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@#AIM: To investigate subfoveal subretinal fluid thickness(SFT)and subfoveal choroidal thickness(CT)after scleral buckling surgery(SBS)for macula-off rhegmatogenous retinal detachment(RRD).<p>METHODS: Retrospective observational case series. Twenty-three patients with macula-off RRD underwent successful SBS combined with cryotherapy. Patients with recurrent retinal detachment and proliferative preretinal membranes were excluded. Optical coherence tomography(OCT)was used to measure subfoveal SFT and subfoveal CT. The OCT images were then evaluated preoperatively and postoperatively at 1wk, 1, 3, 6, and 12mo. Best-corrected visual acuity(BCVA)was measured preoperatively and postoperatively.<p>RESULTS: All of the patients had subretinal fluid 1wk after operation. Subfoveal SFT gradually reduced over time. The subfoveal CT was thicker 1wk postoperatively and gradually decreased subsequently. The BCVA(mean±SD, LogMAR)was 0.60±0.35, which was a statistically significant change from the preoperative BCVA(<i>t</i>=6.35, <i>P</i><0.01).<p>CONCLUSION: The subretinal fluid was gradually absorbed with time, and the subfoveal CT gradually decreased after the early thickening. The SBS rapidly improved the visual acuity of the patients after the early postoperative period.
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AIM: To observe the effect of 25G- assisted scleral buckling under direct vision in the treatment of retinal detachment in silicone oil-filled eyes.?METHODS: In the retrospective case study, 15 eyes of 15 patients who had retinal detachment after silicone oil filling were treated with 25G- assisted scleral buckling under direct vision. Experimental patients were followed up for 3-6mo to observe the retinal reattachment, visual acuity and intraocular pressure.?RESULTS: There were 15 eyes of 15 patients with inferior retinal detachment before operation. Retinal reattachment was achieved in 13 eyes (13 patients), and retina failed to be reattached in 2 eyes ( 2 patients ) after operation. Furthermore, postoperative visual acuity was found to be improved more than one line in 11 eyes ( 11 patient ) , unchanged in 3 eyes ( 3 patients ) , and decreased more than one line in 1 eye ( 1 patient ) . Meanwhile, early postoperative intraocular pressure increased in some patients and returned to normal after drug control.?CONCLUSION:The 25G-assisted scleral buckling under direct vision has a definite curative effect in the treatment of retinal detachment in silicone oil-filled eyes.
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Objective To explore the characteristics and surgical managements of recurrent retinal detachment in silicone oil tamponade eyes.Methods The records of consecutive series of 134 patients (134 eyes) with recurrent retinal detachment in silicone oil tamponade eyes from January 2012 to December 2015 in our hospital were reviewed retrospectively,the vitrectomy combined with silicone oil replacement or scleral buckling procedure were performed.The follow-up time was 6 months,the surgical efficient was evaluated.Results 101 eyes underwent vitrectomy combined with silicone oil replacement.Retina was completely reattached in 79 eyes,and vitrectomy was reperformed in the left 22 eyes,the successful rate was 78.2％ (79/101);The visual acuity improved in 16 eyes,unchanged in 56 eyes,decreased in 29 eyes;The intraocular pressure of 31 eyes increased more than 25 mmHg (1 kPa =7.5 mmHg).33 eyes underwent scleral buckling procedure.Retina was completely reattached in 23 eyes,and vitrectomy combined with silicone oil replacement was performed in the left l0 eyes,the successful rate was 69.7％ (23/33);The visual acuity improved in 5 eyes,unchanged in 16 eyes,decreased in 12 eyes;The intraocular pressure of 14 eyes increased more than 25 mmHg.Conelusion For limited retinal detachment caused by inferior or peripheral holes,proliferative vitreoretinopathy in the A or B-class,the refractive medium does not affect the fundus examination,scleral buckling surgery is preferred;For the hole in the posterior pole or extensive retinal detachment caused by giant retinal holes,proliferation or retinal fixed fold formation,vitrectomy combined with silicone oil replacement is a better option.
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To investigate the curative effect of minimally invasive sclera buckling on single retinal detachment.METHODS:Totally, 100 cases of patients with retinal detachment ( 106 eyes ) enrolled in our hospital were randomly divided into observation group and control group, 53 eyes in each group. Patients in observation group were treated with minimally invasive sclera buckling, while patients in control group received traditional limbal conjunctival incision. After surgery, patients were all followed up for 6 ~18mo, during which the retinal recurrence situation, degree of vision enhancement and compliance occurrence rate was recorded. RESULTS: The retinal reattachment rate once of observation group (96. 22%) was significantly higher than that of control group (88. 68%), there was statistically significance (P<0. 05). The vision enhancement rate of observation group (84. 90%) was significantly higher than that of control group (71. 70%), there was statistically significance (P<0. 05). The compliance occurrence rate of observation group (11. 32%) was significantly lower than that of control group (32. 08%), there was statistically significance (P<0. 05).CONCLUSlON: The improved minimally invasive sclera buckling can significantly enhance the curative effect for retinal detachment, decrease the compliance occurrence rate, improve vision function, and is a scientific, practical and rigorous tool for retinal detachment treatment.
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AIM: To study the characteristics of retinal detachment surgery after laser in situ keratomileusis (LASIK).METHODS: Eleven eyes of ten patients that experienced rhegmatogenous retinal detachment after LASIK procedure participated in the study. The characteristics of retinal detachment, management and complications after surgery were analyzed . RESULTS: Retinal detachment was characterized by the large percentage of multiple peripheral holes (73%) and giant tears (27%). All eyes underwent sclera buckling, and three of them combined with pars plana vitrectomy (PPV) and silicone oil tamponade. Silicone oil was removed after 1 month. Retina was reattached successfully at the first retinal detachment surgery in all eyes except one that succeeded at the fourth time. One eye of LASIK flap dehiscence and one eye of corneal subepithelial opacity occurred after surgery.CONCLUSION: Patients after LASIK should be carefully examined under pupillary dilation during follow-up. Sclera buckling is necessary to most retinal detachment after LASIK, and corneal protection is important in the treatment.
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PURPOSE: To investigate serial changes in photoreceptor status and associated visual outcome in patients with persistent submacular fluid after successful scleral buckle surgery for macula-off rhegmatogenous retinal detachment. METHODS: This was a prospective observational case series including 76 consecutive patients who underwent successful scleral buckle surgery for macula-off rhegmatogenous retinal detachment with symptom duration < or =90 days at a single tertiary hospital. Optical coherence tomography (OCT) and visual acuity examination were performed at one month and three months postoperatively and at three-month intervals until the submacular fluid disappeared. Main outcome measures were postoperative photoreceptor status on OCT and visual acuity. RESULTS: Forty-two patients (55.3%) showed persistent submacular fluid at postoperative one month. Of 42 patients with persistent submacular fluid, three (7.1%) showed photoreceptor disruption on OCT. None of the 34 patients without persistent submacular fluid showed photoreceptor disruption. Two patients (4.8%) had progressive photoreceptor disruption, and one patient (2.4%) had early photoreceptor disruption. All three patients showed photoreceptor reappearance and limited visual restoration after absorption of submacular fluid. Final visual acuities were significantly worse in these three patients (20 / 1000, 20 / 133, and 20 / 133) compared to those of the other patients (mean, 20 / 30) with persistent submacular fluid and intact photoreceptors. CONCLUSIONS: Even after successful scleral buckle surgery for rhegmatogenous retinal detachment, photoreceptor disruption can occur related to persistent submacular fluid and may be a cause of poor visual outcome.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Young Adult , Aqueous Humor/metabolism , Follow-Up Studies , Photoreceptor Cells/pathology , Postoperative Complications , Prospective Studies , Retinal Detachment/surgery , Scleral Buckling , Tomography, Optical Coherence , Visual Acuity/physiologyABSTRACT
Objective By using optical coherence tomography (OCT) to observe the residual subretina fluid changes in fovea that may explain visual recovery after anatomically successful repair of rhegmatogenous retinal detachments (RD). Design Prospective observational case series. Participants 34 patients(35 eyes) with successful retinal reattachment after macula involving RD repair. Methods 34 patients were followed up at 3 days, 15 days, 2 months and 6 months after sclera buckling. The best corrected visual acuity(BCVA), eye fundus status were recorded. The OCT images through the center of the fovea were obtained. Main Outcome Measures The OCT images and BCVA after RD repair. Results The BCVA and OCT images were obtained 3 days to 6 months postoperatively. There were 3 eyes, 5 eyes, 9 eyes and 23 eyes respectively with residual subfovea fluid absorbed totally at 3 days, 15 days, 2 months and 6 months. In the residual subforvea fluid group, the mean visual acuity increased at 0.124?0.013. In the subfovea fluid absorbed group, the mean visual acuity increased at only 0.019?0.006. Conclusions After anatomically successful repair of RD performend with sclera buckling, the minimal residual subforvea fluid will exist for a long time and will be absorbed slowly. This may explain slow increase of postoperative visual acuity after anatomically successful repair.