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PubMed1998

[The effect of total protein and albumin levels in serum on retinal detachment due to EPH-gestosis].

The purpose of the report is to describe a 31-year-old pregnant woman with EPH-gestosis presenting typical clinical features of bilateral retinal detachment. We noticed that it was associated with low degree of total protein and albumin in serum. Shortcoming protein balance was associated with adhibition of retinae. Attention is paid to the fact that elevation of retinal detachment responded to the treatment involving parenteral administration of albumin. In this case we achieved reattachment of retinae and regained full visual acuity.

Adult↗
PubMed1989

Complications of endodrainage retinotomies created during vitreous surgery for complicated retinal detachment.

The authors report nine cases of endodrainage retinotomy site complications that occurred after vitreous surgery for complicated retinal detachments (RDs). Postoperative subretinal neovascularization developed in four eyes at the retinotomy drainage site. In two eyes, postoperative proliferation at a posteriorly placed endodrainage site created traction macular detachments. Redetachment due to retinotomy opening caused by postoperative drainage site proliferation developed in three eyes. The retinas of all nine eyes were eventually reattached, and vision improved from the preoperative level. These complications are related to retinal pigment epithelium and/or Bruch's membrane damage during internal subretinal fluid drainage and retinotomy endolaser photocoagulation. Careful evaluation of extrusion instruments, drainage techniques, retinotomy placement, and subsequent endolaser treatment is necessary to minimize these complications.

Adolescent↗
PubMedDate not supplied

Changes in axial length after retinal detachment surgery.

PURPOSE: To evaluate changes in axial length and corneal curvature after an encircling procedure combined with segmental buckling. MATERIALS AND METHODS: We prospectively analysed cases with rhegmatogenous retinal detachment treated with an encircling band and scleral buckling surgery, comparing the pre-and postoperative ultrasonographic measurements of axial length and corneal curvature, and patients' age and sex in relation to the axial length of the eyeballs. We studied 74 patients (25 female, 49 male, aged 14-78 years, mean 46.7 years), who underwent retinal detachment surgery in 1995 and 1996. RESULTS: Axial eye length was significantly increased by surgery (median 0.77 mm one month after surgery). One year after treatment the elongation of the eye had decreased by 0.20 mm. The average increase of corneal curvature was 0.22 D one month after surgery, and 0.43 D at one year. The distribution of axial length showed a significant preponderance of eyes with a longer axial length among males. CONCLUSIONS: Encircling with a scleral buckling procedure with moderate indentation causes axial elongation of the eye.

Adolescent↗
PubMed1994

Retinal detachment with tear in the posterior fundus following ocular contusion.

Two unusual cases of rhegmatogenous retinal detachment following contusion to the eyeball showed retinal tears at the posterior fundus close to the optic disc and the large retinal blood vessels. In both cases, the tears were not detected immediately after the injury due to a coexisting vitreous hemorrhage. Both patients were successfully treated by pars plana vitrectomy, air-fluid exchange, and endolaser photocoagulation. During vitrectomies, an adhesion of the vitreous to the flap or the operculum of the tear was observed, with detachment of the remainder of the posterior vitreous from the retina. Vitrectomy allowed a more complete resolution of posterior tractional forces than scleral buckling, and eliminated the vitreous hemorrhage.

Adult↗
PubMed1989

Pseudophakic retinal detachments and post-operative visual acuity.

We reviewed 254 cases of extracapsular cataract extraction and posterior chamber intraocular lenses (ECCE & IOL) which were performed between the years 1983 and 1985 at the Royal Victoria Hospital, Belfast. The aim of the study was to evaluate the incidence of pseudo-phakic retinal detachment in uncomplicated cases of ECCE & IOL. The incidence of retinal detachment (RD) was found to be 0.79% overall. The incidence of other post-operative complications such as posterior capsular thickening was 2.8% and of cystoid macular oedema 1.2%.

Aged↗
PubMed1991

Scleral buckling for rhegmatogenous retinal detachment associated with severe myopia.

From Jan. 1, 1980, to Dec. 31, 1989, we performed scleral buckling surgery on 48 eyes of 46 patients for rhegmatogenous retinal detachments associated with severe myopia (greater than 5.00 diopters). Forty eyes of 38 patients were observed for at least six months, and the mean follow-up period was 46 months. Intraoperative complications occurred in four of 48 eyes (8%) and included retinal incarceration (two eyes), choroidal hemorrhage (one eye), and choroidal detachment (one eye). Three of the 40 eyes (7.5%) followed up for more than six months developed a recurrent retinal detachment and underwent a revision of the scleral buckle. At the last follow-up examination, the retinas of all 40 eyes were totally reattached. Final visual acuity of 20/40 or better was attained in 26 of 40 eyes (65%). Because of the low rate of intraoperative complications and the high rate of success, scleral buckling is recommended for most patients with rhegmatogenous retinal detachments associated with severe myopia.

Adolescent↗
PubMed1988

Pneumatic repair of primary and secondary retinal detachments using a binocular indirect ophthalmoscope laser delivery system.

Using intravitreal gas injection of sulfur hexafluoride after retinopexy utilizing a binocular indirect ophthalmoscope argon laser delivery system, the authors treated 12 primary rhegmatogenous retinal detachments and 10 detachments which recurred after previous scleral buckle surgery. Topical anesthesia only was used in most of the cases (18 of 22). Detachments in all quadrants of the fundus were repaired. Twenty cases remained successfully attached after a minimum follow-up of 6 months. Two failures occurred early in eyes with primary retinal detachments and both were successfully repaired by conventional scleral buckling techniques. The authors found pneumatic retinal reattachment in conjunction with laser retinopexy to be particularly valuable in repairing secondary detachments, thereby avoiding conventional surgical reoperations.

Cryosurgery↗
PubMed1990

[Prevention of retinal detachment. I. Cryopexy before cataract extraction. Preliminary report].

The authors discuss the results of cryopexy applied prophylactically in 32 eyes. The freezing was executed at least 6 weeks before the cataract extraction in eyes endangered by retinal detachment. This were the high myopia eyes, so called fellow eyes and eyes in persons aged between 30 and 40 years. Retinal detachment did not occur in either of the observed eyes in the period of 1-5 years.

Adult↗
PubMed2000

Epiretinal membranous tissue in retinal detachment due to macular holes in highly myopic eyes

Objective: To determine the frequency of occurrence of epiretinal membranous tissue in retinal detachment due to macular hole and to evaluate the efficacy of vitreous surgery including removal of the membrane.Design: Noncomparative case series.Participants: Eighteen highly myopic eyes with retinal detachment due to macular holes. Results: Epiretinal membranous tissue was removed from 7 eyes (39%) and retinal reattachment was obtained in 14 eyes (78%) after the initial vitreous surgery. Of 4 eyes that required reoperation, 2 eyes achieved reattachment after a long term of internal tamponade. Histological examination of an epiretinal membrane from one case revealed that it was composed of glial cells, connective tissue, and fragments of inner limiting membrane. An intraoperative use of autologous serum as a tissue adhesive for macular holes had no effect on surgical success.Conclusion: The first therapeutic choice for this disease should be vitreous surgery with removal of the epiretinal membrane when practical, though the membrane cannot always be identified in every case.

Journal Article↗
PubMed1999

Effects of the neurotrophin brain-derived neurotrophic factor in an experimental model of retinal detachment.

PURPOSE: To examine the effects of brain-derived neurotrophic factor (BDNF) in an animal model of retinal detachment. METHODS: Cat retinas were detached from the retinal pigment epithelium for either 7 or 28 days. Animals received either an intravitreal injection of BDNF (100 ILg) or phosphate-buffered saline (PBS), the vehicle for BDNF. Retinas were evaluated using morphology and immunocytochemistry. The width of the outer segment zone was measured, and the retinas were evaluated for changes in protein expression by labeling with antibodies to rod opsin, phosducin, synaptophysin, calbindin D, and glial fibrillary acidic protein (GFAP). The effect of BDNF on both proliferation and apoptotic cell death was examined. RESULTS: Although there was variability in the treated retinas, most of the animals receiving BDNF had well-organized outer segments that were longer than those in vehicle-treated controls. Immunocytochemistry revealed that treated retinas had consistently less opsin redistribution to the plasma membrane, less phosducin upregulation, and fewer calbindin D-labeled horizontal cell processes. BDNF did not reduce overall cell death in the detachments or death of photoreceptors by apoptosis. However, it significantly reduced the proliferative response of Miller cells and the extent of upregulation of GFAP. CONCLUSIONS. The results suggest that BDNF may aid in the recovery of the retina after reattachment by maintaining the surviving photoreceptor cells, by reducing the gliotic effects in Müller cells, and perhaps by promoting outer segment regeneration.

Animals↗
PubMedDate not supplied

Relation of posterior staphyloma in highly myopic eyes with macular hole and retinal detachment.

PURPOSE: To investigate whether the type of posterior staphyloma (PS) affects the development of macular hole and retinal detachment (MHRD) in high myopia. METHODS: Included in this retrospective study were 28 highly myopic eyes with MHRD (MHRD group) and 47 highly myopic eyes without MHRD (control group). The presence or absence of PS and the type of PS according to the classification of Curtin, the postoperative visual acuity, and the retinal reattachment rate were investigated. RESULTS: The percentage of eyes with PS was significantly higher in the MHRD group than in the control group (P < 0.001). The rate of type II PS was significantly higher in the MHRD group (P = 0.01). There were no significant differences among the types of PS regarding the retinal reattachment rates and visual outcome. CONCLUSIONS: Eyes with type II PS have a higher risk for the development of MHRD. However, the type of PS did not seem to affect the anatomic and visual outcome.

Adult↗
PubMed1987

Retinal detachment after extracapsular cataract extraction with posterior chamber intraocular lens.

The authors reviewed 3065 consecutive cases of extracapsular cataract extraction with posterior chamber lens implant (ECCE-PC IOL) and found the incidence of retinal detachment to be 1.4% overall (44/3065) and 1.7% in a group of eyes followed for at least 1 year (40/2330). Retrospective analysis of the retinal detachment (RD) group (n = 44) showed the patients to be significantly younger than the overall group (n = 3065) (P less than 0.0001). Comparison with an age-matched group of 302 eyes without RD showed higher rates of RD in males (P = 0.0013) and in eyes with axial eye length (AEL) greater than 25 mm (P less than 0.0001). No significant correlation was found between RD and PC IOL manufacturer, phacoemulsification (PKE), or primary discission. Sixty-four percent of RDs occurred within 1 year of cataract operation. Only 10% occurred more than 2 years later. Visual results in eyes with ultimate anatomic success of RD repair (43 of 44 eyes, averaging 15 months follow-up) are substantially better than previously reported in series with other types of IOLs (96% greater than or equal to 20/40 if the macula was not involved, 75% greater than or equal to 20/40 if the macula was involved).

Age Factors↗
PubMed1984

Retinal detachment in myopic eyes after intracapsular and extracapsular cataract extraction.

We analyzed two consecutive series of cataract extractions in patients with moderate to severe myopia for the incidence of postoperative retinal detachment. One series consisted of 122 intracapsular cataract extractions without surgical loss of vitreous and the other series consisted of 151 extracapsular (phacoemulsification and planned extracapsular) cataract extractions without loss of vitreous and with intact posterior capsules. All patients were 40 years of age or older and all were followed up for one to four years. We defined moderate to severe myopia as an aphakic refraction of +7.00 diopters spherical equivalent or less. The rate of postoperative retinal detachment was greater in the intracapsular series (seven of 122 cases; 5.74%) than in the extracapsular series (one of 151 cases; 0.66%).

Adult↗
PubMed1993

[Evaluation of surgical methods of treatment for retinal detachment].

During last year we have used episcleral buckling and cryopexy in 63 eyes with retinal detachment. Final reattachment of the retina after 6 months follow-up was achieved in 52 eyes (83%) after one or two surgical procedures. 4 patients refused further surgery. In 7 cases pars plana vitrectomy and silicone oil tamponade were used. In 4 cases complete retinal reattachment was obtained. In further 2 eyes central retina was attached but flat detachment in the lower part of the retina was observed. Visual acuity of 0-0.5/50 was achieved in 5 eyes, 1/50-4/50 in 5 eyes, 5/50-5/12 in 18 eyes and 5/10-5/5 in 35 eyes. Our results show that the majority of cases with retinal detachment can be successfully treated with episcleral buckling and cryopexy. Pars plana vitrectomy and silicone oil tamponade allowed some success in only the small number of eyes that otherwise would have a prognosis.

Female↗
PubMed2006

Scleral buckling procedures for longstanding or chronic rhegmatogenous retinal detachment with subretinal proliferation.

OBJECTIVE: To investigate longstanding or chronic retinal detachments (RDs) with subretinal strands and their clinical features and therapeutic effects using conventional retinal surgery. DESIGN: Retrospective, consecutive, noncomparative case series. PARTICIPANTS: Cases of 36 patients (40 eyes) with longstanding RD and subretinal proliferation who had undergone scleral buckling or encircling procedures between January 1, 1995 and October 31, 2003 at one institution were reviewed. METHODS: A retrospective analysis of the patient data was conducted from the medical records. MAIN OUTCOME MEASURES: Visual acuity (VA) and postoperative anatomic retinal reattachment at the final follow-up visit between 3 and 24 months (mean, 6.9). RESULTS: Forty eyes with an RD (mean duration, 13.8 months) treated with scleral encircling and buckling had a 90% cure rate after one surgery. The VA levels increased in 77.5% of eyes to over 5/100 at the final follow-up visit. Longstanding or chronic RD with subretinal proliferation had subretinal proliferative strands (i.e., a shallow RD) and a smooth atrophic detached retina, not a thickened retina. CONCLUSIONS: Our results suggest that scleral encircling and buckling can be used in most patients with a longstanding RD. The chronic pathologic course of longstanding rhegmatogenous RD should be considered before treatment.

Adolescent↗
PubMed1989

The fellow eye of patients with phakic lattice retinal detachment.

A retrospective study was performed to determine whether the prophylactic treatment of areas of lattice degeneration, holes, or breaks reduced the risk of subsequent new breaks or detachment in the fellow undetached phakic eyes of patients with a phakic lattice retinal detachment (RD). Three hundred eighty-eight consecutive patients who presented to the University of Iowa between 1959 and 1984 were followed for a mean of 7.9 +/- 5.8 years after the detachment in the first eye. Fellow eyes which received no prophylactic treatment had a 2.5 times greater risk of a new break or RD over 7 years than eyes receiving full prophylactic treatment (19.4 versus 7.5%; P = 0.0002). Fellow eyes receiving no treatment also had a greater risk of a new RD over 7 years than eyes receiving full treatment (5.1 versus 1.8%; P = 0.0125). These results do not allow us to make recommendations concerning which fellow eyes, if any, should be prophylactically treated. On the one hand, prophylactic treatment did significantly reduce the risk of new breaks and detachments. On the other hand, however, prophylactic treatment reduced the risk of new RD alone in the fellow eye only from 5.1 to 1.8% over 7 years. In addition, prophylactic treatment did not reduce the risk of detachment in the higher risk eyes with high myopia or extensive lattice.

Follow-Up Studies↗