Treatment Of Rhegmatogenous Retinal Detachment Research Articles

Non-contact wide-field viewing system-assisted scleral buckling surgery for retinal detachment in silicone oil-filled eyes.

To evaluate scleral buckling (SB) surgery using a non-contact wide-field viewing system and 23-gauge intraocular illumination for the treatment of rhegmatogenous retinal detachment in silicone oil (SO)-filled eyes. Totally 9 patients (9 eyes) with retinal detachment in SO-filled eyes were retrospectively analyzed. All patients underwent non-contact wide-field viewing system-assisted buckling surgery with 23-gauge intraocular illumination. SO was removed at an appropriate time based on recovery. The patients were followed up for at least 3mo after SO removal. Retinal reattachment, complications, visual acuity and intraocular pressure (IOP) before and after surgery were observed. Patients were followed up for a mean of 8.22mo (3-22mo) after SO removal. All patients had retinal reattachment. At the final follow-up, visual acuity showed improvement for 8 patients, and no change for 1 patient. The IOP was high in 3 patients before surgery, but it stabilized after treatment; it was not affected in the other patients. None of the patients had infections, hemorrhage, anterior ischemia, or any other complication. This new non-contact wide-field viewing system-assisted SB surgery with 23-gauge intraocular illumination is effective and safe for retinal detachment in SO-filled eyes.

Efficacy of scleral buckling for the treatment of rhegmatogenous retinal detachment using a novel foldable capsular buckle.

To evaluate the effectiveness and safety of scleral buckling for the treatment of rhegmatogenous retinal detachment (RRD) using a novel foldable capsular buckle (FCB). This was a series of case observation studies. Eighteen patients (18 eyes) who visited our ophthalmology department between August 2020 and August 2022 and were treated for RRD with scleral buckling using FCB were included. The procedure was similar to conventional scleral buckling, while a balloon-like FCB was placed onto the retinal break with balanced salt solution filling for a broad, external indentation instead of the silicone buckle. The retinal reattachment rate, best corrected visual acuity (BCVA), intraocular pressure (IOP), refractive dioptre and astigmatism degree, and complications were evaluated and recorded. There were 7 males and 11 females aged 19-58y. The average time course of RRD was 12d, ranging from 7-20d. The retinal break was located in the superior quadrants in 8 eyes and in the inferior quadrants in 10 eyes, with macula-off detachments in 12 eyes. The patients were followed-up for at least 6mo. The final retinal reattachment rate was 100%. The BCVA was significantly improved compared with the baseline (P<0.05). There was no significant change in refractive dioptre or astigmatism degree at each follow-up (all P>0.05). Three patients had transiently high IOPs within one week after surgery. Mild diplopia occurred in 5 patients after surgery and then disappeared after the balloon fluid was removed. The success rate of FCB scleral buckling for RRD is satisfactory. This procedure can be expected to be applied in new, uncomplicated cases of RRD.

Outcomes and variables that impact pneumatic retinopexies.

To evaluate the efficacy of pneumatic retinopexy (PR) in patients undergoing PR as primary treatment for rhegmatogenous retinal detachment (RRD) and analyze the factors associated with success and failure in the studied population. A retrospective chart review was done of patients with RRD treated with PR as primary management method treated at New York Eye and Ear Infirmary of Mount Sinai between January 2017 and December 2021. Primary outcome measured success or failure of PR. Secondary outcome measured best corrected visual acuity (BCVA) after PR. A separate risk analysis was done to identify and stratify risks associated with success and failure of PR. A total of 179 eyes from 179 patients were included for final analysis. The 83 patients (46.37%) achieved anatomical reattachment of the retina after primary PR with no need for additional surgery. The 96 patients (53.63%) had a failed primary PR and required a PPV and 6 of them required pars plana vitrectomy (PPV) with scleral buckle (SB). In total, 19 cases (10.61%) were done as temporizing pneumatics, 18 (94.74%) underwent PPV, and 1 (5.26%) did not require further intervention. The visual acuities at postoperative month 1 (POM1) for patients who underwent primary PR successfully and for those that underwent PPV after, were 0.58 (20/80) and 1.03 (20/200) respectively. Patients who met Pneumatic Retinopexy Versus Vitrectomy for the Management of Primary Rhegmatogenous Retinal Detachment Outcomes Randomized Trial (PIVOT) criteria had a statistically significant decreased risk of primary PR failing (hazard ratio 0.29, P=0.00). Majority of missed or new breaks were found superotemporally. PR is a good treatment option for treating RRDs in patients that meet PIVOT criteria and can be conducted as a temporizing measure. PIVOT criteria and fovea on status decrease the risk of PR failure.

CLINICAL OUTCOMES OF SCLERAL BUCKLING COMBINED WITH PARS PLANA VITRECTOMY FOR RHEGMATOGENOUS RETINAL DETACHMENT

Introduction and Objective: The various types of primary interventions for rhegmatogenous retinal detachment (RRD) include pars plana vitrectomy (PPV), scleral buckling (SB), and combination of both. Intraocular tamponade with silicone oil (SO) or expanding gas. This research was conducted to evaluate the clinical outcomes of SB combined with PPV as a treatment for RRD.&#x0D; Methods: This research was prospective descriptive study with total sampling for RRD treated by SB combined with PPV from August 2022 to January 2023 in RSUP. Prof. Dr. R.D. Kandou. BCVA, IOP, clinical findings, intraocular tamponade and complications after the surgery were observed.&#x0D; Results: Most of the patients was male with average age of 28 ± 40 years. RRD was observed in 6 eyes and laterality on right eye. BCVA was 2.5 ± 2 logMAR before the surgery and 2.3 ± 1 logMAR 1 month after the surgery. BCVA day 1, 1 week, 2 weeks and 1 month showed no significant difference after the surgery compared to baseline (p = 0.317, p = 0.949, p = 0.611, p= 0.611 respectively). Preoperative IOP was 7 ± 11 mmHg and 13.6 ± 10 mmHg 1 month after the surgery. IOP 1 week and 1 month showed significant difference (p = 0.027, p=0.011). IOP day 1, 2 weeks and 1 month showed there was no significant difference after the surgery on day 1 and 2 weeks.&#x0D; Conclusion: There were several clinical condition seen such as BCVA after the surgery didn’t improve as expected, subconjunctival bleeding was found the most as postoperative complications.&#x0D; Keyword: Scleral buckling, Pars plana vitrectomy, silicon oil, retinal detachment

Clinical Outcomes of Scleral Buckling combined with Vitrectomy Pars Plana for Rhegmatogenous Retinal Detachment

Introduction &amp; ObjectivesThe various types of primary interventions for rhegmatogenous retinal detachment (RRD) includepars plana vitrectomy (PPV), scleral buckling (SB), and combination of both. Intraocular tamponadewith silicone oil (SO) or expanding gas. This research was conducted to evaluate the clinicaloutcomes of SB combined with PPV as a treatment for RRD.&#x0D; MethodsThis research was prospective descriptive study with total sampling for RRD treated by SB combinedwith PPV from August 2022 to January 2023 in RSUP. Prof. Dr. R.D. Kandou. We observed the BCVA,IOP before and after the surgeries. Clinical findings, intraocular tamponade and complications afterthe surgeries were observed.&#x0D; ResultsMost of the patients was male with average age of 28 ± 40 years. RRD was observed in 6 eyes andlaterality on right eye. BCVA was 2.5 ± 2 logMAR before the surgery and 2.3 ± 1 logMAR 1 monthafter the surgery. Preoperative IOP was 7 ± 11 mmHg and 13.6 ± 10 mmHg 1 month after thesurgery. Macular detachment, 1 Quadrant Detachment, 1 Number of retina break mostly on superotemporalquadrant were found the most. Proliferative vitreoretinopathy was found in 1 eye.Intraoperative triamcinolone used in 4 eyes and perfluorocarbon in 1 eyes. Subconjunctival bleedingwas found the most, followed by corneal edema and subretinal hemorrhage as postoperativecomplications respectively.&#x0D; ConclusionThere were several clinical condition seen such as BCVA after the surgery that didn’t improve asexpected, High IOP found in several eyes and subconjunctival bleeding was the complication foundthe most in these eyes.

Pars Plana Vitrectomy in the Treatment of Rhegmatogenous Retinal Detachment.

The aim of the study is to retrospectively evaluate the anatomical success rate and functional results of 25G+ PPV in the treatment of newly diagnosed rhegmatogenous retinal detachment (RRD). The set consists of 152 eyes of 152 patients, of which 71 (47%) were men, average age 54 years, operated on by one surgeon for RRD at the Eye Clinic of the University Hospital and Medical Faculty of Masaryk University Brno from 1.7.2019 to 4.5.2021 using the 25G+ PPV technique. 25G+ PPV with pre-equatorial cerclage was performed on 7 patients. The patients' anamnesis included blunt ocular trauma and uncomplicated cataract surgery with implantation of a posterior chamber intraocular lens. The cause of RRD was retinal tear/s, regardless of their number and location. The transparency of the anterior segment of the eye enabled reliable visualization of the posterior segment. Preoperative proliferative vitreoretinopathy (PVR) grade A-D2 was admissible. Patients with a history of penetrating ocular trauma were excluded. The postoperative findings and functional outcomes of the patients were evaluated 1-3 months after PPV. The operation was anatomically successful if the retina was fully attached. Final visual acuity (VA) was evaluated for each patient. The final visual acuity examination was carried out typically on a Snellen optotype, either without correction, with the patient's own spectacle correction or with correction according to the current values on the autorefractometer. The arithmetic average was used for the numerical expression of the attained results, and the numerical values were also expressed in percentages. Since the different groups were not compared with each other, no statistical test was necessary to analyze the results. In 150 (98.7%) of the 152 patients in the group, we achieved complete retinal reattachment, in 2 (1.3%) patients the retina remained detached, and we recorded anatomical failure of the treatment. Fifty (33%) patients achieved VA ≥ 4/8. In 133 (87.5%) patients, we are able to state anatomical success even without the presence of intraocular tamponade in the operated eye. These patients can be considered completely cured. 25G+ PPV has demonstrated its contribution to resolving RRD.

Modification of the Suprachoroidal Buckling Technique for the Treatment of Rhegmatogenous Retinal Detachment.

To describe modification of the suprachoroidal buckling technique for the treatment of rhegmatogenous retinal detachment (RRD), which may improve the safety profile. A single-surgeon foot-pedal-controlled automated suprachoroidal injection (SCI) of sodium hyaluronate 1%, namely ProVisc (Alcon Laboratories, Fort Worth, TX) was used for the treatment of RRD. MicroDose Injection Kit (MedOne Surgical, Sarasota, FL) including a connector and a 1-mL syringe, designed for subretinal injection, was used to adapt Constellation Vision System (Alcon Laboratories) console for SCI of ProVisc from the 1-mL syringe. This approach enables better surgeon control during SCI. Three highly myopic eyes of three patients with primary macula-on RRD and single superior peripheral retinal break were treated. Complete retinal reattachment was achieved in all eyes without complications. Injecting ProVisc under foot-pedal control provides a more precise and potentially safer suprachoroidal buckling technique compared with the manual technique with more variable injection speed and pressure.

Performance of Automated Machine Learning in Predicting Outcomes of Pneumatic Retinopexy

ObjectiveAutomated Machine Learning (AutoML) has emerged as a novel tool for medical professionals lacking coding experience, enabling them to develop predictive models for treatment outcomes. This study evaluated the performance of AutoML tools in developing models predicting the success of pneumatic retinopexy (PR) in treatment of rhegmatogenous retinal detachment (RRD). These models were then compared with custom models created by ML experts. DesignRetrospective multicenter study. Population539 consecutive patients with primary RRD that underwent PR by a vitreoretinal fellow at six training hospitals between 2002 and 2022. MethodsWe used two AutoML platforms, MATLAB Classification Learner and Google Cloud AutoML. Additional models were developed by computer scientists. We included patient demographics and baseline characteristics, including lens and macula status, RRD size, number and location of breaks, presence of vitreous hemorrhage and lattice degeneration, and physicians’ experience. The dataset was split into a training (n = 483) and test set (n = 56). The training set, with a 2:1 success-to-failure ratio, was used to train the MATLAB models. Since Google Cloud AutoML requires a minimum of 1000 samples, the training set was tripled to create a new set with 1449 datapoints. Additionally, balanced datasets with a 1:1 success-to-failure ratio were created using Python. Main Outcome MeasuresSingle-procedure anatomic success rate, as predicted by the ML models. F2-scores and area under the receiver operating curve (AUROC) were used as primary metrics to compare models. ResultsThe best performing AutoML model (F2-score=0.85, AUROC=0.90; MATLAB), showed similar performance to the custom model (0.92, 0.86) when trained on the balanced datasets. However, training the AutoML model with imbalanced data yielded misleadingly high AUROC (0.81) despite low F2-score (0.2) and sensitivity (0.17). ConclusionsWe demonstrated the feasibility of using AutoML as an accessible tool for medical professionals to develop models from real-world data. Such models can ultimately aid in the clinical decision-making, contributing to better patient outcomes. However, outcomes can be misleading or unreliable if used naively. Limitations exist, particularly if datasets contain missing variables or are highly imbalanced. Proper model selection and data preprocessing can improve the reliability of AutoML tools.

Changes of the morpho-functional parameters of the retina of patients after surgical treatment of rhegmatogenous retinal detachment complicated by macular hole in the early postoperative period

Objective: to realize the effectiveness of surgical treatment of patients with retinal detachment and macular hole PVR C, depending on the method of closing the macular hole. Material and methods. The data of 20 patients (20 eyes) with a diagnosis of retinal detachment with macular hole PVR С were studied. Patients of the 1st group (10 patients, 10 eyes) underwent surgical treatment with closure of the macular hole with an inverted flap of the inner limiting membrane. Patients of the 2nd group (10 patients, 10 eyes) did not undergo closure of the macular hole during the first stage of surgical treatment. Results. In the 1st group, it was possible to achieve closure of the macular hole in 80% of cases. In the 2nd group, a day after the operation, there was a significant decrease in the diameter to 263±46 urn. When re-examined a month later, in 80% of cases, the macular hole was closed. When studying the results of micro-perimetry one day after the operation, positive dynamics was noted. While after a month of observation, the indicators of patients in the second group were significantly higher. Conclusion. The method of surgical treatment of retinal detachment with macular hole showed greater efficiency in refusing to perform membranopiling; in patients of this group, higher functional results were achieved. During the observation period, cases of a decrease in the diameter of an intact macular hole and its complete closure under the action of silicone tamponade were recorded. If necessary, membrane peeling can be delayed during a second silicone oil removal operation.

REtinal Detachment Outcomes Study (REDOS): study protocol for a factorial, randomized controlled trial

BackgroundFew large randomized controlled trials provide strong evidence to guide surgical repair of primary rhegmatogenous retinal detachment (RRD) repair. The purpose of this factorial, single-blind, randomized controlled trial is to analyze and compare the surgical outcomes, functional visual outcomes, complications, and quality of life associated with RRD repair using (A) pars plana vitrectomy only (PPV) or PPV with scleral buckle (PPV-SB) and (B) sulfur hexafluoride gas (SF6) or perfluoropropane gas (C3F8) tamponade.MethodsEligible patients with moderately complex RRD will be randomized 1:1 to PPV or PPV-SB and 1:1 to SF6 or C3F8 gas tamponade. Approximately 560 patients will be recruited to be able to detect a difference of around 10% in SSAS rate between the groups. Patients will be followed using multimodal imaging and quality of life questionnaires after the surgical repair until 1 year postoperative. The primary outcome will be a single-surgery anatomic success (SSAS), defined as the absence of reoperation for recurrent RRD in the operating room. Secondary outcomes will be pinhole visual acuity (PHVA) at 8–10 weeks and 6 months, final best-corrected visual acuity (BCVA), final retina status (i.e., attached or detached), time to onset of RRD recurrence, severity and number of complications, and questionnaire results.DiscussionThis will be the first 2 × 2 factorial RCT examining repair techniques in primary RRD. It will also be the first RCT to compare gas tamponade between the two most common agents. Notably, it will be adequately powered to detect a clinically significant effect size. The use of multimodal imaging will also be a novel aspect of this study, allowing us to compare head-to-head the impact of adding an SB to the retina’s recovery after RRD repair and of differing gas tamponades. Until now, the treatment of RRD has been largely guided by pragmatic retrospective cohort studies. There is a lack of strong evidence guiding therapeutic decisions and this trial will address (1) whether supplemental SB is justified and (2) whether longer duration gas tamponade with C3F8 is necessary.Trial registrationClinicalTrials.gov NCT05863312. Registered on 18 May 2023.

The effect of patient symptom awareness on the visual outcome in retinal detachment.

To explore whether a patient's prior knowledge of the symptoms associated with rhegmatogenous retinal detachment (RRD) relates to the visual outcome after treatment. We performed a prospective survey study on 126 patients receiving treatment for primary RRD between March and July 2021. Thirty-seven per cent (n = 47) of patients responded that they were aware of the RRD symptoms prior to the detachment. A history of RRD in the fellow eye or knowledge of family members treated for RRD was frequently reported as a reason for the patient's awareness of RRD symptoms. Patients aware of RRD symptoms presented significantly more often with an attached macula (χ2 , p = 0.002) and a better visual outcome following surgery (Mann-Whitney U, p = 0.028) compared to patients who were not aware of RRD-related symptoms. Among 76 patients with a myopic refractive error, only 15% (n = 11) indicated that they had been warned about the increased RRD risk related to myopia, suggesting that three-quarters of patients were not actively informed by their eye care professionals. RRD symptom awareness is significantly related to a higher rate of macula-on RRDs and better visual outcomes after treatment. There is limited awareness of increased RRD risk in myopic RRD patients. These findings suggest that counselling individuals at high risk of RRD about related symptoms is inadequate and better counselling may improve visual outcomes following RRD treatment.

Современные представления о склеральном пломбировании в лечении регматогенной отслойки сетчатки

Relevance. Rhegmatogenous retinal detachment (RRD) is a serious problem of modern ophthalmology, leading to an irreversible decrease in vision and, in extreme cases, to its loss. The prevalence of RRD according to various sources varies from 8.9 to 24.4 cases per 100,000 population, in most cases these are patients of working age – 84–89%. Purpose. To analyze the role of extrascleral buckling in treatment of rhegmatogenous retinal detachment. Material and methods. In the search for materials, open electronic databases Google and Google Scholar, PubMed, Embase, MEDLINE and Web of Science were used, 58 sources were analyzed up to 2023. Results. At the beginning of the 20th century, retinal detachment irreversibly led to blindness, but starting from the late 1920s, the first surgical techniques appeared that made it possible to successfully restore its anatomical position. Extrascleral buckling (ESP) became an established treatment for retinal detachment with a long-term success rate of 93%. The vast majority of rebleeds ultimately continued to occur due to missed tears, inaccurate buckling, or inadequate retinopexy. Much has changed since the development in 1971 by R. Machemer of a device for vitrectomy through the pars plana, as a result of which the surgical focus shifted towards the vitreal cavity. Conclusion. Scleral buckling still remains an effective surgical intervention in a certain group of patients with retinal detachment, including combined operations, and its undoubted advantage is the unpretentiousness of technical support. Key words: rhegmatogenous retinal detachment, extrascleral buckling, encircling, cryopexy, encircling tape length

Guidelines and treatment patterns for primary rhegmatogenous retinal detachments: Expert consensus and survey in Taiwan Retina Society.

Rhegmatogenous retinal detachment (RRD) is a significant cause of vision loss and requires appropriate surgical intervention. There are several approaches available, including observation, laser demarcation, pneumatic retinopexy, scleral buckling, and pars plana vitrectomy, which are chosen based on patient condition, surgeon experience, and national health insurance policies. Despite the various options, there is still no consensus on the optimal intervention. To address this, the Taiwan Retina Society assembled an expert committee with 11 experienced retina specialists to review the current evidence and develop a guideline with seven recommendations for managing RRD patients. Additionally, a survey was conducted with six questions to assess treatment patterns in Taiwan, which included input from the expert committee and an open poll at the 2023 Congress of the Taiwan Retina Society. This report provides a comprehensive summary of the current knowledge and expert consensus on the treatment of RRD, discussing the characteristics of current approaches and providing an overview of current treatment patterns in Taiwan. These findings aim to provide ophthalmologists with the best possible treatment for RRD.

The Role of Preoperative Case Selection in the Training of Surgical Repair of Primary Rhegmatogenous Retinal Detachment.

To analyse single-operation anatomical success (SOAS) of primary rhegmatogenous retinal detachment (RRD) repair by junior vitreoretinal surgeons guided by preoperative individual case selection by an experienced mentor vitreoretinal surgeon. Retrospective, single institute, observational study, included all patients who underwent standard pars plana vitrectomy (PPV) or combined encircling band (CB) and PPV and gas tamponade in the treatment of RRD from November 2021 to December 2022 were included. Preoperative selection for the surgery decision, whether standard PPV or combined CB & PPV was undertaken through the senior surgeon; according to the location and extensions of the RRD, number of retinal tears (RT) and lens status. We excluded patients with tractional retinal detachment, RD with proliferative vitreoretinopathy stage C, giant tears, trauma, previous scleral buckle, schisis RD and RD requiring silicone oil. The primary outcome measure was to evaluate the single-operation anatomic success (SOAS). Secondary outcome measures evaluated whether there was a statistical significant difference between both procedures. Eighty-two eyes were included in the study. Forty-five eyes were selected for combined CB&PPV and 37 eyes for standard PPV. SOAS was achieved in 40 eyes (88.8%) in combined group and 35 eyes (94.5%) in standard PPV group. There was no statistically significant difference in the success rate between both operations, p = 0.65. Structured preoperative selection of standardized surgical techniques according to the degree of complexity of RD together with close supervision enables junior vitreoretinal surgeons in training to achieve re-attachment rates of more than 80% with both types of surgeries.

Pars Plana Vitrectomy Alone or Combined with Phacoemulsification to Treat Rhegmatogenous Retinal Detachment: A Systematic Review of the Recent Literature.

Pars plana vitrectomy is today a common first-line procedure for treatment of rhegmatogenous retinal detachment (RRD). Removal or preservation of the natural lens at the time of vitrectomy is associated with both advantages and disadvantages. The combination of cataract extraction (i.e., phacoemulsification) with pars plana vitrectomy (PPVc) enhances visualization of the peripheral retina and the surgical management of the vitreous base. However, PPVc prolongs the surgical time and is associated with iatrogenic loss of the accommodation function in younger patients, possible postoperative anisometropia, and unexpected refractive results. Performance of pars plana vitrectomy alone (PPVa) requires good technical skills to minimize the risk of lens damage, and quickens cataract development. We retrieved all recent papers that directly compared PPVc and PPVa using parameters that we consider essential when choosing between the two procedures (the success rate of anatomical RRD repair, postoperative refractive error, intra- and postoperative complications, and costs). PPVa and PPVc were generally comparable in terms of RRD anatomical repair. PPVc was associated with fewer intraoperative, but more postoperative, complications. Macula-off RRD PPVc treatment was often associated with undesirable myopic refractive error. PPVa followed by phacoemulsification was the most expensive procedure.

Single-stage endovitreal surgery of retinal detachment complicated by macular hole involving the short-term perfluorocarbon tamponade

Rhegmatogenous retinal detachment complicated by macular hole is a rare disorder that is the most challenging in terms of vitreoretinal surgery, and good anatomical outcome is not always associated with high visual functions. Today, vitrectomy, involving macular hole closure with autologous platеlet-rich plasma, sealing peripheral retinal tears, and subsequent vitreal cavity tamponade with vitreous substitutes, is considered to be the most effective method for surgical treatment of this disorder. Despite variability of surgical approaches to treatment of rhegmatogenous retinal detachment complicated by macular holes, the search for safe and effective surgical technique, allowing one to achieve benificial morphological and functional outcome with minimal damage to the retinal structures and to minimize the patient's rehabilitation period, is still relevant. The clinical case reported demonstrates the possibility of performing single-stage endovitreal treatment of retinal detachment complicated by macular hole using the autologous conditioned plasma in combination with the short-term perfluorocarbon tamponade. The results of using this technique show its reliability and superior efficiency and ensure good morphological and functional outcome in the postoperative period: restored macular architectonics, macular hole closure, anatomic retinal adhesion, and improved visual functions.

Хирургическое лечение регматогенной отслойки сетчатки с применением воздушной и газовоздушной тампонады

Relevance. Retinal detachment is a serious disease, that requires immediate surgical treatment. If there is no doubt about the need for urgent surgical treatment, then the question of choosing tamponing substance after retinal immobilization remains open. Often there are no clear criteria for choosing one or another tamponing substance and this issue is determined by the preference of the surgeon. Purpose. To evaluate effectiveness and compare result of surgical treatment of rhegmatogenous retinal detachment using air and C3F8 gas tamponade. Material and methods. Surgical treatment of 43 patients diagnosed with rhegmatogenous retinal detachment was performed and the results of treatment were evaluated. All patients were divided into 2 groups. The first group included 23 patients with the best corrected visual acuity 0.01– 0.9 (±0.06). Surgical treatment of patients from this group was completed with sterile air tamponade. The second group included 20 patients with the best corrected visual acuity of 0.01–0.8 (±0.08). Surgical treatment was completed with a 2.5% C3 F 8 gas tamponade. Results. By the third month of follow-up after surgical treatment B-scan data showed no pathology in all cases of both groups. Visual acuity in group 1 was 0.55-1.0 (±0.063), in group 2 was 0.45–1.0 (±0.061). Light sensitivity in group 1 was 24.5–30.1 (±0.34) dB, in group 2 was 23.1–27.7 (±0.41) dB. Conclusion. Given the comparable clinical results, air tamponade in surgery for rhegmatogenous retinal detachment is preferable than using 2.5% C 3 F 8 gas tamponade. Key words: rhegmatogenous retinal detachment, surgical treatment, air tamponade, C3F8 gas tamponade

Сравнительный анализ хирургического лечения регматогенной отслойки сетчатки с нижней локализацией разрывов с тампонадой витреальной полости газом или силиконом

Purpose. To perform a comparative evaluation of the efficacy and functional results of surgical treatment of rhegmatogenous retinal detachment (RRD) with breaks in the lower hemisphere using gas or silicone tamponade of the vitreal cavity. Material and methods. Seventy-eight patients (78 eyes) with RRD and the location of breaks in the lower hemisphere were examined. Depending on the nature of retinal detachment patients were divided into 2 groups: without macular detachment («Macula-on») – 36 patients (36 eyes) and with retinal detachment in the macular area («Macula-off») – 42 patients (42 eyes). Each group included two subgroups «Gas» and «Silicone» depending on the type of final vitreal tamponade performed with gas (12% gas-air mixture with perfluoropropane C3F8 ) or silicone (Densiron), respectively. The type of tamponade was chosen randomly. Results. Subgroups of patients with different types of tamponade did not differ from each other in clinical and demographic characteristics. In the postoperative period, a complete retinal attachment was achieved in 75 patients (96%). At 6 months postoperatively, retinal light sensitivity (total and in central point) in the Macula-on group was significantly higher after treatment with gas tamponade compared to the final tamponade with silicone. For other parameters in the Macula-on group, the type of tamponade did not play a significant role. In the Macula-off group, neither functional parameters nor optical coherence tomography data at 6 months depended on the type of tamponade. Conclusion. The use of tamponade with an air-gas mixture and silicone in RRD patients with localization of breaks in the lower hemisphere is equally effective in achieving a high frequency of retinal attachment. Patients with RRD without macular involvement had significantly higher retinal light sensitivity (total and in central point) after treatment with gas-air tamponade compared to final tamponade with silicone. Gas-air tamponade has the advantage of not requiring a second surgical intervention and can be recommended for wide use in RRD patients with breaks in the lower hemisphere without significant proliferative vitreoretinopathy. Key words: rhegmatogenous retinal detachment, inferior hemisphere break, gas tamponade, silicone tamponade, photosensitivity

Surgical Outcomes of Vitrectomy for Primary Treatment of Rhegmatogenous Retinal Detachment in Patients with Atopic Dermatitis.

To investigate the clinical results of vitrectomy alone as the primary treatment for rhegmatogenous retinal detachment (RD) in patients with atopic dermatitis (AD). 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. 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. 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.

Air versus Gas Tamponade for Primary Rhegmatogenous Retinal Detachment: A Systematic Review and Meta-Analysis

Background: Air tamponade’s effectiveness in treatment of rhegmatogenous retinal detachment (RRD) remains unclear. Objective: We aimed to review the surgical outcomes between air and gas tamponade after vitrectomy for RRD. Method: PubMed, Cochrane Library, EMBASE, and Web of Science were reviewed. The study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD42022342284). The primary outcome was the primary anatomical success after vitrectomy. The secondary outcome was the prevalence of postoperative ocular hypertension. Certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation system. Results: Ten studies involving 2,677 eyes were included. One study was randomized, and the others were non-randomized. The primary anatomical success after vitrectomy was not significantly different between the air and gas groups (odds ratio [OR], 1.00; 95% confidence interval [CI], 0.68–1.48). The risk of ocular hypertension was significantly lower in the air group (OR: 0.14; 95% CI: 0.09–0.24). The certainty of evidence regarding air tamponade having a comparable anatomical outcome and lower frequency of postoperative ocular hypertension in treatment of RRD were low. Discussion: The current evidence base for tamponade selection in treatment of RRD has several major limitations. Further appropriately designed studies are needed to guide tamponade selection.