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At least 487 records · Page 27Linked to original sources
PubMed1996

[Conventional methods in retinal detachment surgery].

PURPOSE: To evaluate the usefulness of conventional methods in retinal detachment (RD) surgery basing on the relationship between factors characterizing clinical picture of the RD, the type and course of surgical procedures and the retinal reattachment. MATERIALS AND METHODS: 252 patients (252 eyes), operated on in the last 5 years in our clinic were enrolled in the studies. There were 120 men and 132 women, aged 9 to 83, mean 53. In all cases scleral buckling procedures with silicone band or sponge and cryocoagulation of the breaks were used. The relationship between retinal reattachment and the following parameters were examined: visual acuity, retinal degenerations, myopia, extent of the detachment, number and kinds of breaks, macular involvement, state of vitreous, PVR, intraocular pressure, extent of scleral buckling, subretinal fluid drainage and intra- or post-operative complications. RESULTS: Retinal reattachment was achieved in 82% of the eyes with one operation and additionally in 7% after reoperation. The significant relationship was found between: visual acuity, intraocular pressure, extent of the detachment, number of breaks, PVR, extent of scleral buckling and retinal reattachment. CONCLUSION: PVR is a significant cause of failure in RD surgery with conventional methods and PVR grade C is the threshold beyond which the percentage of reattachments decreases to about 50%. Value of other risk factors, determining severity of RD is not certain for prognosis. Cerclage with silicone band is a method of choice in the majority of RD with PVR grade B and C. Our observations do not confirm the reports of severe complications caused by cerclage, which might be connected with excessive tightening of the band.

Adolescent↗
PubMed2003

Modified external needle drainage procedure for rhegmatogenous retinal detachment.

PURPOSE: To describe the results of a modified external needle subretinal fluid drainage technique to treat eyes with a rhegmatogenous retinal detachment. METHODS: One hundred eighty-seven consecutive patients with a rhegmatogenous retinal detachment who underwent scleral buckle and modified external needle drainage at Duke Eye Center or Vistar Eye Associates were included in this study. Subretinal fluid was drained by a technique whereby the intraocular pressure was raised to a supranormal level by tightening an encircling scleral buckle and then the subretinal space was entered by a needle introduced externally while the retina was directly viewed with an indirect ophthalmoscope. Subretinal fluid drainage success rate, one-operation reattachment rate, final retinal reattachment rate, intraoperative and postoperative complication rates, and final visual acuity were the main outcome measures. RESULTS: Subretinal fluid was successfully drained in all eyes. The one-operation reattachment rate was 91%, and the final reattachment rate was 98%. Intraoperatively, 15% of eyes required corneal debridement to obtain an adequate view for safe subretinal fluid drainage. Subretinal hemorrhage of no more than one clock hour occurred in 4.2% of eyes. A total of 2.6% of eyes developed an epiretinal membrane postoperatively that required a vitrectomy to improve the visual acuity. The postoperative visual acuity, 0.54 by logMAR (20/69 by Snellen), was significantly better than the preoperative visual acuity, 1.1 logMAR (20/250 by Snellen) (P < 0.0001). CONCLUSIONS: The modified external needle drainage technique is a flexible, effective method to drain subretinal fluid in eyes with a rhegmatogenous retinal detachment. The retinal reattachment rate and complication rate compare favorably to alternative subretinal fluid drainage techniques.

Body Fluids↗
PubMed1991

Nitrous oxide and internal tamponade during vitrectomy.

We analysed the nitrous oxide composition of the intraocular gas bubble following vitrectomy and fluid-air exchange in 12 patients. Samples were taken under standardised conditions at 20 minutes after completion of the fluid-air exchange. Analysis was conducted by a Medishield MS2 mass spectrometer. The percentage composition of nitrous oxide in the samples varied between 4 and 21% (mean 9%). This influx of nitrous oxide was associated with an increase of intraocular pressure. Pressure rises of greater than 20 mm Hg were not seen owing to venting of gas through the sclerostomies. An inverse relationship was noted between the extent of retinal detachment preoperatively and the amount of nitrous oxide entering the eye. A possible explanation for this relationship is proposed. The importance of nitrous oxide movement is stressed.

Adolescent↗
PubMedDate not supplied

Silicone oil-induced secondary glaucoma: a case study.

Silicone oil intraocular tamponade is a widely accepted procedure in the management of complex retinal detachments caused by proliferative diabetic vitreoretinopathy. Silicone oil has a high surface tension that mechanically limits fibrovascular reproliferation resulting in successful retinal reattachments. However, postoperative secondary glaucoma is a relatively frequent complication that may require intensive nursing management focused at intraocular pressure monitoring, positioning compliance, pain management, fluid and electrolyte balance, and glucose control. This article presents the postoperative clinical course of a 51-year-old man with diabetes and recurrent proliferative diabetic vitreoretinopathy who developed secondary glaucoma after silicone oil injection with a dramatic rise in intraocular pressure on the first postoperative day. Nursing management concurrent with medical and surgical management is discussed and the necessary nursing plan of care is identified.

Diabetic Retinopathy↗
PubMed1978

New flat air injection cannula.

I developed a 6-mm long, flattened, 30-gauge air cannula with a polished tip for instillation and extraction of air and fluids from the anterior chamber during intraocular surgery. The polished flattened tip prevents Descemet's membrane detachments and the extra length allows easy instillation of air over an intraocular lens.

Air↗
PubMed1994

Concurrent endophthalmitis and retinal detachment.

PURPOSE: Eyes with concurrent endophthalmitis and retinal detachment usually have a poor anatomic and visual outcome after treatment. The purpose of this study is to define the relation among the causative organism, the results of retinal detachment repair, and the final visual acuity. METHODS: Data were retrieved by a retrospective, computer-assisted review of the coded inpatient diagnoses from April 1987 through March 1992. RESULTS: This study included 16 patients (9 males, 7 females) ranging in age from 5 to 88 years (average, 58.7 years). Endophthalmitis was classified as exogenous in 13 (81%) patients and endogenous in 3 (19%). Two groups were identified: a virulent group that included eight (50%) patients (Staphylococcus aureus, streptococci, gram-negative, Bacillus), and a less-virulent group that included eight (50%) patients (Staphylococcus epidermidis, Propionibacterium acnes, fungal). The initial surgical procedure consisted of diagnostic vitreous fluid collection by pars plana vitrectomy (11 cases), anterior vitrectomy (1 case), or vitreous aspiration (4 cases). Additional initial adjunctive surgical procedures included pars plana lensectomy (2 cases), scleral buckling (6 cases), fluid-gas exchange (7 cases), and intraocular antibiotic injections (9 cases). In six (75%) of eight patients with endophthalmitis in the virulent group, the retina remained detached. However, in seven (88%) of eight patients with endophthalmitis in the less-virulent group, the retina remained reattached postoperatively, and the remaining patient had a stable, nonprogressive peripheral tractional retinal detachment. None of the eight patients with endophthalmitis in the virulent group retained a postoperative visual acuity of better than 3/200, and four (50%) lost all light perception. Five (62%) of the eight patients with endophthalmitis in the less-virulent group retained a postoperative visual acuity of 5/200 or better, and none lost all light perception. CONCLUSIONS: Concurrent endophthalmitis and retinal detachment patients with virulent organisms have a poor prognosis. Visual and anatomic outcomes were better in the less-virulent group.

Adolescent↗
PubMed2003

Force comparison of air currents produced by a standard and modified infusion cannula.

OBJECTIVE: To develop and characterize an infusion cannula that reduces the intraocular jet forces created during fluid-air exchange. METHODS: A new infusion cannula was manufactured by adding a baffle 1.0 mm perpendicular to the distal opening of a 20-gauge infusion. The forces generated by the modified and standard cannulas were measured at a constant air infusion pressure of 50 mmHg by using a force sensor coupled to a schematic eye with eight radial positions from 0 degrees to 180 degrees along the circumference. Five different orientations relative to the baffle support of the modified cannula were evaluated at each position to assess the turbulent flow. RESULTS: The standard cannula produced a maximum force of 0.14 mmHg at 180 degrees from the sensor. The modified cannula generated a maximum pressure of 0.017 mmHg at 67.5 degrees from the sensor. Overall, the force from the modified cannula was an order of magnitude less than the standard infusion cannula (P < 0.01). CONCLUSIONS: The modifications of the new infusion cannula are passive with respect to its surgical performance. However, the additional baffle transforms laminar air currents into turbulent ones and allows dispersion of the jet forces, which should reduce barotrauma and desiccation of the retina during fluid-air exchange.

Biomechanical Phenomena↗
PubMed1988

Retinal detachment. A study of a population-based patient material in Sweden 1971-1981. III. Surgical results.

Surgical results and complications were studied retrospectively in 590 cases of retinal detachment in a population-based material of 538 patients. Of the 590 cases 96.3% were operated upon, and 22.9% of these underwent one or more re-operations. The technique used was cryo- or photocoagulation (100%) + scleral buckling or an encircling band (96%) + drainage of subretinal fluid (80%). The surgical complications were intraocular bleeding (13%), choroidal detachment (7%), and proliferative vitreo-retinopathy (5%). All complications were significantly more frequent after re-operations. Complete re-attachment was achieved in 78.1%. The re-attachment rate was significantly lower in aphakic cases (66.7%) than in phakic non-traumatic cases (80.8%). The visual acuity in re-attached cases was better than 0.5 in 33.7% and better than 0.1 in 72.2%.

Adult↗
PubMed2001

Non-penetrating glaucoma surgery using AquaFlow(TM)collagen implants.

AquaFlow TM is an absorbable collagen implant for use in non-penetrating surgery for primary open angle glaucoma. Its purpose is to facilitate drainage of fluid from the eye, thereby reducing intraocular pressure. AquaFlow TM is approved for use in Canada in medically refractory cases of primary open angle glaucoma. Non-penetrating glaucoma surgery with the AquaFlow TM implant appears to be a relatively safe procedure. However, there is a steep learning curve for the surgeon and it is initially associated with a high rate of conversion to conventional surgery during the operation. Limited evidence from small non-randomized trials suggests that the AquaFlow TM implant may offer benefits over conventional surgical approaches in terms of reduced complication rates, reduced medication use, an earlier return of improved vision and sustained control of intraocular pressure. However, the efficacy and cost-effectiveness of this approach have not been established. January, 2001 for use in patients with uncontrolled

Canada↗
PubMed2003

[An experimental substantiation of nitric-oxide containing gas flow in the treatment of eye traumas].

The hypothesis on the biostimulating effect of exogenous nitric oxide (NO) was made use of to develop a new method to stimulate the healing of wounds through treating them by a NO saturated gas flow. The above gas flow is generated by air-plasma unit "Plazon". The experimental and clinical studies confirmed that the NO-therapy is a highly effective treatment method for different lesions of the skin and soft tissues. We tried to use the above method in ophthalmology. A comprehensive experimental study was carried out to assess the impact of the NO-containing gas flow on the eyeball structures. An optimal mode was designed, which does not exert any influence on the intraocular pressure, Ph of the lachrymal fluid, antioxidative activity and on the proteinase-inhibitor balance in tears; no morphological changes occurred in the ocular tissue structures. The mentioned morphological and biochemical studies confirmed that the application of the NO-containing gas flow speeds up the healing, process of both an experimental cornea erosion and penetrating corneal wounds. Optimal modes of NO-therapy were defined for both types of lesions.

Animals↗
PubMed1977

Encirclement versus 360 degrees buckling and prognostic factors in retinal separation surgery.

In 554 consecutive primary cases, adverse prognostic factors for successful retinal detachment surgery were aphakic retinal detachment, severe vitreous traction creating retinal breaks, especially with lattice degeneration, long-standing retinal separations, choroidal or combined detachments, giant tears, Marfan's syndrome, and preoperative massive vitreous retraction (MVR). Vitreous haemorrhage was of secondary importance, and not a primary cause of MVR. The use of therapeutic encirclement is unnecessary and does not prevent the proliferative process of MVR. The few indications for cerclage, such as total retinal separation with no detectable breaks, total retinal separation with breaks in all quadrants, and MVR, are more effectively treated by 360 degrees scleral buckling. Encirclement should not be used as a constriction to obtain a buckle or to compensate for lost intraocular volume after drainage of subretinal fluid.

Humans↗