttraumatic retinal detachment. A broadened variant of a classification of traumatic retinal detachment signs in associated pathology of the retina and vitreous body is proposed. Recommendations are worked out concerning the approach of surgical treatment of traumatic detachment with determination of indications and the sequence of vitrectomy and scleroplastic operations. It is advisable to assess the effectiveness of surgical intervention in this pathology in more delayed terms.

Adolescent↗