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At least 613 records · Page 34Linked to original sources
PubMed1977

Cataract operation and retinal detachment.

(1) 36 patients with a certified retinal detachment and a dense senile cataract who underwent cataract surgery prior to retinal surgery, (2) 32 patients with a history of detachment of one eye and a senile cataract of the other eye, who suffered a retinal detachment after cataract surgery. Discussion of the results of retinal surgery in the first group and on the incidence of retinal detachment and results of retinal surgery in the second group.

Cataract↗
PubMed1987

New retinal detachment after pneumatic retinopexy.

Thirteen cases of rhegmatogenous retinal detachment repaired by pneumatic retinopexy were reviewed retrospectively. All patients were followed for a minimum of 6 months after surgery. At the end of follow-up, retinal detachment repair by pneumatic retinopexy succeeded in nine cases (70%) and failed in four (30%). Within 2 days of pneumatic retinopexy, vitreous condensation and traction with new retinal tears and associated detachments in previously uninvolved quadrants developed in two patients. The occurrence of new retinal detachments in the early postoperative period after pneumatic retinopexy has not been previously observed.

Aged↗
PubMed2001

Incidence of retinal detachment and visual outcome in eyes presenting with posterior vitreous separation and dense fundus-obscuring vitreous hemorrhage.

PURPOSE: To determine visual outcomes and the incidence of retinal detachment in eyes presenting with posterior vitreous separation and dense fundus-obscuring vitreous hemorrhage. DESIGN: Retrospective consecutive noncomparative interventional case series. PARTICIPANTS: Thirty-six eyes (15 right eyes and 21 left eyes) of 34 patients (18 female and 16 male) ranging in age from 42 to 94 years. Mean follow-up was 14 months. METHODS: A comparison of the best-corrected initial visual acuities versus final visual acuities after spontaneous resolution of vitreous hemorrhage or surgical intervention. The number of eyes that were found to have retinal tears or that had a rhegmatogenous retinal detachment develop was documented. Logarithm of the minimum angle of resolution-converted visual acuities was used for comparison. Categorical data were analyzed by Fisher's exact test, and population means were compared by Student's t test. MAIN OUTCOME MEASURES: Final mean visual acuities, number of eyes with at least one retinal tear, location of retinal tears, number of eyes that had retinal detachment develop, and the number of eyes repaired with scleral buckling surgery and/or pars plana vitrectomy. RESULTS: Twenty-four of 36 eyes (67%) were found to have at least one retinal break (range, 0-4 breaks), with 88% of breaks located in the superior retina. Eleven eyes (31%) had more than one retinal break. Fourteen of 36 eyes (39%) had a rhegmatogenous retinal detachment develop that was repaired with pars plana vitrectomy and scleral buckling. An additional 14 eyes (39%) underwent vitrectomy for nonclearing vitreous hemorrhage. The incidence of retinal detachment in eyes with a history of retinal detachment in the contralateral eye was 75% (P = 0.04). Seven of 14 eyes (50%) with retinal detachment had coexisting proliferative vitreoretinopathy. Most retinal breaks and detachments occurred in emmetropic or myopic eyes. For all 36 eyes the mean preoperative visual acuity was 20/1233, and the mean final visual acuity was 20/62 (P < 0.0001). Eyes that had a macula-off retinal detachment develop had worse final visual outcomes (20/264; P = 0.01), as did eyes that had proliferative vitreoretinopathy develop (20/129; P = 0.04). CONCLUSIONS: Acute, spontaneous, nontraumatic posterior vitreous separation with dense fundus-obscuring vitreous hemorrhage is associated with a high incidence of retinal tears and detachment. Close follow-up with clinical examination and ultrasonography is necessary, because many of these eyes may eventually require surgical intervention. Aggressive management with early vitrectomy should be considered when there is a history of retinal detachment in the contralateral eye.

Adult↗
PubMedDate not supplied

Early rhegmatogenous retinal detachment following laser in situ keratomileusis for high myopia.

PURPOSE: Four eyes had early rhegmatogenous retinal detachment within 3 months of laser in situ keratomileusis (LASIK) for correction of high myopia using the microkeratome, Clear Corneal Molder. METHODS: In two eyes, retinal detachment resulted from horseshoe tears, one occurring in an otherwise normal region of the retina and the other at the margin of an area of lattice degeneration detected during preoperative examination. The first eye was treated with retinopexy using a 287 encircling scleral exoplant, drainage of subretinal fluid, and laser photocoagulation by indirect ophthalmoscopy. The other eye was treated with pneumatic retinopexy and cryotherapy. In the other eyes, retinal detachment was the result of giant tears with no evidence of prior retinal degeneration. These eyes were treated with pars plana vitrectomy, fluid-gas exchange with 15% perfluoropropane (C3F8), endolaser photocoagulation, and a 42 encircling scleral exoplant. RESULTS: After treatment, the first two eyes achieved spectacle-corrected visual acuity of 20/40. In the last two eyes, final spectacle-corrected visual acuity was 20/400 in one eye and light perception in the other. CONCLUSIONS: Although no cause-effect relationship between LASIK and retinal detachment can be stated, these cases suggest that LASIK may be associated with retinal detachment, particularly in highly myopic eyes. Further studies are necessary to determine high-risk patient characteristics.

Adult↗
PubMed1992

Xyloside-induced disruption of interphotoreceptor matrix proteoglycans results in retinal detachment.

Unique domains of the retinal interphotoreceptor matrix (IPM), termed cone matrix sheaths, are composed largely of chondroitin 6-sulfate proteoglycan in most higher mammalian species. Recent investigations suggest that cone matrix sheaths participate in the maintenance of normal retinal attachment. To investigate the potential functional roles of IPM proteoglycans further, the synthesis of cone matrix sheath chondroitin 6-sulfate proteoglycan was perturbed in vivo. Intravitreal injections of p-nitrophenyl-beta-D-xylopyranoside (xyloside), a sugar that inhibits chondroitin sulfate proteoglycan synthesis, were administered to Yucatan micropigs. Their eyes were examined funduscopically and electroretinographically. At selected times, the eyes were enucleated and examined histochemically and immunohistochemically with various probes directed against cone photoreceptor cells and cone matrix sheaths. The IPM was affected selectively after xyloside administration; no inner retinal pathology or dysfunction was detected morphologically or electroretinographically. The degree of xyloside-induced perturbation was dependent on the duration of xyloside exposure and dose. It was classified into three stages, based on morphologic and histochemical criteria. Although all three stages could be observed in a given retina, a single stage typically predominated, depending on the particular dosage regimen. The early stage was characterized by IPM disruption, as evidenced by disorganization of chondroitin 6-sulfate and peanut agglutinin (PNA)-binding glycoconjugates. Cone photoreceptor cell outer segment degeneration and markedly decreased chondroitin 6-sulfate immunoreactivity distinguished the middle stage. During the late stage, there was a near complete absence of both immunoreactive chondroitin 6-sulfate and PNA-binding glycoconjugates in the IPM. Shallow retinal detachments that appeared funduscopically as patches of retinal whitening frequently were observed after moderate durations of xyloside exposure; these progressed peripherally with continued xyloside exposure. Histologically, the areas of retinal whitening corresponded to regions in which cone matrix sheaths were split transversely (ie, in a plane perpendicular to the longitudinal axes of the photoreceptor cell outer segments) or were separated completely from cone outer segments. Similar effects were not observed in control eyes. These results suggest that adhesion between the neural retina and retinal pigmented epithelium may be dependent, in part, on continuous synthesis of cone matrix sheath-associated proteoglycans and, potentially, other IPM proteoglycans. In addition, these proteoglycans appear to be necessary for the maintenance of cone photoreceptor cell outer segment integrity.

Animals↗
PubMedDate not supplied

Management and results of retinal detachment after silicone oil removal.

Of the 168 eyes undergoing silicone oil removal from 1993 to 2000, 34 developed retinal detachment after the removal of silicone oil. The management and the results of the 34 eyes were reviewed. Surgical procedures included pars plana vitrectomy, encircling band, cryocoagulation, endotamponade. Five of the 34 eyes had a second retinal detachment after these operations. One of these 5 eyes had a third retinal detachment. Final retinal reattachment was achieved in all eyes. Visual acuity decreased in 16 of the 34 eyes with retinal detachment, and 18 of the 34 eyes had a visual acuity of less than 0.02. These results show that surgery for retinal detachment after silicone oil removal yields a high rate of anatomic success, while the visual outcome is poor for a substantial number of patients.

Adult↗
PubMed2006

Pediatric rhegmatogenous retinal detachment in taiwan.

PURPOSE: To describe the clinical features and surgical outcomes in a series of pediatric patients with rhegmatogenous retinal detachments in Taiwan. METHODS: Retrospective study of pediatric patients (age 1 to 15 years) with rhegmatogenous retinal detachment dated between January 1995 and December 2004. Patients with perforating ocular trauma were excluded. Patients were divided into four groups according to the predisposing factors: Group 1, those with congenital or developmental anomalies; Group 2, those with trauma history; Group 3, those with myopia greater than -3 D but excluding patients in Groups 1 and 2; and Group 4, the others with miscellaneous etiologies. Patients' age, sex, medical history, ocular history, type of detachment, macular status, refractive status, previous visual acuity, number and type of surgeries performed, postoperative retinal status, and current visual acuity were recorded. RESULTS: Thirty-five eyes of 32 patients were included in this study. The median age was 13 years, and 75% of patients were boys. There were 17 eyes (49%) in Group 1, 8 in Group 2 (23%), 8 in Group 3 (23%), and 2 in Group 4 (6%). Bilateral retinal detachment was present in 7 patients (22%). In Group 1, familial exudative vitreoretinopathy was present in 7 eyes; retinopathy of prematurity was noted in 5 eyes; Marfan's syndrome was present in 3 eyes; mental and growth retardation was present in 2 eyes. Macula sparing retinal detachment was found in 3 eyes. Retinal attachment was achieved in 28/35 eyes. Visual recovery was modest. CONCLUSION: Congenital or developmental anomalies, myopia, and trauma were the most common risk factors for pediatric rhegmatogenous retinal detachment in Taiwan. Regular follow-up for children at risk of developing rhegmatogenous retinal detachment is necessary for early detection.

Adolescent↗
PubMed1998

Surgical management of retinal detachments related to coloboma of the choroid.

OBJECTIVE: This study aimed to develop a rationale for the management of retinal detachments related to choroidal coloboma and to study the outcome of their management. DESIGN: The study design was a retrospective study. PARTICIPANTS: A total of 85 eyes of 81 patients with retinal detachments related to coloboma of the choroid participated. INTERVENTION: All eyes underwent pars plana vitrectomy with internal tamponade using silicone oil (80 eyes) or perfluropropane gas (5 eyes). Behavior of the retina on fluid-air exchange was used to guide the further steps of surgery. Endolaser was performed along the coloboma border. Silicone oil was removed in 80% of eyes. The main outcome measures were retinal reattachment and visual recovery. RESULTS: Recurrent retinal detachment occurred in 16.3% of silicone oil-filled eyes and 60% of gas-filled eyes. After silicone oil removal, 15.6% of eyes had recurrent retinal detachment. After a mean follow-up of 13.4 months, 81.2% of eyes had attached retina and 69.4% recovered equal to or better than 10/200 visual acuity. CONCLUSION: Retinal detachment secondary to coloboma of choroid is treated best by pars plana vitrectomy along with silicone oil tamponade. Gas tamponade has limited indications. Clinical evaluation of the extent of retinal detachment within the colobomatous area and the behavior of the retina on fluid-air exchange help the authors understand the pathogenesis of the retinal detachment and plan a rational therapy.

Adolescent↗
PubMed1993

Pilot trial of transscleral diode laser retinopexy in retinal detachment surgery.

OBJECTIVE: To evaluate the safety and efficacy of the transscleral diode laser for retinopexy in rhegmatogenous retinal detachments. DESIGN: Ten consecutive patients with primary rhegmatogenous retinal detachments underwent scleral buckling surgery, using the transscleral diode laser for retinopexy. Patients were followed up for at least 6 months. STUDY PARTICIPANTS: Ten patients with primary rhegmatogenous retinal detachments were enrolled. Patients with chronic detachments, a retinal break greater than 90 degrees, history of uveitis or infectious retinopathy, or proliferative vitreoretinopathy were excluded. MAIN OUTCOME MEASURE: Retinal reattachment. Secondary measures: visual acuity and complications, including choroidal, retinal, and vitreous hemorrhage, inflammation, and scleral damage. RESULTS: By 6 months, nine of 10 retinas were successfully repaired following only one operation. The retina of the 10th patient redetached at 6 1/2 weeks owing to proliferative vitreoretinopathy. Following a vitrectomy and retinal reattachment procedure, the retina of the 10th patient has remained attached for 1 year. No significant complications were encountered with the laser retinopexy, although small presumed breaks in Bruch's membrane occurred in three eyes and a moderate scleral thermal effect occurred in two. Visual results in the postoperative course were comparable to those achieved previously with cryotherapy. CONCLUSION: In this pilot series, transscleral diode laser retinopexy served as a safe and effective means of obtaining chorioretinal adhesion in retinal detachment surgery.

Adult↗
PubMed1993

[Prevention of non-traumatic retinal detachment by surgical cerclage. Apropos of 20 cases].

Prophylactic retinal detachment with laser photocoagulation is ineffective for some vitreo-retinopathies in which vitreous traction is predominant (non traumatic giant retinal tears, Wagner Stickler's syndrome, Marfan's syndrome...). Twenty eyes were operated by prophylactic episcleral circular buckling. In eighteen cases, the fellow eyes had previously presented a retinal detachment. We performed two types of encircling buckle. We only observed minor operative complications, without any functional consequences, attesting to the innocuity of this type of treatment. But we have to wait for vitreous detachment to know the efficacy of this prophylactic treatment. This detachment occurs at different time in each vitreoretinopathy, but with a specific rate of retinal detachment for each pathology.

Adolescent↗
PubMed1995

[Retinal detachment and pigment dispersion syndrome].

PATIENTS: The frequency of retinal detachment has been studied in 107 consecutive patients suffering from pigmentary glaucoma. The frequency of retinal detachment in pigmentary glaucoma is 12%, while in the normal population is only 0.001%. Pigmentary glaucoma is a disease which may manifest itself for the first time either as a retinal detachment or with symptoms of pigmentary glaucoma. CONCLUSION: Therapy with miotics affecting accommodation is completely contraindicated.

Adult↗
PubMed2004

Analysis of changes in corneal shape and bulbus geometry after retinal detachment surgery.

PURPOSE: To investigate changes in corneal shape and anterior segment following retinal detachment surgery. MATERIAL AND METHODS: 25 consecutive patients with retinal detachment were enrolled in this study. Computer-assisted videokeratography was performed before and after retinal detachment surgery and changes in the anterior segments of postoperative patients were also noted. RESULTS: In the local buckling group, statistically significant changes were observed in the anterior chamber depth, lens thickness, and vitreous length (distance from posterior surface of lens to the retina) in the postoperative period. However, in the encircling group, statistically meaningful changes were observed in the vitreous length, axial length of the globe, and the central corneal curvature and thickness in the postoperative period. CONCLUSION: Corneal topography and axial measurements may be useful for evaluating the shape of the cornea after retinal detachment surgery. Because the resultant refractive changes are very important for the visual rehabilitation of the patients.

Adolescent↗
PubMed2005

Rhegmatogenous retinal detachment in phakic eyes after posterior chamber phakic intraocular lens implantation for severe myopia.

OBJECTIVE: To report the clinical presentation, surgical management, and outcomes of rhegmatogenous retinal detachment (RRD) in patients with severe myopia corrected by posterior chamber phakic (PCP) intraocular lens (IOL) implantation. DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: Sixteen eyes of 15 patients in whom retinal detachment developed after PCP IOL implantation. METHODS: The 16 eyes with retinal detachment after PCP IOL implantation underwent scleral buckling and pars plana vitrectomy. MAIN OUTCOME MEASURES: Uncorrected visual acuity, refraction, best spectacle-corrected visual acuity (BSCVA), time between refractive procedure and RRD, vitreoretinal findings, and anatomic reattachment rate. RESULTS: The incidence of RRD after PCP IOL implantation was 2.07%. Mean patient age was 32.9 years (range, 23-46). Nine patients underwent bilateral PCP IOL implantation (60%). Primary RRD developed in 16 eyes of 15 patients. Prophylactic laser photocoagulation was performed in 3 eyes of 3 patients (18.75%). Mean preoperative spherical equivalent (SE) was -17.3+/-2.47 diopters (D) (range, -13.75 D to -22 D). Rhegmatogenous retinal detachment occurred from 1 to 70 months after PCP IOL implantation (mean, 29.12 months). Each of 11 RRDs (68.75%) had 1 causative break. Fourteen breaks (60.86%) were horseshoe tears and 9 (39.14%) were atrophic holes. Scleral buckling was performed in 10 eyes (62.5%). Pars plana vitrectomy alone was performed in 5 cases (31.25%) with posterior breaks. Initial reattachment rate was 90.9%. Final retinal reattachment was 100%. Mean postoperative BSCVA was 20/28 (decimal fraction, 0.72+/-0.25). Mean follow-up after retinal detachment surgery was 35.25+/-17.29 months (range, 12-67 months). CONCLUSIONS: Rhegmatogenous retinal detachment after PCP IOL implantation is rare. Case-control studies are warranted to determine whether this surgical procedure increases the risk of retinal detachment in these patients. The characteristics of RRD do not differ from the natural history of retinal detachment. Surgical management of RRD was successful in restoring vision in our patients. This article contains additional online-only material available at .

Adult↗
PubMed2003

Jules Gonin. Pioneer of retinal detachment surgery.

Before the turn of the 20th century, eyes with a retinal detachment were considered doomed. Contrary to other branches of ophthalmology, such as cataract extraction, the surgical treatment of retinal detachment was still in its infancy, and the surgical success rates were less than five percent. From 1902 to 1921 Jules Gonin almost single handedly changed the landscape of retinal detachment surgery forever. He recognised that the retinal break was the cause--and not the consequence as it was largely believed at the time--of the retinal detachment, and that the treatment had at all costs to comprise the closure of the break by cauterisation. He named the procedure ignipuncture, as he cauterised the retina through the sclera with a very hot pointed instrument. Despite rigorously detailed clinical observations and increasing success rates, his discovery was not readily accepted and sometimes openly opposed by a large part of the ophthalmic establishment. It was not until 1929 that he received worldwide acclaim at the International Ophthalmological Congress in Amsterdam for his surgical technique. His legacy lives on in the eye hospital in Lausanne that bears his name, in the Gonin Medal awarded by the International Council of Ophthalmology every four years for the highest achievement in ophthalmology, and in a street named after him, the very street that he used to walk from his home to the hospital every day.

History, 19th Century↗
PubMed1992

New inferior retinal detachment after scleral buckling procedure with intraocular gas injection.

In a series of 72 rhegmatogenous retinal detachments treated by scleral buckling procedure with or without intraocular gas injection, 5 patients showed a subsequent inferior retinal detachment in the operated eye early in the postoperative period. All 5 eyes had been injected with air or sulfur hexafluoride intraoperatively or postoperatively, and had vitreoretinal adhesions such as lattice degeneration in the inferior equatorial fundus. To investigate the factors involved in the development of the new inferior retinal detachment, the data on the 72 eyes of retinal detachment were analyzed. Intraocular gas injection, inferior vitreoretinal adhesion, and the volume of injected gas were the significantly associated factors (P < 0.05). It was suggested the intraocular gas bubble could produce traction on the site of inferior vitreoretinal adhesion, leading to new inferior retinal detachment.

Adolescent↗