Posterior Segment Complications After Vitrectomy for Macular Hole

Park, S. S.; Marcus, Dennis M.; Duker, Jay S.; Pesavento, Richard D.; Topping, Trexler M.; Frederick, Albert R.; Amico, Donatella

doi:10.1097/00006982-199616060-00020

Cited by 30 publications

(38 citation statements)

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“…Rohit et al [6] reported that 140 consecutive Incidences of postoperative retinal breaks without retinal detachment following MH surgery with the conventional 20-gauge vitrectomy system have been reported as 1.2% (2 of 170 cases) [7], 0% (0 of 95 cases) [8], and 3% (3 of 98 cases) [1], with an incidence of 1% (5 of 373 MH cases) for the pooled data. Retinal detachment occurred at a rate of 1.2% (2 of 170 cases) [7], 10.5% (10 of 95 cases) [8], and 14.3% (14 of 98 cases) [1], with a morbidity of 7% (26 of 373 MH cases) for the pooled data. Therefore, it is likely that a retinal break following MH surgery with the conventional 20-gauge vitrectomy system is associated with the occurrence of retinal detachment.…”

Section: Discussionmentioning

confidence: 98%

“…Although the same procedure was routinely performed for many patients with MH, retinal detachment with myopic macular hole, and diabetic macular edema, postoperative retinal breaks occurred only in MH cases. Therefore, abnormality of the vitreo-retinal interface seen in patients with MH may have predisposed them to peripheral retinal breaks [7].…”

Section: Discussionmentioning

confidence: 99%

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Postoperative retinal break after 25-gauge transconjunctival sutureless vitrectomy: report of four cases

Okuda

Nishimura

Kobayashi

et al. 2006

Graefe's Arch Clin Exp Ophthalmol

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Postoperative retinal break after 25-gauge transconjunctival sutureless vitrectomy: report of four cases

Okuda

Nishimura

Kobayashi

et al. 2006

Graefe's Arch Clin Exp Ophthalmol

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“…We do not believe the benefits of such action outweigh the risks of a surgical procedure, such as peripheral retinal breaks, rhegmatogenous retinal detachment, and endophthalmitis. 5 In patients who have been operated on for a macular hole, we suggest performing a posterior capsulotomy intraoperatively at the end of cataract surgery to avoid a future Nd:YAG capsulotomy that could reopen the macular hole. The same can be said when cataract surgery is performed at the same time as macular hole surgery.…”

Section: Discussionmentioning

confidence: 99%

Reopening of 2 macular holes after neodymium:YAG capsulotomy

García‐Arumí

Palau²,

Boixadera³

et al. 2006

Journal of Cataract and Refractive Surgery

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“…Die Re-Operationsraten verschiedener Studien lagen zwischen 1,1 % und 14 % [14][15][16][17][18][19][20][21][22].…”

Section: Hintergrundunclassified

Qualitäts-Statistik von Operationen an der Augenabteilung des Krankenhauses Hietzing in Wien

Weingessel

Vécsei

Irsigler

et al. 2011

Spektrum Augenheilkd.

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Background: Intraoperative complication rate as quality-criteria in cataract-surgery varies from 2.3 % to 27.4 % in literature. Re-surgery rate for vitreoretinal surgeries ranges from 1.1 % to 14 %. Some preoperative conditions and intraoperative factors have a serious impact on complication rate. Other affecting factors are the surgeon's expertness, the structure of the surgical curriculum and the intraoperative management. Material and Methods: A retrospective chart review of 17.665 surgeries, the number of cataract surgeries and vitreoretinal surgeries were recorded, data of re-surgeries due to complications were collected. Based on complication rates of the year 2007 and 2008 the following actions were taken: Identification of pre-and intraoperative risk factors, allocating complicated surgeries to experienced surgeons, consistent intraoperative management and a structured surgical curriculum. Results: Massive reduction of re-surgeries in both cataract and vitreoretinal surgery was achieved, 66.8 % for cataract surgery and 86.6 % for vitreoretinal surgery. Conclusions: Identifying pre-and intraoperative risk factors, allocating complicated surgeries to experienced surgeons, consistent intraoperative management and a structured surgical curriculum reduce intraoperative complications and re-surgery rate dramatically. Zusammenfassung. Hintergrund: Die Komplikationsraten als Kriterium für die Qualität bei Katarakt-Operationen variieren in der Literatur zwischen 2,3 % bis 27,4 %. Die Re-Operationsraten bei vitreoretinalen Operationen liegen zwischen 1,1 % und 14 %. Es gibt verschiedene prä-und intraoperative Faktoren, die einen Einfluss auf die Komplikationsrate haben. Aber auch die Erfahrenheit der ChirurgIn und die Strukturiertheit der Ausbildung haben Auswirkungen, ebenso wie das intraoperative Management. Material und Methode: Retrospektive Untersuchung aller Operationen, die zwischen Jänner 2007 und März 2011 an der Augenabteilung durchgeführt wurden, mit Schwerpunkt auf Katarakt-und vitreoretinale Operationen. Basierend auf den Kom pli kationsraten von 2007 und 2008 kamen folgende Maß-nahmen zur Anwendung: präoperative Identifikation von prä-und intraoperativen Risikofaktoren, die Auswahl einer/s geeigneten Operateur/in, konsequentes intraoperatives Kompli kationsmanagement und ein strukturierter Ausbildungsplan für AssistenzärztInnen. Resultate: Reduktion der Re-Operationsrate bei Katarakt-Operationen um 66,8 % seit 2007 bzw. um 64,8 % seit 2008 und der Re-Operationsrate von vitreoretinalen Operationen um 86,6 % im Vergleich zu 2007 bzw. 59,3 % zu 2008. Schlussfolgerung: Die Berücksichtigung von prä-und intraoperativen Risikofaktoren, die Auswahl einer/s geeigneten Operateur/in, konsequentes intraoperatives Komplikationsmanagement und ein strukturierter Ausbildungsplan für AssistenzärztInnen führt zu einer wesentlichen Reduktion von OP-Komplikationen und Re-Operationen.

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Posterior Segment Complications After Vitrectomy for Macular Hole

Cited by 30 publications

References 0 publications

Postoperative retinal break after 25-gauge transconjunctival sutureless vitrectomy: report of four cases

Postoperative retinal break after 25-gauge transconjunctival sutureless vitrectomy: report of four cases

Reopening of 2 macular holes after neodymium:YAG capsulotomy

Qualitäts-Statistik von Operationen an der Augenabteilung des Krankenhauses Hietzing in Wien

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