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At least 973 records · Page 54Linked to original sources

PubMed1981

[Retinal holes - cause and therapeutical key of retinal detachments. Iatrogenic holes (author's transl)].

The author reports on 20 hopeless cases of retinal detachment with no visible retinal hole after vitrectomy and membrane-peeling procedures. Nearly all these cases showed a funnel-shaped rigid retinal detachment. In order to perform an internal drainage and air tamponade from inside a iatrogenic hole was cut in the periphery of the retina. The hole was necessary for the internal drainage of the subretinal fluid. The air tamponade forced the retina to unfold. Astonishingly, in 12 out of these 20 cass the retina became reattached.

Drainage↗

PubMed1984

Biometric studies of the eyeball and retinal detachment.

The relationship between axial length and equatorial diameter and eye volume has been studied in 4 groups of eyes: intact emmetropic eyes, emmetropic eyes with retinal detachment, eyes with moderate myopia and retinal detachment, and eyes with high myopia and retinal detachment. It was found that eyes with detached retinas, regardless of whether they are myopic or emmetropic, are of significantly different dimensions from emmetropic control eyes. There is usually a significant increase in equatorial diameter and therefore in equatorial circumference. The results indicate that eyes with detached retinas differ from normal eyes in their abnormally large size.

Anthropometry↗

PubMed1977

Retinal detachment following hockey injury.

Thirty-three cases of retinal detachment following hockey injury were seen during a 15-year period at the retina clinic of Maisonneuve-Rosemont Hospital, Montreal. Most injuries occurred in adolescents, the average age being 18 years. The mean interval between injury and preoperative examination was 3 years. Almost half of these young hockey players remained legally blind in the affected eye even after a successful operation. A helmet with a protective face visor is suggested as the best prevention against severe ocular damage such as retinal detachment.

Adolescent↗

PubMed2006

Pars plana vitrectomy versus combined pars plana vitrectomy-scleral buckle for primary repair of pseudophakic retinal detachment.

PURPOSE: To evaluate pars plana vitrectomy (PPV) versus a combined PPV and scleral buckle (PPV/SB) for repair of noncomplex, pseudophakic retinal detachment. DESIGN: Retrospective, nonrandomized, comparative interventional study. PARTICIPANTS: One hundred fifty-two eyes of 152 patients followed up for a mean of 10 months. The case series included 68 consecutive patients who underwent PPV and 84 consecutive patients who underwent a PPV/SB for primary repair of primary pseudophakic retinal detachment at Wills Eye Hospital between 2002 and 2004. METHODS: All primary PPV cases were performed by 2 surgeons who perform primary vitrectomy without regard to location of detachment, number and location of break(s), refractive error, or macula status. All primary PPV/SB were performed by a group of surgeons who solely perform PPV/SB on pseudophakic retinal detachments. All eyes underwent a standard 3-port 20-gauge PPV under wide-field viewing and scleral depression. Endolaser photocoagulation was applied either around the retinal tears or 360 degrees to the vitreous base region followed by gas tamponade. Patients with proliferative vitreoretinopathy grade C or worse were excluded from the study. MAIN OUTCOME MEASURES: (1) Single surgery anatomic success rates, (2) preoperative and postoperative visual acuity, and (3) complications. RESULTS: The single surgery anatomic success rate in the primary PPV group was 63 of 68 eyes (92.6%; 95% confidence interval [CI], 84%-98%) and in the primary PPV/SB group was 79 of 84 eyes (94.0%; 95% CI, 87%-98%). Both groups obtained 100% final reattachment rate. There was no statistically significant difference between the success rates (P = 0.75, Fisher exact test). The PPV group's best-corrected postoperative visual acuity demonstrated a +0.10 logarithm of the minimum angle of resolution improvement over the PPV/SB group (P = 0.07). The PPV group had a smaller incidence of postoperative complications (13/68 patients [19.1%] vs. 27/84 patients [32.1%]; P = 0.10, Fisher exact test). CONCLUSIONS: Primary PPV and PPV/SB seem to have similar efficacy in the repair of a matched group of patients with primary noncomplex pseudophakic retinal detachment. There was no statistically significant difference in complication rate between the 2 groups.

Adult↗

PubMed1976

Radial buckling in the repair of retinal detachment.

Experience with external sponge buckles for the treatment of retinal detachment has led to a preference for radial placement of the sponge. More retinal holes, particularly large horseshoe breaks, can be closed effectively with radially oriented buckles than with limbus parallel ones; limbus parallel buckles often were complicated by "fish-mouthing" of the breaks and leaking radial folds. A radial orientation of the buckle averts this complication. The geometry of retinal detachment and scleral buckling reveals the origin of "fish-mouthing" and radial folds and why radially oriented buckles prevent this complication.

Humans↗

PubMed1995

Clinical features of retinal detachment in the elderly.

We conducted a retrospective study of 636 eyes (624 patients, aged 65 years or more) to identify the clinical features of nontraumatic retinal detachment in the elderly. The incidence of retinal detachment due to a macular hole in our series (21%) was much higher than those described in previous reports, suggesting a racial difference between Japanese and Caucasian patients. Tractional tear was seen more commonly in patients of less advanced age. In addition, in our series of elderly patients, we demonstrated (1) a preponderance of retinal breaks in the upper temporal quadrant, (2) a high incidence of aphakic retinal detachment, (3) a preponderance of females to be affected and (4) broad detachment of the retina that involved the macula.

Age Distribution↗

PubMed2007

Anatomical and visual outcomes after episcleral macular buckling compared with those after pars plana vitrectomy for retinal detachment caused by macular hole in highly myopic eyes.

PURPOSE: To report anatomical and visual outcomes after episcleral macular buckling (EMB) and pars plana vitrectomy (PPV) for retinal detachment caused by macular hole in highly myopic eyes with posterior staphyloma. PATIENTS AND METHODS: This retrospective, interventional case series included 58 eyes of 58 patients with retinal detachment caused by macular hole in highly myopic eyes with posterior staphyloma and geographic chorioretinal atrophy. The cases were assigned to 2 groups according to the surgical technique: the EMB group (30 eyes) underwent posterior episcleral buckling using a solid silicone plate specifically designed for macular indentation, and the PPV group (28 eyes) underwent PPV combined with fluid-gas exchange. Baseline clinical data including age, sex, refractive errors, and degree of retinal detachment did not differ between EMB and PPV groups. Main outcome measures included ophthalmoscopy findings, three-mirror contact lens biomicroscopy results, and visual acuity at the end of follow-up (mean follow-up, 52.8 months in the EMB group and 44.1 months in the PPV group). Optical coherence tomography was performed in selected cases in the EMB group. RESULTS: In the EMB group, the retinal reattachment rate was 93.3% after primary surgery and 100% after secondary surgery. In the PPV group, the retinal reattachment rate was 50% after primary surgery and 86% after secondary surgery using the EMB procedure, thus indicating a better anatomical success rate after primary EMB than after primary PPV. The mean logarithm of the minimum angle of resolution (logMAR) visual acuity +/- SD in the EMB group increased significantly from 1.45 +/- 0.50 before surgery to 0.92 +/- 0.42 at the end of follow-up (P < 0.001). The mean logMAR visual acuity in the PPV group increased significantly from 1.70 +/- 0.45 before surgery to 1.35 +/- 0.61 at the end of follow-up (P < 0.02). Visual acuity improvement at the end of follow-up was significantly better after EMB than after PPV (P < 0.005). Optical coherence tomography revealed that 10 of 12 eyes with successful indentation of the macular hole area after EMB had complete closure of the macular hole as well as reattachment of the retina, and the remaining 2 eyes had persistent retinal reattachment with the foveal defect. CONCLUSIONS: EMB is a preferred surgical procedure for the repair of retinal detachment and macular hole closure in highly myopic eyes with posterior staphyloma.

Adult↗

PubMed2003

[Binocular vision after treatment of retinal detachment].

The study covered 79 patients after treatment of retinal detachment. Double vision, strabismus and disturbances of eyeballs motility were found. Up to 12 months after intervention, the deterioration of binocular vision was observed in 48.28 to 89.66% of patients, depending on the method used. The majority of disturbances were observed during the first 3 months with tendency to gradual subsidence during consecutive 9 months. A patient, after treatment of retinal detachment, can be qualified to return to work where stereopsis is needed under condition that ophthalmologic examination is done every three months during the first year after operation and than once a year.

Adolescent↗

PubMed1999

Management of traumatic retinal detachment with vitreon in children.

PURPOSE: To report the use of perfluoroperhydrophenanthrene (vitreon) for traumatic retinal detachment in children. METHODS: Vitreon was used as an intraoperative adjunct in 34 children with complicated retinal detachment secondary to penetrating and perforating trauma. The characteristics of the injuries, the final visual acuities, the postoperative complications and the rate of anatomic success were evaluated in a retrospective study. RESULTS: Patients were followed-up an average of 20 months. Eighteen retinas (53%) were reattached, and the postoperative visual acuity was counting fingers or better in 9 cases (26%), and only 4 eyes saw better than 10/200 at last follow-up. Hypotony developed in 7 (21%) of 34 eyes. CONCLUSION: Management of traumatic retinal detachment in children is difficult. Vitreon, as other perfluorocarbons, may be an effective intraoperative tool for vitreoretinal surgery in pediatric eyes that suffer trauma.

Adolescent↗

PubMedDate not supplied

Scleral infolding combined with vitrectomy and gas tamponade for retinal detachment with macular holes in highly myopic eyes.

PURPOSE: To describe the effectiveness of a surgical procedure, scleral infolding combined with vitrectomy and gas tamponade, for retinal detachment caused by macular holes in highly myopic eyes. METHODS: In a pilot study, scleral infolding was performed in 5 patients with macular holes, who were selected from 10 consecutive highly myopic patients with retinal detachment caused by macular holes (8 patients) or extramacular posterior-pole holes (2 patients), treated during 1 year at Okayama University Hospital. The patients were all women, 48-77 years of age (mean = 63.4 years), who had been followed-up for 1-2 years. Selection criteria for scleral infolding were either second surgeries for reopening of macular holes (2 patients) or residual retinal detachment around macular holes after complete fluid-air exchange with drainage of subretinal fluid at the initial surgery (3 patients). Following vitrectomy and complete epiretinal membrane removal in the posterior pole, the sclera was shortened by infolding on the temporal side. Three mattress sutures with 5-0 Dacron in each quadrant, 6 sutures in total, were placed at a 7-mm anteroposterior interval with posterior sutures located as deep as possible, near vortex veins. Fluid-gas exchange was then done, with or without endophotocoagulation applied around macular holes. RESULTS: After scleral infolding, macular holes were closed, and the retina was totally attached in all 5 patients. The final visual acuity ranged from 20/2000 to 20/70. CONCLUSION: Scleral infolding is a simple and effective procedure for treating retinal detachment with macular holes in highly myopic eyes and could be used as an optional procedure of reoperation for a failed initial vitrectomy.

Aged↗

PubMed1981

Mechanisms in traction retinal detachment.

We have developed a reproducible model of traction retinal detachment in the rhesus monkey secondary to a penetrating eye injury. The model is characterized histologically by intravitreal fibroblastic proliferation and by epiretinal and by retroretinal membranes. Cells proliferating within the vitreous and in the epiretinal membranes have the ultrastructural characteristics of myofibroblasts. The presence of these contractile cells suggests that vitreous traction and the contraction of epiretinal membranes may be cell mediated. Our findings suggest that the pathophysiology of traction retinal detachment has many features in common with the normal process of wound healing and in particular with the mechanisms responsible for wound contraction and cicatrization.

Animals↗

PubMedDate not supplied

Choroidopathy with serous retinal detachment in a patient with polymyositis.

PURPOSE: The authors report a unique case of multifocal choroidopathy in association with polymyositis. METHODS: The clinical presentation, laser treatment, and subsequent change in ocular findings are described. RESULTS: A 65-year-old Japanese man with polymyositis experienced mid acute vision impairment in both eyes during systemic corticosteroid treatment for interstitial pneumonia. Fundus examination revealed a gray-white subretinal exudate with serous retinal detachment. Angiographic examination disclosed partial dilatation of the choroidal vein at the posterior pole and dye leakage points in the retinal pigment epithelium. The patient's left eye developed bullous retinal detachment and multi focal choroidal nodules at the posterior pole during the period of tapering of oral corticosteroid administration. Retinal burns were applied to the dye leakage points in the right eye using an argon laser. Vision in the right eye showed rapid recovery due to regression of the serous retinal detachment. However, in the left eye without retinal burns visual acuity decreased to light perception only even after regression of the bullous retinal detachment and choroidopathy. CONCLUSIONS: In serous retinal detachment with choroidopathy associated with polymyositis, laser photocoagulation at leakage points may be useful for rapid restoration of vision and for the prevention of permanent severe vision loss.

Aged↗

PubMed1989

Rhegmatogenous retinal detachment following cryotherapy in retinopathy of prematurity.

Three patients who had been treated with transscleral cryotherapy to the avascular retina for stage 3+ retinopathy of prematurity with threshold disease had total rhegmatogenous retinal detachments develop. In each case, the retinal detachment developed more than 1 year after treatment and resulted from a tear at the junction of the treated and untreated retina. Rhegmatogenous retinal detachment is a late complication of transscleral cryotherapy that to our knowledge has not previously been documented.

Child, Preschool↗

PubMed1994

Incidence of retinal detachment following clear-lens extraction in myopic patients. Retrospective analysis.

OBJECTIVE: A retrospective study was performed to establish the incidence of retinal detachment among 107 patients (165 eyes) with pathologic myopia who underwent clear-lens extraction. INTERVENTIONS: The techniques employed were intracapsular extraction (3.0%), aspiration (59.4%), and extracapsular extraction (37.6%); average follow-up was 31 months. RESULTS: Retinal detachment developed in 12 eyes (7.3%) an average (SD) of 30.7 +/- 26.6 months postoperatively; the mean age of these patients was 34 years. We found a clear association between postoperative YAG laser/surgical posterior capsulotomy and the incidence of retinal detachment (11% vs 5.5%) but no association between intraoperative rupture of the posterior capsule and the ultimate incidence of retinal detachment. The retina was reattached in nine cases (75%).

Adult↗

PubMed1988

Subretinal precipitates of retinal detachments associated with intraocular tumors.

Yellowish white precipitates are sometimes observed clinically in the subretinal area of the retinal detachments. We investigated retinal detachments observed in a 47-year-old man associated with choroidal malignant melanoma and in a 1-year-old girl with retinoblastoma. Yellowish white precipitates were foam cells located around degenerated outer and inner segments of photoreceptor cells. They were more abundantly present associated with malignant melanoma than with retinoblastoma. They exhibited abundant lipid droplets, abundant lysosomes with phagocytosed materials including inner segments, fibrin, melanin and lipofuscin, abundant glycogen particles, indented nuclei, and cytoplasmic processes without intercellular junctional apparatus. They appeared to be macrophages.

Choroid Neoplasms↗

PubMed2004

Orbital cysticercosis-associated scleral indentation presenting with pseudo-retinal detachment.

PURPOSE: To report a clinical picture similar to retinal detachment caused by orbital myocysticercosis-associated scleral indentation. DESIGN: Interventional case series. METHODS: Of the 49 cases of orbital myocysticercosis, four eyes of four patients had pseudoretinal detachment presentations that are detailed. RESULTS: Of the four patients with pseudoretinal detachment, three were found to have orbital myocysticerci in lateral and one in inferior recti muscles, mechanically indenting the eyeball, causing scleral indentation, evidenced by ultrasonography or computed tomography. Associated signs of myocysticercosis were orbital inflammation, restricted ocular motility or proptosis. In 2 to 10 days, the cysts traveled forward and came to lie in a sub-Tenon position. Three cysts were removed surgically and one extruded spontaneously. CONCLUSIONS: Patients presenting with a clinical picture similar to retinal detachment in the presence of symptoms and signs of orbital cysticercosis, with a history of exposure to an endemic area, should be considered to have orbital myocysticerci causing scleral indentation.

Adolescent↗

PubMed2004

Vitrectomy and gas for inferior break retinal detachments: are the results comparable to vitrectomy, gas, and scleral buckle?

AIMS: To compare the success rates of vitrectomy and gas with vitrectomy, gas, and buckle in the treatment of inferior break retinal detachments. METHODS: A retrospective case note review of 86 patients who presented with inferior break retinal detachments was carried out. An inferior break was defined as a horseshoe tear present between 4 and 8 o'clock. Patients were analysed in two groups; group A consisted of 41 patients who underwent a vitrectomy and gas, group B consisted of 45 patients who underwent a vitrectomy, gas, and scleral buckle. The features of the retinal detachment, peroperative and postoperative complications, and outcomes of treatment were recorded for each patient. RESULTS: The primary anatomical success rate at 3 months was 89% in group A versus 73% in group B (p = 0.11). There was no statistical difference in the complication rate between the two groups (p = 0.819). The most common cause of treatment failure was proliferative vitreoretinopathy, 20% (n = 9) in group B compared with 5% (n = 2) in group A and this reached statistical significance (p = 0.0159). There was a higher rate of epiretinal membrane development in group B (p = 0.0004). The final attachment rate was not statistically different between the two groups, 95% (39) in group A and 93% (42) in group B (p = 1.0). CONCLUSION: Vitrectomy and gas without the application of a scleral buckle may be used to safely treat inferior break retinal detachments. It may be used as an alternative to vitrectomy, gas, and buckle which has an increased risk of choroidal haemorrhage, requires a longer operating time, and has all the associated complications of a scleral buckle.

Humans↗

PubMed1992

The treatment of bullous rhegmatogenous retinal detachment.

We describe the results of a consecutive series of 97 cases of bullous superior retinal detachment treated by conventional surgery. The retinal detachments were characterized by either a single retinal break or multiple retinal breaks confined within 1 clock hour and no proliferative vitreoretinopathy. The surgery involved sequential drainage of subretinal fluid, injection of air, cryotherapy and the application of local explant. All cases would otherwise be suitable for pneumatic retinopexy. The anatomical success rate was 85.5% with a single operation and 97% with further procedures. We report on the complications encountered and appraise the advantages and disadvantages of this operation. Forty-five of the 97 cases had detachment of the macula for less than 2 weeks, and 35 of the 45 (80%) achieved a visual acuity of 6/18 or better. These visual results challenge the assertion that better visual outcome might be attained with pneumatic retinopexy.

Air↗