Surgical management of complicated retinal detachment in a case of retinal hemangioblastoma

Background: A 40-year-old male presented with a complaint of sudden onset diminution of vision in the left eye for 2 weeks. He was a follow-up case with retinal hemangioblastoma in both eyes. He underwent two sittings of fundus fluorescein angiography-guided trans-pupillary thermotherapy 2 years back. Since then, he was regularly followed up for 2 years with stable vision and stable retinal findings. At present, the best-corrected visual acuity (BCVA) in the right eye is 6/6, and in the left eye, it is counting fingers 2 meters. On fundus examination, he had one active hemangioblastoma in the right eye and total retinal detachment in the left eye with multiple active lesions. The right eye was treated with a single sitting of thermotherapy, and the left eye underwent pars plana vitrectomy and angioma excision, followed by silicone oil tamponade. The immediate and late post?operative periods were uneventful, with successful anatomical and functional outcomes. The left eye BCVA on late follow-up was 6/36, no further treatment was advised, and the patient was kept under follow-up and observed closely. Purpose: To educate regarding the systemic workup, diagnosis, and surgical management of complicated retinal detachment in retinal hemangioblastoma. Synopsis: Systemic workup, diagnosis, and surgical steps in the management of complicated retinal detachment in retinal hemangioblastoma were performed. Highlights: Close follow-up, keen observation, and prompt treatment in the early stages of the disease are indispensable to prevent untoward sequelae of retinal hemangioblastoma. A thorough systemic workup is necessary to diagnose the systemic involvements early. Surgery, if indicated for the retinal hemangioblastoma or its associated sequelae, should be performed diligently and with careful handling of blood vessels and anomalous tissues.

Effect of clinical nursing path with GTI on health education to patients with complex retinal detachment / 现代临床护理

Objective To study the effect of clinical nursing path with graph and text instructions (GTI) on health education to patients with complex retinal detachment.Methods Toally 76 inpatients with complex retinal detachment were enrolled in the study:38 of them hosptalized from March to August 2015 were put in the control group received routine treatment and the others hosptalized from September 2015 to March 2016 as the experiment group treated with GTI.The clinical outcomes were compared.Result The patients treated with GTI were better in the knowledge of the complex retinal detachment and moreover,they felt significantly more satisfied compared to that of the control group (P＜0.05).Conclusion It is beneficial to use GTI in the patients with complex retinal detachment.GTI is effective for improving their knowledge on the disease,and increasing their satisfaction with the clinical nursing.

Application of Vitreoretinal Surgery in Treating Complicated Retinal Detachment / 医学研究杂志

Objective To explore the effect of the vitreoretinal surgery on the complicated retinal detachment.Methods We collected the clinical data of 50 cases with complicated retinal detachment treated by vitreoretinal surgery combined with the methods of vitrectomy,membrane excision,perfluorocarbon liquids,retinal coagulation of laser or condensate,exchange between silicon oil and gas perfluorocarbon liquids,silicon oil fill.The period of follow up was 3 to12months.Results The retina was attached completely in 46 cases(92%).4 cases did not reset auownting for 8%.The sight of all eyes was improved in varying degrees.Conclusion Vitreoretinal surgery is an effectial way for treat complicated retinal detachment.

Intraoperative Use of Perfluo rocarbon Liquids in the Management of Proliferative Vitreoretinopathy

Perfluorocarbon liquids have been shown to be a useful intraoperative adjunct in managing complicated retinal detachment. To prove the effectiveness of intraoperative use of perfluorocarbon liquid and the improvement of surgical and functional outcomes, we retrospcetively evaluated the clinical results of the patients[13 eyes]who had retinal detachment complicated with proliferative vitreoretinopathy [over PVR Grade C4, C4 :7 eyes, C5 :6 eyes]. We performed standard 3-port pars plana vitrectomy in all eyes included in this study.Perfluorodecalin[DK-line]was used as a shortterm vitreous substitute intraoperatively and removed before the end of the surgery. The mean follow-up period was 15 months.Anatomical success rate was 86%[6 eyes]in Grade C4, 67%[4 eyes]in Grade C5, Visual acuity was over 5/200 in one eye[8%]and there was improvement in 5 eyes[40%] although it was below 5/200. Consequently, we could easily manage the retinal detachment with PVR with help of intraoperative perfluorocarbon liquid and could improve the postoperative surgical and visual outcomes.

Intraoperative Perfluorophenanthrene Use in Complicated Retinal Detachment

23 eyes of 23 patients who underwent conventional vitreoretinal surgery with high specific gravity perfluorocarbon liquid, perfluorophenanthrene, for complicated retinal detachment were evaluated retrospectively. Preoperative vitreoretinal findings showed grade C2 PVR in 4 eyes and C3 in 1 eye and C4 in 10 eyes and C5 in 8 eyes. As a result, 17 eyes(74%) showed anatomical success, completely reattached in 15 eyes, partially reattached in 2 eyes, and 12 eyes(52%) showed functional success (corrected visual acuity 5/200 or better). Follow-up period was over 6 months in all cases. Postoperative complications includes keratopathy in 6 eyes, hypotony in 5 eyes, cataract in 2 eyes, transient vitreous hemorrhage in 1 eye, acute increased IOP in 1 eye, posterior synechiae in 1 eye, cystoid macular edema in 1 eye, and pupillary membrane in 1 eye. Consequently, perfluorophenanthrene can be used beneficially in yield of surgical field and mechanical stabilization of retina in complicated retinal detachment surgery.

The Use of Retinal Tacks for the Treatment of Complicated Retinal Detachment

An improved retinal tack and applicator have been increasingly used as an adjunct in the repair of complicated retinal detachments. We used this technique in 7 consecutive cases of complicated retinal detachment. After a mean follow-up of 3 months, anatomical reattachment including partial reattachment was achieved in 5 eyes among 7 eyes, and 6 eyes had improved vision or no change(one improved to 20/70). Retinal tacks appear to be a useful tool either temporarily or permanently in preventing retraction and detachment of the retina until adjunctive diathermy, cryopexy, or photocoagulation becomes effective.