ABSTRACT
OBJECTIVE: To evaluate the anatomical and functional outcomes of retinectomy in the management of primary rhegmatogenous retinal detachments with inferior retinal breaks and advanced proliferative vitreoretinopathy (PVR C). STUDY DESIGN: Quasi-experimental study. PLACE AND DURATION OF STUDY: LRBT, Free Base Eye Hospital, Karachi, from July 2015 to June 2017. METHODOLOGY: Forty eyes of 40 patients with primary inferior retinal breaks macula off detachments and advanced proliferative vitreoretinopathy (grade C) in which retinectomy was performed were included. Primary outcome measured was anatomic success, defined as complete retinal reattachment between neurosensory retina and retinal pigment epithelium at six months follow-up. Secondary outcomes included changes in best corrected visual acuity and postoperative complications. The follow-up period was up to six months after the last surgery. Association was determined between the retinectomy extension and the best corrected visual acuity postoperatively. RESULTS: Retina was reattached after single operation in 29 eyes (72.5%), after the second operation in eight eyes (20%), and after the third operation in two eyes (5%). Final retinal reattachment was achieved in 39 out of 40 eyes (97.5%). The preoperative visual acuity was counting fingers CF in eight eyes (20%), hand motion HM in 28 eyes (70%), and light perception PL in four eyes (10%). The postoperative visual acuity improved in 27 eyes (67.5%), remained stable in 11 eyes (27.5%), and worsened in 2 eyes (5%). There was no statistically significant association between the retinectomy extension and maximum postoperative best corrected visual acuity (p=0.098). The significant postoperative complications were retinal redetachment and hypotony. CONCLUSION: Retinectomies are effective in managing primary rhegmatogenous retinal detachment with severe PVR (PVR C), and Increase the final retinal reattachment rate.
Subject(s)
Ophthalmologic Surgical Procedures/methods , Retina/surgery , Retinal Detachment/surgery , Retinal Perforations/surgery , Vitreoretinopathy, Proliferative/complications , Vitreoretinopathy, Proliferative/surgery , Adult , Female , Humans , Male , Middle Aged , Postoperative Complications , Retina/physiopathology , Retinal Detachment/etiology , Retinal Detachment/physiopathology , Treatment Outcome , Visual Acuity/physiology , Vitreoretinopathy, Proliferative/physiopathologyABSTRACT
OBJECTIVE: To assess the visual and anatomical outcomes following idiopathic macular epiretinal membrane (IERM) surgery. STUDY DESIGN: Case series. PLACE AND DURATION OF STUDY: Layton Rehmatulla Benevolent Trust (L.R.B.T), Free Base Eye Hospital, Karachi, from January 2015 to June 2016. METHODOLOGY: Thirty eyes of thirty patients affected with idiopathic macular epiretinal membrane stage 2 were enrolled in this study. They subsequently underwent 23-gauge pars plana vitrectomy (PPV) with epiretinal membrane removal without internal limiting membrane peeling. The visual outcome was measured as improvement in best corrected visual acuity (BCVA) of at least two or more lines on ETDRS chart as compared to preoperative BCVA. The anatomical outcome was measured as decrease in foveal thickness on Spectral Domain-Optical Coherence Tomography (SD-OCT). Patients were followed for a period of 06 months. RESULTS: At the end of follow-ups, 23 (76%) eyes out of 30 gained 2 or more lines of vision. In 05 (16%) eyes, BCVA remained same and only 02 (6.6%) eyes showed worsening of vision. Mean preoperative foveal thickness was 392 ±20 µm, whereas mean postoperative thickness was 305 ±16 µm with an average decrease of 87 µm, in foveal thickness. Recurrence of ERM was found to be the most frequent complication. CONCLUSION: IERM surgery is a safe procedure and beneficial in achieving significant visual acuity improvement and anatomical recovery in the majority of cases.
Subject(s)
Epiretinal Membrane/diagnostic imaging , Epiretinal Membrane/surgery , Macular Edema/physiopathology , Retina/diagnostic imaging , Visual Acuity , Vitrectomy/methods , Epiretinal Membrane/physiopathology , Female , Humans , Macular Edema/pathology , Macular Edema/surgery , Male , Postoperative Period , Tomography, Optical Coherence , Treatment OutcomeABSTRACT
OBJECTIVE: To evaluate the efficacy, visual outcome and complication following Nd:Yag laser hyaloidtomy for subhyaloid hemorrhage. METHODS: This interventional case series was managed at LRBT, Free Base Eye Hospital Karachi from January 2010 to December 2010. It included 30 eyes of 30 patients with subhyaloid hemorrhage due to different causes which underwent Nd: Yag laser sublyaloidotomy Results: Out of thirty patients, eighteen (60%) were male and twelve (40%) were females. Mean age was 32.57 years. Males pre-dominated the study. Pre laser visual acuity was between counting finger at one meter in 22 patients (73.33%) and between counting finger one meter to hand movement in 8 patients (26.66%). Vision improved to 6/6 in 10 patients (33%), 6/9 - 6/12 in 17 patients (56.66%) and between 6/24 - 6/60 in 3 patients (9.99%) at the end of follow up. Complications were persistent vitreous hemorrhage in one (3.33%) patient, failed drainage in one (3.33%) patient and metamorphopsia in one (3.33%) patient. CONCLUSION: Nd: Yag laser hyloidotomy is an excellent technique for management of Subhyaloid hemorrhage with early visual recovery provided there is no macular pathology.
