Two Cases of Ocular Ischemia following Scleral Encircling

PURPOSE: To report two cases of ocular ischemia following scleral encircling. METHODS: A 21-year-old man with glaucoma and a 76-year-old woman without any medical problem were transferred to our department for surgery to treat retinal detachment. After retrobulbar anesthesia and limbal peritomy of conjunctiva, the 4-rectus muscles were isolated. Scleral encircling was performed with No. a 42 band (4.0 mm in width) after cryotherapy done completely around retinal tear. RESULTS: Following surgery, One patient experienced ophthalmic artery occlusion and while the other patient experienced central retinal artery occlusion. Vision was not restored in either cases despite IV injection of 250 ml of 15% mannitol solution and anterior chamber paracentesis. CONCLUSIONS: In the cases where patients are of old age or suffer from glaucoma, we strongly recommend that the surgeons perform the scleral encircling carefully.

Combined Surgery of Retinal Reattachment Surgery and Cataract Extraction for Retinal Detachment

PURPOSE: To report the anatomical and functional outcomes of combined surgery-pars planar vitrectomy, scleral encircling and phacoemulsification and posterior chamber intraocular lens implantation. METHODS: We retrospectively studied the anatomical success, functional success and complications in 12 patients who had undergone combined surgery due to retinal detachment with cataract and vitreous opacity from March 2001 to August 2003. RESULTS: Twelve eyes were included in this study. Anatomical success was achieved after the initial operation in 10 (83.3%) eyes, and functional success in 6 (50%). Intraoperative complications included posterior capsule rupture in 1 eye, postoperative complications including hyphema in 3 eyes, and increased intraocular pressure in 3. CONCLUSIONS: The results of this study suggest that combined surgery is a safe and effective procedure for patients with rhegmatogenous retinal detachment, concomitant cataract, and vitreoretinal diseases.

Scleral Encircling for Complex Types of Rhegmatogenous Retinal Detachment

We performed treat the 41 eyes of rhegmatogenous retinal detachment to scleral encircling.The causes of retinal detachment were unidentifiable breaks (10 eyes), high myopia (8 eyes), pseudophakia or aphakia (8 eyes), giant tear (8 eyes)and multiple holes (7 eyes). Overall the reattachment ratewas 80.5% (33/41 eyes). The anatomic success rate was relatively high (85.7%)in eyes with giant tear, high myopia and multiple hole but relatively low in eyes with breaks unidentified (60%) or pseudophakic and aphakic retinal detachment (75%). Among those 33 eyes, functional success was achived in 27 eyes (81.8%). We achieved higher functional success rate in pseudophakia or aphakia, multiple hole and high myopia (over 83.3%) but low functional success rate in unidentifiable breaks (66.7%)and giant tear (71.4%). Our results suggest other treatments such as pars plana vitrectomy should be considered to treat eyes with retinal detachment of breaks unidentified, although scleral encircling has been used conventially.

Pefractive Changes After Encircling Scleral Buckling Surgery

Sixty rhegmatogenous retinal detachment patients who had received retinal detachment surgery by same surgeon at Yongdong Severance Hospital from Feb. 1990 to Feb. 1991 were evaluated prospectively to detect the refractive changes after operation. The authors studied the postoperative retinoscopic findings 3 months after retinal detachment surgery, and compared with preoperative refractive errors. The results were as follows; 1. The encircling scleral buckling with 3mm silicone sponge increased an average induced myopia of -1.63 diopter. 2. The segmental buckling increased an average induced myopia of -0.50 diopter. 3. The combined operation of encircling buckling and radial buckling increased an average induced myopia of -2.75 diopter. 4. The pneumatic retinopexy with SF6 gas caused never postoperative refractive changes.