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Results for “Retinal Detachment”

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At least 1,081 records · Page 60Linked to original sources

PubMed1991

National outcomes of cataract extraction. I. Retinal detachment after inpatient surgery.

Rehospitalization for retinal detachment (RD) was studied in 338,141 Medicare beneficiaries older than 65 years of age who were undergoing inpatient cataract extraction in 1984. Extracapsular cataract extraction (ECCE) was performed in 60% of patients, intracapsular cataract extraction (ICCE) in 31%, and phacoemulsification in 9%. The risk of rehospitalization for RD within 4 years of ICCE was 1.55% over 1.5 times the risk associated with ECCE (0.9%). The risk of RD after phacoemulsification was 1.17%. Cataract surgery accompanied by anterior vitrectomy was associated with a 5.0%, likelihood of RD at 4 years, which is 4.5 times greater than that for cataract surgery alone (1.12%). White patients were 1.7 times more likely to be rehospitalized for RD than were black patients (1.15% versus 0.67%; P less than 0.001). In both races, younger patients were more likely to be rehospitalized for RD than were older patients (P less than 0.001). While the increased rate of RD after ICCE versus ECCE confirms previously held clinical beliefs, the increase in the risk following phacoemulsification (P less than 0.0001) has not been reported previously.

Aged↗

PubMed1998

Ocular motility disturbances after surgery for retinal detachment.

PURPOSE: Relatively little has been published on the management of motility problems after surgery for retinal detachment. We report a large series with the aim of describing clinical features, management, and outcome. METHODS: The charts of 68 of 86 consecutive patients referred to one of us between 1989 and 1995 were retrieved and analyzed. Sixty-two had unilateral and 6 bilateral surgery for retinal detachment. In 45 cases the macula was detached at surgery. The visual acuity of the affected eyes ranged from hand motions to 6/6. Sensory testing suggested potential binocular function in 39.7%. Fifty-nine patients had combined vertical and horizontal strabismus, 8 horizontal alone, and 1 vertical only. The average vertical deviation measured 10.2 PD and the average horizontal 19 PD. RESULTS: Twelve patients underwent strabismus surgery, 26 were treated with botulinum toxin, 21 were managed conservatively with prisms or occlusion, and 8 refused or did not require treatment. Forty-seven percent of the group regained binocularity (20.5% cured with surgery or botulinum toxin, 26.5% controlled with prisms or intermittent injection with botulinum toxin). A total of 20.7% gained improvement in appearance, 19.1% were managed with permanent occlusion, and 13.2% either refused or did not require treatment. CONCLUSION: Macula off retinal detachment, poor visual acuity plus or minus distortion, and multiple procedures for retinal reattachment are associated with a poor prognosis for restoration of binocular vision and a good outcome. In our hands, botulinum toxin treatment is the method of choice, with surgery used in selected cases.

Adolescent↗

PubMed2004

Lens-sparing vitrectomy for progressive tractional retinal detachments associated with stage 4A retinopathy of prematurity.

OBJECTIVE: To describe the results of lens-sparing vitrectomy in infants with progressive, fovea-threatening, tractional retinal detachments associated with stage 4A retinopathy of prematurity. METHODS: In a retrospective, interventional, consecutive clinical case series, the records of patients with stage 4A retinopathy of prematurity who underwent lens-sparing vitrectomy for progressive retinal detachments were reviewed. Retinal attachment status, reversed or arrested retinal dragging, and visual acuity were assessed after the procedure. RESULTS: Thirty-two eyes of 29 patients underwent lens-sparing vitrectomy at a mean postconceptional age of 43 weeks. Thirty (94%) of 32 eyes had complete retinal reattachment and arrest or reversal of retinal dragging after 1 lens-sparing vitrectomy. Visual acuity of at least central, steady, and unmaintained was observed in 17 (81%) of the 21 eyes in which it was tested and at least central, steady, and maintained vision was measured in 13 (62%) of 21 eyes, with 1 eye achieving 20/40 visual acuity. CONCLUSIONS: Lens-sparing vitrectomy is a safe and effective procedure for the treatment of fovea-threatening retinal detachments in patients with stage 4A retinopathy of prematurity.

Birth Weight↗

PubMed1984

Rhegmatogenous retinal detachments caused by paravascular vitreoretinal traction.

We describe three cases of shallow posterior rhegmatogenous retinal detachment caused by tiny retinal tears. The clinical appearance of the detachments was very similar to that of idiopathic central serous chorioretinopathy or traction retinal detachment. However, the correct diagnosis was made by finding a tiny paravascular break. Vitrectomy without a thermal adhesion was successful in repairing the detachments.

Adult↗

PubMed1998

[Relaxing peripheral retinotomy with endolaser in treatment of retinal detachment with severe anterior proliferative vitreoretinopathy].

OBJECTIVE: To investigate the effects of relaxing peripheral retinotomy with endolaser for treatment of complicated retinal detachment with severe anterior proliferative vitreoretinopathy. METHODS: 44 eyes of complicated retinal detachment with severe anterior proliferative vitreoretinopathy underwent relaxing peripheral retinotomy with endolaser treatment and silicone oil injection. Outcome measures included retinal reattachment, visual acuity, intraocular pressure as well as these after silicone oil removal. RESULTS: After minimum follow-up of 3 months, the retina was completely attached in 44 eyes (8 of them with folds), 38 eyes achieved improvement of visual acuity. The silicone oil was removed in 22 eyes, the retina kept attached in 21 eyes of them. Hypotony (intraocular pressure < 10 mmHg) was seen in 8 of the 22 eyes with reattached retina. CONCLUSION: Relaxing peripheral retinopathy with endolaser in the surgery for complicated retinal detachment with severe anterior proliferative vitreoretinopathy is an effective procedure. Subretinal membrane peeling benefits a complete retinal reattachment. Hypotony occurred in some cases, therefore indications should be limited.

Adolescent↗

PubMedDate not supplied

Endophotocoagulation to retinal pigment epithelium as an adjuvant therapy in the management of retinal detachment caused by a highly myopic macular hole.

Retinal detachment secondary to a highly myopic macular hole remains a particular surgical challenge. Pars plana vitrectomy, endophotocoagulation at the base of a macular hole in conjunction with fluid-gas exchange was performed in 4 consecutive patients with a mean refraction of -13.8D (range, -8D-(-)18D). Mean axial length was 27.5 mm (range, 26.0-29.0 mm). Mild atrophy of the retinal pigment epithelium was present in 3 patients while 1 patient had moderate atrophy. The mean follow-up period was 12 months (range, 6-18 months). The overall primary anatomical success rate was 75%. All 3 eyes with mild retinal pigment epithelium atrophy had retinal reattachment after one operation.

Adult↗

PubMedDate not supplied

[Laser instrument surgery in preventing and treating retinal detachment (communication II)].

The paper is devoted to the actual problem of ophthalmology--removal of cysts and retinal detachments caused by cystoid retinal lesions. 3 stages of treatment are identified: stage 1 used YAG-laser dissection of the external wall of the retinal cyst with drainage of its contents. Stage 2 involved extrascleral filling reinforced by argon coagulation of the zone of the emptied cyst or by endolaser coagulation. Laser intervention was performed by the laser combine "Visulas-YAG II" produced by the firm "Karl Zeiss" (Germany) and fitted up by endolaser output. Coagulation energy was 0.2-0.7 W, the power of YAG-laser was 0.1-5.7 mJ with impulses of 120. Almost in all of the cases laser action was realized during one session. The laser's action was associated with hemorrhage in 11 cases (57.9%), and within 1 year of observations 2 relapses were noted (10.5%). YAG perforation of the external wall of a retinal cyst brings on its drainage and evacuation that is a perspective factor in subsequent surgical interventions during operations for retinal detachment due to cystoid degeneration.

Adult↗

PubMed1986

Pars plana vitrectomy in aphakic and pseudophakic retinal detachment.

Eighty-two consecutive aphakic or pseudophakic retinal detachments were treated by buckling and vitrectomy procedures. Functional results (86.6%) and the incidence of proliferative vitreoretinopathy (11%) were comparable with reports of cases treated by the classic method.

Aphakia↗

PubMed1986

The effects of retinal detachment repair on clear corneal grafts.

Seven patients who underwent retinal detachment surgery after penetrating keratoplasty all achieved successful reattachment, but one graft failed (14%) within six months. Four of the seven eyes were aphakic or pseudophakic and three, including the one in which the graft failed, were phakic at the time of retinal detachment. All patients had scleral exoplant buckling procedures and three had external drainage of fluid.

Adult↗

PubMed2002

Management of retinal detachments in pseudophakic patients with Artisan lenses.

PURPOSE: To report the management and outcomes of retinal detachment repair in patients with Artisan intraocular lenses (IOLs) used for pseudophakic correction. SETTING: Two university-based referral centers.In this retrospective case-control study, all cases of retinal detachments in patients with an Artisan IOL used for pseudophakic correction were reviewed over 5 years at 2 university clinics. RESULTS: Of the 20 patients identified, all had a detachment in 2 or more quadrants. A retinal tear was identified in 19 patients preoperatively. Thirteen patients had a standard buckling procedure, 3 with the addition of gas; 3 required a pars plana vitrectomy; and 2 were treated with pneumatic retinopexy alone. Reattachment was achieved with 1 procedure in 11 patients, with 2 procedures in 5 patients, and with 3 procedures in 3 patients; reattachment could not be achieved in 2 cases. Anterior displacement of the lens was noted when gas tamponade was used. When the displacement was significant, sodium hyaluronate 1% (Healon was used to prevent corneal endothelial touch. CONCLUSIONS: In most cases, the Artisan lens did not significantly limit peripheral retinal visibility. Standard buckling procedures were generally successful. Given the limited support provided by the iris, the presence of gas in the vitreous cavity can lead to anterior displacement of the lens. Corneal endothelial touch can be prevented by the use of Healon, which is sufficient if short-term gas tamponade is used.

Adult↗

PubMed1992

[Exudative retinal detachment in the pregnancy-induced hypertension syndrome].

22 cases of pregnancy-induced hypertension syndrome with exudative retinal detachment were studied. Fluorescein angiography performed in 5 patients 7-14 days post-parturition revealed choroidal circulatory disturbances and retinal pigment epithelial damages, while the retinal capillaries also showed damages of varying degrees. The authors regarded the former as the primary pathological basis for the retinal detachment, with the latter also playing a pathogenic role. The incidence and the source of fluid of the retinal detachment in relation to general edema, proteinuria, and hypertension were discussed.

Adult↗

PubMed2003

Peripheral retinal degenerations and the risk of retinal detachment.

PURPOSE: To review the degenerative diseases of the peripheral retina in relationship with the risk to develop a rhegmatogenous retinal detachment and to present recommendations for use in eyes at increased risk of developing a retinal detachment. DESIGN: Focused literature review and author's clinical experience. RESULTS: Retinal degenerations are common lesions involving the peripheral retina, and most of them are clinically insignificant. Lattice degeneration, degenerative retinoschisis, cystic retinal tufts, and, rarely, zonular traction tufts, can result in a rhegmatogenous retinal detachment. Therefore, these lesions have been considered for prophylactic therapy; however, adequate studies have not been performed to date. CONCLUSIONS: Well-designed, prospective, randomized clinical studies are necessary to determine the benefit-risk ratio of prophylactic treatment. In the meantime, the evidence available suggests that most of the peripheral retinal degenerations should not be treated except in rare, high-risk situations.

Humans↗

PubMedDate not supplied

The management of retinal detachments associated with choroidal colobomas by vitrectomy with cyanoacrylate retinopexy.

The techniques used and the outcome in eyes treated for retinal detachment associated with choroidal coloboma are described. We reviewed the medical reports on five eyes of five patients with retinal detachment associated with choroidal coloboma who underwent vitrectomy. Retinal breaks were identified at the margin of or within the coloboma and the retina was successfully reattached by vitrectomy and cyanoacrylate retinopexy in four of the five eyes. The remaining one eye, with no visible retinal break both before and during surgery, also underwent cyanoacrylate retinopexy at regions suspected of retinal break, and was successfully reattached. In four eyes (80%) the vision showed improvement and had a visual acuity of 20/100 or better after surgery. None of the eyes required silicone oil tamponade or endophotocoagulation around the disc or at the papillomacular bundle. For the management of retinal detachment associated with choroidal coloboma, cyanoacrylate retinopexy is the method of choice, providing adequate chorioretinal adhesion and satisfactory visual outcome.

Adolescent↗

PubMed1999

Anatomic and visual results in asymptomatic clinical rhegmatogenous retinal detachment repaired by scleral buckling.

PURPOSE: To report presenting characteristics as well as anatomic and visual results in asymptomatic clinical rhegmatogenous retinal detachment repaired by scleral buckling. METHODS: Review of 28 eyes of 27 patients with an asymptomatic clinical retinal detachment-defined as a rhegmatogenous retinal detachment with subretinal fluid extending more than 2 disk diameters posterior to the equator-which were repaired by scleral buckling from January 1989 through December 1996 with follow-up of 6 months or longer. RESULTS: With a single scleral buckling procedure, anatomic reattachment of the retina occurred in all eyes; one eye redetached 14 months after the initial surgery secondary to a new retinal break and was successfully reattached. All eyes had best-corrected presenting and final visual acuity of 20/50 or better. Final best-corrected Snellen visual acuity was within 1 line of best-corrected presenting visual acuity in 82% of eyes; three eyes improved more than 1 line of Snellen visual acuity and two eyes lost more than 1 line. CONCLUSION: Anatomic and visual results in asymptomatic clinical rhegmatogenous retinal detachment after scleral buckling surgery are excellent. Strong consideration should be given to repair of these detachments.

Adult↗

PubMed1990

Micro-vitreous surgery combined with scleral encircling for the management of complex retinal detachment.

50 cases (50 eyes) of various complex retinal detachments (RD) were treated with a combination of vitrectomy, membrane peeling, intraocular air tamponade and scleral encircling. RD with opaque media, RD with proliferative vitroretinopathy, traction RD due to trauma or other factors, RD with posterior breaks, and giant tears were included. During the follow-up periods of 3-12 months, 27 cases (54%) obtained anatomic reattachment, 23 failed (46%). Of the successful case, 24 eyes achieved improvement, 2 eyes remained unchanged, and one eye became worse in their vision. The surgery complications were: retinal haemorrhage, choroidal haemorrhage, iatrogenic tears, and the development of cataract.

Adolescent↗

PubMed2006

Neuron-specific TGF-beta signaling deficiency results in retinal detachment and cataracts in mice.

We generated a mouse model (cKO) with a conditional deletion of TGF-beta signaling in the retinal neurons by crossing TGF-beta receptor I (TGF-beta RI) floxed mice with nestin-Cre mice. Almost all of the newborn cKO mice had retinal detachment at the retinal pigment epithelium (RPE)/photoreceptor layer junction of the neurosensory retina (NSR). The immunostaining for chondroitin-6-sulfate showed a very weak reaction in cKO mice in contrast to intense staining in the photoreceptor layer in wild-type mice. Macroscopic cataracts, in one or both eyes, were observed in 50% of the mice by 6 months of age, starting as early as the first month after birth. The cKO mouse model demonstrates that the TGF-beta signaling deficiency in retinal cells leads to decreased levels of chondroitin sulfate proteoglycan in the retinal interphotoreceptor matrix. This in turn causes retinal detachment due to the loss of adhesion of the NSR to RPE.

Animals↗

PubMed1977

Radial sponges in retinal detachment surgery.

Radial silicone sponge explants were used in the repair of 100 retinal detachments. The radial sponges were particularly effective in treating retinal detachments with horseshoe tears posterior to the equator, large retinal breaks, and elongated radial tears. In 90 of these cases an encircling silicone band was used in addition to the radial sponge. The silicone band was employed to close other small retinal breaks and to relieve vitreous traction in aphakes and myopes. The success rate of reattachment was 94% and the final vision was better or the same post-operatively in 88% of cases.

Adult↗

PubMed1994

[Treatment of macular hole retinal detachment with vitrectomy].

Pars plana vitrectomies were performed on 64 eyes with macular hole retinal detachment of which 20 with severe proliferative vitreoretinopathy (PVR C-D) and 18 with definite vitreoretinal traction on the maculae were found. Retinal reattachment occurred in 57 eyes in the follow-up (89.1%) of which the visual acuities improved in 43 (74.5%), unchanged in 13 and decreased in 1. The points for attention in the operation were discussed. The key factors influencing the success of the operation are severe PVR, the course of the retinal detachment.

Adult↗