New Viscodissection Instrument for Use With Microincisional Vitrectomy in the Treatment of Diabetic Tractional Retinal Detachments

Fortun, Jorge A.; Hubbard, G. Baker

doi:10.1001/archophthalmol.2011.15

Cited by 12 publications

(7 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Vitreous hemorrhage was reported in 22 studies (58%) (n = 1889 eyes) and occurred in 425 eyes (22.5%).…”

Section: Resultsmentioning

confidence: 99%

“…The remaining 35 studies were assessed using the before-after study tool of which 19 were graded good ; 15 fair ; and the remaining study as poor. This latter study was given a poor rating as outcomes and inclusion-exclusion criteria were not predefined. Additionally, statistical methodology was not reported, and it could not be determined owing to the masking of outcome assessors.…”

Section: Resultsmentioning

confidence: 99%

“…Two, both published in the European Vitreoretinal Society (EVRS) Educational Electronic Journal, where irretrievable from Queen’s University library (Belfast, UK) and The British Library (London, UK) and could not be assessed. After full-text evaluation of all other studies, 38 (with 3839 eyes) were found eligible and included . Patients had a median (IQR) age of 52.2 (49.6-55.7) years.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Outcomes and Complications of Pars Plana Vitrectomy for Tractional Retinal Detachment in People With Diabetes

et al. 2023

View full text Add to dashboard Cite

ImportanceTractional retinal detachment (TRD) occurs in approximately 5% of people with proliferative diabetic retinopathy and poses a threat to vision. Pars plana vitrectomy (PPV) is the treatment of choice for TRD.ObjectiveTo determine anatomic and functional outcomes of PPV for the treatment of TRD in people with diabetes (dTRD).Data SourcesMEDLINE and Embase were searched systematically from January 1, 2000, to February 20, 2022. In addition, a reference list of eligible studies were screened.Study SelectionEligible studies were those published in English, those reporting outcomes of PPV for dTRD, and those that included more than 25 eyes and with a minimum follow-up of 3 months.Data Extraction and SynthesisPreferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines for data extraction/synthesis were followed, and the National Institute for Health quality assessment tool was used to assess risk of bias. Study eligibility was determined independently by 2 reviewers; data extraction was conducted by 1 reviewer and entries checked for accuracy by another. Data were pooled using a random-effects model.Main Outcomes and MeasuresMain outcomes included rate of failure of retinal reattachment following 1 surgery and final visual acuity (VA). The association of baseline patient characteristics and surgical maneuvers with postoperative surgical outcomes was investigated.ResultsOf the 406 studies identified, 38 (3839 eyes) were eligible and included for analysis. Patients had a median (IQR) age of 52.2 (49.6-55.7) years. In the studies reporting patient sex (31 of 38 studies), 1441 were female individuals (50.1%). The overall failure rate of retinal reattachment after 1 surgery was 5.9% (95% CI, 1.4%-8.3%), and the mean final VA was 0.94 (95% CI, 0.82-1.05) logMAR (approximate Snellen equivalent, 6/53; 95% CI, 6/39-6/71). People with higher preoperative VA achieved higher postoperative vision (0.66 logMAR worse final vision; 95% CI, 0.39-0.84 per 1.0 logMAR worse at baseline; P &lt;.001). On multivariable analysis, no other patient characteristics or surgical variables had a statistically significant association with outcomes.Conclusions and RelevanceResults of this systematic review and meta-analysis suggest that PPV was an effective strategy to achieve retinal reattachment in people with dTRD. Given that higher preoperative VA was the only factor associated with higher postoperative vision, early intervention should be considered and discussed in detail with patients. Overall, final postoperative VA remains low, and patients should be counseled on the guarded prognosis of dTRD.

show abstract

“…Vitreous hemorrhage was reported in 22 studies (58%) (n = 1889 eyes) and occurred in 425 eyes (22.5%).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Outcomes and Complications of Pars Plana Vitrectomy for Tractional Retinal Detachment in People With Diabetes

et al. 2023

View full text Add to dashboard Cite

show abstract

“…The combination of high cutting speeds with 25 or 27 gauge instruments allows precise segmentation and delamination. [ 29 ] In combination with low flow rates causing minimal tissue movement and in some cases adjuvant proportional reflux hydrodissection[ 31 ] or viscodissection,[ 32 ] small-gauge vitrectomy cutters can be used to delaminate tightly adherent preretinal tissue, in some cases abolishing the need for additional instruments such as picks and scissors. However, in general, lifting and cutting in a unimanual or bimanual technique is a safer option for tightly adherent preretinal plaques than pushing through as in proportional reflux and viscodissection.…”

Section: Surgical Tips and Tricksmentioning

confidence: 99%

Surgery for proliferative diabetic retinopathy: New tips and tricks

Oellers¹,

Mahmoud²

2016

J Ophthalmic Vis Res

View full text Add to dashboard Cite

Over the recent years, retina specialists have enjoyed significant improvements in the surgical management of proliferative diabetic retinopathy including improved preoperative planning, vitreoretinal instrumentation and new surgical maneuvers. In this review, we present new tips and tricks such as preoperative pharmacotherapy approaches including pegaptanib injection and biodegradable dexamethasone implantation, bimanual vitrectomy techniques and the concept of mixing small gauges as well as valved cannulas and intraoperative optical coherence tomography. With advanced surgical planning and sophisticated operative maneuvers tailored to the individual patient, excellent outcomes can be achieved even in severe cases of diabetic tractional detachment.

show abstract