ABSTRACT
Objective:To investigate the clinical efficacy of triamcinolone acetonide peribulbar injection combined with vitrectomy for rhegmatogenous retinal detachment associated with choroidal detachment (RRD-CD).Methods:This study was a retrospective case series study. Nineteen cases (19 eyes) with RRD-CD who had undergone pars plana vitrectomy at the Dalian No.3 People′s Hospital were analyzed. All the cases received 20 mg triamcinolone acetonide peribulbar injection within 3 to 7 days before surgery. The severity of patient′s uveitis was assessed before and after peribulbar injection of triamcinolone acetonide. Best corrected visual acuity (BCVA) and intra ocular pressure (IOP) before and after surgery, the area of retinal detachment, the rate of retinal reattachment, the rate of recurrent retinal detachment and surgical complications were analyzed. Patients′ blood pressure and blood glucose levels were also monitored.Results:19 patients were followed up for (13.1±1.5)months. The severity of uveitis reduced to different extents compared with preoperative condition. The IOP was (8.73±3.38)mmHg before injection and (10.95±2.46)mmHg after injection, and the difference was statistically significant ( t=-7.571, P=0.027). The choroid detachment range was 4-12(9.37±2.69)sites before injection, and 0-11(4.63±4.10)sites after injection, and the difference was statistically significant ( Z=-3.834, P=0.001). Compared with the preoperative results, the BCVA increased in 12 patients, unchanged in 5 cases and decreased in 2 cases. In the final follow-up of 18 patients with retinal reattachment, 17 eyes underwent a single operation, 2 eyes had recurrent retinal detachment, and 1 eye had retinal reattachment after a second operation. There were no significant difference in blood glucose and blood pressure before and after injection (all P>0.05). There were no other complications besides temporarily elevated IOP and cataract. Conclusions:Vitrectomy combined with triamcinolone acetonide peribulbar injection is effective and safe for patients with RRD-CD.
ABSTRACT
Purpose: To evaluate the incidence of shallow anterior chamber in the early postoperative period following Ahmed glaucoma valve (AGV) implantation and its effect on the hypertensive phase (HP), intermediate-term intraocular pressure (IOP) control, and success rate. Methods: A retrospective analysis of 369 eyes of 360 patients who underwent AGV implantation between January 2005 and January 2020 with a minimum follow-up of 2 months was performed. Twenty-six patients developed shallow anterior chamber (AC) within 8 weeks following surgery (cases). They were compared with 39 randomly selected controls (no shallow AC post AGV). HP (IOP spike >21 mmHg), use of ocular hypotensive medications, and other associations were compared. Results: Incidence of shallow AC post AGV was 7% (95% confidence interval [CI] 4, 9). The onset of shallow AC was 3 ± 2.1 days and resolved within 6 ± 4.7 days. Hypotony (12 [47%] vs. 1 [2.5%], P 0.0001) and choroidal detachment (CD; 7 [27%] vs. 3 [8%], P 0.03) were more common in cases compared to controls. The HP occurred in 11 (43%) cases versus 13 (34%) controls (P 0.4). Cases required more ocular hypotensive medications than controls at the end of 8 weeks (1.1 ± 1 vs. 0.5 ± 0.5, P 0.01). There was no significant difference in the qualified success between the groups at 1 year. Conclusion: The development of postoperative shallow AC post AGV implantation was not detrimental to IOP control at 1 year. However, there is a need to monitor the occurrence of HP in these eyes.
ABSTRACT
Purpose: To assess the long?term outcomes of choroidal detachments (CDs) in eyes following trabeculectomy. Methods: Retrospective comparative case series. Data of patients with CDs following trabeculectomy (5?year period) with or without cataract surgery with a minimum of 3 months of follow?up were included. Results: In total, 45 patients with CDs following trabeculectomy were included. The mean age was 63.27 ± 8.68 years, (M:F = 2:1); 29 of 45 eyes (64.4%) had a baseline IOP of >24 mm Hg. Patients had a median follow?up of 22.2 (IQR: 16.2–30.5) months. Further, 10 of 45 eyes (22.2%) had CDs following suture lysis. The median onset of choroidal detachment from the time of surgery was 16.0 (IQR: 11–36) days. The mean BCVA improved from 0.62 ± 0.28 to 0.24 ± 0.27 (P < 0.001) and mean IOP increased from 4.07 ± 2.66 to 11.20 ± 5.31 (P < 0.001) at last visit. The cumulative success rates were 76.4% (95% CI: 48.4–90.5) in POAG eyes and 79.3% (95% CI: 62.8–89.1) in PACG eyes (P = 0.547). Medical management was the mainstay in all patients. Four of 45 (8.88%) patients underwent subsequent choroidal drainage. Conclusion: Choroidal detachment following modern?day trabeculectomy has favorable long?term visual acuity and IOP outcomes. There was no difference in the long?term surgical success of trabeculectomy with choroidal detachments in primary angle?closure and open?angle glaucoma eyes. Long?term follow?up is essential to prevent chronic hypotony and trabeculectomy failure
ABSTRACT
Purpose: To study the safety and efficacy of pre?operative suprachoroidal triamcinolone acetonide (SCTA) for achieving reduction/resolution of serous choroidal detachment (CD) associated with rhegmatogenous retinal detachment (RRD). Methods: This was a prospective, noncomparative, interventional pilot study. All consecutive patients presenting with RD and coexisting CD underwent transconjunctival injection of SCTA before proceeding with vitrectomy/scleral buckle surgery. Sequential ultrasound B scans were performed for assessing the change in height of the CD. Results: The mean age of the cohort was 53.8 � 10.8 years (range: 39� years). The CD was present in a median of 3 quadrants; the cumulative mean CD height was 5.59 mm (range: 2.02�42 mm). Following SCTA, a successful response (>50% reduction) was seen in five eyes by day 3 and in two eyes by day 5. Three eyes failed to respond to SCTA and required surgical drainage before proceeding with vitrectomy. No intraprocedural injection?related complications were noted. A transient rise in the intraocular pressure (30 mmHg) was seen in one eye following vitrectomy and was managed successfully with topical antiglaucoma medications. Conclusion: Suprachoroidal administration of triamcinolone appears to be a safe and effective technique to achieve CD resolution in eyes with RRD.
ABSTRACT
PURPOSE: To report a case of simultaneous bilateral acute angle closure attack combined with bilateral choroidal detachment in a patient with acquired immune deficiency syndrome (AIDS).CASE SUMMARY: A 63-year-old male who had a history of several months of diarrhea, abdominal pain, and weight loss visited the emergency room with sudden bilateral blurred vision accompanied with headache, periocular pain, nausea, and vomiting. His visual acuity was finger counting in both eyes and the intraocular pressure (IOP) was 49/44 mmHg (right/left). The anterior chamber depth was three times the corneal thickness in the center and less than 1/4 of the corneal thickness in the periphery in both eyes. Maximum medical therapy had no effect and emergency cataract surgery combined with vitrectomy was performed on the right eye. During surgery, severe choroidal detachment was noted. One day after surgery, choroidal detachment was also found in the left eye and emergency cataract surgery with suprachoroidal fluid drainage was performed. Approximately 1 month after surgery, choroidal detachment of both eyes regressed without systemic therapy. The IOP was 14/7 mmHg (right/left) with a visual acuity of 0.32/0.4 (right/left). The blood test performed in the emergency room showed a positive result for AIDS and the patient started medical therapy.CONCLUSIONS: In patients with AIDS, bilateral simultaneous acute angle closure attack combined with choroidal detachment may rarely develop. Although choroidal effusion can regress spontaneously, combined suprachoroidal fluid drainage is recommended when a surgical intervention is required.
ABSTRACT
@#AIM: To investigate and analyze the safety and clinical efficacy vitrectomy combined with scleral buckling in treatment of rhegmatogenous retinal detachment associated with choroidal detachment.<p>METHODS: Totally 19 patients(19 eyes)of rhegmatogenous retinal detachment associated with choroidal detachment treated by vitrectomy combined with scleral buckling in our hospital from January 2014 to September 2017 were retrospective analyzed. Silicone oil was removed from the vitreous cavity 3 to 12mo after operation. Retinal reattachment rate, intraocular pressure(IOP), visual acuity recovery and complications were observed.<p>RESULTS:The IOP in vitreous cavity filled with silicone oil at 3mo after operation(16.09±3.58mmHg)and 6mo after silicone oil removal(14.69±3.10mmHg)were higher than those before operation(6.78±1.90mmHg)(all <i>P</i><0.05). Six months after silicone oil removal, the visual acuity of 15 eyes was improved. No complications of low IOP and atrophy occurred after operation.<p>CONCLUSION: Vitrectomy combined with scleral buckling is relatively safe and effective in treatment of rhegmatogenous retinal detachment associated with choroidal detachment, with high retinal reattachment rate, fewer complications and low reoperation rate.
ABSTRACT
@#AIM: To explore the changes of morphological parameters of corneal endothelial cell in patients with choroidal detachment following rhegmatogenous retinal detachment(RDD-CHD). <p>METHODS: Seventy patients(70 eyes)with RDD-CHD were collected consecutively. In patients with RDD-CHD, thirty-eight cases(38 eyes)not with high myopia were enrolled in group A; 32 cases(32 eyes)associated with high myopia were enrolled in group B. Thirty-six normal controls(36 eyes)were enrolled in group C. We measured the related morphological parameters of corneal endothelial cells in all subjects using corneal specular microscope. The parameters of corneal endothelial cells included minimum size of cell area(S<sub>min</sub>), maximum size of cell area(S<sub>max</sub>), average size of cell area, standard deviation of cell area(SD), coefficient of variability cell area(CV), cell density of corneal endothelial cells(CD)and hexagonality(HG). <p>RESULTS: There were statistically differences in the CD(<i>P</i><0.001)and hexagonality(<i>P</i><0.001)between the patients with RDD-CHD and normal subjects. There were statistically differences in the CD between groups A and B(<i>P</i><0.05), between groups A and C(<i>P</i><0.05), between groups B and C(<i>P</i><0.001). SD correlated with axis length(<i>r</i><sub>s</sub>=-0.426, <i>P</i><0.01); CV correlated with axis length(<i>r</i><sub>s</sub>=0.494, <i>P</i><0.01), CD correlated with intraocular pressure(<i>r</i><sub>s</sub>=-0.025, <i>P</i><0.05), CD correlated with axis length(<i>r</i><sub>s</sub>=0.368, <i>P</i><0.05), HG correlated with course(<i>r</i><sub>s</sub>=0.552, <i>P</i><0.05). In patients with RDD-CHD, SD correlated with axis length(<i>r</i><sub>s</sub>=0.236, <i>P</i><0.05); CV correlated with axis length(<i>r</i><sub>s</sub>=0.159, <i>P</i><0.05), HG correlated with course(<i>r</i><sub>s</sub>=0.142, <i>P</i><0.05), S<sub>max</sub> correlated with intraocular pressure(<i>r</i><sub>s</sub>=-0.314, <i>P</i><0.01).<p>CONCLUSION: The valus of HG and CD of corneal endothelial cells in patients with RDD-CHD were both lower than that of the normal subjects. Axis length, course and intraocular pressure might influence the morphological parameters of corneal endothelium in RDD-CHD patients.
ABSTRACT
@#Glucocorticoid as adjunctive drug before and after the surgery for retinal detachment associated with choroidal detachment. It has obvious effects in controlling inflammation and improving choroidal detachment, which creates favorable conditions for the operation. However, the ophthalmologists have different opinions on the effects of postoperative retinal reattachment rate and improvement of visual function. There has been controversy about whether to use hormones before surgery, the time of use and the way they are used. This article will review the relevant knowledge. In order to provide a more accurate and feasible reference for clinical treatment.
ABSTRACT
Bilateral uveal effusion syndrome associated with bilateral acute retinal necrosis is a diagnostic and therapeutic challenge. A 52 year old man presented with bilateral angle closure with choroidal detachment. With restricted fundus view, parenteral steroid was started. During close follow up bilateral discrete areas of peripheral retinitis were noted. Parenteral steroids were promptly stopped and parenteral antivirals with oral steroids were continued. It showed healing response with nil recurrences till last follow up. Aggressive treatment of bilateral uveal effusion with parenteral steroids can cause progression of bilateral acute retinal necrosis leading to phthisis bulbi. However early diagnosis, prompt intervention and close follow up are the key elements to therapeutic success even during diagnostic surprises and avoid costly mistakes.
ABSTRACT
@#AIM: To observe and analyze the safety and clinical efficacy of full-thickness scleral incision and <i>in situ</i> paracentesis in the treatment of patients with coexisting rhegmatogenous retinal detachment and choroidal detachment using minimally invasive vitrectomy. <p>METHODS: From April 2015 to April 2017, 20 patients(20 eyes)with coexisting rhegmatogenous retinal detachment and choroidal detachment who were treated in Department of Ophthalmology, Jiangsu Province Hospital were enrolled in this retrospective analysis. All patients received modified scleral puncture drainage combined with 23G minimally invasive vitrectomy. This study analyzed and compared intraoperative paracentesis success rate, the incidence of intraoperative, postoperative visual acuity, intraocular pressure, and postoperative retinal reattachment rate. <p>RESULTS: Suprachoroidal fluid from all patients were drainaged successfully. Compared with preoperative conditions, the postoperative visual acuity was significantly improved(<i>P</i><0.01). There was a significant difference in average intraocular pressure(IOP)between preoperative one and postoperative one(7.00±2.05mmHg and 15.38±2.66mmHg respectively, <i>P</i><0.01). The origin retinal reattachment rate was 90%(18/20), and the final retinal reattachment rate was 95%(19/20). <p>CONCLUSION: The modified scleral puncture surgery in the treatment of patients with coexisting rhegmatogenous retinal detachment and choroidal detachment in 23G vitrectomy has great clinical effects. It not only simplifies the procedure of operation, but also reduces the difficulty and complication of operation.
ABSTRACT
The application of sutureless minimally invasive vitrectomy has been used for more than 10a.High-speed cutting and fine instrumentation have been effective in the treatment of severe vitreoretinal diseases,but intraoperative and postoperative complications have also seriously affected vision recovery,including choroidal detachment is minimally invasive vitrectomy and postoperative relatively rare complications,secondary glaucoma,decreased vision,etc.The reasons and treatment of choroidal detachment during and after minimally invasive vitrectomy are summarized below.
ABSTRACT
@#AIM: To evaluate the clinical effect of Conbercept combined with vitrectomy in the treatment of proliferative vitreoretinopathy(PVR)after choroidal detachment. <p>METHODS: From January 2015 to January 2018, 66 eyes of 64 patients with PVR were treated in our hospital. All the patients were randomly divided into control group(32 cases, 34 eyes)and observation group(32 cases, 32 eyes). The control group was treated with routine vitreoretinal surgery. The observation group was treated with routine vitreoretinal surgery combined with intravitreal injection of conbercept. The clinical efficacy, operative duration, intraoperative bleeding, incidence of iatrogenic holes and the best corrected visual acuity(BCVA), subfoveal choroidal thickness before and after treatment were compared between the two groups. <p>RESULTS: After 3-6mo follow-up, the total effective rate in the observation group(94%)was significantly higher than that in the control group(74%), and the difference was statistically significant(<i>P</i><0.05). The duration of operation in the observation group was significantly shorter than that in the control group, and the incidence of intraoperative hemorrhage and iatrogenic hiatus were significantly lower in the observation group than in the control group(<i>P</i><0.05). Before treatment, there was no significant difference in serum VEGF level and bFGF content between the two groups(<i>P</i>>0.05). After treatment, the above indexes were lower than those before treatment. The levels of serum VEGF and bFGF in the observation group were significantly lower than those in the control group(<i>P</i><0.05). Before treatment, there was no significant difference in the thickness of subfoveal choroid and BCVA between the two groups(<i>P</i>>0.05). The BCVA of the two groups was significantly higher than that before treatment. The thickness of subfoveal choroid in the observation group was significantly lower than that before surgery(<i>P</i><0.05), and the thickness of the subfoveal choroid in the observation group was significantly lower than that in the control group(<i>P</i><0.05). <p>CONCLUSION: Vitrectomy combined with intravitreal injection of conbercept in the treatment of PVR after choroidal detachment has a good effect. It can effectively shorten the operation time, reduce the incidence of intraoperative hemorrhage and iatrogenic hole, and reduce the level of serum VEGF and bFGF content. Improve the visual acuity and reduce the thickness of choroid.
ABSTRACT
@#AIM: To evaluate the effects of internal limiting membrane peeling and vitrectomy with triamcinolone acetonide and silicone oil tamponade for the treatment of retinal detachment with choroidal detachment attributable to macular hole in patients with high myopia. <p>METHODS: Totally 28 eyes of 28 patients with retinal detachment associated with choroidal detachment attributable to macular hole in patients with high myopia, were treated with pars plana vitrectomy(PPV)and indocyanine green(ICG)assisted internal limiting membrane peeling(ILMP)and silicone oil tamponade. All patients had been followed up for 6-24mo. The reset rate of retinal detachment and the vision recovery, complications were analyzed. <p>RESULTS: All patients had been followed up 6-24mo. The mean LogMAR CVA was 1.01±0.31 after surgery, which significantly improved compared to that before surgery(<i>t</i>=-39.28, P<0.01). Of these 28 eyes, macular hole closed in 19 eyes(68%), macular hole did not close in 9 eyes(32%), retinal reattached in 26 eyes(93%), high intraocular pressure appeared in 6 eyes. <p>CONCLUSION: For the treatment of retinal detachment associated with choroidal detachment attributable to macular hole in patients with high myopia, PPV combined with ILMP and silicone oil tamponade and triamcinolone acetonide show a high retinal reattachment rate, which can arrest the regeneration of proliferative vitreoretinopathy.
ABSTRACT
AIM: To observe the clinical effects of intravitreal injection of triamcinolone acetonide ( TA ) before vitrectomy for retinal detachment associated with choroidal detachment. · METHODS: Totally 23 cases ( 23 eyes ) of retinal detachment associated with choroidal detachment in our hospital were treated by intravitreal injection of TA 4-5d before 23-Gauge micro-invasive vitrectomy combined with silicone oil injection. All the cases were followed up between 6 to 9mo. The anatomic retinal reattachment, visual acuity, intraocular pressure and postoperative complications were observed and analyzed. ·RESULTS: After the surgery, the visual acuity of all patients were improved, with 9 eyes better than 0. 3 (39%), and 18 eyes better than 0. 05 (78%). The BCVA at 1wk, 1 and 3mo and last follow up were different compared with before operations (P<0. 05). The mean intraocular pressure was 4. 02±1. 47mmHg before injection, 13.69±4. 68mmHg before operation (P<0. 05), and17.72±5.87 mmHg after operation (P<0.05). The retina of all patients treated were reattached 2wk post-operatively. The retinal reattachment rate after the primary surgery and the secondary surgery was 87% and 100%, respectively. Post-operative complications included 7 eyes of transient high intraocular pressure, occurred during 12-14d after operations and returned to normal after less glucocorticoid eye drops and giving IOP lowering drugs. There were no intraocular hemorrhage, iatrogenic retinal breaks, infections, or lens injuries. · CONCLUSION: Intravitreal injection of TA before vitrectomy for retinal detachment associated with choroidal could improve the clinical effects, and decrease the difficulty of surgery while the injection itself is pretty safe.
ABSTRACT
PURPOSE: Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder with widespread manifestations that rarely include the eye. We present a case of SLE-associated choroidoretinopathy and secondary angle closure attack in both eyes. CASE SUMMARY: A 58-year-old male was admitted into the urologic department complaining of right scrotal swelling, and then consulted with the ophthalmology department regarding both ocular pain and eye injection. The patient was diagnosed with acute angle closure attack using a slit lamp test and tonometry secondary to choroidoretinitis with choroidal detachment at fundus examination in both eyes. The rheumatologist performed systemic evaluation, including serologic tests, and then diagnosed the patient with SLE. After systemic steroid therapy, intraocular pressure was decreased and choroidal detachment disappeared with improvements of choroidoretinitis in both eyes. CONCLUSIONS: Patients with systemic lupus erythematosus choroidopathy can develop secondary angle closure attack, which can be effectively treated using systemic steroid therapy and antiglaucoma drugs.
Subject(s)
Humans , Male , Middle Aged , Choroid , Choroiditis , Intraocular Pressure , Lupus Erythematosus, Systemic , Manometry , Ophthalmology , Serologic Tests , Slit LampABSTRACT
We report a rare case of multicentric Castleman's disease that presented with ophthalmic involvement, along with a review of the literature. A 63-year-old male presented with decreased visual acuity in both eyes. Both eyes had serous elevations of the retinas with shifting subretinal fluid and annular choroidal detachment. No retinal breaks were found. Laboratory tests revealed pancytopenia, hypergammaglobulinemia, and an increased erythrocyte sedimentation rate. Chest and abdominal computed tomographies showed multiple lymphadenopathies in the mediastinum, abdomen, and in both inguinal areas. Histological examination of the inguinal lymph node biopsy was consistent with Castleman's disease. After combination chemotherapy, the serous elevations of both retinas and the annular choroidal detachments of both eyes disappeared. Ophthalmic involvement in Castleman's disease is very rare, and to the authors' knowledge, this is the first report of ophthalmic involvement of Castlemans's disease in Korea.
Subject(s)
Aged , Humans , Male , Choroid Diseases/etiology , Drug Therapy, Combination , Exudates and Transudates/metabolism , Fluorescein Angiography , Fundus Oculi , Castleman Disease/complications , Hypergammaglobulinemia/complications , Magnetic Resonance Imaging , Syndrome , Tomography, Optical Coherence , Treatment Outcome , Uveal Diseases/diagnosisABSTRACT
PURPOSE: We present three cases of atypical Harada's disease that exhibited different clinical courses. CASE SUMMARY: (Case 1) A 56-year-old male initially presented with typical findings of Harada's disease accompanied by exudative retinal detachment of the left eye. However, he did not show any signs and symptoms of Harada's disease in his right eye for 4 years. (Case 2) A 73-year-old male came to our clinic complaining of decreased visual acuity in both eyes with headache and tinnitus. Fundoscopic findings showed bilateral annular choroidal detachment but no evidence of exudative retinal detachment. The same result was obtained on remission. (Case 3) A 53-year-old female presented with decreased visual acuity in both eyes with headache and tinnitus. Fundoscopic findings showed severe choroidal folds instead of exudative retinal detachment, which was observed in 2 other remissive cases. CONCLUSIONS: We report 3 cases of atypical Harada's disease that did not present with bilateral exudative retinal detachment. Ophthalmologists should know that Harada's disease can exhibit diverse clinical courses.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Choroid , Eye , Headache , Porphyrins , Retinal Detachment , Tinnitus , Visual AcuityABSTRACT
PURPOSE: To report the case of delayed suprachoroidal hemorrhage after Ahmed valve implantation in a neovascular glaucoma (NVG) patient. CASE SUMMARY: A 74-years-old male visited the hospital with ocular pain in the left eye. He had a history of vitrectomy and Intraocular lens (IOL) scleral fixation due to trauma in the left eye. NVG was diagnosed and Ahmed valve was implanted in his left eye. Three days later, hypotony occurred with all quadrant choroidal detachment. Next day, raised intraocular pressure (IOP) was checked and anterior chamber was flat on slit lamp examination. Vitreous hemorrhage and suprachoroidal hemorrhage were suspected. We performed anterior chamber formation with viscoelastics. The anterior chamber became deeper and hemorrhage gradually decreased. A month later, the patient visited us with severe ocular pain. Raised IOP and shallow anterior chamber due to moderate hyphema and anteriorly placed IOL were found. Retinal detachment was suspected on B-scan. Vitrectomy, IOL removal, silicone oil insertion, and Ahmed valve removal were performed. CONCLUSIONS: We report we experienced one patient of delayed suprachoroidal hemorrhage after Ahmed valve implantation and he had poor prognosis.
Subject(s)
Humans , Male , Anterior Chamber , Choroid , Eye , Glaucoma, Neovascular , Hemorrhage , Hyphema , Intraocular Pressure , Lenses, Intraocular , Prognosis , Retinal Detachment , Silicone Oils , Vitrectomy , Vitreous HemorrhageABSTRACT
PURPOSE: Choroidal detachment (CD) associated with rhegmatogenous retinal detachment (RRD) is a rare, but serious condition, which makes the prognosis worse. Previously reported risk factors for CD in RRD patients include high myopia, aphakia, pseudophakia, and advanced age. However, macular hole has not been discussed as an important factor in increasing the risk of CD in RRD patients. The purpose of this study was to evaluate macular hole as a risk factor for CD in eyes evidencing RRD. METHODS: The medical records of 480 patients with primary RRD were reviewed. We compared the CD incidence among the RRD patients in accordance with the presence or absence of macular holes. The relationship between gender, age, presence of systemic disease, refractive errors, lens status, intraocular pressure and the development of CD were also analyzed. RESULTS: The incidence (4/21 eyes, 19.0%) of CD in the RRD with macular hole was significantly higher than that (7/459 eyes, 1.5%) observed in the RRD without macular hole (p=0.010). The preoperative intraocular pressure (mean+/-SD; 2.5+/-1.3 mmHg) in the RRD with CD and macular hole was significantly lower than that (7.4+/-4.4 mmHg) observed in the cases of RRD with CD without macular hole (p=0.035). The eyes complicated by CD evidenced a higher prevalence of diabetes mellitus (p=0.024) than was observed in the eyes without CD. CONCLUSIONS: The retinal detachment combined with macular hole creates a predisposition toward the development of profound hypotony and CD.