Primary Retinal Detachment Outcomes Study Report Number 2

Ryan, Edwin H.; Ryan, Claire; Forbes, Nora J.; Yonekawa, Yoshihiro; Wagley, Sushant; Mittra, Robert A.; Parke, David W.; Joseph, Daniel P.; Emerson, Geoffrey G.; Shah, Gaurav K.; Blinder, Kevin J.; Capone, Antonio; Williams, George A.; Eliott, Dean; Gupta, Omesh P.; Hsu, Jason; Regillo, Carl D.

doi:10.1016/j.ophtha.2020.03.007

“…Cataract development or progression is more prevalent in PPV, and PPV is associated with a slower visual recovery [22][23][24]. The average age of the patients in our study was 49:3 ± 18:9 years; six years after the surgery, A recent multicenter study also confirmed that patients with phakic moderately complex primary RRD who underwent scleral buckling had significantly better visual outcomes [10]. Several studies have reported that the use of chandelier-assisted scleral buckling yielded a reattachment rate of 83.3-95.5% [3,5].…”

Section: Discussionsupporting

confidence: 74%

Six-Year Outcomes of 25-Gauge Chandelier Illumination-Assisted Scleral Buckling

Li

¹

,

Zhang

²

,

Wei

³

et al. 2021

BioMed Research International

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Objectives. To report the long-term results of scleral buckling using 25-gauge chandelier illumination. Methods. The medical records of all patients presenting to Shanghai Tenth People’s Hospital with simple rhegmatogenous retinal detachment (RRD) from June 2013 to Oct 2015 were retrospectively reviewed in this consecutive case series. All patients underwent preoperative and postoperative best corrected visual acuity (BCVA), B-ultrasound, fundus photography, and optical coherence tomography examination. Ultrasound biomicroscopy (UBM) was obtained postoperatively. Results. Ten patients (10 eyes) were included in the final analysis. Of 10 patients, the average age was 49.3 ± 18.9 years old, the average duration of RRD was 30.9 ± 53.3 days, and the mean follow-up period was 6.2 ± 0.9 years. There were nine eyes with myopia and four eyes with macular detachment. The primary anatomical success rate was 90%. Five eyes underwent 360-degree band with element surgery, and five eyes underwent element surgery alone. The average length of encircling band and element was 68.2 ± 1.3 mm and 10.5 ± 2.5 mm, respectively. There were no intraoperative or postoperative complications that occurred. The final BCVA was greater than or equal to 20/40 in nine eyes, of which four eyes achieved 20/20. UBM examination of the 25-gauge chandelier insertion site revealed no tissue proliferation. Conclusions. For simple rhegmatogenous retinal detachment treatment, 25-gauge chandelier illumination-assisted scleral buckling is a kind of effective and safe method.

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“…Both delay in presentation and delay in surgical repair of macula-off retinal detachments are associated with worse visual acuity and surgical outcomes. 8 , 9 , 10 , 11 Prior studies have suggested a delay of 7 days can lead to worse visual outcomes, while some recent studies have suggested that a delay in even 3 days leads to worse visual acuity outcomes. 12 , 13 The purpose of this report is to investigate the effect of the initial COVID-19 pandemic on the clinical presentation of acute, primary RRD to a tertiary referral-based retina subspecialty practice setting.…”

Section: Introductionmentioning

confidence: 99%

Clinical Presentation of Rhegmatogenous Retinal Detachment during the COVID-19 Pandemic

Patel

¹

,

Peck

²

,

Starr

³

et al. 2021

Self Cite

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Objective To investigate the effect of the COVID-19 pandemic on the clinical presentation of acute, primary rhegmatogenous retinal detachment (RRD). Design Single-center, consecutive case series with historical controls. Subjects Consecutive patients presenting with primary RRD in a 50-day period during the USA COVID-19 pandemic (March 9 th - April 27 th , 2020) and the corresponding 50-day period in the previous year (March 4 th - April 22 th , 2019). Methods The cohorts were compared to assess demographic variables and clinical presentations. Multivariate logistic regression was used to identify factors predictive of presenting macular attachment status. Main Outcome Measure The primary outcome was the proportion of patients with macula-on RRD at presentation. Secondary outcomes included visual acuity (VA), duration of symptoms prior to presentation, proportion presenting within one day of symptom onset, and presence of primary proliferative vitreoretinopathy (PVR). Results Eighty-two patients were included in the 2020 cohort compared to 111 patients in the 2019 primary control cohort. Demographic factors were similar between the groups. Significantly fewer patients presented with macula-on RRD in the 2020 cohort (20/82 patients, 24.4%) than in 2019 (55/111 patients, 49.5%, p = 0.001). Patients in the 2020 cohort had worse median VA at presentation (LogMAR 1.00, Snellen 20/200 in 2020 versus LogMAR 0.48, Snellen 20/60 in 2019, p = 0.008), fewer patients presenting within one day of symptoms (16/80 patients [19.5%] in 2020 versus 41/106 patients [36.9%] in 2019, p = 0.005), and a greater proportion with primary PVR (11/82 patients [13.4%] in 2020 versus 5/111 patients [4.5%] in 2019, p = 0.03). In multivariate analysis, younger age (p = 0.03) and established patient status (p = 0.02) were independent predictors of macula-on status in the 2020 cohort. Conclusions Patients with primary RRD during the 2020 COVID-19 pandemic were less likely to be macula-on and more likely to have delayed presentation, worse vision, and PVR.

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“…According to a recent large multicenter study, scleral buckle showed better results (91.7%) than pars plana vitrectomy (83.1%) in moderately complex phakic primary RRD. 13 These results encourage surgeons to utilize this procedure in favorable contexts.…”

Section: Discussionmentioning

confidence: 92%

Heads up Sutureless Chandelier assisted scleral buckle

AlAkeely

¹

,

Alageely

²

,

Alageely

³

2020

American Journal of Ophthalmology Case Reports

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Purpose This study aims to describe chandelier assisted scleral buckle (CSB) using 3D visualizing system in phakic uncomplicated Rhegmatogenous Retinal Detachment (RRD). Methods This technique was performed in 6 eyes of 6 patients with primary rhegmatogenous RD who underwent encircling circumferential scleral buckling with scleral tunnels. Heads up display 3D system was used for visualization and localization of the breaks, and Chandelier Endoillumination was used as a light source was inserted through a 27 G needle sclerotomy 3.5mm from the limbus. A partial-thickness scleral “belt-loop” tunnels in the four quadrants were created using crescent knife angle beveled (2.3 mm in width) to facilitate the smooth passage of the band a 240-silicone band as encircling circumferential buckle. Cryopexy was performed and the incision was closed with cautery or absorbable sutures. Results Primary attachment success of 5 out of 6 and overall success was 100%. No intraoperative or postoperative complications observed although fellows in training performed half the procedures. Conclusions Heads up Sutureless Chandelier assisted Scleral Buckle can achieve excellent anatomical success while improving ergonomics and training. Furthermore, it is a safe procedure with less risk of complications and retinal phototoxicity.

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Primary Retinal Detachment Outcomes Study Report Number 2

Cited by 77 publications

References 20 publications

Six-Year Outcomes of 25-Gauge Chandelier Illumination-Assisted Scleral Buckling

Six-Year Outcomes of 25-Gauge Chandelier Illumination-Assisted Scleral Buckling

Clinical Presentation of Rhegmatogenous Retinal Detachment during the COVID-19 Pandemic

Heads up Sutureless Chandelier assisted scleral buckle

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