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Gisquet C, Ndiaye NC, Dubroux C, Angioi-Duprez K, Berrod JP, Conart JB. Retinal redetachment after silicone oil removal: a risk factor analysis. BMC Ophthalmol 2024; 24:346. [PMID: 39148018 PMCID: PMC11325823 DOI: 10.1186/s12886-024-03618-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 08/06/2024] [Indexed: 08/17/2024] Open
Abstract
PURPOSE To report the rate of retinal redetachment after silicone oil removal following rhegmatogenous retinal detachment surgery and to determine potential risk factors. METHODS Retrospective observational case series of 161 eyes who underwent rhegmatogenous retinal detachment surgery and subsequent silicone oil removal. Pre- and intraoperative risk factors were evaluated using univariate and multivariate logistic regression. We also evaluated the effect of tamponade duration on anatomical outcomes. RESULTS The median tamponade duration was 5.9 [4.3;7.6] months. Seventeen (10.6%) eyes underwent silicone oil removal within 3 months of surgery, with a median delay of 2.3 [2.0;2.8] months. The rate of retinal detachment after silicone oil removal was 14.9%. A history of previous unsuccessful surgery was the only significant risk factor for retinal redetachment after silicone oil removal (OR 4.8, 95%CI [1.5;19.0], p = 0.02). The use of 360° laser retinopexy and concomitant air or gas tamponade during silicone oil removal were not found to affect the redetachment rate. Eyes with silicone oil tamponade ≤ 3 months showed an increased, albeit not significant, risk of developing recurrent rhegmatogenous retinal detachment after silicone oil removal (35.3% versus 12.5%, p = 0.06). CONCLUSION A retinal redetachment occurred in 14.9% of eyes undergoing silicone oil removal following rhegmatogenous retinal detachment surgery. Previous failed surgery was associated with a 4.8-fold increased risk of developing recurrent rhegmatogenous retinal detachment after silicone oil removal. Eyes with silicone oil tamponade ≤ 3 months tended to have a higher redetachment rate. TRIAL REGISTRATION NUMBER ID NCT05647928 (12th April 2022).
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Affiliation(s)
- Clément Gisquet
- Department of Ophthalmology, University Hospital of Nancy, Rue du Morvan, Vandoeuvre-les-Nancy, 54500, France.
| | - Ndeye Coumba Ndiaye
- UMR Inserm U1256 NGERE (Nutrition-Genetics and Exposure to Environmental Risks), Université de Lorraine, Nancy, France
| | - Chloé Dubroux
- Department of Ophthalmology, University Hospital of Nancy, Rue du Morvan, Vandoeuvre-les-Nancy, 54500, France
| | - Karine Angioi-Duprez
- Department of Ophthalmology, University Hospital of Nancy, Rue du Morvan, Vandoeuvre-les-Nancy, 54500, France
| | - Jean-Paul Berrod
- Department of Ophthalmology, University Hospital of Nancy, Rue du Morvan, Vandoeuvre-les-Nancy, 54500, France
| | - Jean-Baptiste Conart
- Department of Ophthalmology, University Hospital of Nancy, Rue du Morvan, Vandoeuvre-les-Nancy, 54500, France
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Park HW, Kim M, Kim SS, Kang HG. Prognostic Factors for Recurrent Rhegmatogenous Retinal Detachment after Silicone Oil Removal. KOREAN JOURNAL OF OPHTHALMOLOGY 2024; 38:284-295. [PMID: 38897593 PMCID: PMC11321828 DOI: 10.3341/kjo.2024.0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 06/07/2024] [Accepted: 06/15/2024] [Indexed: 06/21/2024] Open
Abstract
PURPOSE To investigate the prognostic factors for recurrent rhegmatogenous retinal detachment following silicone oil removal. METHODS This retrospective review included 147 consecutive patients with rhegmatogenous retinal detachment treated with silicone oil tamponade at a high-volume referral-based tertiary hospital between January 2012 and May 2022. All patients underwent follow-up for a minimum of 6 months after subsequent silicone oil removal. The primary outcome measure was the rate of recurrent retinal detachment following silicone oil removal, and the secondary outcome was best-corrected visual acuity after silicone oil removal. RESULTS The mean silicone oil tamponade duration was 4.7 ± 5.01 months (range, 1-38 months; median, 3 months), and the recurrent retinal detachment rate after silicone oil removal was 15.6%. Logistic regression analysis revealed that argon endolaser photocoagulation during silicone oil removal (odds ratio [OR], 0.309; 95% confidence interval [CI], 0.106-0.898; p = 0.031) was associated with a lower rate of anatomical success after silicone oil removal. Demographics, preoperative ocular characteristics, proliferative vitreoretinopathy, previous scleral encircling or buckling, previous retinectomy, concomitant phacoemulsification, duration of silicone oil tamponade, and gas tamponade after silicone oil removal were not significantly associated with recurrent retinal redetachment after silicone oil removal. Duration of silicone oil tamponade (OR, 1.226; 95% CI, 1.073-1.402; p = 0.003) and recurrent retinal detachment after silicone oil removal (OR, 3.400; 95% CI, 1.311-8.817; p = 0.012) were associated with poor visual outcomes after silicone oil removal. CONCLUSIONS Among all factors examined in this study, including the duration of silicone oil tamponade, laser retinopexy was the only significant prognostic factor for recurrent retinal detachment after silicone oil removal. A longer duration of silicone oil tamponade was associated with worse visual outcomes and a lower rate of visual improvement after silicone oil removal.
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Affiliation(s)
- Hyun Woo Park
- Department of Ophthalmology, Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, Seoul,
Korea
| | - Min Kim
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul,
Korea
| | - Sung Soo Kim
- Department of Ophthalmology, Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, Seoul,
Korea
| | - Hyun Goo Kang
- Department of Ophthalmology, Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, Seoul,
Korea
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Cicinelli MV, Benatti E, Starace V, Nadin F, Di Nisi E, Bandello F, Coppola M. Recurrences and Macular Complications after Perfluorocarbon-Liquid-Free Vitrectomy for Primary Rhegmatogenous Retinal Detachment. Ophthalmol Ther 2023; 12:3219-3232. [PMID: 37775683 PMCID: PMC10640444 DOI: 10.1007/s40123-023-00811-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/31/2023] [Indexed: 10/01/2023] Open
Abstract
INTRODUCTION This study investigates factors associated with recurrent rhegmatogenous retinal detachment (RRD), macular complications, and visual outcomes after pars plana vitrectomy (PPV) without perfluorocarbon liquids (PFCLs) for primary RRD. METHODS A longitudinal cohort study included consecutive patients with RRD who underwent PFCL-free PPV. Postoperative visual acuity and spectral-domain optical coherence tomography findings [cystoid macular edema (CME), epiretinal membrane (ERM), ellipsoid zone/interdigitation zone (EZ/IZ) damage] were collected. Logistic regression and linear mixed models analyzed rates and risk factors for RRD recurrence, CME, ERM, EZ/IZ damage, and visual acuity at 12 months. RESULTS 346 eyes with RRD were studied. Single-operation success rates were 96% and 93% for uncomplicated (n = 274 eyes) and complicated (n = 72 eyes) RRD, respectively. Factors associated with RRD recurrence were posterior retinal breaks [odds ratio (OR) = 10.7 compared to peripheral retinal breaks, p = 0.008], silicone oil tamponade (OR = 5.66 compared to gas, p = 0.01), and sectorial laser retinopexy (OR = 4.34 compared to 360° laser retinopexy, p = 0.007). The prevalence of CME, ERM, and EZ/IZ damage at 12 months was 10%, 9%, and 6%, respectively. Eyes with EZ/IZ defects had worse postoperative visual acuity in both uncomplicated and complicated RRD. Proliferative vitreoretinopathy (OR = 2.95, p = 0.03) and silicone oil tamponade (OR = 3.70 compared to gas, p = 0.05) were associated with EZ/IZ damage. CONCLUSIONS PFCL-free PPV demonstrated satisfactory single-operation success rates for uncomplicated and complicated RRD, with a low prevalence of macular complications. Analyzing factors associated with RRD recurrence can provide provisional recommendations for PFCL-free approaches in the absence of randomized trials.
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Affiliation(s)
- Maria Vittoria Cicinelli
- Ophthalmology Unit, Azienda Ospedaliera di Monza, Monza, Italy.
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.
| | | | | | - Francesco Nadin
- Ophthalmology Unit, Azienda Ospedaliera di Monza, Monza, Italy
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - Edoardo Di Nisi
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Francesco Bandello
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - Michele Coppola
- Ophthalmology Unit, Azienda Ospedaliera di Monza, Monza, Italy
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
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Long-term visual prognosis and characteristics of recurrent retinal detachment after silicone oil removal. PLoS One 2023; 18:e0265162. [PMID: 36753472 PMCID: PMC9907833 DOI: 10.1371/journal.pone.0265162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 02/25/2022] [Indexed: 02/09/2023] Open
Abstract
PURPOSE Silicone oil (SO) is commonly used for tamponade purposes in retinal detachment (RD) surgery, but the long-term visual prognosis after removal of the oil, and in particular, what is known about the recurrence of RD after SO removal, remains unclear. The purpose of this study is to evaluate the long-term vision prognosis after SO removal, and to understand the frequency and characteristics of RD recurrence. METHODS We retrospectively reviewed the medical charts of 1017 eyes of patients with a diagnosis of RD who had a pars plana vitrectomy with SO tamponade between January 2009 and December 2018. Best-corrected visual acuity (BCVA) was obatained before and after vitrectomy and also at the last visit. After SO removal, the group who showed improvement in visual acuity and the group who did not were compared. The anatomical results were compared between the group in which the retina was detached again after SO removal and the group in which the retina was not detached. To determine whether the duration of SO tamponade affects RD recurrence, further analysis was performed by dividing subgroups according to SO tamponade duration. RD recurrence, visual acuity, SO tamponade period were investigated. RESULTS Mean follow-up period was 56.65 ± 72.02 months. An average SO tamponade period was 6.68 ± 11.39 months. The average logMAR BCVA was 1.75 ± 0.91 before SO injection, 1.60 ± 0.75 before SO removal and 1.29 ± 0.96 after the removal. After SO removal, 926 of the 1017 (91.1%) patients had well attached retina without recurrence. There was no significant difference in visual acuity before SO removal in re-detachment group compared to no re-detachment group, but visual acuity of re-detachment group was worse than no re-detachment group after SO removal (p<0.001). The SO tamponade period in the group with improved vision after SO removal was 5.09 ± 9.87 months, and the period was significantly shorter than the 9.09 ± 13.05 months in the group not showing vision recovery (p = 0.005). The occurrence of corneal opacity was significantly higher in the group with SO over 6 months, than those of the two groups with SO tamponade duration of less than 3 months and between 3 and 6 months (p = 0.038). The longest tamponade group showed the worst final vision after SO removal (p<0.001). CONCLUSION The prognosis for final vision is generally good when performing surgery using SO in RD, but considering the complications that arise after surgery, long-term retention of SO is not recommended and the timing of SO removal should be considered.
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Recurrent retinal detachment after pars plana vitrectomy with silicone oil tamponade for rhegmatogenous retinal detachment. Int Ophthalmol 2022; 42:3813-3820. [PMID: 35802298 DOI: 10.1007/s10792-022-02401-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 06/13/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND The recurrence of retinal detachment following rhegmatogenous retinal detachment (RRD) is a relatively common complication that can lead to reduced visual acuity and requires further surgery. The purpose of this study was to investigate the risk factors and visual outcomes of recurrent RRD following pars plana vitrectomy (PPV) with silicone oil tamponade for primary RRD. METHODS This was a retrospective follow-up study of 343 eyes that underwent initial PPV surgery with silicone oil tamponade for primary RRD. Patients were divided into a recurrence group and a reattachment group. The main outcome measures included causative factors, visual outcomes related to the recurrence of RRD, and the perioperative factors most affecting the recurrence of RRD. RESULTS After retinal reattachment, we observed RRD recurrence after PPV for primary RRD in 42 out of 343 eyes (12.2%) during the follow-up period. Most causes of recurrence (69%) occurred within 6 months of surgery. Multivariate logistic regression analysis showed that a PVR ≥ Grade C (odds ratio [OR]: 4.015; 95% confidence interval [CI] 1.721-9.367; P = 0.001) was a significant predictor for the development of recurrent RRD. Compared with the reattachment group, the recurrence group exhibited a significant decline in best-corrected visual acuity (BCVA) at the last follow-up visit (P = 0.000). Eyes with PVR prior to primary surgery, or at the diagnosis of re-detachment, showed a worse final BCVA. CONCLUSIONS Our analysis shows that the predominant risk factor for the recurrence of RRD is a PVR ≥ Grade C. PVR prior to primary surgery, or at the diagnosis of re-detachment, was also shown to limit the recovery of final visual acuity.
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Factors affecting retinal re-detachment following silicone oil removal for rhegmatogenous retinal detachments. Retina 2022; 42:1248-1253. [PMID: 35174811 DOI: 10.1097/iae.0000000000003445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To report factors affecting retinal re-detachment rate after silicone oil removal (SOR) following rhegmatogenous retinal detachment (RRD) repair. METHODS Retrospective cohort study from December 1, 2014 to March 1, 2020 of 205 consecutive patients treated for RRD with SO tamponade and subsequent SOR with at least 6 months follow-up. Primary outcome measure was rate of retinal re-detachment following SOR. RESULTS The retinal re-detachment rate following SOR was 18.5%. Preoperative macula and lens status, PVR, previous retinectomy, RD size, concomitant phacoemulsification, previous scleral buckling, and endolaser during SOR did not affect re-detachment rate after SOR. Previous SO exchange was associated with increased re-detachment (OR 2.53, 95% CI (1.11 - 5.80), p = 0.0278). 12 months of SO tamponade had lower re-detachment rates compared to 3 months (OR 0.25, 95% CI [0.04 - 0.09], p = 0.048). Shorter SO tamponade (3 vs. 12 months) had better final visual outcomes after SOR (0.80 ± 0.61 vs 1.41 ± 0.66, p <0.0001). CONCLUSIONS No preoperative or intraoperative factors in this analysis influenced the risk of re-detachment following SOR except duration of SO tamponade and previous SO exchange. While longer SO tamponade duration may be associated with lower rates of re-detachment, visual outcomes may be worse.
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Churashov SV, Shevalova TN, Kulikov AN, Maltsev DS. Surgical outcomes in inferior recurrences of rhegmatogenous retinal detachment. Int J Ophthalmol 2021; 14:1909-1914. [PMID: 34926207 DOI: 10.18240/ijo.2021.12.15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 08/18/2021] [Indexed: 11/23/2022] Open
Abstract
AIM To analyze the anatomical and functional outcomes in the inferior recurrences of rhegmatogenous retinal detachment (RRD) depending on the surgical approach. METHODS Eighty-one eyes of 81 patients (47 males and 34 females with a mean age of 54.8±14.1y) who demonstrated at least one inferior recurrence of RRD were included in this retrospective study. All patients were categorized as having received either circular scleral buckling (SB), pars plana vitrectomy (PPV), a combination of SB and PPV (SB+PPV), PPV with retinotomy (PPV+RT), or PPV+RT and short-term postoperative perfluorocarbon liquid tamponade (PPV+RT+pPFCL). All cases were followed up until successful retinal reattachment or third recurrence. The primary outcome measures were the achievement of the surgical goal without recurrence of RRD and best-corrected visual acuity (BCVA). RESULTS After the treatment of the first recurrence, the recurrence rate in the PPV+SB group was statistically significantly lower than that of the PPV (P=0.0012), PPV+RT (P=0.028), or PPV+RT+pPFCL (P=0.047) group. There was no statistically significant difference between PPV+SB, PPV+RT, and PPV+RT+pPFCL groups in the recurrence rate after treatment of the second recurrence (42 eyes). However, there was a statistically significant (P=0.016) trend towards a decrease of recurrence rate after PPV+RT+pPFCL. There was no statistically significant improvement of BCVA in either study group (P>0.05) after both first and second recurrence surgery. The mean time follow-up was 109.0±91.0d before the first recurrence and 210.0±186.6d between previous surgery at second recurrence. CONCLUSION Patients with first inferior recurrence of RRD may benefit from SB as an adjunct to PPV. RT and short-term pPFCL tamponade in the second recurrence may allow better anatomical outcomes, however, without functional improvement.
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Affiliation(s)
- Sergey V Churashov
- Department of Ophthalmology, Military Medical Academy, St Petersburg 194044, Russia
| | - Tatiana N Shevalova
- Department of Ophthalmology, Military Medical Academy, St Petersburg 194044, Russia
| | - Alexei N Kulikov
- Department of Ophthalmology, Military Medical Academy, St Petersburg 194044, Russia
| | - Dmitrii S Maltsev
- Department of Ophthalmology, Military Medical Academy, St Petersburg 194044, Russia
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Wang YH, Huang C, Tseng YL, Zhong J, Li XM. Refractive Error and Eye Health: An Umbrella Review of Meta-Analyses. Front Med (Lausanne) 2021; 8:759767. [PMID: 34805225 PMCID: PMC8599990 DOI: 10.3389/fmed.2021.759767] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 10/04/2021] [Indexed: 12/28/2022] Open
Abstract
Purpose: To explore the associations between refractive errors and multiple eye health outcomes. Methods: This is an umbrella review based on systematic reviews with meta-analyses. In our study, refractive errors included myopia, hyperopia, astigmatism, and anisometropia. We reconducted the meta-analyses whose primary data were available in sufficient detail by random effect model. Heterogeneity was assessed by I 2. The main outcomes included myopic macular degeneration (MMD), retinal detachment (RD), cataract, open-angle glaucoma (OAG), strabismus, age-related macular degeneration (AMD), and diabetic retinopathy (DR). Results: Myopia was associated with increased risk of MMD (relative risk = 102.11, 95% CI 52.6-198.22), RD (3.45, 1.08-11.00), nuclear cataract (2.15, 1.53-3.03), posterior subcapsular (PSC) cataract (1.74, 1.41-2.15), OAG (1.95, 1.74-2.19), exotropia (5.23, 2.26-12.09), but decreased risk of DR (0.83, 0.66-1.04), and early AMD (0.80, 0.67-0.94). From mild-to-high myopia, the association strengthened for MMD, RD, nuclear cataract, PSC cataract, OAG, and DR. Hyperopia was associated with an increased risk of early AMD (1.09, 1.01-1.18) and esotropia (22.94, 10.20-51.62). Astigmatism and anisometropia were associated with increased risk of both exotropia and esotropia. Conclusions: Myopia, especially high myopia, demonstrated the highest risk for eye health outcomes, such as MMD, RD, OAG, nuclear and PSC cataracts, and exotropia. However, myopia was associated with a lower risk of early AMD and DR. Individuals with hyperopia are more likely to suffer early AMD and esotropia. Astigmatism and anisometropia predispose to strabismus. A lot of research studies on the mechanism of the associations are needed. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=239744; identifier: 239744.
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Affiliation(s)
- Yin-Hao Wang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Chen Huang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Center of Basic Medical Research, Peking University Third Hospital, Beijing, China
| | - Yu-Lin Tseng
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Jing Zhong
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Xue-Min Li
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
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Soekamto C, Chu ER, Johnson DA, Sohn JH, Bahadorani S. Protective Role of 360° Laser Retinopexy in Patients with Rhegmatogenous Retinal Detachment: a Systematic Review and Meta-analysis. KOREAN JOURNAL OF OPHTHALMOLOGY 2021; 35:215-222. [PMID: 34120420 PMCID: PMC8200595 DOI: 10.3341/kjo.2021.0013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/21/2021] [Indexed: 12/30/2022] Open
Abstract
PURPOSE Visual impairment from retinal re-detachment could be debilitating. The aim of this review is to evaluate the role of 360° laser retinopexy on success rate of rhegmatogenous retinal detachment (RRD) repair by a meta-analysis study. METHODS The PubMed, Scopus, and the Cochrane Library databases were searched comprehensively from the date of database inception to January 2021, evaluating the role of 360° laser retinopexy in visual and anatomical success rate of RRD repair. This review was conducted based on the preferred reporting items for systematic review and meta-analysis (PRISMA) protocols. RESULTS Among 202 articles screened for eligibility, six studies were found to be eligible for inclusion in our final analysis. Our meta-analysis demonstrates that prophylactic treatment with circumferential laser photocoagulation has no significant effect on the initial rate of retinal re-detachment or final best-corrected visual acuity following pars plana vitrectomy repair of RRD. Subgroup analysis of studies (n = 3) with 23-gauge pars plana vitrectomy, however, favors attachment rate in patients undergoing 360° prophylactic laser treatment. CONCLUSIONS Three hundred and sixty degree laser retinopexy appears to have favorable outcomes in patients undergoing 23-gauge retinal detachment repair. This protective effect, however, is not apparent with inclusion of 20-gauge vitrectomy studies.
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Affiliation(s)
- Christa Soekamto
- Department of Ophthalmology, University of Texas Health at San Antonio, San Antonio, TX, USA
| | - Edward R Chu
- Department of Ophthalmology, University of Texas Health at San Antonio, San Antonio, TX, USA
| | - Daniel A Johnson
- Department of Ophthalmology, University of Texas Health at San Antonio, San Antonio, TX, USA
| | - Jeong-Hyeon Sohn
- Department of Ophthalmology, University of Texas Health at San Antonio, San Antonio, TX, USA
| | - Sepehr Bahadorani
- Department of Ophthalmology, University of Texas Health at San Antonio, San Antonio, TX, USA
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Outcome of Surgical Management of Glaucoma Following Complex Retinal Detachment Repair With Silicone Oil Tamponade: Drainage Implant Versus Cyclophotocoagulation. J Glaucoma 2020; 29:198-204. [PMID: 31913222 DOI: 10.1097/ijg.0000000000001435] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PRéCIS:: Glaucoma drainage devices (GDDs) are effective for the management of silicone oil-induced glaucoma. Although cyclophotocoagulation (CPC) has the advantage of shorter operative time and repeatability, it carries a higher risk of failure, blindness, and phthisis. BACKGROUND/AIMS To compare the surgical outcome of GDD implantation and diode laser CPC in the management of refractory glaucoma following vitrectomy with silicone oil (SO) injection. MATERIALS AND METHODS In total, 56 eyes with refractory glaucoma after SO tamponade that underwent either CPC or GDD implantation were retrospectively evaluated. All patients underwent a complete ophthalmic examination and intraocular pressure (IOP) measurement at baseline and 1 day, 1 week, 1, 3, 6, and 12 months postoperatively. The rates of complete success and qualified success (for IOP between ≥5 and ≤21 mm Hg) were analyzed. RESULTS A total of 17 eyes underwent GDD implantation and 39 eyes underwent CPC. The preoperative IOP was 35.7±7.9 mm Hg and 27.8±8.4 mm Hg for the CPC and GDD groups, respectively (P=0.001), with a worse baseline visual acuity (P=0.01) and a higher proportion of SO-filled eyes in the CPC group (P<0.01). The IOP at 1 year postoperatively was 23.5±11.5 mm Hg and 15.3±5.9 mm Hg for the CPC and GDD group, respectively (P=0.01). Both groups achieved a reduction in IOP and number of medications at 1 year (P<0.001). The success rate in the GDD group was 94.1% (16/17), and 53.8% (21/39) in the CPC group at 12 months (P<0.005). Five eyes and 1 eye lost light perception vision in the CPC and GDD groups, respectively. CONCLUSIONS GDD implantation may carry a higher surgical success rate than CPC. However, CPC retains the advantage of being technically easier and repeatable.
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Décollement de rétine rhegmatogène chez l’adulte jeune : caractéristiques cliniques et résultats chirurgicaux. J Fr Ophtalmol 2020; 43:404-410. [DOI: 10.1016/j.jfo.2019.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 09/25/2019] [Indexed: 12/11/2022]
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SURGICAL OUTCOMES OF 25-GAUGE PARS PLANA VITRECTOMY USING AIR AS AN INTERNAL TAMPONADE FOR PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT. Retina 2020; 40:2077-2082. [PMID: 31922498 DOI: 10.1097/iae.0000000000002744] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To report surgical outcomes of 25-gauge pars plana vitrectomy using air as an internal tamponade for patients with primary rhegmatogenous retinal detachment (RRD). METHODS A retrospective clinical study of 59 eyes of 59 consecutive patients presented with primary RRD at the Beijing Tongren Eye Center in China. From August 2016 to May 2018, medical records of the patients who underwent 25-gauge pars plana vitrectomy with air tamponade for RRD were reviewed. The main outcome measures were primary and final anatomical success (retinal re-attachment) rates, and postoperative complications. RESULTS Of the 59 patients, aged 54.47 ± 11.81 years, 31 (52.5%) were men. Vitrectomy was performed 3 to 40 (averaged 16.98 ± 10.17) days after the onset of symptoms, and the mean follow-up period was 12.90 ± 5.92 months (ranging 6.07-26.10 months). Forty-two eyes (71.2%) had RRD with retinal breaks in the superior half of the retina, and the mean number of retinal breaks was 1.75 ± 0.94. Three eyes (5.1%) had RRD with giant retinal tears. Of the 59 eyes, 35 (59.3%) had RRD with inferior quadrants involved. Proliferative vitreoretinopathy (PVR) gradings were C1 in 2 (3.4%) eyes and B or below in 57 (96.6%) eyes. The primary and final anatomical success rates were 94.9% (56/59) and 98.3% (58/59), respectively. Of the three eyes which developed re-detachment of the retina, one eye had postoperative progression of PVR and two eyes were RRD associated with macular hole in high myopia. Postoperative complications included 5 eyes (8.5%) with serous choroidal detachment within 3 days after surgery and 4 eyes (6.8%) with macular epiretinal membrane formation 1 to 8 months after surgery. Secondary cataract surgery was performed in 13 of the 53 phakic eyes (24.5%) during follow-up. CONCLUSION Small-gauge pars plana vitrectomy with air tamponade may be effective in treating selected cases of relatively simple primary RRD. Additional studies are needed to verify the efficacy of this surgical approach for more complicated cases such as those with giant retinal tears.
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