Retinal Reattachment Surgery Research Articles

Incidence and outcomes of ocular hypertension from rhegmatogenous retinal detachment surgery in the acute postoperative setting.

PurposeTo determine the incidence of ocular hypertension following surgery for rhegmatogenous retinal detachment in the first 3 months postoperatively and to determine their outcomes in terms of visual acuity, control of IOP, and changes in cup:disc ratio.Patients and methodsA single center prospective cohort study was done involving patients who underwent retinal surgery for rhegmatogenous retinal detachment. The patients were followed up for 3 months postoperatively and were monitored for development of ocular hypertension. The primary outcome measures were changes in IOP, visual acuity, and cup:disc ratio.ResultsOf the 52 eyes enrolled in the study, 19 eyes developed ocular hypertension in the first 3 months postoperatively, giving an incidence rate of 36.5% (95% CI, 48.9–76.0%). Analysis of mean IOP trends shows that most cases of IOP elevations occur in the first day postoperatively with a sustained elevation up to the first month and then returning to normal levels by the 3rd month. There is a significant increase in mean cup:disc ratio among patients who developed ocular hypertension (p=0.047). Visual acuity trends show that mean visual acuity significantly improved from baseline among cases who maintained normal IOP (p=0.002) as compared to those who developed ocular hypertension (p=0.97), although the difference in final visual acuity at the end of 3 months between groups was not statistically significant (p=0.30).ConclusionOcular hypertension may complicate retinal reattachment surgery. Control of IOP in the acute setting is essential to prevent development of secondary glaucoma.

Visual acuity and contrast sensitivity outcomes based on photoreceptor layer after retinal reattachment surgery

Aims: To evaluate correlation between photoreceptor layer thickness with visual acuity and contrast sensitivity in primary retinal reattachment after vitrectomy. Methods: Twenty seven eyes of 27 patients (mean age 45.6±12.7 years) with successfully retinal reattached were analyzed. Snellen chart visual acuity (VA) to evaluate best-corrected visual acuity (BCVA) converted to the logarithm of the minimum angle of resolution scale (logMAR) and contrast sensitivity in photopic and mesopic illumination using Lea Symbol Flip Chart, funduscopy examination and High Definition Optical Coherence Tomography (HD-OCT) were used to measure retinal condition and photoreceptor layer thickness. Results: Nineteen (70.4%) cases of total 27 cases were reported with macularon RRD. The thickness of the photoreceptor layer was 43.8±10.8 µm which was significantly correlated with BCVA (logMAR 0.3-2.4, mean 1.0) with p is less 0.005 and also with contrast sensitivity in mesopic with p 0.033 (p ≤ 0.05). Contrast sensitivity in photopic was better than in mesopic. Foveal anatomic abnormalities were detected in six eyes (22.2%), that was disruption of inner segment (IS)/outer segment (OS) junction and also disruption of external limiting membrane (ELM). Duration of detachment also significantly correlated with BCVA with mean 36±29 days. The macular status before surgery determines the quality of vision, whereas the macular-on rhegmatogen retinal detachment gives visual acuity, contrast sensitivity, that is better in both photopic and mesopic, than macular-off. Conclusion: Photoreceptor layer thickness significantly correlated with visual acuity and contrast sensitivity in mesopic illumination, whereas thicker the photoreceptor, better the visual acuity and mesopic contrast sensitivity.

Treatment of Localized Retinal Redetachment in Silicon Oil Filled Eyes

Purpose: To assess the success rate of retinal reattachment surgery in localized re-detachment in Silicon oil filled eyes which had previously undergone primary retinal detachment (RD) repair with pars plana vitrectomy (PPV) with silicon oil. Study Design: Retrospective cross sectional case series. Place and Duration: Farooq Hospital and Medicare eye centre, Lahore from October 2016 to November 2017. Material and Methods: All those patients were included in our study who underwent primary retinal attachment surgery with pars plana vitrectomy (PPV) and silicon oil for complicated retinal detachment as an internal tamponade and later presented with localized inferior retinal detachment within 6 months of previous RD repair. Patients with total detachment, extensive PVR, retinal shortening, gas tamponade, total Re RD, and external scleral buckle were excluded. Two ports were made under local anesthesia instead of three conventional ports, simple non irrigation vitrectomy technique was used to achieve retinal reattachment under silicon oil without exchange of SO. Results: Ten eyes of ten patients were included, eight (8) males and two (2) females. The age range was from 18 to 79 years. Most common cause of re detachment (RD) in all cases was proliferative retinopathy (PVR) followed by retinal break. The new retinal break was identifiable in three (3) cases. All cases attained anatomical success in term of complete retinal attachment after second operation in one year follow up period. Conclusion: Simple non irrigation vitrectomy surgical technique under local anesthesia is effective, economical and time saving as compared to complicated three port vitrectomy with oil exchange. Keywords: Silicon oil, rhegmatogenous retinal detachment, proliferative retinopathy, retinal break, Perflourocarbon.

Causes and the efficacy of treatment of retinal detachment in silicone oil-filled eyes

Objective To analyze the causes and the efficacy of retinal detachment in silicone oil-filled eyes. Methods The clinical data of 70 silicone oil-filled eyes of 70 cases of retinal detachment from Jan. 2017 to Jun. 2018 were collected and analyzed retrospectively. The causes of retinal detachment in silicone oil-filled eyes were observed. Results There were 3 kinds of causes of retinal detachment in silicone oil-filled eyes: subretinal effusion with retinal detachment in 10 eyes (14.29%); poor closure of primary tear or formation of new tear in 13 eyes (18.57%); the progress of proliferative vitreoretinopathy (PVR) in 47 eyes (67.14%). The retinas of all cases were reattached after retinal reconstructive surgery. Visual acuity after second surgery improved in 60 eyes (85.71%), unchanged in 9 eyes (12.86%), decreased in 1 eye (1.43%). The average visual acuity after second surgery were better than that before surgery (t=8.316, P=0.000). Conclusion The retinal detachment in silicone oil-filled eyes is mainly caused by progress of PVR, followed by the poor closure of primary tear, the formation of new tear and the formation of subretinal effusion. Retinal reattachment surgery for the treatment of retinal detachment in silicone oil-filled eyes is effective. Key words: Detachment, retinal; Causes; Efficacy, treatment

An economy-based study: vitrectomy versus scleral buckle for primary rhegmatogenous retinal detachment in poor population

Purpose The aim of this study was to compare scleral buckling (SB) and primary pars plana vitrectomy (PPV) for the treatment of primary phakic rhegmatogenous retinal detachment (RRD). Patients and methods A prospective interventional study was conducted in the Department of Ophthalmology, South Valley University, Egypt, between January 2013 and May 2016. Patients suffering from primary phakic RRD were recruited. Eyes were divided into two groups: the SB group and the PPV group. The SB group underwent radial or encircling silicone sponge retinopexy with cryopexy, and evacuation of subretinal fluid in most cases with air injection. The PPV group underwent three-port 20-G PPV with sulfur hexafluoride or silicone oil (SO) as endotamponade agents. Cost was estimated for the vitreoretinal surgery, cataract surgery, and SO removal. Main outcome measures were anatomical and visual outcome, reoperation rate, and cost of initial surgery and reoperations. Results Forty-five eyes of 45 patients were included in the present study. Primary anatomical success was achieved in 17 (85%) eyes in the SB group and in 21 (84%) eyes in the PPV group. The final anatomical success rate was achieved in all eyes (100%) in both groups. The final best-corrected visual acuity improved in 14 (70%) eyes in the SB group and in 17 (68%) eyes in the PPV group. Reoperations included retinal reattachment surgery in three (15%) eyes versus four (16%) eyes in the SB and PPV groups, respectively. Cataract extraction with intraocular lens implantation was performed in four (20%) eyes in the SB group versus 16 (64%) eyes in the PPV group, and SO removal was performed in 12 (48%) eyes in the PPV group. SB operation cost was 4960 Egyptian Pounds, whereas PPV surgery cost was 6160 Egyptian Pounds. Conclusion SB and PPV for the treatment of RRD had comparable results as regards anatomical and functional outcomes. When considering other factors to decide which treatment method is better, such as cost of surgery, SB seems to be of lower cost compared with PPV.

Diathermy to tissue adhesives for retinal tears: The future of retinal reattachment surgery.

Diathermy to tissue adhesives for retinal tears: The future of retinal reattachment surgery.

Postoperative aqueous humour flare as a surrogate marker for proliferative vitreoretinopathy development.

As some surgical procedures have been shown to increase postoperative flare values and thus contribute to blood-ocular barrier breakdown, retinal reattachment surgery might influence the risk of developing proliferative vitreoretinopathy (PVR). Therefore, we investigated whether postoperative aqueous flare values are a surrogate marker for the development of postoperative PVR. We prospectively included 195 patients with primary rhegmatogenous retinal detachment (RRD) and measured aqueous laser flare preoperatively, and at 2 and 6weeks postoperatively. Postoperative PVR was defined as reoperation for redetachment due to PVR membranes, within 6months of initial surgery. Logistic regression and receiver operating characteristic (ROC) analysis determined whether higher postoperative flare values were associated with an increased risk of developing PVR later on. Reoperation for postoperative PVR was needed in 12 (6.2%) patients; in 18 (9.2%), reoperation was not related to PVR. The median flare value for patients who would develop PVR was significantly higher than that of patients who would not develop PVR, both at 2weeks (p=0.001) and 6weeks (p<0.001) postoperatively. Logistic regression analyses showed that a higher flare value significantly increased the odds of developing PVR, either at 2weeks [odds ratio (OR) 1.027; 95% CI: 1.010-1.044] or 6weeks (OR 1.076; 95% CI: 1.038-1.115). Flare values both at 2 and 6weeks postoperatively seem a good surrogate marker in terms of sensitivity and specificity for the development of postoperative PVR but have only a modest positive predictive value. The 2-week value would be more useful in terms of early recognition of high-risk patients and hence give the possibility to better study effects of treatment methods.

Anatomical and functional outcomes of scleral buckling versus primary vitrectomy in pseudophakic retinal detachment.

Retinal detachment is the separation of the sensory retina from the retinal pigment epithelium by subretinal fluid. There are several types of retinal re-attachment surgery, including scleral buckling (SB), pneumatic retinopexy, and vitrectomy (with or without SB). The objective of this study was to compare anatomical and visual outcomes between patients with pseudophakic rhegmatogenous retinal detachment (RRD) who underwent pars plana vitrectomy (PPV) with silicone oil (SO) or perfluoropropane (C3F8) gas tamponade and pseudophakic RRD patients who underwent SB surgery. We evaluated retrospectively 101 pseudophakic RRD patients from a single center. The patients were classified into three groups according to the surgical procedure performed: PPV + Silicone - patients who underwent PPV with SO tamponade; PPV + Gas - patients who underwent PPV with perfluoropropane gas tamponade; and SB group - patients who underwent SB surgery. The groups were compared with regard to primary and final anatomical and visual outcomes. The number of patients in PPV + Silicone, PPV + Gas, and SB group was 39 (38.6%), 32 (31.7%), and 30 (29.7%), respectively. The mean follow-up period in PPV + Silicone, PPV + Gas, and SB group was 33.95 ± 23.58, 32.62 ± 10.95, and 33.76 ± 16.62 months, respectively. No significant difference was observed between the groups neither with regard to primary and final anatomical and visual success rates nor in relation to the recurrence rate of retinal detachment. According to our anatomical and visual outcome results, either of the three methods (i.e., PPV + Silicone, PPV + Gas, or SB) can be used in the treatment of pseudophakic retinal detachment.

Delayed Absorption of Subretinal Fluid after Retinal Reattachment Surgery and Associated Choroidal Features.

PurposeThe aim of this study was to investigate the incidence and associated clinical factors of delayed absorption of subretinal fluid (SRF) after surgery for rhegmatogenous retinal detachment.MethodsThis study involved 36 eyes of 36 consecutive patients who underwent successful surgery for rhegmatogenous retinal detachment. A complete ophthalmologic evaluation, including clinical fundus examination, optical coherence tomography, and indocyanine green angiography, was conducted before and after surgery. Delayed absorption was defined as the presence of residual concave SRF or an SRF bleb at 6 months after surgery. Clinical factors and choroidal features on indocyanine green angiography were compared according to the presence and absence of delayed absorption.ResultsEighteen of 36 eyes (50%) showed delayed absorption. Macular involvement and worse preoperative visual acuity were significantly related to the presence of delayed absorption (p = 0.001 and p = 0.034, respectively). On indocyanine green angiography, preoperative choroidal vascular hyperpermeability was noted in 70% of eyes with delayed absorption and in 14% of eyes without it (p = 0.010).ConclusionsDelayed absorption of SRF after retinal reattachment surgery was not rare, with a 50% of incidence in this study. Macula-off status was significantly related to the incidence of delayed SRF absorption, and choroidal features such as choroidal vascular hyperpermeability might be responsible in part, possibly through the resultant exudative property of choroid.

Key Factors to Improve the Outcome of Retinal Reattachment Surgery in Proliferative Vitreoretinopathy and Proliferative Diabetic Retinopathy

Introduction For management of complicated retinal detachments, a pars plana vitrectomy with temporary silicone oil (SO) fill is the method of choice. According to literature, the retinal redetachment rate varies between <10% and >70% with around 36% in our own group (retrospective data analysis, n = 119 eyes). Methods The main goal was to reduce the retinal redetachment rate. Standard operating procedures (SOPs) and evaluation protocols (EVALPs) were developed to prospectively analyse risk factors. Lab analysis of SO was performed, and the role of surgical experience was evaluated and investigated with Eyesi®. Results We achieved a significant reduction of the retinal redetachment rate (to 6.80%, n = 101, p = 0.002). After surgery with SO injection, neither further membrane peeling (in 16.5%) nor retinal laser coagulation (in 100%) during revision surgery had a significant effect on the reattachment rate (p = 0.167, p = 0.23), while extensive additional laser coagulation reduced visual acuity (p = 0.01). A 3-port approach had to be set up to complete SO removal. A difference in success rate depending on surgical experience was confirmed, and the performance in Eyesi correlated with that in the patients' eye. Conclusions A SOP- and EVALP-based management and new strategies to secure the surgical performance seem to be essential for successful surgery.

Long-term surgical outcomes of retinal detachment in patients with Stickler syndrome.

PurposeThe aim of the study was to present the long-term anatomical and visual outcomes of retinal detachment repair in patients with Stickler syndrome.Patients and methodsThis study is a retrospective, interventional, consecutive case series of patients with Stickler syndrome undergoing retinal reattachment surgery from 2009 to 2014 at the Associated Retinal Consultants, William Beaumont Hospital.ResultsSixteen eyes from 13 patients were identified. Patients underwent a mean of 3.1 surgical interventions (range: 1–13) with a mean postoperative follow-up of 94 months (range: 5–313 months). Twelve eyes (75%) developed proliferative vitreoretinopathy. Retinal reattachment was achieved in 100% of eyes, with ten eyes (63%) requiring silicone oil tamponade at final follow-up. Mean preoperative visual acuity (VA) was 20/914, which improved to 20/796 at final follow-up (P=0.81). There was a significant correlation between presenting and final VA (P<0.001), and patients with poorer presenting VA were more likely to require silicone oil tamponade at final follow-up (P=0.04).ConclusionRepair of retinal detachment in patients with Stickler syndrome often requires multiple surgeries, and visual outcomes are variable. Presenting VA is significantly predictive of long-term VA outcomes.

Clinical and surgical risk factors in the development of proliferative vitreoretinopathy following retinal detachment surgery: a systematic review protocol.

BackgroundProliferative vitreoretinopathy (PVR) is a known complication of retinal detachment surgery. It has been postulated that the establishment of PVR involves inflammatory and ischaemic processes. Surgical and clinical risk factors contribute to making certain patients more vulnerable to developing PVR.The objective of this systematic review is to identify and appraise the evidence on clinical and surgical risk factors and their utility in predicting the occurrence or worsening of PVR post-surgery.MethodsElectronic databases and grey literature will be searched dating from 1980. Studies will be eligible if they include patients that underwent retinal reattachment surgery for rhegmatogenous retinal detachment (RRD), with and without PVR, and where risk factors were measured before or during surgery. Screening, data extraction and quality assessment will be performed independently by two reviewers using pre-defined criteria. Should any models be identified, we will liaise with the Cochrane prognostic group to help define the most appropriate quality assessment criteria based on the PROBLAST tool which is in development. All findings will be tabulated and narratively synthesised. Studies presenting models or adjusted data will likely be more informative than studies reporting unadjusted results for a single risk factor. When clinically and methodologically appropriate, random effects meta-analysis will be performed.DiscussionThis review will systematically and comprehensively retrieve evidence to evaluate the clinical and surgical risk factors associated with PVR. The identified evidence may aid standardisation of clinical practice and more effective management for improving patient outcomes following RRD surgery and will provide a clear reference point for vitreoretinal surgeons.Systematic review registrationPROSPERO CRD42016035848Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0284-7) contains supplementary material, which is available to authorized users.

Pioneering surgery for retinal detachment in Australasia: a review.

In the 1930s there was excitement worldwide with the realization that Jules Gonin's observation that closing the retinal break was the key to successful retinal re-attachment surgery. Australians and New Zealanders kept pace with these developments despite the limitations of travel and communication in the 1930s. Dr J. Bruce Hamilton of Tasmania was training at Moorfields Eye Hospital in 1930 and was exposed to the surgical technique espoused by Gonin in its first year of being adopted in Britain. Walter Lockhart Gibson was the first in Australasia to report a successful retinal re-attachment operation in 1931. In the 1960s Australians made two significant contributions to retinal surgery: the Schultz-Crock portable indirect ophthalmoscope and the first instrument for closed pars plana vitrectomy. The latter was developed at the Royal Victorian Eye and Ear Hospital by Dr Jean-Marie Parel and Professor Gerard Crock, in association with Dr Robert Machemer, and it was used by Machemer when he carried out the world's first closed pars plana vitrectomy in 1971.

Dealings between Cataract and Retinal Reattachment Surgery in PVR.

Introduction. To evaluate the impact of the eye lens status and oil side effects on the outcome of vitreoretinal surgery in retinal detachment with proliferative vitreoretinopathy (PVR) and a temporary silicone oil tamponade (SOT). Methods. 101 eyes were analyzed retrospectively and 103 eyes prospectively in regard to their retinal reattachment success rate and key factors for the outcome. Subgroup analysis of 27 eyes with Scheimpflug lens photography (SLP) before and after retinal reattachment service with SOT was performed. For SLP (65% phakic eyes) a Pentacam densitometry reference body with 3 mm diameter was chosen and 3 segments (anterior/mid/posterior) were evaluated separately after a quality check. Results. The retinal reattachment rate was highest in the prospective pseudophakic group (p = 0.039). Lens transparency loss occurred earlier in middle aged patients than in younger patients. Besides the nucleus, layers posterior and anterior to it showed specific transparency changes. The emulsification rate was higher when eyes had been operated on in the anterior chamber before retinal reattachment service. Conclusions. Retinal reattachment surgery seems to benefit from preoperative cataract removal. We found significant lens changes in the nucleus as well as in the layers anterior and posterior to it. This corresponds to the histology of the lens epithelium published before.

Retinal Detachment in Down Syndrome: Characteristics and Surgical Outcomes.

Purpose. To determine the functional and anatomic outcomes of rhegmatogenous retinal detachment (RRD) surgery in patients with Down syndrome. Methods. A retrospective chart review was performed of patients with Down syndrome who had undergone surgery for RRD at King Khalid Eye Specialist Hospital between 1995 and 2014. Results. A total of 245 patients with Down syndrome were evaluated during the study period. Eighteen eyes of 15 patients (6.1%) with RRD were identified. Three out of 15 patients (20%) presented with bilateral retinal detachment. All eyes presented with macula off retinal detachment. The retina was successfully reattached in 16/18 (88.8%) eyes after a mean follow-up of 48 months. The final postoperative visual acuity ranged from light perception to 20/125 (median: hand motion) (11/18 eyes). Conclusions. The anatomic success rate of retinal reattachment surgery in patients with Down syndrome is comparable to the general population. Patients with Down syndrome should undergo regular ophthalmic examinations for early diagnosis. Despite late diagnosis and the presence of proliferative vitreoretinopathy (PVR) in some patients, favorable anatomical outcomes can be achieved.

The first case of endophthalmitis due to Rhinocladiella basitona in an immunocompetent patient

Rhinocladiella, a genus of black yeast–like fungi, is related to many infections in humans, including not only mild cutaneous lesions but also fatal brain infections. However, endophthalmitis caused by Rhinocladiella has never been reported by far. Herein, we present the first case of endophthalmitis due to Rhinocladiella basitona. The diagnosis was based on histopathology, mycology, and molecular identification. A 53-year-old female was struck by a piece of wood in her right eye. The wound in the central cornea became an ulcer and was aggravated continuously. Hyphae were found in the corneal scraping smear. Then endophthalmitis occurred and could not be controlled by the combined intravitreal antibiotic injections and vitrectomy. Finally, penetrating keratoplasty combined with retinal reattachment surgery was performed. Topical and systemic antifungal agents were administered for more than 1month. The patient was cured, with improved visual acuity and clear corneal graft.

Clinical management of proliferative vitreoretinopathy: an update.

Proliferative vitreoretinopathy (PVR) remains the most significant obstacle to successful retinal reattachment surgery. Preclinical studies continue to add insights into the complex molecular events leading to PVR development, helping to identify new targets for potential prophylactic or therapeutic agents. This article reviews the recent evidence supporting surgical and medical treatments for PVR. PUBMED was used for literature search. Clinical studies regarding surgical management of PVR from January 1, 2000 to August 1, 2014 were included. Clinical studies regarding medical management of PVR from January 1, 2000 to August 1, 2014 were included if the design of study was a randomized controlled trial. Many recent studies have evaluated surgical and medical strategies for the treatment and prevention of PVR. Newer vitreoretinal surgery technology (23- and 25-gauge vitrectomy) and tamponade agents (heavy silicone oils) have been studied. Medical therapies evaluated include antiinflammatory agents, low molecular weight heparin, 5-fluorouracil, 13-cis-retinoic acid, and daunorubicin, amongst others. Surgical management with pars plana vitrectomy, with or without scleral buckle or inferior retinectomy, remains an effective treatment for PVR-related detachments. Consensus regarding a preferred surgical strategy remains controversial. Many medical therapies have been studied but fail to demonstrate a statistically significant benefit in clinical trials. Further studies to clarify the efficacy of available and novel treatment options are warranted.

Preoperative findings and visual outcome associated with retinal reattachment surgery in dogs: 217 cases (275 eyes).

Report the correlation of pre-operative findings with visual outcome in dogs undergoing retinal reattachment surgery for giant retinal tears. Retrospective analysis of dogs that underwent pars plana vitrectomy (PPV) with silicone oil (SiO) tamponade and endolaser retinopexy at one institution. Recorded parameters included signalment, etiology, and duration of retinal detachment, observable retinal tissue architecture, visual reflexes, lens status, presurgical aqueous flare, visual status postoperatively, and complications. Two hundred and seventeen patients (275 eyes) were included. Common etiologies of detachment were primary vitreoretinal disease (50.5%), lens surgery (35.3%), and hypermature cataracts (6.2%). Immediate postoperative anatomic success was noted in 98% of operated eyes. Maintenance or return of vision was noted in 74.2% of patients (72% of eyes) through the last known follow-up, with return of vision on average 18.5 days postoperatively. In those eyes that regained vision, 71.7% had retained vision at the last known recheck examination, with an average follow-up time of 550 days. Pre-operative findings correlated with postoperative vision included presence of a dazzle reflex, presence of a menace response, and retinal tissue architecture. The most common complications included migration of SiO into the anterior chamber (49.4%), corneal ulceration (25.7%), glaucoma (25.7%), and cataract formation (24.5%). Giant retinal tears in dogs can be successfully managed via PPV with SiO tamponade and endolaser retinopexy. Vision was maintained in the majority of cases with long-term follow-up. Patient history and thorough ophthalmic examination with attention to retinal tissue architecture are important in assessing surgical candidacy.

Curcumin inhibits human retinal pigment epithelial cell proliferation.

Proliferative vitreoretinopathy (PVR) is a common cause of intraoperative failure following retinal reattachment surgery and is mediated in part through the migration, de-differentiation and proliferation of retinal pigment epithelial (RPE) cells. Given the cytotoxic effects of curcumin on epithelial and endothelial cells, in this study, we assessed the effects of curcumin on human RPE (hRPE) cell proliferation. WST-1 analysis revealed that curcumin significantly inhibited primary hRPE cell proliferation in a dose- and time-dependent manner (P<0.001) with the greatest inhibition observed at the dose of 15 μg/ml curcumin. Flow cytometric analysis indicated that the cytotoxic effects of curcumin on hRPE cell proliferation were mediated by cell cycle arrest at the G0/G1 phase and the induction of apoptosis (both P<0.001), which was confirmed by ultrastructural analysis using transmission electron microscopy. Furthermore, western blot analysis revealed that curcumin induced p53 and p21WAF1/CIP1 expression with a concomitant decrease in proliferating cell nuclear antigen protein levels (P<0.05). Curcumin effectively inhibited primary hRPE cell proliferation, which may be mediated by the p53 pathway. Further in vivo studies are required in order to fully explore the therapeutic potential of curcumin for PVR.

Aniseikonia and Foveal Microstructure after Retinal Detachment Surgery.

Purpose:To quantify aniseikonia after successful surgical repair of rhegmatogenous retinal detachment (RD), and to investigate the relationship between the severity of postoperative aniseikonia and retinal microstructures as well as clinical parameters. Methods:The study included 106 eyes of 106 patients, without any history of ocular disease/surgery and less than 2 diopters of anisometropia, who had undergone successful retinal reattachment surgery. Aniseikonia was measured with New Aniseikonia Test and foveal microstructure was assessed with the spectral-domain optical coherence tomography at 6 months postoperatively. Results:Twenty-eight of 106 patients (26%) had micropsia, 17 patients (16%) had macropsia, and 61 patients (58%) had no aniseikonia. The mean absolute value of aniseikonia was 2.3 ± 2.9% (range; -12.5% - +12.0%). Of 57 eyes with macula-on RD, 3 had micropsia and 12 had macropsia. Of 49 eyes with macula-off RD, 25 had micropsia and 5 had macropsia. Eyes with micropsia mostly exhibited persistent or transient cystoid macular edema, subretinal fluid, hyperreflective or disruption of IS/OS line, while most of the eyes with macropsia presented epiretinal membrane. Stepwise multiple regression analysis revealed that postoperative best-corrected visual acuity and the area of RD were significantly relevant to the mean absolute value of aniseikonia. Conclusions:These results suggested that about half of patients with successful repair of RD had aniseikonia. Eyes with macula-off RD tended to show micropsia, while those with macula-on RD mostly presented macropsia. Micropsia and macropsia were primarily caused by respective specific abnormal structures at the foveal region.