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PubMed1987

Types of avulsed retinal vessels associated with rhegmatogenous retinal detachment: treatment and results.

We performed a prospective study of 87 cases with avulsed retinal vessels in conjunction with tears and rhegmatogenous retinal detachment. The postoperative follow-up period ranged from 6 months to 5 years. The avulsed vessels were classified according to their location (peripheral or central) as well as with respect to their form (5 types). The surgical procedure comprised the fixation of an episcleral sponge implant (high indentation), cryoapplication, and, if necessary, laser coagulation or endodiathermy at a later stage. The postoperative condition of the avulsed vessel mainly depended on its location, the type of avulsion, and the buckle height.

Humans↗

PubMed1999

Racial difference in the incidence of retinal detachment in Singapore.

OBJECTIVE: To determine the incidence of retinal detachment (RD) operations in a multiracial Southeast Asian population. DESIGN: Population-based incidence study using a universal medical savings database in Singapore. METHODS: Information on all RD operations performed for rhegmatogenous RD (International Classification of Diseases, Ninth Revision, Clinical Modification code 361.0) between 1993 and 1996 was retrieved and analyzed from a population-wide, government-administered medical savings database. Exudative, tractional, and unoperated-on rhegmatogenous RD are excluded. The 1990 Singapore population census was used to allow an estimation of age-, sex-, and race-specific annual incidence of RD. RESULTS: Between 1993 and 1996, 1126 RD operations were performed on Singapore residents. The average annual incidence of RD operations was 10.5 per 100,000 population (95% confidence interval [CI], 10.2-10.9). The annual incidence was highest for Chinese (age-adjusted incidence, 11.6 per 100,000), followed by Malays (7.0 per 100,000), and lowest for Indians (3.9 per 100,000). The age-adjusted relative risk of RD operation for Chinese compared with Indians was 3.0 (95% CI, 2.9-3.1). Males were twice as likely as females to require RD surgery (age-adjusted relative risk, 2.0; 95% CI, 1.7-2.4). Chinese men 40 years and older had a 30.9 times higher risk (95% CI, 9.9-96.1) than Indian females younger than 40 years. CONCLUSION: The incidence of RD is strongly associated with male sex and ethnic origin.

Adolescent↗

PubMed2006

Optical coherence tomography analysis of the macula after vitrectomy surgery for retinal detachment.

OBJECTIVE: To define the incidence, duration, and clinical associations of persistent localized submacular fluid after pars plana vitrectomy (PPV) retinal detachment surgery. DESIGN: Observational cohort series. PARTICIPANTS: One hundred patients were identified and recruited into the study. METHODS: Patients aged 18 years and older who had undergone PPV and gas as a primary procedure for rhegmatogenous retinal detachment and postoperative follow-up were recruited from February through August 2004. All patients underwent clinical examination, optical coherence tomography (OCT) scan of the macula, and retinal thickness analysis scan of the macula. Those patients in whom an abnormality was seen on OCT at 6 weeks after surgery underwent follow-up with repeat of the study investigations at 3, 6, 9, 12, and 18 months after surgery until the abnormality resolved. If no abnormality was seen at the 6-week examination, no further investigation was undertaken. Demographic data, including detachment characteristics, were collected retrospectively from the patient case notes. MAIN OUTCOME MEASURES: The principle outcome measure was the presence of subretinal fluid (SRF) on OCT at 6 weeks after surgery. Other outcome measures included duration of persistent fluid and association with visual outcome and type and duration of detachment. RESULTS: One hundred patients were recruited; 15 of these had SRF on OCT performed at 6 weeks after surgery. Subretinal fluid was associated with significantly worse visual acuity (VA) at 6 weeks (P = 0.033, Wilcoxon rank-sum); those with SRF had a median VA of 0.4, and those with no SRF had a median VA of 0.3. The fluid took a median of 5.5 months to resolve. Seven patients had combined PPV and scleral buckle surgery; none of these had fluid at 6 weeks. CONCLUSIONS: Optical coherence tomography is a useful noninvasive diagnostic method that can detect SRF not appreciated on clinical examination. Persistent SRF after PPV and gas surgery occurred in 15% of patients in this study and was still present in 53% of these at 6 months. The presence of SRF at 6 weeks after surgery was associated with a poorer visual outcome at this time point.

Adult↗

PubMed1979

Macular pigment deposits in rhegmatogenous retinal detachment.

This is a study of 20 cases of macular migration after operation for retinal detachment. The frequency of pigment deposits on the macula among the total number of operated detachments was 6.4%. The evolution of pigment migration depened on the form and type of the deposits. In some cases the pigment diminished or disappeared. In 6 of the 20 eyes with pigment migration puckering of the macula occurred 4 months or more after surgery. The improvement in visual acuity 6 months and more after operation was relatively less in the group with pigment deposits than in the group without pigment. In the former group static perimetry showed defects corresponding to the pigment migration.

Aged↗

PubMed2006

Lensectomy and vitrectomy with and without intravitreal triamcinolone acetonide for vascularly active stage 5 retinal detachments in retinopathy of prematurity.

PURPOSE: To determine the anatomical success rate of lensectomy and vitrectomy with and without intravitreal triamcinolone acetonide (TA) for vascularly active stage 5 tractional retinal detachments due to retinopathy of prematurity (ROP). METHODS: In a retrospective, interventional, single-surgeon, consecutive case series, the records of 21 eyes of 21 patients presenting with stage 5 retinal detachment secondary to ROP who underwent primary pars plicata vitrectomy with lensectomy from February 1998 to January 2004 were evaluated. All eyes were vascularly active at the time of surgery. Eleven eyes underwent the surgical procedure without TA (group 1), and 10 eyes received TA at the end of the procedure (group 2). The main outcome measure, retinal reattachment, was reviewed at the final follow-up visit, which ranged from 6 months to 42 months (mean, 28 months) after surgery. RESULTS: None (0/11) of the eyes in group 1 maintained attachment, while 6 (60%) of 10 eyes in group 2 maintained at least posterior pole reattachment at the final visit. None of the group 2 eyes exhibited plus disease during follow-up. None of the eyes in either group exhibited signs of increased intraocular pressure after surgery. All six eyes that maintained posterior pole reattachment were able to fix and follow light at the last follow-up visit. CONCLUSIONS: Vascularly active stage 5 ROP detachments portend a poor progress. The use of TA as a postoperative adjunct may improve the likelihood of retinal reattachment in select cases.

Birth Weight↗

PubMed1987

Silicone oil in the treatment of complicated retinal detachments.

Silicone oil is now used with increasing frequency to treat cases of complicated retinal detachment (RD). The authors report their results using silicone oil in eyes with RD resulting from proliferative diabetic retinopathy (PDR) or proliferative vitreoretinopathy (PVR). The retina was completely reattached at last examination in 16 (70%) of 23 eyes with PDR and 20 (67%) of 30 eyes with PVR. Final vision of 5/200 or better was obtained in 5 eyes with PDR (22%) and 16 eyes with PVR (53%) (P = 0.0016). Reproliferation of epiretinal membranes occurred in 26% of diabetics and 23% of eyes with PVR. Silicone oil did not cause regression of iris neovascularization. Complications of silicone oil included corneal decompensation, lens opacification, intraocular pressure elevation, and hypotony.

Diabetic Retinopathy↗

PubMed2006

Artisan phakic intraocular lens implantation after retinal detachment surgery.

PURPOSE: To report three cases of Artisan phakic intraocular lens (PIOL) implantation to correct myopic refractive error after previous retinal detachment surgery treated with scleral encircling. METHODS: Artisan PIOLs were implanted in a 29-year-old man with -21.0 -2.0 x 180 manifest refraction and best spectacle-corrected visual acuity (BSCVA) of 20/40 (case 1), a 28-year-old woman with BSCVA of 20/20 and -8.5 -1.0 x 180 manifest refraction (case 2), and a 44-year-old man with BSCVA of 20/32 and -11.75 -1.75 x 10 manifest refraction (case 3). RESULTS: In case 1, 24 months after implantation of the Artisan PIOL, uncorrected visual acuity (UCVA) was 20/40. In case 2, 24 months after surgery, UCVA was 20/32. In case 3, 3 months after surgery, UCVA was 20/32. There was no formation of new breaks, progressive vitreoretinal traction, or complications. CONCLUSIONS: The Artisan PIOL may provide an alternative method to correct high myopia after retinal detachment surgery.

Adult↗

PubMed1995

Serous retinal detachment of the macula associated with cat scratch disease.

PURPOSE: We studied an unusual ocular manifestation of cat scratch disease. METHODS: We examined a patient who had a serous retinal detachment of the macula with vision loss out of proportion to her retinal findings. RESULTS: The patient was found to have cat scratch disease by antibody titers. CONCLUSION: Cat scratch disease should be considered in patients with a serous neurosensory retinal detachment of the macula and a history of cat exposure or systemic signs or symptoms consistent with the disease.

Adult↗

PubMed1989

Perfluorocarbon liquids in the management of traumatic retinal detachments.

Low viscosity perfluorocarbon liquids were used as an intraoperative tool during vitrectomy for retinal detachment (RD) after penetrating ocular trauma. These liquids are immiscible with water and have specific gravities from 1.8 to 1.9. Intraoperatively, the perfluorocarbon liquids flattened the retina in 14 eyes by displacing the subretinal fluid through peripheral breaks. Posterior retinotomy was not required for internal drainage of subretinal fluid. Pooled subretinal fluid was displaced from the macular area in five patients. The perfluorocarbon bubble mechanically stabilized the retina during epiretinal membrane dissection. The perfluorocarbon liquid was removed and replaced perfluorocarbon gas or silicone oil. In 11 patients followed for more than 6 months after the final surgery, eight (73%) eyes were anatomically successful, with six (54.5%) gaining visual acuity of 20/400 or better.

Adolescent↗

PubMed2004

Juvenile rhegmatogenous retinal detachment.

PURPOSE: To review the clinical features, evaluate visual, and anatomical outcomes and potential complications following surgery for rhegmatogenous retinal detachment (RRD) in juveniles. METHODS: Retrospective, consecutive case series of children and young adults (birth through 18 years) who underwent surgerys for RRD between February 1999 and January 2002. RESULTS: The authors reviewed a consecutive series of 111 eyes of 105 juveniles [86 (77.47%) eyes belonged to male and 25 (22.52%) to female subjects] operated for RRD. The mean age of patients was 13.62 years. Bilateral retinal detachment was present in 12 (10.8%); 51 (46%) patients had some form of bilateral ocular pathology at initial presentation. The two most common aetiologies were non-penetrating trauma (45.04%) and myopia (41.44%). Decreased vision was the most frequent symptom. The mean duration of symptoms was 165.36 days. The commonest retinal break was a retinal hole (34.23%). Late diagnosis was common, evidenced by high frequency of macular detachment (97.29%) and proliferative vitreoretinopathy (PVR) (45.94%) at initial presentation. The most commonly performed primary surgery was scleral buckle (61.26%). The average postoperative follow-up after the first procedure was 10 months (range 8-19 months). Final retinal reattachment was accomplished in 78.37% (87/111) with a mean of 1.29 surgeries per eye. Improvement, no change and decline in vision was seen in 50 (48%), 32 (31%) and 22 (21%) eyes respectively. CONCLUSION: Non-penetrating injury and myopia were the most common cause for RRD in juveniles. Fellow eyes commonly had vision-threatening abnormalities. Final anatomical and visual recovery rates were encouraging despite late initial presentation and high rates of macular detachment, and PVR at initial presentation.

Adolescent↗

PubMed1992

Traction retinal detachment due to preretinal proliferation of surface epithelium.

A seven-year-old boy sustained severe blunt trauma with globe rupture. After repair of the globe and lensectomy and vitrectomy, a fistula was noted along with epithelial downgrowth on the posterior surface of the cornea. Extensive peripheral preretinal membrane formation resulted in traction retinal detachment. The fistula was excised and the preretinal membranes were removed. Pathologic examination of the membrane revealed it to be composed of surface epithelium. Retinal reattachment was achieved with intravitreal injection of silicone oil. This case illustrates that surface epithelium can proliferate on the inner retina and can lead to tractional retinal detachment.

Athletic Injuries↗

PubMed1997

Pars plana vitrectomy for retinal detachment due to internal posterior ophthalmomyiasis after cataract extraction.

BACKGROUND: The authors report a case of posterior internal ophthalmomyiasis causing vitreous haemorrhage and retinal detachment after uncomplicated cataract extraction. CASE REPORT: The patient suffered an abrupt vitreous haemorrhage 9 days after ECCE and posterior chamber IOL implantation. After 2 months the haemorrhage did not clear up and a retinal detachment arose. The patient underwent encircling scleral buckle, pars plana vitrectomy and fluid-gas exchange. In course of intervention the surgeon removed from the vitreous chamber a 14-mm-long round worm subsequently identified as a dipterous larva of the Sarcophagidae family. DISCUSSION: The patient showed no sign of subretinal tracking or retinal breaks or holes. The sclerocorneal surgical wound seems the most likely site of entrance of the parasite, and this would then be the first reported case of myiasis with no RPE tracking.

Aged↗

PubMedDate not supplied

Cone electroretinograms in response to color stimuli after successful retinal detachment surgery.

Cone electroretinograms (ERGs) in response to different color flashes were examined using a Ganzfeld stimulus in 19 eyes after successful retinal detachment surgery. In the operated eyes, the short wavelength sensitive (S-) cone b-wave was reduced more than the mixed long (L-) and middle (M-) wavelength sensitive cone b-waves. The ratio of the S-cone ERG b-wave amplitude between operated eyes and fellow eyes was significantly lower than the L- and M-cone ERG b-waves (P < .01). These ERG results indicated that the S-cone system is more impaired than the L- and M-cone systems after retinal detachment surgery.

Adolescent↗

PubMed1997

[Lenticular-vitreoretinal surgery for complicated retinal detachment].

OBJECTIVE: To study the efficacy of vitreoretinal (VR) surgery combined with lensectomy/ultrasonic fragmentation. METHODS: Eight-one patients (eyes) with complicated retinal detachment treated with combined lenticular-vitreoretinal (LVR) surgery were reviewed retrospectively. RESULTS: Anatomic success was achieved in 64 (79.01%) eyes, and functional success in 45 (55.56%) eyes. Anterior proliferative vitreoretinopathy (PVR) and intraocular hemorrhage (IOH) significantly reduced the anatomic success rate to 42.86% (P < 0.01) and 58.82% (P < 0.025) respectively. CONCLUSIONS: LVR surgery plays an important therapeutic role in treatment of complicated retinal detachment. The significant factors affecting the surgical outcome are anterior PVR and intra-/post-operative IOH.

Adolescent↗

PubMed1994

Rhegmatogenous retinal detachment after Molteno glaucoma implant surgery.

BACKGROUND: The Molteno implant is a device used for surgical treatment of complicated glaucoma. Rhegmatogenous retinal detachment (RD) is a relatively rare complication of Molteno implant surgery. This study was undertaken to evaluate the clinical features including the surgical management and postoperative outcome of patients with rhegmatogenous RD after Molteno implant surgery. METHODS: The authors reviewed 350 consecutive patients who had Molteno surgery and identified 16 patients with subsequent rhegmatogenous RD. They also studied one patient referred for RD repair after Molteno surgery at another institution. RESULTS: The risk of rhegmatogenous RD was 5%. Seventy percent (12/17) of the patients presented within 4 months of the Molteno procedure. Dialysis and flap tear were the most common types of retinal break found. Forty-one percent (7/17) of the patients had proliferative vitreoretinopathy. In three patients, clinical features suggested RD resulting from the Molteno procedure. In other patients, previous ocular surgery and underlying ocular disease may have contributed to the development of RD. Retinal detachment repair was attempted in all patients. Among 16 patients with at least 6 months of follow-up, 56% (9/16) had successful retina attachment. Forty-four percent (7/16) of the patients maintained formed vision. Eighteen percent (3/16) of the patients maintained visual acuity of at least 20/40. Intractable glaucoma did not develop in any of the patients with an attached retina. Recurrent RD, endophthalmitis, cyclitic membrane, or intractable glaucoma led to phthisis bulbi or enucleation in 44% (7/16) of the patients. CONCLUSION: A combined approach by vitreoretinal and glaucoma surgeons can restore vision and maintain glaucoma control in patients with rhegmatogenous RD associated with Molteno implant surgery.

Adolescent↗

PubMed1992

Treatment of dislocated crystalline lens and retinal detachment with perfluorocarbon liquids.

Removal of a crystalline lens dislocated into the vitreous cavity can be hazardous, particularly in the presence of a retinal detachment. Hard pieces of nuclear material may be difficult to extract and may repeatedly fall onto the retina when emulsification is attempted in the vitreous cavity. Cases involving four eyes with dislocated crystalline lens and rhegmatogenous retinal detachment, into which liquid perfluorocarbon was injected after vitrectomy to float the dislocated lens material off the retina and reattach the retina, are reported. The dislocated lens was removed while floating on the perfluorocarbon liquid, which also provided a cushion that prevented dropped fragments of lens from traumatizing the retina. In all four cases, surgery was not associated with complications and resulted in improvement in visual acuity and retinal reattachment.

Adult↗

PubMed1982

Exudative retinal detachment in Wegener's granulomatosis: case report.

We have presented a case of Wegener's granulomatosis with characteristic systemic and ocular manifestations. The diagnosis was determined pathologically by thoracotomy and lung biopsy. Our patient's ocular complications included an intense vitritis, exudative retinal detachment, choroiditis, and other corneoscleral manifestations. Exudative retinal detachment is a finding not previously described clinically, but alluded to in pathologic descriptions from case reports. Both systemic and ocular response were obtained within weeks after the patient started cyclophosphamide and prednisone. In addition to recording this new finding, we have reviewed the pathology and ocular manifestations of this uncommon disorder, outlined a modern therapeutic protocol, and updated the present-day prognosis of Wegener's granulomatosis.

Cyclophosphamide↗

PubMed2002

[Scleral surgery of retinal detachment without drainage of subretinal fluid and no cryotherapy].

PURPOSE: To evaluate anatomic and functional results in patients treated for uncomplicated rhegmatogenous retinal detachment (RD) with scleral surgery without the use of subretinal fluid (SRF) drainage and using no cryotherapy. MATERIAL AND METHOD: We present a retrospective study of 76 patients who underwent RD scleral surgery without cryotherapy or SRF drainage. We analyze postoperative outcomes and the incidence of intraoperative and postoperative complications. RESULTS: The average of our retinal reapplications totals 90.78%, which is similar to those described by other types of surgical techniques, while our intraoperative and postoperative complications are dramatically reduced including improvement of functional results. CONCLUSIONS: Scleral surgery for retinal detachment using no drainage of subretinal fluid nor cryotherapy is a useful technique for the treatment of RD.

Adolescent↗