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Fallico M, Alosi P, Reibaldi M, Longo A, Bonfiglio V, Avitabile T, Russo A. Scleral Buckling: A Review of Clinical Aspects and Current Concepts. J Clin Med 2022; 11:314. [PMID: 35054009 DOI: 10.3390/jcm11020314] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 12/27/2021] [Accepted: 01/04/2022] [Indexed: 01/27/2023] Open
Abstract
Scleral buckling represents a valuable treatment option for rhegmatogenous retinal detachment repair. The surgery is based on two main principles: the closure of retinal breaks and the creation of a long-lasting chorioretinal adhesion. Buckles are placed onto the sclera with the purpose of sealing retinal breaks. Cryopexy is usually performed to ensure a long-lasting chorioretinal adhesion. Clinical outcomes of scleral buckling have been shown to be more favorable in phakic eyes with uncomplicated or medium complexity retinal detachment, yielding better anatomical and functional results compared with vitrectomy. Several complications have been described following scleral buckling surgery, some of which are sight-threatening. Expertise in indirect ophthalmoscopy is required to perform this type of surgery. A great experience is necessary to prevent complications and to deal with them. The use of scleral buckling surgery has declined over the years due to increasing interest in vitrectomy. Lack of confidence in indirect ophthalmoscopy and difficulties in teaching this surgery have contributed to limiting its diffusion among young ophthalmologists. The aim of this review is to provide a comprehensive guide on technical and clinical aspects of scleral buckling, focusing also on complications and their management.
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Shishkin MM, Kocheva EA, Fayzrakhmanov RR, Sukhanova AV. [Episcleral circular buckling in surgical treatment of recurrent rhegmatogenous retinal detachment after vitrectomy]. Vestn Oftalmol 2022; 138:65-69. [PMID: 36573949 DOI: 10.17116/oftalma202213806165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Despite the improvement of the surgical technique of vitreoretinal interventions, the number of recurrences of rhegmatogenous retinal detachment (RRD) remains quite high. PURPOSE Evaluation of the effectiveness of episcleral circular buckling (ECB) in the treatment of recurrent RRD after vitrectomy due to progression of proliferative vitreoretinopathy (PVR). MATERIAL AND METHODS The study analyzed the results of surgical treatment of 21 patients (21 eyes) with recurrent RRD after primary vitrectomy. All patients underwent standard preoperative examination including visometry, tonometry, ophthalmobiomicroscopy, and additionally, optical coherence tomography was performed to assess the involvement of the macular area; the presence of anterior proliferative vitreoretinopathy was determined by ultrasound biomicroscopy, axial eye length was measured with an optical biometer. All patients underwent ECB, in some cases combined with repeated vitreoretinal surgery. RESULTS Preliminary results of the study showed high efficiency of ECB exclusively, as well as ECB combined with revision of the vitreal cavity in case of RRD recurrence after primary vitreoretinal surgery, which amounted to 95% after one additional operation and removal of silicone oil. CONCLUSIONS Episcleral circular buckling in the treatment of recurrent RRD after vitreoretinal surgery is a multifunctional and safe method that allows achieving favorable functional and anatomical outcomes.
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Affiliation(s)
- M M Shishkin
- N.I. Pirogov National Medical and Surgical Center, Moscow, Russia
| | - E A Kocheva
- N.I. Pirogov National Medical and Surgical Center, Moscow, Russia
| | | | - A V Sukhanova
- N.I. Pirogov National Medical and Surgical Center, Moscow, Russia
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Wilde C, Awad M, Orr G, Kumudhan D, Saker S, Zaman A. Incidence of Clinically Significant Aniseikonia Following Encircling Scleral Buckle Surgery: An Evaluation of Refractive and Axial Length Changes Requiring Intervention. Vision (Basel) 2021; 5:vision5010007. [PMID: 33546116 PMCID: PMC7931070 DOI: 10.3390/vision5010007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/25/2021] [Accepted: 01/29/2021] [Indexed: 11/21/2022] Open
Abstract
To evaluate the incidence of symptomatic anisometropia and aniseikonia requiring intervention following surgery with combined pars plana vitrectomy (PPV) and broad 276 style encircling scleral buckle (ESB) for the repair of rhegmatogenous retinal detachments (RRD) and to report axial length (AL) and keratometry changes, a retrospective review of consecutive RRD patients treated with combined PPV and ESB between June 2016 until September 2019 was performed. All patients with symptomatic optically induced aniseikonia requiring additional interventions or surgical procedures including clear lens exchanges, secondary intraocular lens implants or contact lenses were documented. Keratometry and AL measurements were recorded for each eye and changes calculated. In total, 100 patients underwent combined PPV, ESB and endotamponade with mean age of 59.47 years (SD 11.49). AL was significantly increased (25.39 mm [SD 1.27] to 26.54 mm [SD 1.16], p = 0.0001), with a mean change of 1.15 mm (SD 0.67). Mean corneal astigmatism increased by –0.95 D (SD 0.51) in control eyes preoperatively and –1.33 (SD 0.87) postoperatively (p = 0.03). Over half of phakic patients (39/61; 64%) developed a visually significant cataract, subsequently undergoing surgery. Six of 100 patients developed symptomatic anisometropia with aniseikonia postoperatively (6%). Four proceeded with clear lens exchange despite absence of visually significant cataract (4%). Two of these initially trialled contact lenses (2%). One was intolerant, while the other decided to proceed with clear lens exchange for convenience. Only one patient (1%), being pseudophakic in both eyes, had persistent anisometropia/aniseikonia. AL and keratometry changes induced by encirclement with broad solid silicone rubber buckles are acceptable and similar to those reported previously using narrow encircling components, being unlikely to induce troublesome symptomatic anisometropia/aniseikonia. Many patients are phakic and develop visually significant cataracts, allowing correction of changes induced with the aim of visual restoration. A minority require more prolonged methods of visual rehabilitation, such as contact lens wear or clear lens exchanges. Caution and appropriate consent should be made in patients that are pseudophakic in both eyes at presentation.
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Taroni L, Bernabei F, Pellegrini M, Roda M, Toschi PG, Mahmoud AM, Schiavi C, Giannaccare G, Roberts CJ. Corneal Biomechanical Response Alteration After Scleral Buckling Surgery for Rhegmatogenous Retinal Detachment. Am J Ophthalmol 2020; 217:49-54. [PMID: 32283097 DOI: 10.1016/j.ajo.2020.03.054] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/25/2020] [Accepted: 03/31/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE To compare the corneal biomechanics of eyes that underwent scleral buckle (SB) for rhegmatogenous retinal detachment (RRD) with those of fellow eyes (fellow eyes) and to further investigate the effects of SB on intraocular pressure (IOP) values. DESIGN Retrospective, fellow-eye matched cohort study. METHODS A total of 18 consecutive patients (11 males and 7 females) treated with SB for RRD in 1 eye were enrolled. Goldmann applanation tonometry was used to measure IOP. Biomechanical properties of the cornea were investigated by using the Ocular Response Analyzer (ORA) (Reichert Instruments) for the calculation of corneal resistant factor (CRF), corneal hysteresis, Goldmann-correlated IOP, and corneal-compensated IOP. Customized software was used for analysis of the ORA infrared and pressure signals, and a significance threshold was set to a P value of .05. RESULTS Operated eyes (OEs) showed significantly lower values of corneal hysteresis and CRF than fellow eyes (9.0 ± 1.8 vs 10.1 ± 1.8 mm Hg, respectively; P < .001; 10.0 ± 2.2 vs 10.9 ± 2.2 mm Hg; P < .001). GAT was significantly lower than corneal-compensated IOP in OEs (18.1 ± 4.9 vs 19.8 ± 4.8 mm Hg, respectively; P = .022) but not in fellow eyes. The second applanation event (A2) took place earlier in time, and the cornea was moving faster during A2 in the OEs than in the fellow eyes. CONCLUSIONS SB for the treatment of RRD affects corneal biomechanical response, likely due to a less compliant sclera that limits corneal motion and reduces energy dissipation, reflected in a lower corneal hysteresis. This has potentially meaningful clinical implications as the accuracy of the measurement of IOP values may be affected in these eyes.
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Affiliation(s)
- Leonardo Taroni
- Department of Ophthalmology, S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy.
| | - Federico Bernabei
- Department of Ophthalmology, S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - Marco Pellegrini
- Department of Ophthalmology, S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - Matilde Roda
- Department of Ophthalmology, S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - Pier Giorgio Toschi
- Department of Ophthalmology, S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - Ashraf M Mahmoud
- Department of Ophthalmology and Visual Science and Department of Biomedical Engineering, Ohio State University, Columbus, Ohio, USA
| | - Costantino Schiavi
- Department of Ophthalmology, S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - Giuseppe Giannaccare
- Department of Ophthalmology, S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy; Department of Ophthalmology, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Cynthia J Roberts
- Department of Ophthalmology and Visual Science and Department of Biomedical Engineering, Ohio State University, Columbus, Ohio, USA
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Abstract
Scleral buckling has an important role in the repair of certain categories of rhegmatogenous retinal detachments. These include detachments in young phakic patients, detachments associated with dialysis, and also in conjuction with vitrectomy in patients who have sustained trauma or have developed proliferative vitreoretinopathy. However, it can be associated with significant postoperative complications. The most important ones are refractive change, intrusion or extrusion, infection, globe ischemia, and choroidal detachments, amongst others. Careful planning, appropriate patient selection, and good intraoperative technique can reduce the rate of these complications.
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Affiliation(s)
- Thanos D Papakostas
- a Retina Service, Massachusetts Eye and Ear Infirmary , Harvard Medical School , Boston , MA , USA
| | - Demetrios Vavvas
- a Retina Service, Massachusetts Eye and Ear Infirmary , Harvard Medical School , Boston , MA , USA
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Ophir SS, Friehmann A, Rubowitz A. Circumferential silicone sponge scleral buckling induced axial length changes: case series and comparison to literature. Int J Retina Vitreous 2017; 3:10. [PMID: 28357135 PMCID: PMC5367001 DOI: 10.1186/s40942-017-0063-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 02/22/2017] [Indexed: 11/30/2022] Open
Abstract
Background This study compared axial length changes induced by circumferential
scleral buckling using a silicone sponge with literature reports for solid silicone rubber. Methods Records of patients treated with scleral buckling in 2009–2013 using a silicone sponge, with preoperative axial length biometry measurements were reviewed. Additional information included age, type of surgery, additional surgeries, phakic status and anatomical success of reattachment. Patients underwent repeat biometry. The medical literature was reviewed for articles describing axial length changes induced by circumferential buckling using solid silicone rubber. Results Twenty-eight patients (mean age 49.7 years, range 16–72) met the inclusion criteria. Mean axial length was 25.38 mm preoperatively and 26.12 mm at least 6 months postoperatively (SD 0.50 ± 0.09, p < 0.001); a mean increase of 0.74 mm. Half the patients subsequently underwent cataract surgery. Post-operative changes were not significant compared to pre-surgical refraction and corneal astigmatism. Axial length change was not significant between sexes (9 women and 19 men). Conclusions Axial length changes induced by circumferential scleral buckling using silicone sponge exclusively are similar to those reported in the literature for solid silicone rubber buckles. Scleral buckling using a silicone sponge, which may offer several surgical advantages, induces an acceptable axial length change similar to that seen with widely-used solid silicone rubber buckles.
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Affiliation(s)
- Shira Sheen Ophir
- Department of Ophthalmology, Meir Medical Center, 59 Tshernichovsky St., Kfar Saba, 44281 Israel
| | - Asaf Friehmann
- Department of Ophthalmology, Meir Medical Center, 59 Tshernichovsky St., Kfar Saba, 44281 Israel
| | - Alexander Rubowitz
- Department of Ophthalmology, Meir Medical Center, 59 Tshernichovsky St., Kfar Saba, 44281 Israel
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Chung JK, Kim JK, Lee JB, Lee SJ. Iris-fixated phakic intraocular lens implantation after retinal detachment surgery: long-term clinical results. J Cataract Refract Surg 2013; 39:1494-501. [PMID: 23972384 DOI: 10.1016/j.jcrs.2013.04.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 04/11/2013] [Accepted: 04/15/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE To assess the efficacy and safety of iris-fixated phakic intraocular lens (pIOL) implantation to correct myopia in eyes with previous retinal detachment (RD) surgery. SETTING Department of Ophthalmology, Soonchunhyang University College of Medicine, Seoul, South Korea. DESIGN Retrospective case series. METHODS Patients having pIOL implantation in both eyes were enrolled. Eyes that had scleral buckling or encircling (RD group) and healthy fellow eyes (non-RD group) were evaluated over a 6-year follow-up. The corrected distance visual acuity (CDVA), endothelial cell density (ECD), intraoperative complications, and long-term complications were safety outcomes. Uncorrected distance visual acuity (UDVA), predictability, and stability of refraction were efficacy outcomes. RESULTS The study comprised 34 eyes (17 patients). The mean postoperative CDVA and ECD were not significantly different between groups, and no patient lost CDVA. The rate of transient intraocular pressure spike was significantly higher in the RD group (P=.043). After 3 years and 6 years, the mean postoperative UDVA was 0.06 logMAR ± 0.09 (SD) and 0.08 ± 0.10 logMAR, respectively, in the RD group and 0.04 ± 0.08 logMAR and 0.04 ± 0.09 logMAR, respectively, in the non-RD group (P=.518 and P=.478, respectively). The rate of eyes within ±0.50 diopter of the desired refraction and the postoperative refraction was not significantly different between groups. No eye had vitreoretinal changes requiring secondary surgical intervention. CONCLUSION Iris-fixated pIOL implantation corrected the myopic refractive error in patients who had scleral buckling or encircling surgery for RD with a high degree of efficacy, safety, and long-term stability. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Jin Kwon Chung
- From the Department of Ophthalmology (Chung, S.J. Lee), Soonchunhyang University, College of Medicine, and the Balgensesang Ophthalmology Clinic (Kim), Seoul, and Bundang Yonsei Plus Eye Clinic (J.B. Lee), Sungnam, South Korea
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Kim SI, Byon IS, Lee JE. Clinical Outcomes of Secondary Intraocular Lens Implantation in Vitrectomized Aphakic Eyes Due to Ocular Trauma. J Korean Ophthalmol Soc 2013. [DOI: 10.3341/jkos.2013.54.10.1581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Sung Il Kim
- Department of Ophthalmology, Pusan National University School of Medicine, Busan, Korea
| | - Ik Soo Byon
- Department of Ophthalmology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Ji Eun Lee
- Department of Ophthalmology, Pusan National University School of Medicine, Busan, Korea
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Holopainen JM, Vuori E, Moilanen JAO, Zalentein WN, Tervo TMT. Excimer laser refractive correction of myopia after episcleral buckling for rhegmatogenous retinal detachment. J Cataract Refract Surg 2007; 33:1744-9. [PMID: 17889770 DOI: 10.1016/j.jcrs.2007.06.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2007] [Accepted: 06/08/2007] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate the long-term effects of excimer laser treatment for ametropia after surgical treatment of rhegmatogenous retinal detachment (RRD) with scleral buckles. SETTING Helsinki University Eye Hospital, Helsinki, Finland. METHODS Ten patients (10 eyes) who had 1 or more surgeries for RRD followed by refractive surgery for myopia were retrospectively enrolled in this study and were examined after excimer laser refractive surgery. Photorefractive keratectomy (PRK) or laser in situ keratomileusis (LASIK) was performed using a Star S2 excimer laser system (Visx). The best spectacle-corrected visual acuity (BSCVA), refraction, degree of anisometropia, and topographical changes were evaluated before and after the surgeries. RESULTS All patients were free of asthenopic symptoms after refractive surgery. At the end of the follow-up, a mean of 67 months +/- 14 (SD) after refractive surgery, 6 patients were within +/-1.0 diopter of the intended correction. Compared with previously reported cohorts of myopic patients, the achieved refraction in patients who previously had a scleral buckling procedure was worse. The postoperative refraction was stable, and corneal topography did not show induced scar formation, keratectasia, or irregular astigmatism. After refractive surgery, the BSCVA improved 1 Snellen line in 3 patients and 2 lines in 1 patient. One patient lost 1 Snellen line and another patient lost 2 lines. Four patients showed no changes. New retinal complications were not observed. CONCLUSIONS In the long-term, PRK and LASIK were safe methods for the treatment of myopia in RRD patients after scleral buckling. The predictability of myopic LASIK/PRK may be worse than generally reported in myopic cohorts.
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Affiliation(s)
- Juha M Holopainen
- Department of Ophthalmology, University of Helsinki, Helsinki, Finland.
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Abstract
PURPOSE To assess efficacy and safety of angle-supported phakic intraocular lenses (PIOL) implanted after scleral buckling for retinal detachment. SETTING Private practice in Siena, Italy. METHODS Retrospective, noncomparative consecutive case series. Inclusion criteria for retrospective evaluation were previous uncomplicated external retinal detachment surgery (scleral buckling), and a complete follow-up superior to 3 years from PIOL implantation. RESULTS Nine eyes of seven patients were included. Mean time interval between retinal detachment surgery and PIOL implantation was 3.2 years +/- 4.5 (range 1 to 15). Mean spherical equivalent (SE) before PIOL implantation was -16.36 D +/- 3.98; range: -11.75 to -23. PIOL surgery was uneventful in all cases. Mean SE after PIOL implantation was -0.99+/-0.51 (95% confidence interval for the mean: -0.59 to -1.39). Mean follow-up after PIOL implantation was 4.2 years +/- 0.8 (range 3 to 5). Complications were pupil ovalization (inferior to 1 mm) in two eyes, and worsening of floaters in both eyes of one patient. No recurrences of retinal detachment were observed. CONCLUSIONS In selected eyes with no anterior chamber abnormalities, the implantation of angle supported PIOL after scleral buckling for retinal detachment is associated with good refractive results and minor complications.
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Affiliation(s)
- A Leccisotti
- Ophthalmic Surgery Unit, Casa di Cura Rugani, Siena, Italy.
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Dang Burgener NPL, Petropoulos IK, Stangos AN, Pournaras CJ. Décollements de rétine récidivants après vitrectomie en première intention chez le patient pseudophake. J Fr Ophtalmol 2006; 29:1149-55. [PMID: 17211322 DOI: 10.1016/s0181-5512(06)73910-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the incidence of pseudophakic retinal detachment (RD) recurrence after primary vitrectomy. PATIENTS AND METHODS This was a prospective nonrandomized consecutive case series study, evaluating two series presenting to our clinic with pseudophakic RD from 1998 to 2004 (103 eyes of 97 patients). The study included 24 consecutive pseudophakic eyes treated with gas vitrectomy surgery with placement of an encircling band from January 1998 to December 2000 (group A) and 79 consecutive pseudophakic eyes treated with gas vitrectomy surgery with no encircling band from January 2001 to December 2004 (group B). Pre- and postoperative characteristics were analyzed in both groups. In the cases of postoperative RD recurrence, we particularly analyzed the pre- and postoperative risk factors, as well as the anatomic and functional outcome. RESULTS Visual acuity improved in 74/103 (71.8%) eyes from both groups postoperatively. Recurrence of RD after primary vitrectomy occurred in eight of 103 (7.8%) eyes in both groups. More specifically, two of 24 (8.3%) eyes in group A and six of 79 (7.6%) eyes in group B presented a recurrence after gas vitrectomy with encircling band and gas vitrectomy alone, respectively. Among these eight eyes, four eyes (50%) presented proliferative vitreoretinopathy (PVR) at the time of initial vitrectomy, while all eyes presented PVR at the time of recurrence (one grade B, seven grade C). These eyes required two additional interventions on average. Five eyes (62.5%) required silicone-oil tamponade for a good anatomic reapplication. DISCUSSION These results show that recurrence after primary vitrectomy for pseudophakic RD is most often related to the presence of PVR before or after the first intervention. This series reports a success rate of 91.7% and 92.4%, respectively, for group A and B, thus demonstrating the efficacy of vitrectomy in the treatment of pseudophakic RD. This study also shows a nonsignificant difference in the recurrence rate among patients treated by gas vitrectomy and those undergoing gas vitrectomy in association with encircling band placement, which raises the question of the usefulness of an additional encircling band in pseudophakic RD.
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Abstract
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.
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Affiliation(s)
- J K Chung
- Department of Ophthalmology, Soonchunhyang University Hospital, Seoul, Korea
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Abstract
PURPOSE To compare, in the same individuals, the safety and efficacy of laser in situ keratomileusis (LASIK) in eyes with and without previous retinal detachment surgery. METHODS In a prospective clinical trial, seven myopic patients who had previously undergone scleral buckling surgery in one eye underwent conventional LASIK surgery in both eyes. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refraction, Orbscan topography and pachymetry were recorded before and 1, 3, 6 and 12 months after surgery. The eyes were divided into two groups: group 1 consisted of eyes that had undergone previous surgery for retinal detachment, and group 2 consisted of the fellow eyes of the same patients, which had not undergone any previous ocular surgery. Student's t-test for match-paired data was used to evaluate the significance of differences. RESULTS LASIK was performed successfully in all patients. The UCVA improved in all eyes in both groups. The mean change in the spherical equivalent between 1 and 12 months after LASIK surgery was 1.7 +/- 1.1 and 0.6 +/- 0.5 diopter in groups 1 and 2, respectively (p = 0.019). CONCLUSION LASIK may be considered for treatment of myopia in eyes that have had previous surgery for retinal detachment. However, the risk of regression may be higher in such eyes than in eyes with no previous scleral buckling surgery.
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Affiliation(s)
- Mohsen Farvardin
- Department of Ophthalmology, Shiraz University of Medical Sciences, Shiraz, Iran
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Thompson JT. The Effects and Action of Scleral Buckles in the Treatment of Retinal Detachment. Retina 2006. [DOI: 10.1016/b978-0-323-02598-0.50123-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Dietlein TS, Roessler G, Lüke C, Dinslage S, Roters S, Jacobi PC, Walter P, Krieglstein GK. Signal quality of biometry in silicone oil–filled eyes using partial coherence laser interferometry. J Cataract Refract Surg 2005; 31:1006-10. [PMID: 15975470 DOI: 10.1016/j.jcrs.2004.09.049] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2004] [Indexed: 12/01/2022]
Abstract
PURPOSE To assess the practical feasibility and signal quality of axial length measurements by partial coherence laser interferometry in silicone oil-filled eyes with previous complicated vitreoretinal surgery. SETTINGS Department of Ophthalmology, University Cologne, Cologne, Germany. METHODS Using a Zeiss IOLMaster, axial length measurements and signal-to-noise ratios of optical biometry in silicone oil-filled eyes (n=45) and contralateral eyes without tamponade (n=41) were analyzed. RESULTS Axial length measurements with signal-to-noise ratio > or =2 were feasible in 41 of 45 silicone oil-filled eyes (91%) and 37 of 41 eyes without tamponade (90%). Cataract, central retinal detachment, vitreous hemorrhage, and emulsified oil droplets attached to the intraocular lens were reasons for failure of partial coherence laser interferometry. The signal-to-noise ratio of the first 2 measurements was significantly smaller (P=.04) in silicone-filled eyes (4.4 +/- 2.0) than in eyes without tamponade (5.5 +/- 3.0). Axial lengths of the oil-filled eye and the contralateral eye showed a significant intraindividual correlation (P<.0001, Spearman r=0.84). CONCLUSIONS Partial coherence laser interferometry shows good clinical practicability in silicone oil-filled eyes with previous complicated vitreoretinal surgery. Further studies are needed to assess the reliability of these measurements with regard to postoperative refraction after combined oil removal and cataract surgery.
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Affiliation(s)
- Thomas S Dietlein
- Department of Ophthalmology, University of Cologne, D-50931 Cologne, Germany.
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Barequet IS, Levy J, Klemperer I, Hirsh A, Pollack A, Lifshitz T, Levinger S. Laser in situ Keratomileusis for Correction of Myopia in Eyes After Retinal Detachment Surgery. J Refract Surg 2005; 21:191-3. [PMID: 15796226 DOI: 10.3928/1081-597x-20050301-16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the safety and efficacy of laser in situ keratomileusis (LASIK) for correction of myopia in eyes with previous retinal detachment surgery. METHODS A retrospective review was conducted of all consecutive eyes that underwent LASIK after retinal detachment surgery. Data was collected regarding previous ocular surgery and its time prior to LASIK, intra- and postoperative complications, and visual outcome measures pre- and postoperatively. RESULTS Ten eyes with previous retinal detachment surgery were scheduled for LASIK. One eye was excluded from data analysis as LASIK was aborted due to inadequate microkeratome suction because of conjunctival scarring. Nine eyes underwent an uneventful LASIK procedure. On average, LASIK was performed 130+/-123 months following retinal detachment surgery. Postoperative LASIK follow-up was 14.8+/-12.5 months. No significant intraoperative, postoperative, or retinal complications were observed. The mean preoperative spherical equivalent refraction was -9.00+/-3.00 diopters (D), uncorrected visual acuity (UCVA) was 0.06+/-0.02, and best spectacle-corrected visual acuity (BSCVA) was 0.64+/-0.16. At the end of follow-up, the mean spherical equivalent refraction was 0.65+/-0.88 D, mean UCVA was 0.57+/-0.14, and mean BSCVA was 0.72+/-0.19. Differences between BSCVA before and after LASIK were statistically significant (P=.038). At final follow-up, the safety index was 1.22 and efficacy index was 1.01. CONCLUSIONS Laser in situ keratomileusis was found to be a safe and efficient option for treating refractive errors in eyes with previous retinal detachment surgery.
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Affiliation(s)
- Irina S Barequet
- Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer 52621, Israel.
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18
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Abstract
Background To study the effect of retinal/ vitreoretinal surgeries on corneal elevations. Methods Patients who underwent retinal/ vitreoretinal surgeries were divided into 3 groups. Scleral buckling was performed in 11 eyes (Group 1). In 8 (25%) eyes, vitreoretinal surgery was performed along with scleral buckling (Group 2). In 12 eyes, pars plana vitrectomy was performed for vitreous hemorrhage (Group 3). An encircling element was used in all the eyes. The parameters evaluated were best-corrected visual acuity (BCVA), change in axial length, and corneal topographic changes on Orbscan topography system II, preoperative and at 12 weeks following surgery. Results There was a statistically significant increase in anterior corneal elevation in all the three groups after surgery (p = 0.003, p = 0.008 & p = 0.003 respectively). The increase in posterior corneal elevation was highly significant in all the three groups after surgery (p = 0.0000, p = 0.0001 & p = 0.0001 respectively). The increase in the posterior corneal elevation was more than the increase in the anterior elevation and was significant statistically in all the three groups (group I: p = 0.02; group II: p = 0.01; group III: p = 0.008). Conclusions Retinal/ vitreoretinal surgeries cause a significant increase in the corneal elevations and have a greater effect on the posterior corneal surface.
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Affiliation(s)
- Rajesh Sinha
- Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Namrata Sharma
- Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Lalit Verma
- Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - RM Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Rasik B Vajpayee
- Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Abstract
PURPOSE To examine the effects of scleral buckling on the eye growth of children after retinal detachment repair according to the degree of refractive change. METHODS Thirty-five eyes of 35 patients (mean age, 11.5 years; range, 7-15 years) were treated using a silicone implant scleral buckling procedure. Postoperative refractive change in the treated eyes was analyzed statistically, with the fellow eyes used as controls. The effects of age at the time of surgery, length of the silicone tire, postoperative visual acuity, and postoperative refraction were also examined. RESULTS The mean refractive change in treated eyes from 1 to 4 years after the procedure was -0.6 diopter (D), whereas the mean change in fellow eyes was -1.3 D. The treated eyes became less myopic than the fellow eyes (P=0.024), particularly in patients younger than 10 years (-0.1 D versus -1.6 D, respectively; P=0.003) or when the scleral buckle extended beyond two quadrants (-0.4 D versus -1.3 D, respectively; P=0.020). CONCLUSIONS Scleral buckling resulted in significantly less myopia, particularly in younger patients and in those receiving longer buckling tires. This finding suggests that scleral buckling in children might impede ocular growth.
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Abstract
AIM To assess the efficacy and safety of laser in situ keratomileusis (LASIK) for correction of myopic refractive errors in eyes which have previously undergone retinal detachment surgery. METHODS In a prospective, non-comparative case series, 10 eyes of nine patients who had a myopic refractive error and had previously undergone retinal detachment surgery underwent LASIK surgery according to the standard surgical protocol. The surgery could be completed in eight eyes and in two eyes it was aborted intraoperatively. The parameters evaluated included the uncorrected visual acuity, best corrected visual acuity, refraction, detailed fundus evaluation with indirect ophthalmoscope, slit lamp biomicroscopy, and corneal pachymetry. Any intraoperative or postoperative complications were recorded. Follow up visits were scheduled at day 1, 1 week, 1 month, 3 months, and 6 months after LASIK. RESULTS Eight eyes underwent successful LASIK surgery. The mean spherical equivalent before surgery was -5.436 (SD 1.6) dioptres (D), which was reduced to +0.42 (0.65) D, -0.07 (1.32) D, -0.06 (1.39) D, and -0.06 (0.65) at 1 week, 1 month, 3 months, and 6 months respectively after LASIK. The uncorrected visual acuity improved in all the eyes and the best corrected visual acuity improved or remained same in all the eyes. There was no retinal complication after LASIK. CONCLUSION LASIK may be used to correct refractive errors in eyes that have undergone retinal detachment surgery. However, scarred conjunctiva in such cases may prevent generation of optimal suction for the microkeratome.
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Affiliation(s)
- R Sinha
- Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India
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21
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Bilgihan K, Ozdek SC, Gürelik G, Adigüzel U, Onol M, Hasanreisoglu B. Photorefractive Keratectomy for Visual Rehabilitation of Anisometropia Induced by Retinal Detachment Surgery. J Refract Surg 2000; 16:75-8. [PMID: 10693622 DOI: 10.3928/1081-597x-20000101-10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the efficacy of unilateral photorefractive keratectomy to correct anisometropia induced by retinal detachment surgery. METHODS Photorefractive keratectomy was performed in 10 eyes of 10 patients with anisometropia induced by previous retinal detachment surgery. The Aesculap Meditec MEL 60 excimer laser was used. RESULTS Preoperative mean spherical equivalent refraction was -5.20 D. Mean postoperative spherical equivalent refraction was -0.25 D after a mean follow-up of 12.9 months. Mean preoperative spherical equivalent refraction difference between two eyes of 4.87 D was decreased to a mean 0.60 D postoperatively (t-test, P < .0001). All patients were free of anisometropic symptoms after laser surgery. CONCLUSION Unilateral photorefractive keratectomy seems to be an effective method to correct anisometropia induced by conventional retinal detachment surgery, especially for patients with spectacle and contact lens intolerance.
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Affiliation(s)
- K Bilgihan
- Gazi University, School of Medicine, Ophthalmology Department, Ankara, Turkey.
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Abstract
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.
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Abstract
PURPOSE Previous studies have documented a 3% to 15.5% risk of retinal redetachment in eyes with prior scleral buckling procedures that later undergo intracapsular or extracapsular cataract extraction. The authors reviewed the records of patients with a history of retinal detachment (RD) surgery and subsequent phacoemulsification to assess the risk of retinal redetachment and the visual outcomes. METHODS Forty-seven eyes of 44 patients with a history of scleral buckling surgery who subsequently underwent phacoemulsification were identified. Features found before, during, and after surgery were reviewed. RESULTS No retinal redetachments occurred on a mean follow-up of 2.3 years. Eyes with RD repair were more myopic than fellow eyes (P=<0.001), had longer axial lengths (P=0.001), had steeper keratometry readings (P=0.03), and had larger differences in K readings between principal meridians (P=0.01). Postoperative visual acuity was 20/40 or better in 72.3% of eyes and 20/80 or worse in 6.4% of eyes. Preexisting macular pathology was responsible for poor outcomes. CONCLUSION The risk of redetachment after phacoemulsification in eyes with previous RD surgery is low. Despite retinal and cataract surgery, these eyes can achieve useful vision.
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Affiliation(s)
- J B Kerrison
- Wilmer Ophthalmological Institute, The Johns Hopkins University, Baltimore, MD 21287, USA
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Abstract
We reviewed the records of 28 patients who had undergone successful scleral buckling surgery followed by extracapsular cataract extraction with implantation of an intraocular lens. Posterior chamber intraocular lenses were inserted in 27 eyes, and anterior chamber intraocular lenses were inserted in two eyes with posterior capsule rupture at the time of surgery. The mean follow-up period was 44 months. Final visual acuity was 20/40 or better in 15 of 29 eyes (52%). One eye (3.4%) developed a recurrent retinal detachment 15 months after cataract surgery. Two eyes (6.9%) developed angiographically proven cystoid macular edema. The outcome for extracapsular cataract extraction with intraocular lens implantation in eyes that had previously undergone successful scleral buckling for retinal detachment is favorable.
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Affiliation(s)
- R S Ruiz
- Department of Ophthalmology, Hermann Eye Center, University of Texas Medical School, Houston 77030
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