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At least 523 records · Page 29Linked to original sources

PubMed2000

Visual outcome after silicone oil removal and recurrent retinal detachment repair.

PURPOSE: Prospective analysis of the effect of removal of silicone oil (ROSO) in eyes with complicated retinal detachments and evaluation of the visual outcome following recurrent retinal detachment after silicone oil removal. METHODS: We evaluated 62 consecutive cases of ROSO over a 12 month period. All eyes had previously undergone silicone oil placement for complicated retinal detachments. All eyes undergoing scheduled ROSO over the time period of the study were entered and were reviewed post-operatively. RESULTS: Sixty-two eyes were entered into the study. Twenty-one of 62 (34%) developed recurrent retinal detachment following ROSO; 18 of these 21 recurrent detachments were reattached with one additional procedure and only 5 required replacement of the silicone oil. Ten of these 21 eyes (48%) had improvement or stabilisation in final visual acuity compared with the presenting visual acuity. Overall, 39 eyes (63%) had improvement in vision following ROSO and 76% of all eyes had ambulatory visual acuity at the end of the follow-up period. Fourteen eyes required cataract extraction with ROSO to attain this final visual acuity. CONCLUSIONS: Overall, ROSO has a significant rate of recurrent retinal detachment, with a high reattachment rate with one additional procedure. Few of these eyes need the silicone oil replaced. Most eyes will retain ambulatory visual acuity even with multiple procedures in cases of complicated retinal detachments following ROSO even with recurrent retinal detachment.

Adolescent↗

PubMed1996

Cryopexy in primary rhegmatogenous retinal detachment: a risk factor for postoperative proliferative vitreoretinopathy?

PURPOSE: To evaluate the role of cryopexy in the stimulation of postoperative proliferative vitreoretinopathy (PVR) in primary rhegmatogenous retinal detachment. MATERIALS AND METHODS: A series of 595 eyes of 554 patients with primary rhegmatogenous retinal detachment, referred before any failed surgery, were prospectively evaluated. Univariate and multivariate statistical analyses of the data were conducted. RESULTS: The incidence of postoperative PVR in relation to the methods used for retinopexy was dependent on the types and anatomy of retinal breaks associated with retinal detachment. The incidence of postoperative PVR was nil in retinal detachments due to atrophic holes in lattice, oral dialyses, and macular holes, regardless of the retinopexy methods. Postoperative PVR occurred solely in retinal detachments due to horseshoe tears (incidence 4.42%), paravascular tears of the postequatorial region (18.18%), and giant tears (24.6%) (P < 0.00001). The incidence of postoperative PVR was 0.5% in eyes with horseshoe tears with mobile posterior edges vs 9.72% in eyes with horseshoe tears with curled posterior edges, regardless of the retinopexy methods (P < 0.00001). In retinal detachments due to horseshoe tears with mobile posterior edges the incidence of postoperative PVR (0.5%) was not influenced by the retinopexy methods. In contrast, in retinal detachments due to horseshoe tears with curled posterior edges the incidence of postoperative PVR was higher in eyes managed with cryopexy (14.77%) than in eyes managed with laser retinopexy (1.78%) (P < 0.02). In retinal detachments due to giant tears the incidence of postoperative PVR was not statistically significantly greater in eyes managed with cryopexy (33.3%) than in eyes managed with laser retinopexy (15.6%). In tears 180 degrees and over in size, however, the incidence of postoperative PVR was significantly higher in eyes managed with cryopexy (9/11 eyes) than in eyes managed with laser retinopexy (5/17 eyes) (P = 0.006). CONCLUSIONS: Cryopexy is not a stimulating factor for postoperative PVR in primary rhegmatogenous retinal detachments due to atrophic holes in lattice, oral dialyses, macular holes, or horseshoe tears with mobile posterior edges. In contrast, cryopexy probably is a stimulating factor for postoperative PVR in retinal detachments due to horseshoe tears with curled posterior edges or to retinal tears 180 degrees and over.

Adolescent↗

PubMed1982

Experimental retinal detachment. II. Role of the vitreous.

The role of the cortical vitreous in persistence of experimental retinal detachments was evaluated in cynomolgus monkeys. Detachments were created by subretinal injection of 20% autologous serum in Ringer's solution. A pars plana vitrectomy was performed on selected eyes with a Douvas vitrectomy instrument before creation of the detachment. Retinal holes were created from the subretinal side with a hooked needle or from the vitreal side with the vitrectomy instrument. The rate of reattachment of the retina was rapid and independent of retinal holes size if cortical vitreous covered the retinal hole. If no cortical vitreous covered the retinal hole, the retina remained detached indefinitely (longer than three months). A spontaneous reduction in the size of the retinal hole occurred in many eyes in association with star-fold formation. It is concluded that cortical vitreous is capable of obstructing fluid movement through the retinal hole.

Animals↗

PubMed1994

The changes of ocular axial length and corneal curvatures after scleral buckling for retinal detachment.

As myopia plays an important role in the pathogenesis of retinal detachment, alterations of refractive components after scleral buckling procedures for retinal detachment may be an important factor for retinal redetachment. To find out the refractive change following retinal detachment surgery, we prospectively followed up the alterations of corneal curvature, and axial components (axial length, anterior chamber depth, lens thickness, and vitreous length) of 44 eyes of rhegmatogenous retinal detachment before and after operations. The procedures consisted of encircling scleral buckling (12 eyes) and segmental scleral buckling (32 eyes). All patients were followed for 6 months postoperatively. The corneal curvatures were measured with a keratometer, the axial length and axial components were measured with an A-scan ultrasonography. The methods and materials used in operation were recorded in detail to correlate with the refractive changes. The corneal curvature showed a trend to flatten early after operation (the 1st week), and gradually reversed to steepening. But, the difference was statistically significant only at the K2 (vertical meridian) in the 1st postoperative week and the K1 (horizontal meridian) in the 4th postoperative week. Lengthening of eyeballs were noted in the encircling group (12 eyes), but only the elongation in the 1st postoperative week was statistically significant. While in segmental buckling group, the axial length of the eyeballs was transiently shortened. The shortening was significant in the 2nd, 4th, and 6th week after operation. The reduction of eyeball's axial length was related to the shortening of vitreous length and shallowing of anterior chamber.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1990

An analysis of subretinal fluid in bullous retinal detachment.

A patient with bilateral bullous retinal detachment underwent drainage of the subretinal fluid. The analysis of the subretinal fluid revealed a high protein concentration--17.4 g/dl OD, 27.5 g/dl OS--which was 3-5 times higher than that of the patient's serum. The protein fractionations of the subretinal fluid were almost the same as those of the serum. These findings may well explain the shifting fluid and support the theory that bullous retinal detachment is caused by the breakdown of retinal pigment epithelial function as a barrier between the choroid and retina.

Adult↗

PubMed1975

Retinal detachment in retrolental fibroplasia.

Retrolental fibroplasia is a continuing problem in ophthalmology and may lead to retinal detachment. In this study, two groups of patients with retrolental fibroplasia and retinal detachment are described. The first group consists of youngsters who develop retinal detachment during their teenage years and frequently have not been diagnosed as having the disease until the retina detaches. Usually definite retinal breaks can be found near the equator and these are round or oval in appearance and without opercula. A second group of patients was noted to develop retinal detachment at an earlier age. The configuration of these detachments suggested a rhegmatogenous etiology, but retinal breaks were hard to detect because the peripheral retina was frequently obscured by a membrane or cataract. Additional evidence to support this opinion was provided when a small retinal hole was identified in one youngster whose ora could be easily seen. Because of the progressive nature of vitreoretinal adhesion in retrolental fibroplasia, it is advocated that youngsters with any evidence of retrolental fibroplasia at the time of discharge from the premature nursery be followed at one month, three months, and six months of age and at four-month intervals thereafter until the age of four years. If no difficulty develops by the time, yearly examinations suffice. Follow-up examinations are important because when prompt diagnosis of retinal detachment is made, the involved eye can often be salvaged with surgery.

Adolescent↗

PubMed1998

Pneumatic retinopexy for late-onset recurrent retinal detachment.

BACKGROUND AND OBJECTIVE: Pneumatic retinopexy is used as a primary procedure for the repair of retinal detachments caused by visible retinal tears. Its application for late-onset recurrent retinal detachments following previous pneumatic retinopexy or scleral buckling procedure has not been reported to date. PATIENTS AND METHODS: Pneumatic retinopexy was performed in 12 patients with recurrent retinal detachments due to new retinal tears who presented 6 months to 10 years after pneumatic retinopexy (8 patients) or scleral buckling surgery (4 patients). Follow-up ranged from 6 to 24 months. RESULTS: All the retinas reattached within the first few postoperative days and remained attached throughout follow-up. No intraoperative or postoperative complications were observed. Visual acuity either remained unchanged (if good before) or improved. CONCLUSION: Pneumatic retinopexy may be a feasible option for recurrent late-onset retinal detachment under the proper clinical conditions.

Cryotherapy↗

PubMed1999

Pars plana vitrectomy without scleral buckle for pseudophakic retinal detachments.

OBJECTIVE: To report the anatomic and visual results of primary pars plana vitrectomy (PPV) without scleral buckling to repair primary rhegmatogenous retinal detachments in pseudophakic eyes. DESIGN: Nonrandomized, prospective, comparative clinical trial. PARTICIPANTS: Two hundred eighty-three consecutive patients (294 eyes) with pseudophakia, peripheral retinal tears, and new rhegmatogenous retinal detachments were treated according to the surgery protocol. INTERVENTION: Patients underwent PPV with fluid-gas exchange and endolaser to repair the retinal detachment. Two hundred sixty-four patients (275 eyes) were followed from 6 months to 6 years and 8 months with an average follow-up of 19 months. MAIN OUTCOME MEASURES: Reattachment of the retina and visual outcome were compared to previously published studies. RESULTS: Of 97 eyes with a macula-attached rhegmatogenous retinal detachment, 88 eyes (91%) were reattached with a single operation, and of the 178 eyes with a macula-detached retinal detachment, 153 (86%) eyes were reattached with a single operation. In 241 (88%) of 275 eyes, the retina was reattached with a single operation, and in 265 (96%) of 275 eyes, the retina was ultimately reattached with subsequent operations. The median initial visual acuity was 20/300, and the median final visual acuity was 20/40. The rate of reattachment with one operation was similar for eyes with an anterior chamber intraocular lens (91%) and for eyes with a posterior chamber intraocular lens (88%). Refractive error measurements obtained in 81 eyes were essentially unchanged. The mean change in refractive error was -0.15 diopter. Seventeen eyes (6%) developed macular puckers requiring surgery, 46 eyes (17%) developed cystoid macular edema, and 6 eyes (2%) developed full-thickness macular holes. CONCLUSION: Primary PPV with fluid-gas exchange and laser is a safe, effective method to repair primary pseudophakic retinal detachments. The anatomic reattachment rate and the visual acuity obtained with this technique appear to be at least as good as those reported in the literature for scleral buckling, PPV with scleral buckling, and pneumatic retinopexy.

Fluorocarbons↗

PubMed1979

Massive periretinal proliferation in retinal detachment in relation to diabetes mellitus.

The relationship between the 'diabetic state' and massive periretinal proliferation (MPP) in idiopathic retinal detachment was examined. In 18 (3.5%) of 508 cases of idiopathic retinal detachment, MPP occurred before or after retinal detachment surgery. In 24 cases of retinal detachment, a diabetic or suspected diabetic state was found. 11 of the 24 were receiving treatment for diabetes and never developed MPP, while 5 of the 13 patients who were not being treated had MPP. This suggests that MPP in retinal detachment may easily be induced by the diabetic state and prevented by treatment for diabetes. Additional causes of MPP in retinal detachment were giant tears, massive vitreous hemorrhages at operation and frequent recurrence.

Diabetes Complications↗

PubMed1995

Prospective study of cataract surgery, capsulotomy, and retinal detachment.

We report the incidence of retinal detachment (RD) in 1543 consecutive cases of cataract extraction in a prospective cohort study. Retinal detachment was significantly associated with intracapsular extraction, axial lengths of 24.0 mm or longer and an intact capsule, and capsulotomy in eyes with axial lengths of 24.0 mm or longer. The interval between capsulotomy and RD was significantly shorter in eyes with axial lengths of 24.0 mm or greater. An intraocular lens with stiff, vaulted, poly(methyl methacrylate) optics and a biconvex PMMA optic was associated with significantly less capsule opacification than lenses of other designs.

Cataract Extraction↗

PubMed1992

Acute onset of rubeosis iridis after diabetic vitrectomy can indicate peripheral traction retinal detachment.

Acute onset or exacerbation of rubeosis iridis associated with peripheral retinal detachment after vitrectomy represents a rare but serious complication of advanced diabetic retinopathy that indicates a poor prognosis. The clinical features, surgical procedures, and anatomical and functional results for a series of 13 eyes presenting with this complication are reported. In addition to rubeosis iridis and peripheral retinal detachment, anterior hyaloidal fibrovascular proliferation (APH) was also present in 10 eyes. All eyes had undergone one or more previous vitrectomies for diabetic complications such as nonclearing vitreous hemorrhage and traction retinal detachment. Treatment modalities for iris neovascularization and peripheral retinal detachment included reattachment procedures with an encircling band, peripheral membrane peeling, and, if necessary, peripheral retinectomy. Peripheral coagulation therapy was performed in all eyes. Eight eyes received an intraocular silicone-oil tamponade. Early results (4 weeks post-surgery) showed regression or stabilization of rubeosis iridis in all eyes. Later results (mean, 9 months post-surgery) revealed nine eyes with stabilized anterior ocular neovascularization and reattachment of the retina. Four eyes were anatomic failures due to recurrent rubeosis iridis/AHP or traction retinal detachment, and three of them also developed ocular hypotony. None of the eyes has thus far been lost as a result of neovascular glaucoma or painful phthisis. Ambulatory vision was retained in ten eyes, but function was limited to a low level as a result of the underlying ischemic disease. Immediate reattachment surgery in combination with anterior/peripheral coagulation therapy was shown to be an effective measure for controlling iris neovascular activity in eyes afflicted with acute anterior ocular neovascularization.

Acute Disease↗

PubMed1985

Degenerative retinoschisis with giant outer layer breaks and retinal detachment.

Five unusual cases of retinal detachment were caused by giant (more than 90 degrees) posterior breaks in the outer layer of degenerative retinoschisis. All retinas were successfully reattached by a variety of surgical techniques. The two cases managed with scleral buckling required subsequent buckle removal because of macular distortion. Treatment with cryotherapy or laser, together with intraocular air and postoperative positioning, gave better anatomic results.

Female↗

PubMed1992

Histopathologic characteristics of diode laser-induced chorioretinal adhesions for experimental retinal detachment in rabbit eyes.

A retinal break and localized retinal detachment were induced in 10 rabbit eyes. The retinal break was treated within regions of detached retina using diode laser transscleral retinopexy (four eyes), diode laser indirect ophthalmoscopy (two eyes), or retinocryopexy (two eyes). Two eyes were left as untreated controls. The clinical and histopathologic effects were studied 1 day and 3 weeks after initial treatment. Suitable chorioretinal adhesions were induced with all treatment modalities. The extent of tissue effects was greater in cryopexy and smaller in laser treatment. The histopathologic characteristics of the lesions induced by diode laser indirect ophthalmoscopy were similar to those seen with transscleral diode treatment and were more focal than those seen with cryopexy. Transscleral and transpupillary diode laser photocoagulation were effective in inducing chorioretinal adhesions in detached retina in this experimental model in rabbits.

Animals↗

PubMed1995

Atopic retinal detachment. Report of four cases and a review of the literature.

Ocular complications of atopic dermatitis include cataract, blepharitis, keratoconjunctivitis, keratoconus, iritis and retinal detachment. The aim of this study was to evaluate the characteristics of retinal detachment in atopic dermatitis patients. We examined four patients with atopic dermatitis and retinal detachment, and performed an extensive review of the literature. There have been about 130 reported cases of retinal detachment in patients with atopic dermatitis from Japan, in comparison with only a few reports from Europe and the U.S.A. An extensive review of the literature revealed that retinal detachment occurs at a young age in atopic dermatitis patients, and that often both eyes are involved. As retinal detachment is not a rare complication of atopic dermatitis, we propose that this type of retinal detachment is designated 'atopic retinal detachment'. Dermatologists should be aware of this potential complication of atopic dermatitis.

Adolescent↗

PubMed2004

Prophylactic treatment of the fellow eye of patients with retinal detachment: a retrospective study.

BACKGROUND: Controversy exists over the prophylactic treatment of predisposing lesions to prevent retinal detachment. METHODS: Seven hundred sixty consecutive phakic fellow eyes with rhegmatogenous retinal detachment in the first eye were examined by the same vitreoretinal surgeon before detachment surgery and for a follow-up period ranging from 1 to 72 months, with a mean of 36 months. During this period, in 305 fellow eyes (40.1%) predisposing retinal lesions were present and prophylactic treatments (photocoagulation, cryotherapy or scleral buckle) were performed independently of vitreous status. The results were then compared with the incidence of bilateral RD without prophylaxis reported in Folk and Burton's study of 1982; the two study's data were well matched and showed no significant difference in regards to age, sex, incidence myopia > or =-2.5 and incidence of lattice degeneration. The objective was to investigate whether or not prophylactic treatment is able to avert retinal detachment in the fellow eye. RESULTS: The age of the patients with peripheral retinal lesions was correlated inversely with the presence of myopia. Nine eyes out of 305 eyes treated (2.9%) developed a retinal detachment, reducing the rate of bilateral retinal detachment to 1.2% (9 eyes out of 760). CONCLUSIONS: This incidence of bilaterality (1.2%) was lower than the incidence of retinal detachment in fellow eyes not prophylactically treated as reported in the literature, and there exists a highly statistically significant difference between this study's data of 1.2% after prophylaxis and a 13.4% rate of bilaterality as reported by Folk without prophylaxis (P=0.0000).

Adolescent↗

PubMed2000

Surgical treatment of retinal detachment owing to macular hole.

Retinal detachments owing to macular hole have a low prevalence and occur predominantly in myopic eyes. The choice of surgical technique is primarily based on the axial length of the globe and on the presence or absence of a posterior staphyloma and/or chorioretinal degenerations. Whereas patients with low myopia and no posterior staphyloma are best treated with primary pars plana vitrectomy and air tamponade, patients with marked myopia and large posterior staphylomas should be managed by combining a pars plana vitrectomy with laser photocoagulation of the macular hole rim under perfluorocarbon liquids and a temporary silicone oil tamponade. For the intermediate myopias the surgical technique has to be decided from patient to patient.

Humans↗

PubMed1993

[Peripheral retinal correspondence after retinal detachment].

BACKGROUND: Occasionally, patients who underwent surgery for complicated retinal detachment report spatial distortions. This may be due to a translocation of photoreceptors when they become reattached to the pigment epithelium. We wanted to find out if, and to what extent, similar translocations occur after a simple buckling operation. METHODS: Binocular retinal correspondence was used as an indicator of photoreceptor translocation. Correspondence was measured in the peripheral visual field at eccentricities of 5, 10 and 20 degrees, using a mirror haploscope. We examined two normal observers, one patient having had surgery for complicated retinal detachment including retinotomy, and 23 patients who had simple radial buckling operations. RESULTS: The patient who had received complicated detachment surgery including retinotomy revealed a tremendous shift in correspondence. Of the 23 patients who had simple radial buckle operations, only 10 were able to sustain central fixation while being tested in the periphery. Of these 10 patients, 2 showed distortions of peripheral retinal correspondence in the area of previous retinal detachment. However, only one of them remembered some spatial distortion after surgery. CONCLUSION: As a rule, photoreceptors become correctly reattached after radial buckle operations for retinal detachment. Rarely, vertical or horizontal translocations of about 1 to 2 degrees occur, but this does not usually lead to metamorphopsia.

Adult↗

PubMed1977

Aphakic retinal detachment.

The incidence of aphakia in our series of retinal detachment is 14.82%. The incidence of retinal detachment in aphakia is 2.74%. The use of alpha-chymotrypsin does not influence this incidence. In our own patients, we did not find a sex predominance, although there was a predominance of the male sex in the referred group. The mean age of the patients affected by aphakic retinal detachment was 65.87 years and 82.6% of the cases occurred above the age of 56 years. There was no statistical significant difference between the right and the left eye involvement. Finally, 38.37% of the detachments appeared during the first year after the cataract extraction, 24.4% were myopic and 14.66% bilateral.

Adult↗