Pars plana vitrectomy without scleral buckle for pseudophakic retinal detachments

Campo, Randy V.; Sipperley, Jack O.; Sneed, Scott R.; Park, Donald W.; Dugel, Pravin U.; Jacobsen, Jaclin; Flindall, Richard J.

doi:10.1016/s0161-6420(99)90353-6

Cited by 236 publications

(154 citation statements)

References 20 publications

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“…Although this undertaking has been reported to lower the redetachment rate due to new breaks, 20 investigators are not of one mind as to the benefits it confers. 16,21 However, although not statistically significant, the anatomical success rates after primary scleral buckling plus vitrectomy in phakic and pseudophakic eyes were lower than after scleral buckling alone. This may relate to the circumstance that vitrectomy was reserved for complicated cases of RD.…”

Section: Discussionmentioning

confidence: 88%

“…7 Compared to earlier studies, the anatomical outcome after vitrectomy in pseudophakic eyes has increased dramatically, 8 even without additional cerclage. 16,17 This finding may reflect recent advancements in vitrectomy techniques, including indirect wide-angle optics and a means of removing capsular opacities.…”

Section: Discussionmentioning

confidence: 93%

“…4,9,12 Disagreement on the ideal intervention for pseudophakic RD is not uncommon, especially in cases which lie in the simple-to-complex range. 4,[15][16][17] During cataract surgery, traumatization of the vitreous body, 18 lower concentrations of hyaluronic acid, 19 and liquefaction of the vitreal gel phase, 18 may heighten vitreoretinal traction, thereby leading to RD in an eye that already manifests peripheral degeneration of the retina. Vitrectomy is the logical treatment for this condition, since although scleral buckling would reduce traction, it would not prevent the vitreous body from undergoing further deleterious changes.…”

Section: Discussionmentioning

confidence: 99%

“…24,26,27 One reason for the small difference in anatomical outcome between phakic and pseudophakic eyes could be that previous studies included predominately scleral buckling procedures without vitrectomy, or included eyes that were either aphakic, had received an anterior chamber lens or did not qualify for uncomplicated posterior chamber lens implantations. 4,6,7,16,17,22,23,25 The situation of the implant has already been shown to have an impact on the anatomical and functional outcome of reattachment surgery. 24 This influence is believed to be related to the clarity of fundus viewing, which is more often compromised in eyes with an anterior chamber lens, thereby resulting in a higher incidence of undetected retinal breaks.…”

Section: Discussionmentioning

confidence: 99%

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Primary retinal reattachment surgery: anatomical and functional outcome in phakic and pseudophakic eyes

Halberstadt

Chatterjee-Sanz

Brandenberg

et al. 2004

Eye

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Aim To compare the anatomical and functional success of primary scleral buckling, performed either alone or in combination with vitrectomy, for primary retinal detachment (RD) in phakic eyes and in eyes had undergone uneventful phacoemulsification and had received posterior chamber lens implantations. Methods A total of 243 consecutive patients were included in this retrospective, nonrandomized comparative study. In all, 165 phakic and 78 pseudophakic individuals with primary RD underwent scleral buckling alone or in combination with vitrectomy and were followed up for 6 months. Pre-, intra-and postoperative findings including anatomical success, best-corrected visual acuity (BCVA), complications, and the development of proliferative vitreoretinopathy (PVR), macular pucker, or secondary cataracts were recorded. Cases requiring more than one surgical intervention were defined having failed, although further surgical intervention might have led to success. Results At 6 months after scleral buckling alone, the anatomical success was similar in phakic (88.98%) and pseudophakic (87.65%) eyes (log rank ¼ 0.310). The corresponding results after scleral buckling with vitrectomy were 82.13 and 77.63% for phakic and pseudophakic eyes, respectively (log rank ¼ 0.799). At 6 months after scleral buckling alone, BCVA was similar in phakic and pseudophakic eyes (0.6270.30 vs 0.7070.29; P ¼ 0.227). Likewise, after scleral buckling with vitrectomy, BCVA did not differ significantly (P ¼ 0.322) between phakic (0.3470.32) and pseudophakic eyes (0.5070.27). Conclusion The anatomical and functional outcome of primary retinal reattachment surgery, involving scleral buckling alone or in combination with vitrectomy, is similar in phakic and pseudophakic eyes.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Primary retinal reattachment surgery: anatomical and functional outcome in phakic and pseudophakic eyes

Halberstadt

Chatterjee-Sanz

Brandenberg

et al. 2004

Eye

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“…In patients with a macula-off detachment, 80% achieved 20/50 or better vision. Campo et al 35 reported an initial success rate of 86% of 275 patients who underwent primary vitrectomy for pseudophakic or aphakic detachments and 65% of patients who presented with macula-off detachments regained 20/50 or better vision. With combined vitrectomy and scleral buckling surgery, Desai and Strassman 36 and Devenyi 37 achieved 100% primary success rate.…”

mentioning

confidence: 99%

Visual recovery after macula-off retinal detachment

Ross

2002

Eye

121

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With modern surgical techniques to repair retinal detachments, a greater than 90% primary anatomic success rate can be expected. [1][2][3][4][5][6][7][8][9] Despite this high level of anatomic success, visual results remain compromised mainly because of permanent functional damage once the macula becomes detached. 10 The most important predictor of visual recovery after retinal detachment surgery is preoperative visual acuity. 8,9,11,12 Preoperative acuity appears to be directly related to the height of macular detachment. 13 Shorter duration of detachment and younger age are also important in visual recovery. This paper will review the current literature that helps to improve our understanding of visual recovery after macula-off retinal detachments.

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Analysis of the Macula With Optical Coherence Tomography After Successful Surgery for Proliferative Vitreoretinopathy

Benson

Grigoropoulos²,

Schlottmann³

et al. 2005

Arch Ophthalmol

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Objective: To use optical coherence tomography to assess the in vivo pathologic findings associated with incomplete visual recovery in patients who have undergone anatomically successful surgery to treat proliferative vitreoretinopathy. Methods: Eligible patients were recruited in vitreoretinal outpatient clinics between April 1, 2002, and July 31, 2003. Patients were included who had undergone anatomically successful vitreoretinal surgery to treat proliferative vitreoretinopathy and, at least 3 months after surgery, had postoperative vision worse than expected (Յ6/12) with no identifiable cause at clinical examination. Patients underwent optical coherence tomography, stereo fundus fluorescein angiography was performed in a cohort of patients, and angiographic findings were compared with those on the optical coherence tomograms. Relevant clinical data were collected retrospectively from patient case notes. Results: A total of 35 patients were recruited. Optical coherence tomograms revealed cystoid macular edema in 23 patients (66%) but did not identify any other specific intraretinal disease. Location of edema (outer or inner retina), determined with stereo fundus fluorescein angiography and optical coherence tomography, correlated well. Conclusions: Optical coherence tomography is a useful diagnostic tool for assessing poor postoperative visual acuity and can reveal disease undetected at clinical examination. Cystoid macular edema is a common finding on optical coherence tomograms in eyes with incomplete visual recovery after anatomically successful surgery to treat proliferative vitreoretinopathy.

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Pars plana vitrectomy without scleral buckle for pseudophakic retinal detachments

Cited by 236 publications

References 20 publications

Primary retinal reattachment surgery: anatomical and functional outcome in phakic and pseudophakic eyes

Primary retinal reattachment surgery: anatomical and functional outcome in phakic and pseudophakic eyes

Visual recovery after macula-off retinal detachment

Analysis of the Macula With Optical Coherence Tomography After Successful Surgery for Proliferative Vitreoretinopathy

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