Trends in Primary Retinal Detachment Surgery

Falkner-Radler, Christiane I.; Myung, Jane S.; Moussa, Sarah; Chan, Robison Vernon Paul; Smretschnig, Eva; Kiss, Szilárd; Gráf, Alexandra; D’Amico, Donald J.; Binder, Susanne

doi:10.1097/iae.0b013e3181f2a2ad

Cited by 63 publications

(55 citation statements)

References 28 publications

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“…We achieved retinal reattachment in 13 of the 16 eyes (81%). This reattachment rate was comparable with the success rate of case series of scleral buckling for rhegmatogenous retinal detachment performed in the traditional way [5,6]. …”

Section: Discussionsupporting

confidence: 61%

Scleral Buckling with a Non-Contact Wide-Angle Viewing System

et al. 2011

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Purpose: To assess the outcome of scleral buckling surgery using a non-contact wide-angle viewing system for fundus visualization in patients with rhegmatogenous retinal detachment without proliferative vitreoretinopathy. Patients and Methods: Sixteen eyes of 16 patients underwent scleral buckling using a non-contact wide-angle viewing system combined with a 25-gauge illumination fibre inserted into the sclera at the pars plana. Results: The mean age of the patients was 53.6 ± 13.7 years and the mean follow-up time was 13.4 ± 2.8 months. Retinal reattachment was achieved in 13 of the 16 eyes (81%). Three eyes underwent vitrectomy with silicone oil injection because of development of proliferative vitreoretinopathy in 2 eyes and scleral perforation due to excessive indentation during cryoretinopexy in 1 eye. Two eyes developed limited subretinal haemorrhage during subretinal fluid drainage. Conclusion: Simultaneous use of a non-contact wide-angle viewing system combined with a 25-gauge light fibre illumination for fundus visualization brings the advantages of microsurgery and indirect ophthalmoscopy into scleral buckling surgery.

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Section: Discussionsupporting

confidence: 61%

Scleral Buckling with a Non-Contact Wide-Angle Viewing System

et al. 2011

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“…We achieved retinal reattachment in 27 (93%) of 29 eyes in this initial surgery. This reattachment rate was comparable to the success rate reported in a case series of scleral buckling for RRD performed in the traditional way [15, 16]. The mean best corrected visual acuity after surgery at 6 months was improved significantly because our study included many patients with macula off RRD.…”

Section: Discussionsupporting

confidence: 69%

Effectiveness of Scleral Buckling with a Wide-Field Surgical Microscope and Chandelier Illumination in Retinal Detachment Repair

Jeon

Han

2019

Ophthalmologica

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Purpose: To assess treatment efficacy of scleral buckling surgery with wide-field surgical microscope and 27-gauge (G) chandelier illumination for rhegmatogenous retinal detachment (RRD). Methods: This study is a retrospective chart review of 29 eyes in 29 patients with RRD who underwent scleral buckling surgery with a wide-field surgical microscope and 27-G chandelier illumination fiber inserted into the sclera at the pars plana. Results are expressed as mean ± standard deviation. Data were analyzed using the paired sample t test. Statistical significance was considered if p value was less than 0.05. Results: The mean age of patients was 43.5 ± 3.5 years, and the mean follow-up time was 10.4 ± 2.5 months. Retinal reattachment was achieved in 27 of 29 eyes at initial surgery. The mean best corrected visual acuity improved from 0.38 ± 0.29 (logMAR) preoperatively to 0.19 ± 0.21 at 6 months after surgery. Two eyes underwent vitrectomy with silicone oil tamponade because of development of proliferative vitreoretinopathy. There was no complication such as choroidal hemorrhage, hypotony, or vitreous herniation at the end of surgery. Conclusion: Scleral buckling with a wide-field surgical microscope and 27-G chandelier illumination has the advantage of offering exact identification of retinal tears and determination of the adequacy of buckle height and position in retinal detachment surgery compared to conventional scleral buckling surgery.

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“…This is because growing advances in instrumentation technology, including direct visualization of vitreous tractions on the retina during surgical maneuvers and the possibility of witnessing the retina reattach intraoperatively, have made this technique more and more popular. [1][2][3][4][5] When PPV is performed, a tamponade is usually left in the eye at the end of surgery. The use of a tamponade, either gas or SO, may be associated with unintentional displacement of the retina.…”

Section: Discussionmentioning

confidence: 99%

“…The reasons behind this trend include the advent of outpatient ambulatory surgery and improvements in technology, instrumentation, and viewing systems. [1][2][3][4][5] When PPV is chosen for the treatment of RRD, it is typically accompanied with a postoperative intraocular tamponade agent-most commonly gases or silicone oils (SOs). Many surgeons prefer to use SO for complicated RRD or if postoperative airplane or high elevation travel is planned.…”

mentioning

confidence: 99%

Incidence and Factors Influencing Retinal Displacement in Eyes Treated for Rhegmatogenous Retinal Detachment With Vitrectomy and Gas or Silicone Oil

dell’Omo

Scupola

Viggiano

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. The purpose of this study was to study the incidence and factors influencing retinal displacement in eyes treated for rhegmatogenous retinal detachment (RRD) with pars plana vitrectomy (PPV) and gas or silicone oil.METHODS. This was a prospective observational case series. One hundred twenty-five eyes with macula-off RRD from 125 patients underwent 25-gauge PPV at two vitreoretinal institutional practices. Eyes without proliferative vitreoretinopathy (PVR) or PVR grade A were tamponated with sulfur hexafluoride (SF6) gas, whereas eyes with PVR grade B received 1000 centistokes silicone oil (SO). The patients postured face-down immediately after surgery. Blue-fundus autofluorescence (B-FAF) pictures were obtained at each follow-up examination. Main outcome measures were incidence and direction of retinal displacement.RESULTS. Ninety-seven eyes (77.6%) were tamponated with SF6 and 28 eyes (22.4%) with SO. After retinal reattachment, displacement was observed in 44 of 125 (35.2%) eyes (40 eyes in the SF6 group and 4 eyes in the SO group, respectively). The type of tamponade, specifically gas, was the only significant predictor of retinal displacement (P ¼ 0.007). The displacement was downward in 39 (88.6%) eyes (36 tamponated with SF6 and 3 with SO) and upward in 5 (11.4%) eyes (4 tamponated with SF6 and 1 with SO).CONCLUSIONS. Displacement of the retina after repair of macula-off RRD with PPV is observed using either SF6 gas or SO. Downward and upward displacements may occur with both tamponades, but downward dislocation is more common. Of the factors potentially implicated in favoring displacement that were studied, only the type of tamponade, specifically the gas, was significant.Keywords: blue fundus autofluorescence, retinal vessel printings, retinal detachment, pars plana vitrectomy, retinal displacement T here has recently been a trend toward pars plana vitrectomy (PPV) as the preferred method for treatment for rhegmatogenous retinal detachment (RRD). The reasons behind this trend include the advent of outpatient ambulatory surgery and improvements in technology, instrumentation, and viewing systems. [1][2][3][4][5] When PPV is chosen for the treatment of RRD, it is typically accompanied with a postoperative intraocular tamponade agent-most commonly gases or silicone oils (SOs). Many surgeons prefer to use SO for complicated RRD or if postoperative airplane or high elevation travel is planned. However, a recent prospective study has shown that PPV with SO injection is also a safe and efficient surgical approach for treatment of primary uncomplicated RRD. 6 The use of both gas and SO in conjunction with PPV for repair of RRD may be associated with unintentional displacement of the retina. [7][8][9][10][11][12] Blue fundus autofluorescence (B-FAF) elegantly depicts this shift via lines of increased autofluorescence, which closely reflect the caliber and orientation of the adjacent retinal vessels. These lines indicate the original location of the retinal vessels, which have been displaced along with t...

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Trends in Primary Retinal Detachment Surgery

Abstract: Although there is a trend toward primary vitrectomy, scleral buckling was preferred in the center in Vienna and primary vitrectomy in the center in New York. Despite the different primary RD procedures, anatomical and visual outcomes were comparable.

Cited by 63 publications

References 28 publications

Scleral Buckling with a Non-Contact Wide-Angle Viewing System

Scleral Buckling with a Non-Contact Wide-Angle Viewing System

Effectiveness of Scleral Buckling with a Wide-Field Surgical Microscope and Chandelier Illumination in Retinal Detachment Repair

Incidence and Factors Influencing Retinal Displacement in Eyes Treated for Rhegmatogenous Retinal Detachment With Vitrectomy and Gas or Silicone Oil

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