-
Cureus Dec 2023Orthokeratology may be effective in slowing myopic progression. However, whether orthokeratology is beneficial enough to prevent rhegmatogenous retinal detachment...
Orthokeratology may be effective in slowing myopic progression. However, whether orthokeratology is beneficial enough to prevent rhegmatogenous retinal detachment formation remains unclear. Two cases of bilateral rhegmatogenous retinal detachment were seen during orthokeratology treatment and corrected with scleral buckling and cryopexy under general anesthesia. This is the first report of bilateral retinal detachment found during orthokeratology treatment. Although orthokeratology is effective for myopic correction and prevents axial length elongation, patients still have a risk of rhegmatogenous retinal detachment. Careful follow-up not only of the anterior segment but also of the peripheral retina is necessary.
PubMed: 38249232
DOI: 10.7759/cureus.50958 -
American Journal of Ophthalmology Case... Mar 2024To describe a novel technique for repair of rhegmatogenous retinal detachment in an eye with a previous non-valved glaucoma drainage device, the Aurolab Aqueous Drainage...
PURPOSE
To describe a novel technique for repair of rhegmatogenous retinal detachment in an eye with a previous non-valved glaucoma drainage device, the Aurolab Aqueous Drainage Implant (AADI).
OBSERVATIONS
A 5-year-old child with bilateral primary congenital glaucoma presented with an inferior retinal detachment (RD) in the left eye. The left eye had a history of multiple surgical interventions including combined trabeculotomy and trabeculectomy done twice, AADI implantation and subsequently phacoaspiration with IOL implantation, 18 months prior to presentation. The left eye retinal detachment was managed by scleral buckling technique using the plate of the AADI as a buckling element without its explantation.
CONCLUSIONS
AND IMPORTANCE: Management of retinal detachment in eyes with a pre-existing glaucoma drainage device (GDD) is uniquely challenging. Explantation of the GDD would likely result in intractable glaucoma post-operatively, requiring another surgery. Use of the trimmed plate of the GDD itself as the buckling element helped in settling the RD and preserving intraocular pressure control.
PubMed: 38192606
DOI: 10.1016/j.ajoc.2023.101962 -
Journal of Biomechanics Jan 2024We numerically study the fluid dynamics of oil tamponade in models of vitrectomized eyes prompted by a subset of daily activities corresponding to movements on the...
We numerically study the fluid dynamics of oil tamponade in models of vitrectomized eyes prompted by a subset of daily activities corresponding to movements on the horizontal plane with the patient in a standing position. Bulk flow features are related to near-wall flow topology and transport at the retinal surface through a wall shear-stress-based analysis. Proliferative VitreoRetinopathy (PVR) is the leading cause of retinal re-detachment occurring in about 20% of all cases due to the accumulation of inflammatory cells in discrete retinal regions. Signalling soluble mediators stimulate inflammatory cells' chemotaxis and studying their distribution across the retinal surface may acquire clinical relevance. In all the investigated cases, persistent and elongated regions along the retina, potentially prone to accumulate chemo-attractants and cells are observed. Gradients of soluble inflammation mediators present in the aqueous are known responsible for the so-called epithelial-mesenchymal transition that initiates PVR and favours recurrent retinal detachment prompting the proliferation of inflammatory cells with collagen matrix deposition and its contraction. The surgical apposition of encircling scleral buckling elements, known for over a century to influence PVR formation and localization, modifies the attracting regions, possibly causing an accumulation of molecules and cells along approximately vertical lines that follow the rising menisci due to the cerclage indentation. The resulting spatial pattern is compatible with clinical observations. This study may open toward rational analyses of near-wall transport to predict PVR pathogenesis by relating biochemical accumulation in certain areas of the retina to clinical conditions.
Topics: Humans; Vitreoretinopathy, Proliferative; Vitrectomy; Visual Acuity; Retinal Detachment; Scleral Buckling; Retrospective Studies; Treatment Outcome
PubMed: 38157782
DOI: 10.1016/j.jbiomech.2023.111914 -
BMC Ophthalmology Dec 2023To review cases of branch retinal vein occlusion (BRVO) secondary to rhegmatogenous retinal detachment (RRD) and its surgical management and presume their mechanism.
BACKGROUND
To review cases of branch retinal vein occlusion (BRVO) secondary to rhegmatogenous retinal detachment (RRD) and its surgical management and presume their mechanism.
METHODS
Medical records of patients who underwent surgery for RRD between 2015 and 2019 at a single tertiary care center were retrospectively reviewed. New BRVO secondary to RRD or its surgical procedure was diagnosed based on the fundus examination and its clinical course.
RESULTS
A total of 734 RRD surgeries were performed for five years, and six cases of new BRVOs were noticed in the first year after surgery (incidence was 0.68%: six cases of BRVO / 734 cases of surgical RRD); five cases occurred after vitrectomy, and one occurred after scleral buckling. In three cases, retinal veins were presumed to already be partially occluded related due to a kink of the retinal vein seen before surgery. In the other three cases, the retinal veins were presumed to have incurred damage during vitrectomy.
CONCLUSION
In the present cohort, RRD or its related procedures caused BRVO within a year of surgery at an incidence of 0.68%. The proposed mechanisms are kinks of the retinal vein on the detached retina and damage to the retinal vein during vitrectomy.
Topics: Humans; Retinal Detachment; Retinal Vein Occlusion; Retrospective Studies; Scleral Buckling; Fundus Oculi; Vitrectomy; Treatment Outcome
PubMed: 38110856
DOI: 10.1186/s12886-023-03244-1 -
Case Reports in Ophthalmology 2023Rhegmatogenous retinal detachment (RRD) presents as a common ophthalmological emergency that impacts vision and may lead to blindness in the involved eye. Recently,...
INTRODUCTION
Rhegmatogenous retinal detachment (RRD) presents as a common ophthalmological emergency that impacts vision and may lead to blindness in the involved eye. Recently, chandelier-assisted scleral buckling (SB) is considered as one of procedures for the management of RRD. Herein, we present a case of acute cataract progression caused by a chandelier light during chandelier-assisted SB for RRD.
CASE PRESENTATION
A 69-year-old male patient presented with right eye RRD. The best-corrected visual acuity (BCVA) was reduced to 20/40 in the right eye, and a retinal tear was observed at the upper temporal side with macula-off retinal detachment. The retinal tear was on the periphery, and the crystalline lens opacity was mild; therefore, the patient was treated with SB with a chandelier. Intraoperatively, posterior lens opacity was gradually observed, but it did not affect surgery. Thus, the surgery was completed as planned and retinal reattachment was confirmed. The day after surgery, the cataract had progressed, with a significantly decreased right BCVA of 20/400 in the right eye; therefore, cataract surgery was performed 2 months after the initial surgery. Because the posterior capsule had already ruptured, we performed lens extraction and anterior vitrectomy and fixed the intraocular lens with an optic capture. Postoperatively, the patient's BCVA had recovered to 20/40 in the right eye.
CONCLUSION
SB with a chandelier is an effective treatment for visibility and educational purposes; however, several points of caution are raised. Proper care should be taken while handling the illumination in the SB.
PubMed: 38107073
DOI: 10.1159/000535428 -
Scientific Reports Dec 2023This study aimed to analyze the duration and causes of persistent subretinal fluid (PSF) after scleral buckle (SB) surgery in patients with macula-involving...
This study aimed to analyze the duration and causes of persistent subretinal fluid (PSF) after scleral buckle (SB) surgery in patients with macula-involving rhegmatogenous retinal detachment (RRD). Sixty-one eyes of 61 patients with macula-involving RRD who underwent SB surgery between 2016 and 2022 were reviewed retrospectively. PSF was confirmed on optical coherence tomography. The PSF duration after surgery and the analysis of relevant ocular and systemic factors were conducted according to the PSF duration. The mean duration of PSF was 5.9 ± 4.6 months in all eyes and 8.1 ± 5.0 months in eyes not treated with external subretinal fluid (SRF) drainage, which was significantly longer than 4.5 ± 3.7 months in those subjected to external SRF drainage. The mean best-corrected visual acuity improved significantly 3 months after surgery. There were significant visual improvements in the external SRF drainage group compared to the non-drainage group during all follow-up periods. Longstanding shallow RRD was significantly associated with longer PSF duration after SB surgery. External SRF drainage during SB surgery can effectively reduce SRF, shorten the duration of PSF, and accelerate visual improvement.
Topics: Humans; Retinal Detachment; Subretinal Fluid; Retrospective Studies; Visual Acuity; Scleral Buckling; Tomography, Optical Coherence; Vitrectomy; Drainage
PubMed: 38093092
DOI: 10.1038/s41598-023-49719-5 -
Journal of Vitreoretinal Diseases 2023To report 2 cases of persistent inflammation associated with human leukocyte antigen-B27 (HLA-B27) after pars plana vitrectomy (PPV) with scleral buckling. Two cases...
To report 2 cases of persistent inflammation associated with human leukocyte antigen-B27 (HLA-B27) after pars plana vitrectomy (PPV) with scleral buckling. Two cases were analyzed. A 47-year-old man had pars plana vitrectomy (PPV), scleral buckle (SB) placement, and endolaser for a macula-on rhegmatogenous retinal detachment (RRD). A 61-year-old man also had uneventful PPV, SB placement, and endolaser for a macula-off RRD. Postoperatively, both patients reported eye pain and had persistent intraocular inflammation. Both were found to be HLA-B27 positive despite having no previous signs or symptoms that would warrant HLA-B27 testing. Discovering the source of prolonged postoperative inflammation is critical in initiating the correct treatment and removing suspicion of infection. Although intraocular inflammation associated with HLA-B27 does not often present initially after surgery, HLA-B27 testing should be considered in cases of persistent, unexpected postoperative inflammation.
PubMed: 37974913
DOI: 10.1177/24741264231176143 -
Photodiagnosis and Photodynamic Therapy Dec 2023To evaluate anterior segment parameter changes following scleral buckling (SB) surgery for rhegmatogenous retinal detachment (RRD) using the Pentacam Scheimpflug system.
PURPOSE
To evaluate anterior segment parameter changes following scleral buckling (SB) surgery for rhegmatogenous retinal detachment (RRD) using the Pentacam Scheimpflug system.
METHODS
Twenty-eight phakic eyes of 28 patients who underwent SB surgery for RDD were included. The anterior chamber volume (ACV), central anterior chamber depth (CACD), mean anterior chamber angle (ACA) and ACA in a specific position (buckle quadrant), and central corneal thickness (CCT) were evaluated preoperatively and at 1 day, 1 week, and 1 and 3 months postoperatively by an anterior Pentacam Scheimpflug method.
RESULTS
The ACV parameters were significantly decreased compared with preoperative levels at 1 day after SB surgery (P = 0.0004), but had no significant differences at 1 week, and 1 and 3 months (P > 0.05). The mean intraocular pressure (IOP) at 1 day was significantly higher than the preoperative level, but no subsequent significant difference was noted between the preoperative IOP and that at 1 week and 1 and 3 months postoperatively (P > 0.05). The CCT at 1 day after surgery increased significantly (P = 0.0122) and subsequently returned to the normal level postoperatively at 1 week and remained stable until 3 months (P > 0.05). The degree of postoperative ACA displayed different changes in the different quadrants and there was a significant increase in the ACA of the buckle quadrants at 1 day (P < 0.0001), 1 week (P = 0.02), and 1 month (P = 0.0266) after surgery, returning to the normal level at 3 months.
CONCLUSIONS
The changes of anterior chamber parameters after SB can be demonstrated by Pentacam both objectively and quantitatively. The ACV and CCT changes were mild and resumed their preoperative parameters after 1 week, while the increase of the ACA at the buckle quadrant returned to normal after 3 months. SB surgeries without encircling or conducted with radial buckling might decrease anterior chamber change.
Topics: Humans; Scleral Buckling; Photochemotherapy; Photosensitizing Agents; Anterior Chamber; Retinal Detachment
PubMed: 37935344
DOI: 10.1016/j.pdpdt.2023.103881 -
Journal of Vitreoretinal Diseases 2023To describe the surgical outcomes of rhegmatogenous retinal detachments (RRDs) associated with giant retinal tears (GRTs) and define factors associated with primary...
To describe the surgical outcomes of rhegmatogenous retinal detachments (RRDs) associated with giant retinal tears (GRTs) and define factors associated with primary anatomic failure. : This retrospective consecutive study comprised primary GRT-RRD surgeries between 1999 and 2021 at a single institution. Exclusion criteria were a follow-up of less than 3 months and incomplete surgical data. : The series included 69 eyes (64 patients). Single-surgery anatomic success (SSAS) was achieved in 75% and final anatomic success (FAS) in 90%. The mean logMAR visual acuity improved from 1.5 ± 1.1 to 0.6 ± 0.9. Preoperative factors significantly associated with redetachment were proliferative vitreoretinopathy (PVR) (odds ratio [OR], 6.2; < .01), hypotony (OR, 13.6; < .01), and a 180-degree or larger GRT (OR, 3.3; = .04). All cases were treated with pars plana vitrectomy (PPV) and perfluoro-N-octane (PFCL). Perfluoropropane (CF) was used in 59% and silicone oil in 41%; the redetachment rate was significantly lower in gas cases (15% vs 39%) ( = .02). An encircling band, placed in 84% eyes, had a tendency to reduce redetachment (22% vs 36%) ( = .32). Lensectomy was performed in 61% of phakic eyes, with no effect on redetachment (20% vs 21%) ( = .92). On multivariate analysis, PVR and hypotony were significantly associated with redetachment. : PPV with PFCL achieved high SSAS and FAS rates. PVR and hypotony were the main preoperative factors associated with anatomic failure. In cases without PVR, CF tamponade significantly increased SSAS. Encircling scleral buckling showed a nonsignificant tendency toward an increase in SSAS. Lensectomy had no effect on SSAS.
PubMed: 37927327
DOI: 10.1177/24741264231171458 -
Journal of Vitreoretinal Diseases 2023To report a new modification of an illuminated endolaser to facilitate safe endophotocoagulation during chandelier-assisted scleral buckling surgery. This case series...
To report a new modification of an illuminated endolaser to facilitate safe endophotocoagulation during chandelier-assisted scleral buckling surgery. This case series comprised phakic patients with rhegmatogenous retinal detachments (RRDs) who had primary scleral buckling with chandelier endoillumination, external drainage, and endophotocoagulation using the modified endolaser instrument. All 6 patients had successful outcomes after primary scleral buckling for RD repair without significant intraoperative or postoperative complications. The new modified endolaser instrument can be safely used in a nonvitrectomized eye during chandelier scleral buckling.
PubMed: 37927316
DOI: 10.1177/24741264231171243