Incidence Of Redetachment Research Articles

Incidence and risk factors associated with retinal redetachment after silicone oil removal in the African population.

The purpose of this study was to investigate the incidence and risk factors associated with retinal redetachment after silicone oil (SO) removal in the African population. A retrospective cohort study was performed on patients undergoing SO removal over a period of 4years. The risk factors assessed were (1) characteristics of the retinal detachments including type of retinal detachment, type, number and location of the retinal tears, and proliferative vitreoretinopathy (PVR) score, and (2) surgical factors including type of silicone oil used, use of laser prior to SO removal, and location of the laser (360° or around the tear only). SO was removed either through a pars plana approach or transpupillary approach and anterior limbal incision. Ninety-nine eyes met the inclusion criteria during the study period. Twelve patients (12%) had retinal redetachment after SO removal. Factors associated with redetachment were a preexisting macular hole, PVR grade B or worse, and no intraoperative endolaser photocoagulation. The incidence of redetachment in African population is similar to that reported from developed countries and other advanced vitreoretinal centers. Redetachment occurred at higher rates in patients with preexisting macular holes and tears who did not receive intraoperative endolaser photocoagulation and patients with a severe grade of PVR.

Post-operative hospitalization in retinal detachment correlation to recurrences.

To evaluate relationships between the incidence of re-detachment and postoperative days of hospitalization in patients with diagnosis of retinal detachment (RD) who underwent surgery either through ab-externo approach (scleral buckling and encircling) or ab-interno approach (vitrectomy and oil-gas tamponade). This retrospective study included 268 patients (268 eyes) with diagnosis of primary RD: 127 males (47%) and 141 (53%) females, mean age of 64.1 ± 17.3 years. 46 patients (17%) underwent a surgical ab-externo approach (group A), while 222 patients (83%) underwent an ab-interno surgical approach. Each RD was graded according to the "Retinal detachment grading system of Royal College of Ophthalmologists" and treated within 5 days after diagnosis. The redetachment (RT) related to a surgical failure was considered within 30 days after first operation. In the group 1 without night hospitalization (day surgery) global RT rate was 3.5% (4.17% for ab-interno technique and 0% for ab-externo techniques). In the group 2 with one day of hospitalization global RT rate was 1.33% (1.49% for ab-interno technique and 0% for ab-externo techniques). In the group 3 with 2 days of hospitalization global RT rate was 3.80% (4.62% for ab-interno techniques and 0% for ab-externo techniques). In the group 4 with 3 or more days of hospitalization global RT rate was 12.28% (14.29% for ab-interno techniques for 6.67% ab-externo techniques). The incidence of RT in group 1, day surgery, is comparable to the other groups and it is less compared to group 4 (3 or more days of hospitalization). The incidence of retinal redetachment (RRD) is not increased in day surgery mode. These data support outpatient management of RD patients to reduce medical cost and problems related to the hospitalization. Further studies are needed for patients' security.

SD OCT Features of Macula and Silicon Oil–Retinal Interface in Eyes Status Post Vitrectomy for RRD

Aim: To objectively document findings at the Silicon oil-Retinal interface, macular status and tamponade effect in Silicon Oil (SO) filled eyes using SD OCT. Methods: 104 eyes of 104 patients underwent SD OCT examination, horizontal and vertical macular scans, in silicone oil filled eyes which underwent silicone oil injection post vitrectomy for rhegmatogenous retinal detachment. Findings were divided into 3 Groups; Group A: Findings at silicon oil retinal interface, Group B: Macular pathology and Group C: Tamponade effect. Group C was further divided into two groups; Group 1: Complete tamponade and Group 2: Incomplete tamponade. Results: Group A: subsilicon epiretinal membranes N = 17 (16.3%), emulsified silicon oil N = 16 (15.4%) Group B: foveal thickening N = 22 (21.2%), foveal thinning N = 6 (5.7%), subfoveal fluid N = 8 (7.6%), macular hole N = 2 (1.9%); Group C: Incomplete tamponade was noted in N = 12 (11.5%), complete tamponade N = 92 (88.5%).10 out of 104 eyes (9.6%) had recurrent retinal detachment post silicon oil removal. 8 of these eyes had complete tamponade and 2 had incomplete tamponade. Conclusion: SD OCT is a useful tool to assess the SO–Retina interface, tamponade effect and macular pathology in SO filled eyes. There is lesser incidence of redetachment with incomplete tamponade in OCT.

Incidence of redetachment 6 months after scleral buckling surgery

The preoperative and intraoperative clinical variables associated with redetachment and/or a poor visual outcome following scleral buckling (SB) surgery for rhegmatogenous retinal detachment (RRD) have mainly been studied after a short follow-up. This study aimed to analyse long-term effects by following patients for at least 6 months. In a retrospective survey we evaluated the data of 436 eyes that underwent SB surgery. Postoperative data were collected at 3-month intervals. After a mean follow-up period of 51 months, anatomic reattachment was achieved in 76% after one SB procedure, with a final reattachment rate of 97% after additional vitreoretinal procedures. In total, 104 eyes developed redetachment during follow-up. After more than 6 and 12 months of follow-up, 32 eyes (7%) and 20 eyes (5%), respectively, developed redetachment. Multivariate regression analysis showed that recurrent redetachment and more than 7 days of visual field loss were significant predictors for a poor postoperative visual outcome at 12 months. A cumulative size of the tear of more than three disc diameters was a significant predictor of recurrent RRD. Conventional SB surgery is a reliable procedure in a selected group of eyes with primary RRD. However, in eyes with a retinal tear with a cumulative size of more than three disc diameters, a primary vitrectomy should be considered. Taking into account that 7% of eyes developed redetachment after 6 months, a longer follow-up period seems necessary to evaluate the anatomical and visual outcomes after SB surgery.

Is prophylactic 360° laser retinopexy protective?: Risk factors for retinal redetachment after removal of silicone oil

Objectives To identify risk factors for retinal redetachment after removal of silicone oil. To determine the effectiveness of prophylactic laser in preventing retinal redetachment after removal of silicone oil. Design A nonrandomized retrospective comparative interventional trial. Participants Three hundred seventy-six patients undergoing vitrectomy with silicone oil tamponade for rhegmatogenous retinal detachment at one institution over a 4-year period. Two hundred eighty-seven patients with fully attached retinas subsequently underwent removal of silicone oil. One hundred thirty-eight cases had undergone prophylactic 360° laser retinopexy before removal of silicone oil, either at the time of their final retinal reattachment procedure (n = 36) or as a separate supplementary procedure (n = 102). Methods A retrospective case note review was performed to identify clinical and demographic factors associated with increased or reduced odds of retinal redetachment after removal of silicone oil. Both univariate and multiple variable analysis were used to identify significant risk factors. Main outcome measures Incidence of retinal redetachment after removal of silicone oil. Results Median follow-up after removal of silicone oil was 272 days. Three hundred sixty–degree prophylactic laser retinopexy was associated with a reduction from 26% to 14% in the incidence of redetachment after removal of silicone oil (adjusted odds ratio, 0.42; 95% confidence interval, 0.22–0.78; P = 0.006). Patients requiring further retinal reattachment surgery after their first oil procedure were at twice the odds of re-detachment after oil removal (adjusted odds ratio, 2.10; 95% confidence interval, 1.03–4.26; P = 0.04). Conclusions The need for retinal reattachment surgery subsequent to a first silicone oil procedure was associated with twice the odds of retinal redetachment after removal of silicone oil. Prophylactic laser retinopexy may halve the incidence of retinal redetachment after removal of silicone oil.

Surgical audit of outcome of rhegmatogenous retinal detachment repair at Vitreoretinal unit JPMC in year 2014.

Objective:To investigate the outcome of rhegmatogenous retinal detachment repair at Vitreoretinal unit of Jinnah Post Graduate Medical Centre Karachi in year 2014.Methods:One hundred and three eyes of one hundred and three patients, who underwent three ports parsplana vitrectomy + band + silicone oil, three ports pars plana vitrectomy + silicone oil, three ports pars plana vitrectomy + C3F8 for rhegmatogenous retinal detachment (RRD) repair, at Jinnah Post Graduate Medical Centre, were included in this observational prospective study. Parsplana vitrectomy was done using 23G vitrectomy system. Duration of study was one year. Removal of silicone oil (ROSO) was done on the basis of completely flat retina at least for eight weeks or because of complications due to silicone oil. Patients were followed up post operatively on day one and after one week and then at four weekly interval till the end of the study.Results:Anatomical success was achieved in 91 eyes (88.3%). However in 12 eyes (11.7%) retina redetached after removal of silicone oil. Functional success achievement of visual acuity of 3/60 or better was achieved in 85 (82.5%) of eyes post operatively after removal of silicone oil or absorption of gas C3F8 as the case may be.Conclusion:Re-detachment is common after removal of silicone oil and incidence of re-detachment is related to the degree of preoperative PVR and location of breaks. Re-detachment occurs more commonly if the breaks are inferiorly located as compared to the superior ones.