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At least 109 records · Page 6Linked to original sources
PubMed2003

Surgical treatment of retinal detachment following acute retinal necrosis syndrome: surgical results in four patients.

BACKGROUND: Acute retinal necrosis (ARN) syndrome is an uncommon but severe ocular disease that typically affects otherwise healthy individuals. It is frequently complicated with retinal detachment and the visual prognosis in such patients is usually poor. METHODS: We operated on four eyes in four patients from 1999 through 2001. Three ophthalmologists in our hospital did these operations, respectively. The surgical methods included pars plana vitrectomy, lensectomy, encircling scleral buckling combined with membrane dissection, air-fluid exchange, endolaser photocoagulation, and retinal tamponade with silicone oil or perfluoropropane gas. RESULTS: Three patients received one operation and the other one needed a second operation to release the retinal traction. One patient needed a lensectomy at the time of vitrectomy. Macular attachment was achieved in all four eyes (100%). Vision improved in two patients but none achieved visual acuity better than 20/200. The complications were cataract in three patients, macular pucker in three, and silicone keratopathy in one. CONCLUSION: Our results suggest that modern vitrectomy techniques provide a very high retinal attachment rate in patients with retinal detachment following ARN syndrome.

Adult↗
PubMedDate not supplied

Pseudophakic retinal detachment.

Pseudophakic retinal detachment is a rare, but potentially serious, complication of cataract surgery. The incidence of pseudophakic retinal detachment following current surgical techniques of cataract extraction, including extracapsular cataract extraction by nuclear expression and phacoemulsification, is lower than that found after intracapsular cataract extraction. The risk of pseudophakic retinal detachment appears to be increased in myopic patients, in those patients in whom vitreous loss had occurred at the time of cataract surgery, and in patients undergoing Nd:YAG posterior capsulotomy. Most cases present to the clinician when the macula is already detached and the central vision is affected. When evaluating patients with pseudophakic retinal detachment, the fundal view is often impaired by anterior or posterior capsular opacification, reflections related to the intraocular lens, or poor mydriasis. Scleral buckling, pneumatic retinopexy, and primary pars plana vitrectomy, with or without combined scleral buckling, are the surgical techniques used to treat pseudophakic retinal detachment. Anatomical success rates are high after vitreo-retinal surgery for pseudophakic retinal detachment, although a smaller proportion of patients recover good vision following surgery.

Cataract Extraction↗
PubMed1995

Early pars plana vitrectomy without buckling procedure in cytomegalovirus retinitis-induced retinal detachment.

BACKGROUND: Retinal detachments induced by cytomegalovirus (CMV) retinitis can often be treated successfully with a buckling procedure combined with vitrectomy and silicone oil instillation, but this technique yields varying visual results. METHODS: To minimize operational trauma, pars plana vitrectomy and silicone oil instillation without additional buckling was performed in a series of 11 consecutive patients with acquired immune deficiency syndrome (AIDS) and CMV-retinitis-induced retinal detachment. Surgery was performed early in the course of the retinal detachment: 6 patients (55%) had an attached macula, and 7 patients (64%) had a visual acuity of 20/200 or better. RESULTS: After a mean follow-up period of 5 months (range, 1-9 months) 9 patients (82%) had a completely reattached retina and 9 patients (82%) had visual acuity of 20/200 or better. The macula was reattached in all patients. A localized detachment of the inferior retina was noted in 2 patients (18%), and a second operation was required in one eye. Significant cataract formation occurred in two patients during the follow-up period. Proliferative vitreoretinopathy and increased intraocular pressure were not observed. CONCLUSION: Early vitrectomy without additional buckling procedures is justified in patients with CMV-associated retinal detachment because it stabilizes the retinal situation without major complications and improves visual function.

AIDS-Related Opportunistic Infections↗
PubMed1989

[Retinal circulation in rhegmatogenous retinal detachment demonstrated by videofluorescence angiography and image analysis. I. The condition of retinal circulation before retinal detachment surgery].

The retinal circulation in cases of retinal detachment was studied in eight eyes with rhegmatogenous retinal detachment. Retinal mean circulation times of the detachment areas and the non-detachment areas were measured by a system using videofluorescence angiography and image analysis with dye dilution technique. The mean circulation times were 4.05 +/- 1.13 seconds (mean +/- standard deviation) in the non-detachment areas and 6.59 +/- 2.91 seconds in the detachment areas. The difference between the two areas was statistically significant (p less than 0.03). The results demonstrated that the velocity of retinal circulation is slower in retinal detachment area.

Adult↗
PubMed1999

Removal of silicone oil with vision improvement after rhegmatogenous retinal detachment following CMV retinitis in patients with AIDS.

PURPOSE: To report that silicone oil may be safely removed from immuno-recovered patients with acquired immunodeficiency syndrome (AIDS) after instillation for cytomegalovirus (CMV)-related rhegmatogenous retinal detachment. METHOD: We report two patients with CMV-related retinal detachment who had previously been treated with vitrectomy and silicone oil. RESULTS: Six months after removal of silicone oil, the retina remained attached in both patients. Without specific anti-CMV therapy, there was no relapse of CMV retinitis while patients were undergoing highly active antiretroviral therapy. Best-corrected visual acuity improved in both patients. CONCLUSION: It appears to be possible to remove silicone oil safely from patients with AIDS who show immune recovery, thus avoiding side effects of long-standing silicone oil and increasing quality of life. After silicone oil removal, visual acuity was improved.

AIDS-Related Opportunistic Infections↗
PubMed2003

Rhegmatogenous retinal detachment after rupture of retinal arterial macroaneurysm.

PURPOSE: To report two cases of rhegmatogenous retinal detachment following rupture of retinal arterial macroaneurysm. DESIGN: Observational case report. METHODS: Review of clinical records of 75 consecutive eyes (73 patients) with macroaneurysm. RESULTS: Ruptured macroaneurysm was present in 68 of the 75 eyes, and rhegmatogenous retinal detachment developed spontaneously in 2 (2.9%) of the 68 eyes. In the 2 eyes with retinal detachment, there were no predisposing lesions to retinal detachment and the detachment occurred either 2 weeks or 1 month after the rupture of a macroaneurysm. Retinal detachment and posterior vitreous detachment developed simultaneously after bleeding from the macroaneurysm spread into the vitreous in 1 eye. CONCLUSIONS: We report the occurrence of retinal detachment after macroaneurysmal rupture. Detailed fun-dus examination is required to detect retinal detachment in the follow-up of patients with ruptured macroaneurysm.

Aged↗
PubMed1993

[Liquid perfluorocarbons in the surgical treatment of retinal detachment caused by retinal inversion].

Surgical procedures used today to treat retinal detachment with an inverted giant retinal tear have considerably improved. Vitrectomy associated with perfluorocarbon liquid injection has replaced old procedures necessary to unfold the inverted retinal flap. Seventeen patients were operated on with an anatomic success rate of 76% and an average follow up of fifteen months. The successive surgical stages (lensectomy, retinopexy, internal tamponade, circular scleral buckle) are discussed. Proliferative vitreoretinopathy is the maill postoperative complication explaining the high rate of reoperation (56%). In high myopia, a prophylactic circular scleral buckle of the fellow eye has become systematic.

Adolescent↗
PubMed2005

[Retinal detachment associated with giant retinal tear: surgical procedures and results of the perfluorocarbon liquid-silicone oil exchange with scleral buckling].

INTRODUCTION: Anatomical and functional results of the treatment of retinal detachment associated with giant retinal tear have been markedly improved with the development of the vitrectomy procedure and especially the use of perfluorocarbon liquids. In this study, we report treatment results of retinal detachment associated with giant tear in 17 patients. MATERIALS AND METHODS: Our study included 17 patients (17 eyes), aged between 18 and 61 years, with retinal detachment associated with giant retinal tear. The size of the tear was between 90 degrees and 220 degrees . Proliferative vitreoretinopathy grade C was present in two eyes. Preoperative visual acuity ranged between 40/50 and light perception. All patients underwent scleral buckling, vitrectomy, perfluorocarbon liquid injection to flatten the retina, endophotocoagulation, cryoapplication and temporary silicone oil tamponade. RESULTS: Mean follow-up was 20 months +/- 16. Recurrent retinal detachment occurred in five eyes under silicone oil and in two eyes after its removal. Anatomical success at final follow-up was obtained in 14 eyes (82.3%). Visual acuity improved in all cases with anatomical success in all but one. The most frequent postoperative complications were cataract in 10 cases among 12 phakic eyes and ocular hypertension in four cases. CONCLUSION: Vitrectomy with internal silicone oil tamponade improves the anatomical and functional prognosis of retinal detachment associated with giant retinal tear. Recurrent retinal detachment is usually due to relapsing proliferative vitreoretinopathy. The most frequent postoperative complications remain lens opacification and ocular hypertension.

Adolescent↗
PubMed1992

Exudative retinal detachment subsequent to retinal vein occlusion.

Previous studies have shown the possible development of exudative retinal detachment (ERD) as a complication of retinal vein occlusion (RVO). Considering 473 consecutive cases of RVO, only 3 cases of ERD with peculiar clinical aspects were discovered. In the first case, the ERD followed a branch RVO, but it developed in the opposite quadrant, with a late occurrence of venous retinal collaterals. In the second case, the ERD developed after a central RVO, having a retinoschisis aspect, with the subsequent occurrence of optic disk collateral vessels. In the third case, the ERD was secondary to a hemicentral RVO and involved the entire macular area. The pathogenesis of the ERD subsequent to RVO is still debated. Our experience seems to indicate that the ERD pathogenesis is linked not only to an inability of the draining vascular system, but also to an impairment in the function of the retinal pigment epithelium.

Acetazolamide↗
PubMed1999

[Functional signs indicating retinal detachment].

PURPOSE: Retinal detachment is a rare but potentially blinding disease. Incidence of retinal detachment is stable in France, in spite of argon laser prophylaxis. METHOD: We have performed a prospective study on 100 patients with reghmatogenous, idiopathic retinal detachment. RESULTS: Functional signs were carefully recorded in 89% of cases. Vitreous signs were frequent (85%) mostly black points (67% of cases) myodesopia (32% of cases) floating images (14% of cases) black stains and filaments (11% of cases). Phosphens were recorded in 45% of cases and described as flashes of lightning in 30% of cases. Macular detachment was significantly more frequent among patients consulting after retinal signs appeared. CONCLUSION: Our study shows the frequency of functional signs in retinal detachment disease for rapid take over of these patients.

Adult↗
PubMed2000

Effect of highly active antiretroviral therapy on the incidence of HIV-related cytomegalovirus retinitis and retinal detachment.

Cytomegalovirus retinitis (CMVR) is the most common intraocular infection encountered in ophthalmic practices. To assess the impact of highly active antiretroviral therapy (HAART) on the incidence of CMVR and subsequent retinal detachments, a retrospective review of the HIV+ patients seen at a single university and community-based practice between 1992-1993 (group 1), before the advent of protease inhibitors, was compared with the data obtained from October 1996 to October 1997 (group 2) and October 1997-1998 (group 3), after the widespread use of HAART. The incidence of CMVR and retinal detachment rates for each group was calculated and compared. Twenty five (2.6%) of 974 HIV+ patients in group 1 developed CMVR. Of these, four patients developed retinal detachment (16%). Group 2 had a total of 1084 HIV+ patients, 18 (1.7%) of whom developed CMVR, which indicates a 35% decline of the incidence of CMV retinitis at our institution (p = 0.052, Odds ratio = 0.533, Confidence interval 0.28-1.01) and three patients (20%) developed retinal detachment. Only 1 patient (0.07%) of 1274 patients in group 3 developed CMVR, which represents a 99% reduction since 1993 (p = 0.0000000456). We conclude that the incidence of CMVR at this institution has decreased significantly with the recent use of HAART therapy. This effect may be related to the aggressive use of HAART and associated immune recovery in this population of AIDS patients. In this small series, however, the rate of retinal detachment appeared unchanged, but was only observed in those individuals who were not on HAART or who had just recently started.

AIDS-Related Opportunistic Infections↗
PubMed1995

Silicone oil in repair of retinal detachments caused by necrotizing retinitis in HIV infection.

OBJECTIVE: To evaluate the safety and efficacy of 1000- and 5000-centistoke silicone oil as retinal tamponades for the treatment of retinal detachments secondary to necrotizing retinitis in patients with human immunodeficiency virus (HIV) infection. DESIGN: A prospective observational study. SETTING: Community and university-based ophthalmology clinics. PATIENTS: Three hundred fifty patients with HIV infection, who had 407 eyes with retinal detachments secondary to necrotizing retinitis. INTERVENTION: Vitrectomy surgery for retinal detachment with 1000- or 5000-centistoke silicone oil as the retinal tamponade. OUTCOME MEASURES: Efficacy was measured both by anatomic success (defined as complete retinal attachment or macular attachment) and by visual acuity success (defined as preservation of visual acuity or ambulatory vision). Safety was determined by the rate of complications, including abnormal intraocular pressure and corneal and lens opacification. RESULTS: At the last follow-up examination, the retina was completely attached in 287 (73%) of 393 eyes, the macula was attached in 370 eyes (94%), 268 eyes (68%) had ambulatory vision, and visual acuity was preserved in 219 (56%) of 388 eyes. Corneal opacification, hypotony, and silicone oil emulsification were present in 4%, 2%, and 1% of eyes, respectively. One eye had elevated intraocular pressure. Of the 57 patients who had both eyes treated, 35 died, of whom four (11%) had nonambulatory vision in both eyes. Of the 293 patients who had one eye treated, 122 died, of whom 44 (36%) died with nonambulatory vision in the treated eye. The median time to cataract was 192 days; to nonambulatory vision, 474 days; and to death, 204 days. CONCLUSIONS: Silicone oil repair of retinal detachments in necrotizing retinitis is an efficacious and safe procedure that delays or prevents loss of vision in advanced HIV disease.

Adult↗
PubMed1997

Retinal detachment after branch retinal vein occlusion: influence of the type of break on the outcome of vitreous surgery.

BACKGROUND: Branch retinal vein occlusion (BRVO) is occasionally complicated by two types of retinal breaks (retinal holes without vitreous traction or retinal traction tears) that may lead to a rhegmatogenous retinal detachment (RRD). The authors describe surgical results of vitrectomy for RRD after BRVO and investigate whether there is any difference between clinical features or surgical results from eyes with the two types of retinal breaks. PATIENTS AND METHODS: The authors retrospectively studied 25 patients (25 eyes) who underwent vitrectomy for RRD after BRVO. Twelve of 25 eyes (48%) had a detachment secondary to one or more retinal holes (group I), and 13 of the eyes (52%) had one or more retinal tears (group II). RESULTS: Seventeen of the eyes (68%) achieved total retinal reattachment after the initial surgery; 22 (88%) did so by the time of final examination. Patients with retinal holes achieved more favorable final vision than those with retinal tears (P = 0.0391). A higher rate of preoperative macular detachment (P = 0.0112) and a higher rate of recurrent retinal detachment after initial vitrectomy (P = 0.0302) were the factors associated with the reduced final visual acuity in patients with retinal tears. The increased rate of recurrent retinal detachment in patients with retinal tears was associated with a higher rate of existing preretinal neovascular membranes (P = 0.0112) and a trend toward an increased incidence of intraoperative iatrogenic retinal breaks. CONCLUSION: Among patients who undergo vitrectomy for RRD after BRVO, better surgical results are expected in eyes with retinal holes without vitreous traction than in those with retinal traction tears. This difference is thought to be due to the difference in vitreoretinal anatomy between eyes with the two types of retinal breaks.

Aged↗
PubMed1992

Choroidal detachment associated with retinal detachment as a presenting finding.

Choroidal detachment along with retinal detachment as a presenting finding is rare. We identified five such cases presenting to our ophthalmology practice between 1964 and 1991. The patient is usually myopic and presents with marked visual loss, profound hypotony and a marked anterior chamber reaction. The pathogenesis seems to revolve around the hypotony and myopia and an unstable choroidal vascular system. Management usually involves a scleral buckling procedure with cryotherapy under direct visualization to release choroidal and subretinal fluid, possibly preceded by a few days of anti-inflammatory therapy. The overall prognosis is poor owing to delays in diagnosis and the postoperative development of proliferative vitreoretinopathy.

Adult↗
PubMed2003

Inverted pneumatic retinopexy: a method of treating retinal detachments associated with inferior retinal breaks.

PURPOSE: To introduce the new approach of inverted pneumatic retinopexy for the management of rhegmatogenous retinal detachments with inferior retinal breaks. DESIGN: Retrospective, noncomparative case series. PARTICIPANTS: Eleven patients presenting with rhegmatogenous retinal detachments with causative inferior retinal breaks. INTERVENTION: Sterile gas/air injection, cryopexy/laser retinopexy, with inverted positioning. MAIN OUTCOME MEASURES: Postoperative primary and final anatomical outcome, visual acuity, and complications. RESULTS: Patients were followed for a minimum of 3 months (mean, 5.1 months). Primary retinal reattachment was obtained in 10 of 11(91%) patients. One patient sustained a redetachment secondary to proliferative vitreoretinopathy, resulting in a single operation reattachment rate of 82%. Final reattachment was obtained in 11 of 11 (100%) patients. Mean visual acuity improved about 3 lines from 20/60 to 20/30, with 11 of 11 patients experiencing improvement in their visual acuity. Two patients required an additional surgical procedure to achieve final anatomic success. No new breaks were identified in the postoperative period, and no complications resulted from the pneumatical procedure. CONCLUSIONS: Inverted pneumatic retinopexy can successfully repair retinal detachments with inferior retinal breaks under appropriate conditions.

Adult↗
PubMed1991

[Retinal detachment after perforating eye injuries. II. The interval between injury and retinal detachment and factors which may have contributed to the development of retinal detachment].

The authors operated in 1977-1987 by the cryosurgical method 69 patients after injuries on account of detachment of the retina. Detachment developed in 37 patients after simple perforation of the eye and in 32 patients after perforation of the eye with a foreign intraocular body. In all patients the perforation reached as far as the vitreous body. The interval injury--detachment was assessed retrospectively. The authors found that for the development of post-traumatic detachment of the retina a period of two years after the injury is decisive--within this period detachment of the retina occurred in 55% of the cases. Another 31.9% of the cases occurred during the late post-traumatic period, i.e. 6-40 years after injury. In 21.7% patients anamnestic data were found which were, no doubt, associated with the detachment of the retina: surgical trauma in 8.7%, direct contusion of the eye in 10.1% and lifting a heavy burden in 2.9%.

Adolescent↗