Pseudophakic Retinal Detachment Research Articles

SF 6 COMPARED WITH C 2 F 6 FOR INFERIOR RHEGMATOGENOUS RETINAL REPAIR : The Manchester Pseudophakic Retinal Detachment Study.

To compare SF 6 relative with C 2 F 6 in the anatomical and functional outcomes following pars plana vitrectomy for uncomplicated primary pseudophakic rhegmatogenous retinal detachment with inferior causative breaks. This is a retrospective, comparative study on eyes with pseudophakic rhegmatogenous retinal detachment with inferior causative breaks that had small-gauge pars plana vitrectomy repair using SF 6 and C 2 F 6 tamponade between 2011 and 2020 at a tertiary centre in the United Kingdom. Primary outcome was single surgery anatomical success, and the secondary outcome was best-corrected visual acuity. Propensity score matching, using preoperative findings as covariates to account for relevant confounders, was performed. From 162 pseudophakic rhegmatogenous retinal detachment eyes with inferior causative breaks, the median (interquartile range) follow-up was 82 (52-182) days. The single surgery anatomical success was 156 (96.3%) overall: 47 of 47 (100.0%) and 109 of 115 (94.8%) in the SF 6 and C 2 F 6 groups, respectively ( P = 0.182). Relative to the SF 6 group, the C 2 F 6 group had a higher mean number of tears (SF 6 : 3.1[2.0], C 2 F 6 : 4.5[2.7], P = 0.002) and greater retinal detachment extent (SF 6 : 5.3[2.9], C 2 F 6 : 6.2[2.6] clock hours, P = 0.025). Following propensity score matching analysis, 80 eyes were matched with 40 in each group to homogenize preoperative factors. No significant difference was found in single surgery anatomical success and best-corrected visual acuity between the groups following propensity score matching. Primary pars plana vitrectomy with gas tamponade leads to a high single surgery anatomical success rate in uncomplicated pseudophakic rhegmatogenous retinal detachment with inferior causative breaks with no additional benefit associated with long-acting tamponade when comparing C 2 F 6 with SF 6 .

The effect of axial length on pseudophakic retinal detachment.

The purpose of the study was to analyse the surgical management and outcome regarding axial length in the population affected by pseudophakic retinal detachment (PRD) 2015-2020. The patients included were from an observational cohort study of patients undergoing cataract surgery in the region of Skåne during 2015-2017. Data were retrieved from the Swedish National Cataract Register and cross-referenced with cases of PRD in the same region from 2015 to 2020. The surgical method used and findings at follow-up were recorded. The patients were stratified according to axial length (AL) to <25 mm, 25 ≤ n < 26.5 mm and ≥26.5 mm. The main outcome was primary success with one surgery apart from silicone oil removal. The secondary outcome was postoperative visual acuity. In the whole study group of 58 624 cases, complete follow-up data were available for 288 eyes. The median follow-up time was 324 days, and primary operation was successful in 82.9% of these cases. The median visual acuity was 0.31 (LogMAR). In the stratification those with AL < 25 mm had a primary success of 75.8%, AL 25 ≤ n < 26.5 mm of 87.9% and ≥26.5 mm of 95.8%. The primary anatomical success was 82.9% in the whole group of PRD but with stratification they had an increasing number of primary success with longer AL.

THE LONG-TERM RECOVERY OF VISION IN PSEUDOPHAKIC MACULA-OFF RHEGMATOGENOUS RETINAL DETACHMENTS.

To assess the long-term visual recovery in uncomplicated macula-off pseudophakic rhegmatogenous retinal detachment treated with pars plana vitrectomy and gas tamponade in the absence of other visual comorbidities. Single-center retrospective longitudinal study on eyes with macula-off pseudophakic rhegmatogenous retinal detachment successfully treated with pars plana vitrectomy between 2011 and 2020 and with at least 2 follow-ups (FU), first gas-free FU (first-FU) and a final-FU, were included. Patients with subsequent ocular surgery or comorbidities affecting best-corrected visual acuity were excluded. The duration between operation date and final-FU was calculated (total days FU) and split into total days quintiles-1: ≤57, 2: >57 and ≤77, 3: >77 and ≤152, 4: >152 and ≤508, and 5: >508 days. Multivariable regression was performed with logMAR gain between the first and the final-FU as the dependent variable. In 209 eyes, the authors report association with increase of logMAR gain between the first and the final-FU, with reducing clock hours of pseudophakic rhegmatogenous retinal detachment ( P = 0.041) and relative to the total days Quintile 1. Mean (SD) logMAR gain between the first and the final-FU was 0.02 (0.07) in the first quintile, increasing to 0.14 (0.13) ( P < 0.001) by the fifth quintile on multivariable regression. For patients not achieving 0.30 logMAR at the first-FU, this was attained at the final-FU with a sensitivity of 51.9% and specificity of 95.5% at a cut off ≤0.58 logMAR at the first-FU (area under the curve 0.756 [95% confidence interval 0.664-0.848], P < 0.001). The authors report a significant time-dependent visual improvement after uncomplicated pars plana vitrectomy with gas tamponade for macula-off pseudophakic rhegmatogenous retinal detachment without visual confounders and provide important quantitative data for counselling patients with macula-off repair.

Expansile gas concentration in primary pseudophakic retinal detachment repair, effect on intraocular pressure and outcomes; the Manchester Pseudophakic Retinal Detachment Study.

To investigate the effect of isovolumetric and expansile gas tamponade concentrations on single surgery anatomical success (SSAS) and day 1 intraocular pressure (IOPD1) following pars plana vitrectomy (PPV) for mild-moderate complexity primary pseudophakic rhegmatogenous retinal detachment (PRD). We conducted a single-centre retrospective continuous and comparative study on eyes that had undergone small-gauge PPV using isovolumetric versus expansile gas for PRD repair between 2011 and 2020 at a single tertiary vitreoretinal centre in UK. We performed propensity score matching (PSM) using preoperative findings as covariates to account for relevant confounders. Significant risk factors such as proliferative vitreoretinopathy C or giant retinal tears were excluded. From 456 eyes, PSM analysis matched 240 eyes with 120 in each group. The median (interquartile range) follow-up was 96 (59 to 218) days. The SSAS was 229/240 (95.8%) overall; 115/120 (95.8%) and 114/120 (95.0%) in isovolumetric and expansile groups, respectively (p = 1.000). Relative to the isovolumetric group, the expansile group had lower proportion of eyes with IOP ≤ 21mmHg (odds ratio, 95% confidence interval, 0.40 [0.23-0.68], p < 0.001); but significantly higher number of eyes with IOP ≥ 22mmHg (2.53 [1.48-4.34], p < 0.001), ≥ 25mmHg (2.77 [1.43-5.33], p < 0.001), ≥ 30mmHg (2.90 [1.28-6.58], p = 0.006) and ≥ 40mmHg (p = 0.029, isovolumetric: 0 [0%] vs expansile group: 6 [5%]). There was only one case of hypotony (≤ 5mmHg) 1/240 (0.4%) which occurred in the expansile group. Expansile gas concentration does not impact SSAS but is associated with significantly raised IOPD1 with no reduction in hypotony rates following PPV for primary PRD.

Effect of the Presence of Silicone Oil in the Anterior Chamber After Complicated Retinal Detachment Surgery on Corneal Morphology by In Vivo Confocal Microscopy

Purpose This study evaluated the corneal endothelium, stromal keratocytes, subbasal nerve number and density in patients with silicone oil transferred to the anterior camera after pseudophakic complicated retinal detachment surgery by in vivo laser scanning confocal microscopy (IVLSCM). Methods Sequential measurements were made by IVLSCM between 3–6 months after surgery in two groups of patients: a) with silicon oil migration (Group 1) and without silicone oil migration (Group 2). Results A total of 63 cases (Group 1: 32 and Group 2: 31) were examined. The mean ages of patients were 65 ± 12 and 61 ± 11 and M/F ratio was 18/14 and 17/14, respectively. Mean intraocular pressures were 16.60 ± 4.60 and 15.75 ± 5.70 mm Hg, respectively. Changes were detected by IVLSCM mostly on the superior part of the cornea. A significant decrease in endothelial cell density and the number was detected in group 1 (2072 ± 116.2 cells/mm2 vs 2752 ± 512.3 cells/mm2; p < 0.001). Significant increases in posterior keratocyte density and stromal hyperreflective deposits were observed in group 1 (887 ± 45.8 cells/mm2 vs 725 ± 65.8 cells/mm2; p < 0.001). A significant negative correlation was observed between the size of stromal deposits and endothelial cell density (r=–0.758; p < 0.001). The number and density of corneal subbasal nerves were significantly lower in group 1 (1.8 ± 0.8 and 4.8 ± 1.2 vs 420 ± 101 and 701 ± 112 µm/square; p < 0.001). Conclusion IVLSCM is a useful tool for the early detection of corneal abnormalities caused by silicone oil injection. This study verified silicone oil’s detrimental effect on the corneal endothelium and revealed stromal changes in the anterior chamber, which we believe can be also been associated with the presence of silicone oil.

Risk Factors of Cystoid Macular Edema After Pars Plana Vitrectomy for Pseudophakic Retinal Detachment.

This study aimed to investigate the prevalence of cystoid macular edema after pars plana vitrectomy for the treatment of pseudophakic rhegmatogenous retinal detachment and identify possible related risk factors. A retrospective monocentric study was conducted within a cohort of pseudophakic patients undergoing vitrectomy for rhegmatogenous retinal detachment between January 2019 and December 2022. Demographic data, initial and intraoperative characteristics of rhegmatogenous retinal detachment, and postoperative data were analyzed. Cystoid macular edema was defined on optical coherence tomography exclusively. A total of 164 eyes of 164 patients were included for analysis. The mean age of the patients at surgery was 65.7 ± 12.0years. The mean best-corrected visual acuity was 2.1 ± 1.0logMAR preoperatively and 1.0 ± 0.7logMAR postoperatively. The mean follow-up was 13.4 ± 7.7months. The prevalence of cystoid macular edema was 17.1% [9.8-26.4]. In multivariate analysis, severe proliferative vitreoretinopathy (relative risk 3.6 [1.3-9.7]) and laser retinopexy (relative risk 8.4 [1.1-64.7]) were independently and significantly associated with cystoid macular edema. The prevalence of cystoid macular edema in pseudophakic rhegmatogenous retinal detachment after pars plana vitrectomy was 17.1%. Severe proliferative vitreoretinopathy stage and the use of endolaser retinopexy were independent risk factors for development of cystoid macular edema.

Are all primary retinal detachments the same? Anatomic and functional differences between phakic and pseudophakic patients

BackgroundGiven differences in the pathogenic mechanisms underlying primary retinal detachment (RD) as a function of the status of the lens, the objective was to explore differences between pseudophakic and phakic patients with primary RD.MethodsA retrospective study including 821 patients who underwent surgery for RD [491 cases of phakic and 330 of pseudophakic RD (pRD and psRD, respectively)] in our hospital between 2012 and 2020.ResultsThe mean age was 58.24 ± 12.76 years in the pRD group and 66.87 ± 11.18 years in the psRD group (p = 0.001). There were more men in both groups (70% and 64.23% of pseudophakic and phakic patients, respectively; p = 0.07). The most common location for the RD was superior in both groups (43.94% and 51.93% of pseudophakic and phakic patients, respectively), rates of inferior and total RD were somewhat higher in the psRD group (31.82% and 13.33% in pseudophakic vs 25.25% and 11.0% in phakic patients, p = 0.001). In pseudophakic and phakic patients respectively, macular involvement in 69.09% and 62.73% of cases (p = 0.067). Proliferative vitreoretinopathy was significantly more common in the psRD group (7.88% vs 3.6% in phakic patients, p = 0.01).The rate of final anatomic reattachment differed markedly between groups, with a higher rate in phakic (94.03%) than pseudophakic (87.27%) patients (p = 0.001).ConclusionsThe specific pathogenic mechanism involved in psRD seems to be responsible for worse evolution characteristics which are associated with poorer final anatomic and functional outcomes in pseudophakic patients.

The impact of 360-laser barricade on outcomes of vitrectomy for pseudophakic retinal detachment; The Manchester Pseudophakic Retinal Detachment Study.

To investigate the anatomical and functional outcomes and specifically, the effect of 360-degree barrier-laser, in pars plana vitrectomy (PPV) for primary pseudophakic rhegmatogenous retinal detachment (PRD). We conducted a single-centre retrospective, continuous and comparative study on eyes that had undergone PPV with focal-retinopexy (laser or cryotherapy) versus 360-laser for PRD repair between 2011-2020 at a single tertiary vitreoretinal centre in the UK. Primary outcomes were single surgery anatomical success (SSAS) rate and final postoperative visual acuity (VA). Multivariable regression covariates for primary re-detachment included age, gender, onset-of-detachment, pre-operative VA, ocular co-morbidities, macula-status, majority inferior (vs superior) PRD, number-of-tears and PRD extent (in clock-hours), 360-laser barricade, and perfluorocarbon liquid (PFCL) use. For VA gain, primary re-detachment was added as a covariate. We included 467 eyes with a mean follow-up of 388 (161) days. The SSAS was 444/467 (95.1%) overall, and 351/370 (94.9%) and 93/97 (95.9%) in focal-retinopexy and 360-laser groups, respectively (p = 0.798). Compared to the focal-retinopexy group, the 360-laser group had significantly worse post-operative VA but similar logMAR gain (p = 0.812). A multivariable binary logistic regression found that only PFCL use was linked with increased primary re-detachment (OR:5.32 [p = 0.048]) and 360-laser did not contribute to increased SSAS. A multivariable linear regression analysis showed that poor logMAR gain was significantly associated with better pre-operative logMAR, ocular co-morbidities, greater PRD extent, use of 360-laser and primary re-detachment. However, when excluding macula-off RD (n = 211), 360-laser was no longer significant (p = 0.088). Prophylactic 360-laser does not seem to impact on SSAS and functional outcomes following PPV for primary PRD.

Pseudophakic retinal detachment: a ticking time bomb.

Pseudophakic retinal detachment: a ticking time bomb.

Absorbable suture for band tightening of scleral buckling in pseudophakic rhegmatogenous retinal detachment: a modified surgical technique and a 6-month follow-up.

Rhegmatogenous retinal detachment (RRD) is a separation of the neurosensory retina from the retinal pigment epithelium as a result of liquid vitreous passing through a retinal break. Scleral buckling surgery (SB) is a conventional treatment for RRD. In SB, a silicon explant is used to indent the sclera, reduce vitreous traction, and close the retinal break, and an encircling band is used circumferentially, leading to myopia. This study aimed to evaluate the functional and biometric outcomes after SB with absorbable band-tightening sutures in patients with pseudophakic RRD. In this prospective interventional study, we included pseudophakic eyes with RRD treated surgically with SB and a temporary encircling band using a 6-0 absorbable Vicryl suture to tighten the band, instead of conventional permanent suture tightening. Anterior chamber depth (ACD), axial length (AL), intraocular pressure (IOP), spherical equivalent refractive error (SER), and best-corrected distance visual acuity (BCDVA) were measured preoperatively and at 1 day, 2 weeks, 3 months, and 6 months postoperatively. We included 30 eyes of 30 patients with a mean (standard deviation [SD]) age of 66.1 (10.5) years who underwent SB with an absorbable band-tightening suture for pseudophakic RRD. Significant increases in AL and ACD were observed at 2 weeks after surgery, with a significant decline in values thereafter; however, at the 6-month follow-up, the values were significantly higher than those at baseline (all P < 0.05). Based on the Vicryl tension and its hydrolysis, mean (SD) SER at 2 weeks postoperatively was significantly more myopic than at baseline (-5.8 [1.6] D versus +1.3 [1.8] D). However, the mean (SD) SER decreased significantly throughout the 6-month follow-up (all P < 0.05), and it reached -1.8 (0.9) D, which was comparable with the mean baseline SER (P = 0.140). The participants experienced significant improvement in BCDVA throughout the follow-up period (all P < 0.05). Using an absorbable suture to tighten the encircling band in patients with pseudophakic RRD can reduce postoperative myopia without adversely affecting the anatomical or functional outcomes. Future comparative studies with larger sample sizes and longer postoperative follow-up are needed to verify these findings.

Associated factors with pseudophakic retinal detachment: Long-term follow-up in a Colombian population

ObjectiveTo identify associated factors with the appearance of pseudophakic retinal detachment in patients with history of cataract surgery. MethodsRetrospective case-control study of 802 eyes of 783 patients with history of cataract surgery. Cases were patients with pseudophakic retinal detachment (n = 258 eyes), while controls were patients with cataract surgery who did not developed retinal detachment during a 10-year follow-up period (n = 544 eyes). ResultsAge at cataract surgery among cases was lower than in the control group (57 ± 13 vs. 67 ± 14 years old, respectively; p < 0.0001). Age at retinal detachment was 59 ± 13 years old (range 6-88) and the time between the cataract surgery and the retinal detachment had a median of 2 years (interquartile range 1–4) with a range of 1 month to 14 years. Associated factors for pseudophakic retinal detachment were younger age (<50 years: adjusted odds ratio [aOR] = 18.03, 95% confidence interval [95%CI] = 5.92–54.87; 50–59 years: aOR = 10.09, 95%CI = 3.37–30.23; and 60–69 years: aOR = 5.48, 95%CI = 1.88–15.93), male sex (aOR = 3.71, 95%CI = 2.54–5.44), anterior vitrectomy (aOR = 3.26, 95%CI = 1.16–9.16), history of retinal detachment in the fellow eye (aOR = 6.95, 95%CI = 3.15–15.31), and intraoperative complications during cataract extraction (aOR = 7.45, 95%CI = 3.54–15.69). ConclusionsThis is the first report of associated factors with pseudophakic retinal detachment in a Colombian population. Surgical complications, sex, and age were found to be associated with retinal detachment. Patients should be aware of these potential risks to make informed decisions about their eye health.

Factores asociados al desprendimiento de retina pseudofáquico: seguimiento a largo plazo en una población colombiana

ObjectiveTo identify associated factors with the appearance of pseudophakic retinal detachment in patients with history of cataract surgery. MethodsRetrospective case–control study of 802 eyes of 783 patients with history of cataract surgery. Cases were patients with pseudophakic retinal detachment (n=258 eyes), while controls were patients with cataract surgery who did not developed retinal detachment during a 10-year follow-up period (n=544 eyes). ResultsAge at cataract surgery among cases was lower than in the control group (57±13 vs. 67±14 years old, respectively; P<.0001). Age at retinal detachment was 59±13 years old (range 6–88) and the time between the cataract surgery and the retinal detachment had a median of 2 years (interquartile range 1–4) with a range of 1 month to 14 years. Associated factors for pseudophakic retinal detachment were younger age (<50 years: adjusted odds ratio [aOR]=18.03, 95% confidence interval [95% CI]=5.92–54.87; 50–59 years: aOR=10.09, 95% CI=3.37–30.23; and 60–69 years: aOR=5.48, 95% CI=1.88–15.93), male sex (aOR=3.71, 95% CI=2.54–5.44), anterior vitrectomy (aOR=3.26, 95% CI=1.16–9.16), history of retinal detachment in the fellow eye (aOR=6.95, 95% CI=3.15–15.31), and intraoperative complications during cataract extraction (aOR=7.45, 95% CI=3.54–15.69). ConclusionsThis is the first report of associated factors with pseudophakic retinal detachment in a Colombian population. Surgical complications, sex, and age were found to be associated with retinal detachment. Patients should be aware of these potential risks to make informed decisions about their eye health.

Pseudophakic Retinal Detachment: A Narrative Review

Cataract surgery causes changes in intraocular conditions that are a risk factor for retinal detachment. One of the conditions that can occur during cataract surgery is posterior capsule rupture which can increase the risk of pseudophakic retinal detachment (PRD). PRD examination is often obstructed by opacification of the posterior capsule, a reflection of the intraocular lens (IOL), or poor mydriasis. Scleral buckle, pneumatic retinopexy, and primary pars plana vitrectomy, with or without a combination of the scleral buckle, are surgical techniques used in the management of PRD patients. Anatomical and functional postoperative success rates in PRD patients were found to be higher after primary pars plana vitrectomy (PPV) with or without a scleral buckle. This literature review aims to discuss the epidemiology, risk factors, pathogenesis, and management of PRD.

Effect of Nd:YAG laser capsulotomy on the risk for retinal detachment after cataract surgery: systematic review and meta-analysis.

This study aimed to evaluate the impact of Nd:YAG laser capsulotomy on the incidence of pseudophakic retinal detachment (RD). The PubMed and Embase databases were searched for meta-analysis. Subgroup analyses were conducted according to study location, number of cases, mean follow-up time, and cataract procedure. The final analysis included 11 studies with 309 cases of RD in 65 117 eyes undergoing cataract surgery. Among them, 8232 eyes underwent Nd:YAG capsulotomy. This analysis demonstrated an increased risk for RD with Nd:YAG laser capsulotomy (relative risk [RR], 1.57; 95% CI, 1.17-2.12; P = .003; hazard ratio, 1.64; 95% CI, 1.03-2.62; P = .04). Subgroup analysis suggested somewhat stronger associations in Asian (RR, 4.54; 95% CI, 2.20-9.38; P < .0001) than in non-Asian populations (Americans, P = .12; Europeans and others, P = .21) and with extracapsular cataract extraction (RR, 2.97; 95% CI, 1.83-4.83; P < .0001) than with phacoemulsification (P = .95). To conclude, Nd:YAG laser capsulotomy may be associated with an increased risk for pseudophakic RD.

Role of anterior chamber maintainer in preventing pseudophakic retinal detachment in highly myopic eyes

Purpose To investigate the effect of anterior chamber maintainer (ACM) usage during phacoemulsification on the occurrence of pseudophakic retinal detachment (PRD) in high myopia.Design A retrospective nonrandomized comparative interventional study was conducted.Participants A total of 632 high myopic eyes of 501 patients who had eventless phacoemulsification with in-the-bag intraocular lens implantation in the period between March 2013 and December 2018.Methods Patients were divided into two groups according to the use of ACM during cataract surgery: (a) ACM group, and (b) no-ACM group. Patients were followed at 6, 12, 18, 24, 30, and 36 months after surgery for detection of PRD. The time-related cumulative incidence of RD in each group was evaluated by means of Kaplan–Meier survival curves.Results In the ACM group, the 3-year cumulative incidence of RD was 2.4% compared with 5.9% in the other group (P=0.039). Regarding age, the 3-year cumulative incidence of RD increased significantly in the younger age group when the ACM was not used (P=0.023), whereas it was not when the ACM was used. Using the ACM increased the 3-year cumulative survival ratio from 86.2 to 92% in patients with a posterior staphyloma (P=0.03).Conclusion ACM is a potential prophylactic intraoperative tool against PRD in highly myopic eyes.

Retinal Detachment Following Cataract Surgery

Introduction: The most frequently executed operating technique for cataract worldwide is the extraction of cataract. Development of pseudophakic retinal detachment (PPRD) following surgical extraction of cataract forms a major and growing quantity of rhegmatogenous retinal detachment (RRD) cases. PPRD is one of the severe, vision-related event and hence there is a need to find out the correlation between PPRD and cataract removal surgeries.&#x0D; Objectives: There is a different risk of developing PPRD with different methods of cataract extraction. Attempts are made to find the consequence of the new cataract surgery on the danger of retinal detachment and additional factors that modify this risk by collectively drawing the findings of clinical trials investigations in this review. Also, the comparison is made among different cataract surgeries for incidence of PPRD development.&#x0D; Conclusion: PPRD is an uncommon but significant adverse consequence. According to more recent research, phacoemulsification has a comparable or higher success rate in centers that are experienced with the process. While the exact risk of PPRD related to phacoemulsification is becoming apparent, the specific risk of PPRD attributable to phacoemulsification remains unknown.&#x0D; Limitations: Small population numbers restrict the available literature. The number of PPRDs that occur is minimal due to their rarity; hence just four of our 16 studies had more than 50 PPRDs. Patients with a past history of RRD were commonly omitted from the available research, and several studies had extremely short follow-up periods. Due to the methodological inconsistencies between the numerous studies evaluated there was restricted assessment of the literature, making direct comparisons more difficult.

EVALUATION OF OUTCOMES OF PRIMARY PSEUDOPHAKIC RETINAL DETACHMENT SURGERY

Objective: To evaluate the results of pars plana vitrectomy (PPV) alone and combined with circumferential scleral buckling (CSB) surgeries for aphakic or pseudophakic rhegmatogenous retinal detachment (RRD). Materials and Methods: Thirty-seven eyes of 37 patients who underwent PPV (20 and 23 Gauge) alone or PPV combined with CSB due to pseudophakic or aphakic primary RRD were included in the study. Postoperative anatomical success (AS) and functional success (FS) were evaluated. The AS was defined as a completely flattened retina without any subretinal fluids after the removal of the silicone oil tamponade, if used. The FS was defined as two or more decimal improvements in the logMAR equivalent of Snellen visual acuity. Results: The mean age of the patients was 62.43±11.40 (32-80) years, 21 (56.8%) patients were male, and 16 (43.2%) were female. The mean follow-up time was 21.35±16.86 (6-84) months. PPV combined with CSB were performed in 23 patients. AS was found to be 86.5% (32/37), FS was 49.9% (17/37). No statistically significant difference was observed in both AS and FS between the groups according to preoperative PVR presence (AS-p=0.61, FS-p=0.14), preoperative macular involvement (AS-p=0.98, FS-p=0.36), whether PPV combined with CSB (AS-p=0.97, FS-p=0.29), and the type of tamponade (p&gt;0.05 in all). Conclusion: PPV with or without CSB is safe and effective in cases with primary pseudophakic retinal detachment and achieves good AS without being affected by the presence of PVR or macular involvement. However, functional success may not always follow.

In-depth analysis of risk factors for pseudophakic retinal detachments and retinal breaks.

PurposeTo provide a detailed analysis of risk factors for pseudophakic retinal detachments (PRD) and pseudophakic retinal breaks (PRB).Materials and methodsWe reviewed the medical records of cataract surgeries between 1996 and 2017 at a tertiary care hospital in Austria. A Cox proportional‐hazard regression model was used to analyse risk factors for PRD and PRB.ResultsSixty‐five thousand six hundred and sixty‐two eyes (45 043 patients) underwent phacoemulsification, and 393 eyes (cumulative incidence 0.6%) were diagnosed with PRD (327 eyes) or PRB (66 eyes) during the follow‐up (median 7.1 years, range 0–21). Calculation of adjusted hazard ratios (HR) revealed a hierarchy of risk factors for either event including (from the highest to the lowest risk) posterior capsular rupture (PCR), patient age <65 years (compared with the age group >75 years), male gender and high myopia. Diabetes mellitus was associated with a lower risk. PCR was the strongest risk factor for PRD both in patients with and without perioperative vitrectomy (i.e. vitreous loss), but time to PRD was significantly reduced only following PCR with vitrectomy.ConclusionsPosterior capsular rupture, young patient age, male gender and high myopia were risk factors for PRD, but diabetes mellitus was associated with a lower risk. PCR had the strongest association with PRD, regardless of the need for perioperative vitrectomy due to vitreous loss. Time to PRD was reduced in patients with PCR and vitrectomy compared with PCR without the need for vitrectomy or uneventful surgery.

Vitrectomy Versus Combined Vitrectomy-Scleral Buckling for the Treatment of Pseudophakic and Aphakic Retinal Detachment

There is a disagreement on the ideal intervention for pseudophakic and aphakic retinal detachment. The goal of this thesis is to outline the difference between the two surgical approaches in getting higher reattachment rates and better visual outcomes. The study is a prospective randomised study to evaluate the efficacy of vitrectomy alone versus a combination of both vitrectomy and scleral buckling in the treatment of pseudophakic and aphakic retinal detachment. Aim: The aim of this study is to compare the anatomical and functional results of primary vitrectomy alone versus vitrectomy-scleral buckling for pseudophakic and aphakic retinal detachment. Patients and Methods: A total of 30 eyes with pseudophakic or aphakic retinal detachment will be divided into two groups. Fifteen consecutive pseudophakic or aphakic eyes with retinal detachment will be operated by vitrectomy-scleral buckling (Group-A) and Fifteen additional patients will be operated by vitrectomy alone (Group-B). Results: The two groups of the patients with a postoperative follow-up of at least 6 months continue to maintain an attached retina after one operation. Visual acuity has improved by at least 2 lines on the Snellen chart in 25 patients, remained the same in 2 patients, and decreased in 1 patient. Conclusion: This randomised study shows the same anatomic results when performing a PPV, fluid-air exchange, internal drainage, and endolaser together and SF6 gas injection with or without a scleral buckling for pseudophakic retinal detachment.

Vitrectomy Versus Combined Vitrectomy-Scleral Buckling for the Treatment of Pseudophakic and Aphakic Retinal Detachment

There is a disagreement on the ideal intervention for pseudophakic and aphakic retinal detachment. The goal of this thesis is to outline the difference between the two surgical approaches in getting higher reattachment rates and better visual outcomes. The study is a prospective randomised study to evaluate the efficacy of vitrectomy alone versus a combination of both vitrectomy and scleral buckling in the treatment of pseudophakic and aphakic retinal detachment.