Incidence of Management Changes at the Postoperative Day One Visit After Pars Plana Vitrectomy for Retinal Detachment

Patel, Dillan; Borkar, Durga S.; Madhava, Malika; Obeid, Anthony; Mellen, Phoebe L.; Regillo, Carl D.

doi:10.1016/j.ajo.2020.09.034

Cited by 7 publications

(5 citation statements)

References 18 publications

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“…of eyes Increase in IOP Intraocular inflammation Hypotony Corneal edema Jabbour et al [ 8 ] 2018 RRD, PDR with tRD, MH 254 48 ~ 61.5% within POD 7 N/A N/A N/A Bamonte et al [ 6 ] 2011 Floater, macular pucker, MH, RD, etc. (VH, retained lens fragments, lens subluxation) 122 N/A N/A 13.1% on POD 1 N/A Arikan Yorgun et al [ 5 ] 2016 ERM, VH, MH, RD, VMT 306 15%~25% on POD 1 5 ~ 26% exhibited more than + 2 AC cells on POD 1 1.8 ~ 2.7% on POD 1 N/A Patel D. et al [ 10 ] 2021 RRD or tRD 418 IOP > 21 mm Hg, 69 eyes (16.5%); IOP > 30 mm Hg, 11 eyes (2.6%) N/A N/A N/A Moussa et al [ 9 ] 2023 Pseudophakic RRD 456 IOP ≥ 22: 28.0 ~ 49.6%, IOP ≥ 25: 13.6 ~ 30.3% on POD 1 N/A 0 ~ 0.8% on POD 1 N/A Desai A. et al [ 25 ] 2008 RD, VH, MH, ERM, retained lens fragments, endophthalmitis, floaters 100 2.5 ~ 12% required IOP control on POD 1 N/A N/A N/A …”

Section: Discussionmentioning

confidence: 99%

“…Modern vitreoretinal surgery is safe and effective in treating various retinal disorders, including rhegmatogenous retinal detachment (RRD), [ 1 ] complications of diabetic retinopathy, [ 2 ] macular hole (MH), [ 3 ] and epiretinal membrane (ERM) [ 4 ]. However, since vitreoretinal surgery is invasive, postoperative complications, such as increased (2.5–61.5%) or decreased (1.8–13.1%) intraocular pressure (IOP), [ 5 – 10 ] corneal edema (0.80–1.1%) [ 7 , 11 ], intraocular inflammation (0.25–26%) [ 5 , 12 ], or retinal detachments (1.2–1.7%) may occur in patients [ 11 ]. Therefore, the postoperative care plan for patients may be changed according to the type and severity of these complications [ 12 ].…”

Section: Intruductionmentioning

confidence: 99%

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Incidence of early complications requiring treatment plan changes after vitreoretinal surgery: a single-center study in South Korea

Yoon

Kim

et al. 2023

BMC Ophthalmol

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Background Information regarding incidence of treatment plan changes may be useful when discussing postoperative treatment plans for patients. Moreover, it may help establish a standardized postoperative treatment plan. This study aimed to evaluate the incidence of early complications requiring treatment plan changes in patients following vitreoretinal surgery and investigate its risk factors. Methods This single-center retrospective study included 465 patients who had undergone vitreoretinal surgery. The reasons, incidence, and timing of treatment plan changes within 14 days of surgery were identified. Potential factors associated with the changes, such as patient demographics, surgeon’s experience, diagnoses, and type of surgery were also analyzed. Results The treatment plan was changed in 76 patients (16.3%) at a mean of 4.0 ± 3.2 days after vitreoretinal surgery. The reasons for the plan changes were increased intraocular pressure (IIOP) in 66(86.8%), intraocular inflammation in 2(2.6%), corneal edema in 3(3.9%), leakage from the sclerotomy wound in 3(3.9%) patients, and combined IIOP and intraocular inflammation in 2(2.6%). The date of discharge was postponed because of treatment plan changes in 17 patients (22.4%). The incidence of plan changes was higher in patients who underwent gas or oil tamponade (P < 0.001) and those who underwent surgery performed by less experienced surgeons (P = 0.034). Conclusions Treatment plan was changed in 16.3% of patients after vitreoretinal surgery. The risk of treatment plan changes was associated with the surgeon’s experience in vitreoretinal surgery and the type of surgery. These results should be considered when establishing standardized care plans for patients who require vitreoretinal surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Intruductionmentioning

confidence: 99%

Incidence of early complications requiring treatment plan changes after vitreoretinal surgery: a single-center study in South Korea

Yoon

Kim

et al. 2023

BMC Ophthalmol

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“…These findings are consistent with similar large-scale retrospective investigations. For example, the study by Patel et al [20] , involving 418 cases, reported a 16.5% incidence of elevated IOP, and Arikan Yorgun et al's [21] study, based on 306 cases, showed that 15%-25% of patients showed elevated IOP. None of these participants reported severe pain, or were found to have hypotony or epithelial defects.…”

Section: Perfluoro-n-octane In Retinal Detachmentmentioning

confidence: 99%

Pars plana vitrectomy for retinal detachment using perfluoro-n-octane as intraoperative tamponade: a multicenter, randomized, non-inferiority trial

Shi,

Fan,

Liu

et al. 2024

Int J Ophthalmol

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AIM: To evaluate the efficacy and safety of perfluoro-n-octane (PFO) for ophthalmic surgery versus F-Octane as an intraoperative tamponade in pars plana vitrectomy (PPV) in management of retinal detachment. METHODS: This multicenter, prospective, randomized, double-masked, parallel-controlled, non-inferiority trial was conducted in three ophthalmology clinical centers in China. Patients with retinal detachment, who were eligible for PPV were consecutively enrolled. Participants were assigned to PFO for ophthalmic surgery or F-Octane for intraocular tamponade in a 1:1 ratio. Best-corrected visual acuity (BCVA), intraocular pressure (IOP) measurement, and dilated fundus examination were performed preoperatively and at 1, 7±1, 28±3d postoperatively. The primary outcome was complete retinal reattachment rate at postoperative day one. The non-inferiority margin was set at 9.8%. The secondary outcomes included intraoperative retinal reattachment rate, and mean changes in IOP and BCVA from baseline to 1, 7±1, 28±3d postoperatively, respectively. Safety analyses were presented for all randomly assigned participates in this study. RESULTS: Totally 124 eligible patients completed the study between Mar. 14, 2016 and Jun. 7, 2017. Sixty of them were randomly assigned to the PFO for ophthalmic surgery group, and 64 were assigned to the F-Octane group. Baseline characteristics were comparable between the two groups. Both groups achieved 100% retinal reattachment at postoperative day one (difference 0, 95%CI: -6.21% to 5.75%, P=1). The pre-defined noninferiority criterion was met. No significant difference was observed in intraoperative retinal reattachment rate (difference 1.77%, P=0.61), mean changes in IOP (difference 0.36, -0.09, 2.22 mm Hg at 1, 7±1, 28±3d postoperatively, with all P&#x003E;0.05) and BCVA (difference 0.04, -0.02, 0.06 logMAR at 1, 7±1, 28±3d postoperatively, all P&#x003E;0.05) between the two groups. No apparent adverse events related to the utilization of PFO were reported. CONCLUSION: In patients with retinal detachment undergoing PPV, PFO for ophthalmic surgery is non-inferior to F-Octane as an intraocular tamponade, and both are safe and well-tolerated.

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“…Short-term complications following surgery have been widely reported in patients with ERM [ 9 , 10 ]. Datlinger et al reported postoperative movement of the fovea one day after successful surgery for iERM [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Short-term postoperative changes in the choroidal vascularity index in patients with a unilateral epiretinal membrane

et al. 2023

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Background To investigate short-term choroidal structural and vascular changes after epiretinal membrane (ERM) surgery. Methods In this retrospective study, 65 patients with unilateral ERM underwent pars plana vitrectomy combined with cataract surgery and were examined one day before surgery and one week, one month, and three months after surgery. Choroidal thickness (CT) and choroidal vascular index (CVI) were evaluated using horizontal enhanced depth imaging optical coherence tomography (EDI-OCT) scans and were further calculated using semi-automatic algorithms using MATLAB R2017a. Results Preoperatively, CVI was higher in eyes with ERM (61.70 ± 5.17%) than in fellow eyes (59.99 ± 5.26%). CVI increased significantly at one week after surgery (62.14 ± 5.02%) and decreased at 1 and 3 months after surgery (60.76 ± 4.97% and 60.4 ± 4.83%, respectively). The change was pronounced in the nasal region (p < 0.001) and central region (p < 0.05). CT in the temporal macula increased at 1 week (239.65 ± 72.98 μm) after surgery and decreased at 1 and 3 months after surgery (222.15 ± 71.91 μm and 222.33 ± 65.72 μm, respectively; p < 0.01). Conclusions Short-term postoperative variations in the choroid have been demonstrated in eyes with ERM. This may be related to the release of macular traction. CVI assessment using EDI-OCT may be a useful tool for investigating choroidal structural changes accompanying ERM and postoperative period.

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Incidence of Management Changes at the Postoperative Day One Visit After Pars Plana Vitrectomy for Retinal Detachment

Cited by 7 publications

References 18 publications

Incidence of early complications requiring treatment plan changes after vitreoretinal surgery: a single-center study in South Korea

Incidence of early complications requiring treatment plan changes after vitreoretinal surgery: a single-center study in South Korea

Pars plana vitrectomy for retinal detachment using perfluoro-n-octane as intraoperative tamponade: a multicenter, randomized, non-inferiority trial

Short-term postoperative changes in the choroidal vascularity index in patients with a unilateral epiretinal membrane

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