Pars plana vitrectomy with silicone oil tamponade in failed scleral buckle surgery

Üney, Güner; Acar, Mehmet Akif; Ünlü, Nurten; Hazırolan, Dicle; Yalnız-Akkaya, Züleyha; Örnek, Firdevs

doi:10.1016/j.jcjo.2016.02.021

Cited by 6 publications

(6 citation statements)

References 30 publications

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“…In this study, complications after revitrectomy combined with tamponade were secondary glaucoma in 25% of eyes, complicated cataract in 100% of eyes, SO dependence in 15% of eyes, keratitis in 5% of eyes, and Re-RD in 10% of eyes. In previous reports, the percentage of complicated cataract was 69%–100% [ 8 , 38 ], secondary glaucoma was 30%–60.6% [ 3 , 38 , 45 ], SO-dependent eye was 19.7%–50% [ 10 , 19 , 38 , 46 ], Re-RD was 30.3% [ 38 ], and SO emulsification was 11.7% [ 14 ]. Choudhary et al [ 3 ] found that although IOP increased in 60.6% of patients before SO removal, only 7.5% of patients needed cyclophotocoagulation to reduce the IOP to the normal range after SO removal.…”

Section: Discussionmentioning

confidence: 99%

Re-vitrectomy for recurrent retinal detachment in post-vitrectomy eyes of rhegmatogenous retinal detachment

Bai

Zheng²,

Zhu

et al. 2022

BMC Ophthalmol

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Background Recurrent retinal detachment (Re-RD) usually affects the prognosis of surgery for rhegmatogenous retinal detachment (RRD). Previous clinical studies of Re-RD were not specific. This study aimed to analyze the clinical characteristics of Re-RD in post-vitrectomy eyes with RRD and surgical outcomes after revitrectomy without combining it with retinectomy or scleral buckling. Methods This is a retrospective case series analyzed the ocular characteristics of 20 recurrent and contralateral eyes, evaluated the significance of the associations between variables before reoperation and the final best-corrected visual acuity (BCVA), and calculated the outcome of revitrectomy. Results Patients with phakic eyes, those undergoing only one surgery, and those with more than one break had better final BCVA. The final BCVA was negatively correlated with the axial length and positively correlated with the preoperative BCVA. Among the 12 eyes with no break detected before surgery, 11 (92%) were found to have a small crevice-like break beside the pigment scar of a large number of original laser spots. The single-operation complete retinal reattachment rate was 75%, the complete retinal reattachment rate was 80%, and the final incomplete retinal reattachment rate was 90%. The BCVA improved from 1.2 ± 0.6LogMAR (0.06 ± 0.25) before surgery to 0.8 ± 0.7LogMAR (0.15 ± 0.2) at the last follow-up. The BCVA of 16 patients with complete retinal reattachment improved from 1.0 ± 0.5LogMAR (0.1 ± 0.3) to 0.6 ± 0.4LogMAR (0.25 ± 0.4). In the contralateral eyes, 15% already had vision-damaging disease, and the incidence of eyesight-threating lesions was 5.9% during follow-up. Conclusions Revitrectomy without retinectomy or scleral buckling can effectively treat Re-RD in post-vitrectomy eyes. In Re-RD patients with no definite retinal break detected preoperatively, the retinal hole usually shows small crevice-like changes alongside a large number of original laser pigment scars.

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Section: Discussionmentioning

confidence: 99%

Re-vitrectomy for recurrent retinal detachment in post-vitrectomy eyes of rhegmatogenous retinal detachment

Bai

Zheng²,

Zhu

et al. 2022

BMC Ophthalmol

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“…The presence of PVR is an important reason for reduced nal BCVA [21]. Despite the successful nal anatomical reattachment, a previous study reported that most patients with primary and secondary PPV, with PVR grades of C and D, had a visual acuity of 20/200, or worse [22].…”

Section: Discussionmentioning

confidence: 99%

Recurrent Retinal Detachment After Pars Plana Vitrectomy For Rhegmatogenous Retinal Detachment

Xie

et al. 2021

Preprint

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Background The recurrence of retinal detachment (RD) following rhegmatogenous retinal detachment (RRD) is a relatively common complication that threatens vision and requires further surgery. The purpose of this study was to investigate the risk factors and visual outcomes of recurrent RD following pars plana vitrectomy (PPV) for primary RRD. Methods This was a retrospective follow-up of 343 eyes that underwent initial PPV surgery for primary RRD. Patients were divided into a recurrence group and a reattachment group. The main outcome measures included causative factors, visual outcomes related to the recurrence of RD, and the perioperative factors most affecting the recurrence of RD. Results After retinal reattachment, we observed RD recurrence after PPV for primary RRD in 42 out of 343 eyes (12.2%) during the follow-up period. Most causes of recurrence (69%) occurred within 6 months of surgery. Univariate analysis showed that the presence of proliferative vitreoretinopathy (PVR) ≥ Grade C was significantly associated with recurrent RD (P = 0.003). Logistic regression analysis further showed that a PVR ≥ Grade C (odds ratio [OR]: 9.421; 95% confidence interval [CI]: 2.432 - 56.39; P = 0.020) was a significant predictor for the development of recurrent RD. Compared with the reattachment group, the recurrence group exhibited a significant decline in best-corrected visual acuity (BCVA) at the last follow-up visit (P = 0.000). Eyes with PVR prior to primary surgery, or at the diagnosis of re-detachment, showed a worse final BCVA. Conclusions Our analysis shows that the predominant risk factor for the recurrence of RD is a PVR ≥ Grade C. PVR prior to primary surgery, or at the diagnosis of re-detachment, was also shown to limit the recovery of final visual acuity.

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“…Majority of the studies quote PVR ≥ Grade C, anterior and inferior PVR to be associated with a higher risk re-RD. [ 6 7 8 9 10 11 12 13 14 15 16 17 19 20 21 22 26 ] It was previously reported that 86% of eyes with re-RD after vitrectomy have a component of anterior PVR[ 27 ] and eyes with anterior PVR have poorer surgical prognosis than those with posterior PVR. [ 28 ]…”

Section: Risk Factors Relating To Redetachmentmentioning

confidence: 99%

“…The second most common cause of redetachment was related to retinal breaks. Large breaks more than three disk diameters,[ 6 8 ] formation of new breaks or missed breaks[ 6 7 8 9 13 14 15 19 21 22 ] or ineffective closure of preexisting breaks either by improper positioning of the scleral buckle (SB) or by inadequate chorioretinal adhesion,[ 12 13 21 26 ] reopening of an old break[ 19 ] and reopened macular hole[ 22 ] lead to redetachment.…”

Section: Risk Factors Relating To Redetachmentmentioning

confidence: 99%

Management of recurrent rhegmatogenous retinal detachment

Nagpal¹,

Chaudhary²,

Wachasundar³

et al. 2018

Indian J Ophthalmol

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Rhegmatogenous retinal detachment (RRD) repair is one of the most common vitreoretinal surgeries a surgeon performs. In an ideal scenario, RRD can be repaired with a single surgical intervention; however, despite excellent skill, flawless technique, and the introduction of high-end technology, up to 10% of cases require additional interventions to ultimately repair recurrent detachments. It is thus important to study the outcomes of multiple interventions to understand whether performing repeat vitrectomy on patients with a history of failed surgeries is worthwhile. Thus, recurrent retinal detachment (re-RD) remains a significant challenge for vitreoretinal surgeons as well as the patients considering the economic and the emotional burden of undergoing multiple interventions. The advent of microincision vitrectomy system, perfluorocarbon liquids, and effective intraocular tamponades has opened new doors for managing re-RDs. In this article, we have reviewed and summarized the various causes and approaches for management for optimal anatomical and functional outcomes.

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Pars plana vitrectomy with silicone oil tamponade in failed scleral buckle surgery

Cited by 6 publications

References 30 publications

Re-vitrectomy for recurrent retinal detachment in post-vitrectomy eyes of rhegmatogenous retinal detachment

Re-vitrectomy for recurrent retinal detachment in post-vitrectomy eyes of rhegmatogenous retinal detachment

Recurrent Retinal Detachment After Pars Plana Vitrectomy For Rhegmatogenous Retinal Detachment

Management of recurrent rhegmatogenous retinal detachment

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