Surgical outcomes in rhegmatogenous retinal detachment at Srinagarind Hospital.

OBJECTIVES: To evaluate the surgical outcome for patients with rhegmatogenous retinal detachment and to find out the factors influencing the anatomic reattachment and visual results. MATERIAL AND METHOD: Retrospective review of the medical records of patients for the following details: age, sex, time to diagnosis, time to surgery, phakic status, types, numbers and locations of the retinal breaks, macular status, presence of proliferative vitreoretinopathy (PVR), types of surgical procedures, anatomic reattachment and visual improvement. RESULTS: Two hundred and twelve patients were surgically treated by pneumatic retinopexy, scleral buckling, pars plana vitrectomy or combined procedures. Initial anatomic reattachment was found in 157 cases (74.06%) and final reattachment in 193 cases (91.04%). Several factors including age, phakic status, number of the retinal breaks, macular detachment, PVR and types of surgical procedures have been identified to have a correlation with the anatomic success rate. Types of surgical procedures and time to surgery within 8 weeks of detachment have also been demonstrated to have a correlation with final visual improvement. However, only types of surgical procedures had statistically significant difference. Pneumatic retinopexy had a lower anatomic reattachment rate, but obtained a higher visual improvement than did other surgical procedures. Moreover, after repeated pneumatic retinopexy or further surgical procedures, the final anatomic success rate improved from 65.52% to 92.24%. CONCLUSION: Surgical outcomes for rhegmatogenous retinal detachment are comparable to other studies. Types of surgical procedures had a significant correlation with anatomic reattachment and final visual improvement.

Translimbal fixation of posterior chamber lenses.

OBJECTIVES: To evaluate the result of a surgical technique to insert and secure a standard posterior chamber lens through a simple limbal incision in eyes that had no capsular support or whose capsule was inadvertently ruptured during extracapsular cataract extraction. MATERIAL AND METHOD: Retrospective review of the medical records of patients who underwent translimbal fixation of posterior chamber lenses according to age, gender, preoperative visual acuity, postoperative visual acuity, follow-up period and any complications, especially those that may be related to the surgical technique. RESULTS: Twelve patients were recruited in the present study. The patents' age ranged from 31 to 77 years, with a mean of 62.58 years. There were 9 male and 3 female patients. The preoperative visual acuity ranged from hand motion to counting fingers, and the postoperative visual acuity ranged from 6/6 to 6/24 except one patient who had postoperative visual acuity of counting fingers due to a pre-existing macular hole. The length of follow-up period ranged from 3 to 12 months, with a mean of 6.17 months. There was no clinically significant lens-related complication. CONCLUSION: This simple surgical technique controls the location of the needle entry and exit to decrease the risk of bleeding and increase the chance of ciliary sulcus placement. An inferior groove was made to bury the suture knot and was sutured closed to prevent the knot erosion through the conjunctiva.