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Korean Journal of Ophthalmology : KJO Apr 2023To investigate the clinical results of vitrectomy alone as the primary treatment for rhegmatogenous retinal detachment (RD) in patients with atopic dermatitis (AD).
PURPOSE
To investigate the clinical results of vitrectomy alone as the primary treatment for rhegmatogenous retinal detachment (RD) in patients with atopic dermatitis (AD).
METHODS
The medical records of patients with AD treated for rhegmatogenous retinal detachment (RD) were retrospectively reviewed. We investigated the characteristics of retinal breaks and detachments, applied surgical methods, and results.
RESULTS
Twenty eyes of 14 patients with AD who presented with rhegmatogenous RD and treated by vitrectomy were included in this analysis. Sixteen eyes (80%) were treated with vitrectomy, either alone or in combination with cataract surgery, and the retina was successfully attached to 94% of the eyes. There were four cases in which vitrectomy was combined with encircling. Reoperation was needed in half of the eyes that received vitrectomy with encircling, which presented nearly total detachment, severe proliferative vitreoretinopathy, and pseudophakia.
CONCLUSIONS
Vitrectomy alone, in combination with cataract surgery, may be sufficient to treat rhegmatogenous RD in patients with AD. Additional encircling or buckling should still be considered in complicated cases.
Topics: Humans; Retinal Detachment; Scleral Buckling; Vitrectomy; Dermatitis, Atopic; Retrospective Studies; Treatment Outcome; Cataract
PubMed: 36758537
DOI: 10.3341/kjo.2022.0103 -
Indian Journal of Ophthalmology Feb 2023
Topics: Humans; Sclera; Ophthalmology; Oculomotor Muscles; Strabismus; Scleral Buckling
PubMed: 36727376
DOI: 10.4103/ijo.IJO_962_22 -
Indian Journal of Ophthalmology Feb 2023Scleral perforation during strabismus surgery is considered a rare complication that usually results in no significant consequences. The true rate of such occurrences is...
PURPOSE
Scleral perforation during strabismus surgery is considered a rare complication that usually results in no significant consequences. The true rate of such occurrences is difficult to evaluate due to the young age of most patients and the occult nature of most events. This study aimed to evaluate long-term retinal changes under the suture areas in patients post-strabismus surgery as presumed signs indicating past undiscovered scleral perforations.
METHODS
The study population consisted of patients with a follow-up of at least 10 years post-strabismus surgery at the [redacted for review] Eye Institute and with no known retinal conditions as well as with wide fundus visibility. We performed slit-lamp retinal periphery examinations in search of retinal scars or changes at the suture sites.
RESULTS
Seventy-one eyes from 43 patients were examined. The mean age (±standard deviation [SD]) at the time of examination was 27 years (±14), and the mean number of strabismus surgeries per patient was 1.8. Three of the examined eyes showed retinal changes at the suture sites, yielding an overall incidence rate of suspected perforation/penetration of 4.2% per eye and 3.6% per strabismus surgery. These three patients were all asymptomatic.
CONCLUSION
Scleral perforations during strabismus surgeries could remain unnoticed since a comprehensive exam of the retinal periphery is challenging in young children, especially during the postoperative period. While retinal changes caused by inadvertent scleral perforations appear to have no clinical sequelae in a time frame of 10 years, such changes should be noted for future fundoscopic examinations.
Topics: Child; Humans; Child, Preschool; Adult; Sclera; Retina; Retinal Detachment; Ophthalmology; Strabismus; Retinal Diseases; Scleral Buckling; Retinal Perforations
PubMed: 36727375
DOI: 10.4103/ijo.IJO_3218_21 -
Journal Francais D'ophtalmologie Mar 2023
Topics: Humans; Silicone Oils; Dilatation, Pathologic; Scleral Diseases; Scleral Buckling; Retinal Detachment; Vitrectomy
PubMed: 36682953
DOI: 10.1016/j.jfo.2022.07.026 -
BMC Ophthalmology Jan 2023This study attempted to illustrate the demographic of inpatient eye careservice from 1997 to 2011 in Taiwan, and also the ophthalmic disease landscape and utilization...
BACKGROUND
This study attempted to illustrate the demographic of inpatient eye careservice from 1997 to 2011 in Taiwan, and also the ophthalmic disease landscape and utilization change over time. These insights might apply to resource allocation planning and trainees' better understandings of ophthalmic inpatient practice.
METHODS
This study utilized Taiwan's National Health Insurance Research Database (NHIRD). Admission records of eye service that occurred since 1997 and until 2011 were included. Records were separated into operative and non-operative. The records were further divided according to their time: a group of early time before 2006 and a late one after 2006.
RESULTS
Patients' mean age were 56 and 44 years for operative and non-operative records. The sex ratio (male to female) was 1.3, and the average of admission duration was 4 days. The average spending was around 1000 United State Dollars per admission and a gradually upgoing trend was also noted. The number of inpatient eye services decreased over time, from 3,248 to 2,174 in the studied period. Cases admitted for operation primarily underwent cataract surgery, vitrectomy, and scleral buckling during the studied period. Trabeculectomy emerged as another major indication of admission during the later time. Cases admitted for non-operative management were primarily corneal ulcer, glaucoma, and infection, including orbital cellulitis and lid abscess. Corneal ulcers made up a major proportion of admission records in the non-operative group during both periods.
CONCLUSIONS
This study described the demographics of inpatient eye service in Taiwan. Ophthalmologist, especially trainees, and officials could make better policies according to the presented results in this study.
Topics: Humans; Male; Female; Ophthalmology; Taiwan; Inpatients; Hospitalization; Glaucoma; Corneal Ulcer
PubMed: 36627584
DOI: 10.1186/s12886-022-02765-5 -
American Journal of Ophthalmology Case... Mar 2023Rhegmatogenous retinal detachment (RRD) after retinopathy of prematurity (ROP) laser is rare but has been reported to occur at the border of heavy laser or in...
PURPOSE
Rhegmatogenous retinal detachment (RRD) after retinopathy of prematurity (ROP) laser is rare but has been reported to occur at the border of heavy laser or in combination with tractional retinal detachment (TRD). We describe a rare case of a RRD that developed during treatment for ROP with both laser and intravitreal injections.
OBSERVATIONS
The retinal detachment resolved with scleral buckling surgery with residual macular atrophy.
CONCLUSIONS AND IMPORTANCE
This case highlights the importance of retinal imaging, careful funduscopic examination, and consideration of the risk of RRDs after intravitreal injections and laser in neonates with ROP.
PubMed: 36605183
DOI: 10.1016/j.ajoc.2022.101785 -
Indian Journal of Ophthalmology Jan 2023Vitreoretinal surgeries either in the form of external compression by buckles or by increasing the intraocular volume by tamponades can cause a significant rise in... (Review)
Review
Vitreoretinal surgeries either in the form of external compression by buckles or by increasing the intraocular volume by tamponades can cause a significant rise in intraocular pressure (IOP), causing glaucoma to be one of the most common consequences of vitreoretinal surgeries despite improved surgical techniques. Identifying the mechanism that causes the raised IOP is crucial as the management of glaucoma can differ accordingly. Intravitreal (IVT) injections in the form of IVT steroids or anti-vascular endothelial growth factor (anti-VEGF) injections can also cause a significant rise in the IOP and effect, especially the glaucomatous eyes, which are already predisposed. Not just the overlapping clinical features make the diagnosis confusing but also associated scarring of the conjunctiva, and the presence of episcleral hardware in some cases due to scleral buckle make the surgical management of glaucoma in these eyes very challenging. In this review, we describe in detail the various mechanisms causing secondary glaucoma post vitreoretinal surgeries with a focus on how to distinguish between them. We also discuss the possible consequences of anti-VEGF agents on IOP, various surgical challenges, and modifications with newer surgical options in the management of this refractory glaucoma.
Topics: Humans; Vitreoretinal Surgery; Vitrectomy; Glaucoma; Intraocular Pressure; Scleral Buckling
PubMed: 36588203
DOI: 10.4103/ijo.IJO_1155_22 -
Diagnostics (Basel, Switzerland) Dec 2022This retrospective study aimed to investigate macular microvascular alterations after successful scleral buckling (SB) for rhegmatogenous retinal detachment (RRD)....
This retrospective study aimed to investigate macular microvascular alterations after successful scleral buckling (SB) for rhegmatogenous retinal detachment (RRD). Nineteen eyes with macula-on RRD and 18 eyes with macula-off RRD were included. In all cases, an encircling band was placed. Optical coherence tomography angiography (OCTA) was performed at baseline and postoperatively. Changes in the foveal avascular zone (FAZ) area and vessel density (VD) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were the primary outcomes. Correlations between OCTA findings and clinical variables were considered secondary outcomes. In both the macula-on and macula-off groups, the FAZ area was comparable with controls. In the macula-on group, VD in the whole SCP was lower compared with controls at both baseline (p < 0.001) and 6 months (p = 0.03), but showed a significant increase after surgery (p = 0.004). In the macula-off group, postoperative VD in both whole SCP and whole DCP was lower compared with controls (p < 0.001). In the macula-on group, there was an inverse correlation between axial length increase and SCP VD change (r = −0.508; p = 0.03). These findings demonstrated microvascular alterations after SB for RRD. However, VD impairment seems to be mitigated after surgery. A greater increase in postoperative axial length was associated with a poorer VD outcome.
PubMed: 36553023
DOI: 10.3390/diagnostics12123015 -
Ophthalmic Surgery, Lasers & Imaging... Dec 2022
Topics: Humans; Vitrectomy; Transillumination; Sclera; Retinal Detachment; Scleral Buckling; Retrospective Studies
PubMed: 36547958
DOI: 10.3928/23258160-20220920-02 -
Clinical Ophthalmology (Auckland, N.Z.) 2022To study the surgical outcomes of glaucoma drainage device (GDD) implantation in refractory glaucoma patients.
PURPOSE
To study the surgical outcomes of glaucoma drainage device (GDD) implantation in refractory glaucoma patients.
PATIENTS AND METHODS
Retrospective chart review of glaucoma patients undergoing GDD implantation, Ahmed glaucoma valve (AGV), Baerveldt glaucoma implants (BGI), and Aurolab aqueous drainage implantation (AADI) from January 2012 to June 2021. Glaucoma patients were classified into two groups: primary glaucoma including: primary open angle glaucoma (POAG), primary angle closure glaucoma (PACG) and juvenile open angle glaucoma (JOAG) and secondary glaucoma including: neovascular glaucoma (NVG), ocular surgery (vitreoretinal surgery, scleral buckling procedure, postoperative extra capsular cataract extraction, scleral fixation intraocular lens, penetrating keratoplasty), intraocular trauma, uveitis glaucoma, lens-induced glaucoma, pseudoexfoliation glaucoma (PXG), iridocorneal endothelial (ICE) syndromes and Axenfeld Rieger Syndrome. Surgical outcomes were studied.
RESULTS
Primary glaucoma included 57 eyes from 49 patients. Secondary glaucoma included 87 eyes from 85 patients. The cumulative probability of complete or qualified success of refractory glaucoma patients at five years were 53.4% (95%CI: 38.4%, 66.3%). Higher success rate was discovered in primary glaucoma at 65.8% (95%CI: 38.4%, 83.3%) than 45.2% (95%CI: 26.9%, 61.9%) in secondary glaucoma group significantly with =0.003. While the results among success rate, adverse events and complications was not different between types of GDD. Predictors for failure were neovascular glaucoma with unadjusted hazard ratio (HR) 3.62 (95%CI: 1.45, 9.04) with =0.006, and lens-induced glaucoma with adjusted HR 4.19 (95%CI: 1.10, 15.86) with =0.035 in multivariable analysis. Tube malposition and occlusion were the most frequent adverse events at 11.11%, corneal decompensation at 5.5%, hypotony at 2% in the nonvalved group, and endophthalmitis at 0.69%.
CONCLUSION
Surgical success in refractory primary glaucoma was superior to secondary glaucoma with no difference between nonvalved and valved GDD implantation. Lens-induced glaucoma was a strong predictor for failure in GDD implantation.
PubMed: 36540897
DOI: 10.2147/OPTH.S393730