Outcomes of Macular Hole Surgery in Patients Treated Intraoperatively for Retinal Breaks and/or Lattice Degeneration

Hwang, J.; Escarião, Paulo; Iranmanesh, Reza; Tosi, Gian Marco; Chang, Stanley

doi:10.1097/iae.0b013e318065364b

Cited by 5 publications

(6 citation statements)

References 54 publications

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“…6 Our rate of 16.4% falls in the same order of magnitude as those described previously for vitrectomy for other elective indications. In vitrectomy for macular disease (idiopathic macular hole and idiopathic macular pucker), the reported rate of iatrogenic breaks varies between 11% and 24% for 20-gauge procedures [7][8][9][10] and between 3% and 15% for 25-gauge procedures. 11,12 Although we found a strong positive relation with PVD induction, iatrogenic retinal breaks also were found in eyes that had an existing PVD.…”

Section: Despite the Controversy Surrounding Vitrectomymentioning

confidence: 99%

Safety of Vitrectomy for Floaters

Tan

Mura

Oberstein

et al. 2011

American Journal of Ophthalmology

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Section: Despite the Controversy Surrounding Vitrectomymentioning

confidence: 99%

Safety of Vitrectomy for Floaters

Tan

Mura

Oberstein

et al. 2011

American Journal of Ophthalmology

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“…Intraoperative retinal breaks during MH surgery are thought to be caused by intraoperative creation of a PVD, lattice degeneration, and manipulation of instruments at the sclerotomy site. 17 – 22 , 24 – 27 However, it has been suggested that rhegmatogenous RD is caused by advancing age, myopia, a longer axial length, pseudophakia, and lattice degeneration. 28 – 30 There has been a report suggesting that intraoperative endolaser photocoagulation for lattice degeneration reduces the likelihood of RD after MH surgery.…”

Section: Discussionmentioning

confidence: 99%

“… 28 – 30 There has been a report suggesting that intraoperative endolaser photocoagulation for lattice degeneration reduces the likelihood of RD after MH surgery. 17 Furthermore, prophylactic photocoagulation can reduce the risk of lattice degeneration in the fellow eye in patients with RD, 31 – 35 but might not reduce the risk of RD in the fellow eye. 36 Given these observations, we sought to identify potential risk factors for retinal breaks during MH surgery.…”

Section: Discussionmentioning

confidence: 99%

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Risk factors for retinal breaks during macular hole surgery

Sakamoto¹,

Yoshida²,

Hashimoto³

et al. 2018

OPTH

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PurposeTo identify risk factors for retinal breaks during macular hole (MH) surgery.Patients and methodsThis retrospective, observational, comparative study included the medical records of 364 consecutive patients (382 eyes) who underwent vitrectomy for MH at Toho University Sakura Medical Center between January 2012 and May 2017. The patients comprised 135 men and 229 women with mean age 67.6±8.0 years. Six eyes with a pre-existing retinal tear treated by laser photocoagulation before MH surgery were excluded. Data on sex, age, presence or absence of lattice degeneration, axial length (measured using an IOL Master®), preoperative refraction, whether or not combined lens extraction/vitrectomy had been performed, whether or not the lens was pseudophakic before vitrectomy, and whether or not a posterior vitreous detachment had been created intraoperatively were collected. The lattice degeneration status was classified as none (0), treated using laser photocoagulation (1), or untreated (2).ResultsThe only item identified in logistic regression analysis with the backward elimination method to be a significant risk factor for retinal breaks during MH surgery was the presence of lattice degeneration (P<0.001).ConclusionOphthalmologists should be aware of the increased risk of retinal breaks during MH surgery in eyes with lattice degeneration. Intraoperative retinal breaks may be less likely to occur in eyes with lattice degeneration treated by photocoagulation preoperatively.

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“…The incidence of retinal detachment after vitrectomy is 6–8% in epi-retinal membrane (ERM) cases [1,2], 6% in branch retinal vein occlusion cases [3], and varies between 0-11% in macular hole (MH) cases [4-9]. Retinal detachment may be attributable to the surgical technique, and can be affected by how much of the peripheral vitreous remained in MH cases.…”

Section: Introductionmentioning

confidence: 99%

Effect of prophylactic 360° laser treatment for prevention of retinal detachment after phacovitrectomy: (Prophylactic 360° laser treatment for prevention of retinal detachment)

Iwase

Oveson

2013

BMC Ophthalmol

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BackgroundTo investigate the effect of intraoperative 360° laser retinopexy anterior to the equator for the prevention of retinal detachment after phacovitrectomy.MethodsThe patients were part of two consecutive case series cohorts in macular hole (MH) and rhegmatogenous retinal detachment (RRD), one which did not receive intraoperative prophylactic 360° laser, and one which received intraoperative prophylactic 360° laser. For the 360° laser treatment group, three rows of medium-white burns were positioned anterior to the equator. The baseline characteristics and the risk of retinal detachment over time were analyzed and compared between the groups.ResultsProphylactic intraoperative 360° laser treatment was performed on 77 MH cases (67.3 years) and compared to a control group of 35 MH cases (65.8 years). Additionally, prophylactic intraoperative 360° laser treatment was performed on 108 RRD cases (64.0 years) and compared to 270 RRD cases (64.4 years). The 360° laser group showed a significant reduction (0%, 0/77 eyes) in the rate of the incidence of retinal detachment after vitrectomy at 12 months after surgery in MH cases, compared with the control group (5.7%, 2/35 eyes) (p = 0.034). Kaplan-Meier survival analysis demonstrated that the rate of retinal detachment in the control group was significantly higher than that in the 360° laser group (p = 0.035). There was no significant difference between the groups in RRD cases (p = 0.092).ConclusionsIntraoperative 360° laser retinopexy following phacovitrectomy resulted in a significant reduction in the rate of postoperative retinal detachment in MH cases.

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Outcomes of Macular Hole Surgery in Patients Treated Intraoperatively for Retinal Breaks and/or Lattice Degeneration

Cited by 5 publications

References 54 publications

Safety of Vitrectomy for Floaters

Safety of Vitrectomy for Floaters

Risk factors for retinal breaks during macular hole surgery

Effect of prophylactic 360° laser treatment for prevention of retinal detachment after phacovitrectomy: (Prophylactic 360° laser treatment for prevention of retinal detachment)

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