ABSTRACT
Objective: to evaluate the anatomical and functional outcomes of retinectomy in the management of primary rhegmatogenous retinal detachments with inferior retinal breaks and advanced proliferative vitreoretinopathy [PVR C]
Study Design: quasi-experimental study
Place and Duration of Study: LRBT, Free Base Eye Hospital, Karachi, from July 2015 to June 2017
Methodology: forty eyes of 40 patients with primary inferior retinal breaks macula off detachments and advanced proliferative vitreoretinopathy [grade C] in which retinectomy was performed were included. Primary outcome measured was anatomic success, defined as complete retinal reattachment between neurosensory retina and retinal pigment epithelium at six months follow-up. Secondary outcomes included changes in best corrected visual acuity and postoperative complications. The follow-up period was up to six months after the last surgery. Association was determined between the retinectomy extension and the best corrected visual acuity postoperatively
Results: retina was reattached after single operation in 29 eyes [72.5%], after the second operation in eight eyes [20%], and after the third operation in two eyes [5%]. Final retinal reattachment was achieved in 39 out of 40 eyes [97.5%]. The preoperative visual acuity was counting fingers CF in eight eyes [20%], hand motion HM in 28 eyes [70%], and light perception PL in four eyes [10%]. The postoperative visual acuity improved in 27 eyes [67.5%], remained stable in 11 eyes [27.5%], and worsened in 2 eyes [5%]. There was no statistically significant association between the retinectomy extension and maximum postoperative best corrected visual acuity [p=0.098]. The significant postoperative complications were retinal redetachment and hypotony
Conclusion: retinectomies are effective in managing primary rhegmatogenous retinal detachment with severe PVR [PVR C], and Increase the final retinal reattachment rate
ABSTRACT
Objective: To assess the visual and anatomical outcomes following idiopathic macular epiretinal membrane [IERM] surgery
Study Design: Case series
Place and Duration of Study: Layton Rehmatulla Benevolent Trust [L.R.B.T], Free Base Eye Hospital, Karachi, from January 2015 to June 2016
Methodology: Thirty eyes of thirty patients affected with idiopathic macular epiretinal membrane stage 2 were enrolled in this study. They subsequently underwent 23-gauge pars plana vitrectomy [PPV] with epiretinal membrane removal without internal limiting membrane peeling. The visual outcome was measured as improvement in best corrected visual acuity [BCVA] of at least two or more lines on ETDRS chart as compared to preoperative BCVA. The anatomical outcome was measured as decrease in foveal thickness on Spectral Domain-Optical Coherence Tomography [SD-OCT]. Patients were followed for a period of 06 months
Results: At the end of follow-ups, 23 [76%] eyes out of 30 gained 2 or more lines of vision. In 05 [16%] eyes, BCVA remained same and only 02 [6.6%] eyes showed worsening of vision. Mean preoperative foveal thickness was 392 +/- 20 micro m, whereas mean postoperative thickness was 305 +/- 16 micro m with an average decrease of 87 micro m, in foveal thickness. Recurrence of ERM was found to be the most frequent complication
Conclusion: IERM surgery is a safe procedure and beneficial in achieving significant visual acuity improvement and anatomical recovery in the majority of cases