Vitrectomy Alone in the Management of Giant Retinal Tears

Jain, Nieraj; Kozak, Jennifer A.; Niziol, Leslie M.; Musch, David C.; Zacks, David N.

doi:10.3928/23258160-20140908-03

Cited by 13 publications

(19 citation statements)

References 15 publications

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“…The final BCVA has been reported to be 20/40 or better in 0-50% and 20/200 or lower in 10-58% of patients in different studies. 4,[14][15][16][17] In our study, the baseline BCVA was greater than 20/40 in 1.6% and lower than 20/200 in the majority of eye (90%), that is markedly lower than other studies, however, at final visit the BCVA significantly improved and 16% of eyes had BCVA greater than 20/40.…”

Section: Discussionmentioning

confidence: 49%

Outcome of surgery in patients with giant retinal tear: 10 years experience

Falavarjani

Modarres

Alemzadeh

et al. 2017

Eye

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PurposeTo present our experience with the surgery in retinal detachment (RD) associated with giant retinal tear (GRT) over 10 years in a tertiary referral hospital.Patients and MethodsIn this retrospective study, the charts of all patients with the diagnosis of RD associated with GRT who underwent surgery from 2005 to 2015 at Rassoul Akram Hospital were reviewed. Exclusion criteria were concomitant presence of diabetic retinopathy, and uveitis. All patients had to have at least 3 months of follow up. The success rate and factors associated with repeated surgery were determined.ResultsSixty two eyes of 61 patients including 51 males and 10 females were assessed. Proliferative vitreoretinopathy (PVR) was present in 14 (22.6%) of eyes. Pars plana vitrectomy (PPV) alone was performed in 44 eye (71.0%) and simultaneous vitrectomy and phacoemulsification surgery was performed in 18 eyes (29.0%). An encircling episcleral band was placed in 7 eyes (11.3%). Anatomic success after one vitrectomy procedure was achieved in 45 eyes (72.58%) and ultimately in 61 eyes (98.4%) at last follow up. Seventeen eyes needed repeated PPV due to redetachment associated with PVR in the follow up period. The rate of repeated PPV was significantly higher in eyes with PVR at baseline and surgery with encircling episcleral band. Trauma, extension of tear, age, and lens status had no significant effect on the rate of repeated PPV.ConclusionsOur study shows that the high surgical success can be achieved in patients with RD associated with GRT with single or multiple surgeries.

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Section: Discussionmentioning

confidence: 49%

Outcome of surgery in patients with giant retinal tear: 10 years experience

Falavarjani

Modarres

Alemzadeh

et al. 2017

Eye

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“…In recent years, there has been a gradual trend towards use of small‐gauge instrumentation in the management of GRT‐associated retinal detachments (Jain et al. ; Pitcher et al. ).…”

Section: Discussionmentioning

confidence: 99%

“…Recently, Jain et al. () reported 83% primary anatomical success at 3 months after vitrectomy without adjuvant scleral buckling, including six eyes (15%) with grade C PVR at baseline. They proposed that a GRT‐associated detachment should be treated as any other rhegmatogenous retinal detachment, and adjuvant scleral buckling could be considered only in certain high‐risk cases.…”

Section: Discussionmentioning

confidence: 99%

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Vitrectomy with silicone oil tamponade for retinal detachment associated with giant retinal tears: Favourable outcomes without adjuvant scleral buckling

Hocaoğlu

Karaçorlu

Ersöz

et al. 2018

Acta Ophthalmologica

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Purpose: To evaluate the outcomes of pars plana vitrectomy with silicone oil tamponade in the management of retinal detachment associated with giant retinal tears. Methods: We reviewed 45 eyes of 42 patients with primary retinal detachment associated with giant retinal tears over 10 years at a tertiary referral centre. Patients underwent 23-gauge vitrectomy without adjuvant scleral buckling by a single surgeon and had follow-up at least 6 months after silicone oil removal. Results: Mean follow-up was 37 AE 35 months. Seven eyes (16%) had grade C proliferative vitreoretinopathy, and 16 (36%) had a giant retinal tear ≥180°at baseline. The primary reattachment rate was 84%, and the overall final anatomical success rate was 98%. The mean Snellen visual acuity equivalent at the final visit was 20/58. Final visual acuity ≥20/40 was achieved in 64%. The mean duration of silicone oil tamponade was 10.5 AE 4 weeks. By the final visit, silicone oil had been removed from 44 eyes (98%). Conclusion: The high rates of anatomical and functional success support management of giant retinal tears-associated retinal detachment with vitrectomy without adjuvant scleral buckling. Removal of silicone oil at the earliest possible time helps to avoid complications such as keratopathy, glaucoma and visual loss without apparent reason.

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“…증식유리체망막병증은 열공망막박리의 5-10%에서 발견된다고 보고되며 [12], 70% 정도의 낮은 일차 재유착률을 보여 열공망 막박리의 나쁜 예후인자로 알려져 있다 [6,8]. 본 연구에서 전체 열공망막박리의 10.9%에서 증식유리체망막병증이 관찰되었고, Values are presented as mean SD.…”

Section: 고찰unclassified

Clinical Characteristics of Rhegmatogenous Retinal Detachment Combined with Proliferative Vitreoretinopathy Grade C or Higher

Ahn

Kwon

Lee

et al. 2017

J Retin

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Purpose: To classify rhegmatogenous retinal detachment (RRD) combined with proliferative vitreoretinopathy (PVR) grade C or higher according to clinical difficulties and age and to investigate the outcomes and operation methods. Methods: Eyes with RRD with PVR grade C or higher were reviewed retrospectively among 752 eyes of RRD over a period of 5 years. The cases with total retinal detachment combined with ocular hypotony, giant retinal tear, uveitis treated within 3 months, or atopic dermatitis were classified as the high risk group, and the others were the low risk group. Additionally, the low risk group was classified as the low risk group-older and low risk group-younger according to age 40. Operation methods and anatomical outcomes were analyzed according to group. Results: Eighty-two eyes with RRD with PVR grade C or higher were enrolled, representing 10.9% of the total RRD eyes. Of these, 36 eyes were assigned to the high risk group, and 46 eyes were in the low risk group. In the low risk group, 14 eyes were classified in the low risk group-older, and 32 eyes were in low risk group-younger. The eyes in the high risk group were mainly treated with encircling combined with vitrectomy (89.0%), but the primary anatomical success rate was low (61. 1%). Comparatively, scleral buckling was the main procedure performed in the low risk group-younger (94%), and a higher primary anatomical success rate was achieved (96.7%). The primary success rate of the low risk-older group was 71.4%. Conclusions:The risk factors seem to be important when deciding the operation method and for predicting the prognosis of RRD with PVR grade C or higher. Scleral buckling could be considered as the first option for treating RRD with PVR grade C or higher in the absence of risk factors in patients aged less than 40.

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Vitrectomy Alone in the Management of Giant Retinal Tears

Abstract: Based on this retrospective series, and within the confines of our eligibility criteria, adjuvant scleral buckling does not appear to be necessary in the management of primary GRT detachment.

Cited by 13 publications

References 15 publications

Outcome of surgery in patients with giant retinal tear: 10 years experience

Outcome of surgery in patients with giant retinal tear: 10 years experience

Vitrectomy with silicone oil tamponade for retinal detachment associated with giant retinal tears: Favourable outcomes without adjuvant scleral buckling

Clinical Characteristics of Rhegmatogenous Retinal Detachment Combined with Proliferative Vitreoretinopathy Grade C or Higher

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