Purpose To investigate the learning curve of vitreoretinal (VR) surgeons beginning training in retinal detachment (RD) surgery. Methods The files of all consecutive patients undergoing VR surgery for uncomplicated RD between Jan 2005 und Mar 2020 were retrospectively reviewed. Successful outcome was defined as no retinal redetachment within 3 months after surgery. Results Ten surgeons started their VR career during this period. Together, these 10 surgeons performed 3786 RD operations (mean 379; median 251; range 71–1053). Primary success rate after one operation was 90% (3420 of 3786). When starting to operate retinal detachments, VR surgeons had a primary success rate of about 80%. Redetachment rates steadily decreased and stabilized at just under 10% after about 200 operations. Beginners needed more than twice the time for the procedure compared to experienced surgeons. The individual learning curves varied widely. In our series, female surgeons seem to have a faster learning curve. Conclusion RD surgery performed by VR surgeons in training had acceptable results. With increasing experience, success rates continuously improve reaching stable levels after approximately 200 operations. The training of VR surgeons requires considerable resources.
Purpose To analyze the correlation between lens status, age, and sex in the epidemiology and success rates of rhegmatogenous retinal detachment (RRD) surgery. Methods The files of all consecutive patients undergoing vitreoretinal surgery for uncomplicated RRD between Jan 2005 und Dec 2020 were retrospectively reviewed. Successful outcome was defined as no retinal redetachment occurring within 3 months after surgery. Results 5502 eyes with uncomplicated primary RRD were included. Mean age of the patients was 61.1 years (± 13.6 SD). In the age group over 40 years, a male predominance was found. The percentage of pseudophakic RRD increased from 25 to 40% during the 15 years observation period. In the age group 50 to 69 years, patients with pseudophakic detachments were male in 786 out of 1079 cases (72.9%). In the same age group, 1285 of 2110 (60.9%) patients with phakic RRD were male. Overall, primary success rate after one procedure was 91.2% (5018 of 5502). In the phakic eyes, the primary success rate was higher in those eyes that underwent combined phacovitrectomy (93.0%), compared to those without simultaneous cataract surgery (88.7%; p = 0.002). Conclusion The ratio of male and female patients with RRD varies between age groups. The proportion of pseudophakic RRD has increased within 15 years. The male predominance in RRD is stronger in pseudophakic than in phakic eyes. In phakic eyes with RRD, a combined phacovitrectomy yielded better anatomical results.
The expression pattern of the novel tyrosine phosphatase interacting protein 51 (PTPIP51) was studied during the organogenesis of mouse eye on a transcriptional (RT-PCR and in situ hybridization) and translational level (immunohistochemistry and immunoblotting). Timed developmental stages from day E12 to day E18 were analyzed regarding the distribution of PTPIP51 and compared to the expression patterns observed during postnatal developmental stages and adult eye. PTPIP51 was found to be expressed in all investigated developmental stages in derivatives of mesoderm and ectoderm, such as developing cornea, lens, neuroretina and extraocular muscles. Conjuctiva and corneal epithelia were PTPIP51 reactive during all investigated developmental stages including the mature eye. Embryonic differentiation led to reactive keratocytes of the corneal stroma and remained so in post partal stages, as well as in the adult eye. On day E12, all cells comprising the developing lens body showed PTPIP51 expression. Further development unto the adult eye resulted in a restriction of PTPIP51 expression to the anterior lens epithelium and finally to the equatorial region of the lens epithelium. The developing neuroretina showed a strong PTPIP51 expression in the inner neuroblastic layer and the future receptor cell layer. In the adult eye, the retinal ganglion cells and the inner nuclear layer remained PTPIP51 reactive. The data presented here suggests PTPIP51 to be integrated in signaling cascades regulating differentiation and apoptosis during eye development.
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