Re-vitrectomy for recurrent retinal detachment in post-vitrectomy eyes of rhegmatogenous retinal detachment.

BACKGROUND: Recurrent retinal detachment (Re-RD) usually affects the prognosis of surgery for rhegmatogenous retinal detachment (RRD). Previous clinical studies of Re-RD were not specific. This study aimed to analyze the clinical characteristics of Re-RD in post-vitrectomy eyes with RRD and surgical outcomes after revitrectomy without combining it with retinectomy or scleral buckling. METHODS: This is a retrospective case series analyzed the ocular characteristics of 20 recurrent and contralateral eyes, evaluated the significance of the associations between variables before reoperation and the final best-corrected visual acuity (BCVA), and calculated the outcome of revitrectomy. RESULTS: Patients with phakic eyes, those undergoing only one surgery, and those with more than one break had better final BCVA. The final BCVA was negatively correlated with the axial length and positively correlated with the preoperative BCVA. Among the 12 eyes with no break detected before surgery, 11 (92%) were found to have a small crevice-like break beside the pigment scar of a large number of original laser spots. The single-operation complete retinal reattachment rate was 75%, the complete retinal reattachment rate was 80%, and the final incomplete retinal reattachment rate was 90%. The BCVA improved from 1.2 ± 0.6LogMAR (0.06 ± 0.25) before surgery to 0.8 ± 0.7LogMAR (0.15 ± 0.2) at the last follow-up. The BCVA of 16 patients with complete retinal reattachment improved from 1.0 ± 0.5LogMAR (0.1 ± 0.3) to 0.6 ± 0.4LogMAR (0.25 ± 0.4). In the contralateral eyes, 15% already had vision-damaging disease, and the incidence of eyesight-threating lesions was 5.9% during follow-up. CONCLUSIONS: Revitrectomy without retinectomy or scleral buckling can effectively treat Re-RD in post-vitrectomy eyes. In Re-RD patients with no definite retinal break detected preoperatively, the retinal hole usually shows small crevice-like changes alongside a large number of original laser pigment scars.

Outcome of scleral buckling with or without gas tamponade for recurrent retinal detachment in post-vitrectomy eyes.

BACKGROUND: Treatment of recurrent retinal detachment (re-RD) following vitrectomy (post-gas/air tamponade and post-silicone oil removal) is challenging. Previously reported treatment is commonly revision pars plana vitrectomy (PPV) combined with tamponade, which is invasive and a burden both economically and emotionally when compared with scleral buckling (SB). The purpose of this study is to report anatomical and functional outcomes of SB with or without gas tamponade in eyes with recurrent retinal detachment (re-RD) that previously underwent PPV at least once. METHODS: We retrospectively reviewed the medical records of 14 patients (14 eyes) who underwent PPV at least once and were treated with SB after re-RD. Preoperative characteristics, intraoperative complications, and postoperative data were assessed. The final anatomical and functional outcomes were analyzed. RESULTS: The original PPV was performed for primary rhegmatogenous retinal detachment in 11 eyes, macular hole retinal detachment in 2 eyes, and myopic foveoschisis in 1 eye. Previously, 3 eyes underwent one PPV with gas tamponade, and the remaining 11 (79%) eyes underwent 2-5 operations. Seven eyes underwent the procedure with gas injection. At the last follow-up, 13 eyes achieved total retinal attachment and 1 eye had re-RD. The postoperative intraocular pressure was within the normal range, except in 1 eye (6 mmHg). The finest postoperative best-corrected visual acuity (BCVA) was 20/25. There was a significant improvement in BCVA from 20/160 ± 20/63 at baseline to 20/80 ± 20/50 at the last visit in the 13 successfully treated eyes (P = 0.025). CONCLUSIONS: SB can be effective for re-RD after PPV in specific cases.

[The relationship between refractive error and influencing factors in children].

OBJECTIVE: To investigate the influence of refractive factors, including axial length, cornea power and astigmatism, and total astigmatism to refractive errors. METHODS: Axial length (AL) and cornea power (K) of 295 children (590 eyes) aged 8. 43 years old (4-14 years old) were obtained through IOL-Master, refractive error was measured by retinoscope after cycloplegia. The eyes were divided into 7 groups according to their spherical equivalence (SE). The 7 groups were high myopia, moderate myopia, low myopia, emmetropia, low hyperopia, moderate hyperopia and high hyperopia. AL and cornea parameters of different groups were compared using ANOVA and Pearson's correlation was used to analyze the relationship between SE, AL and cornea astigmatism and total astigmatism respectively. RESULTS: (1) Of the 7 groups, AL was longest in the high myopia group and shortest in the high hyperopia group. There was a statistically significant difference (P < 0.05) in AL among the 7 groups. (2) High and moderate myopes had the greatest K values and though there was no difference between the 2 groups, they had greater K values compared to other groups (P < 0.05). Moderate hyperopes had the smallest K values which were smaller than any other group except high hyperopia group. (3) SE was negatively correlated with K (r = -0.242, P < 0.001) and positively correlated with cornea astigmatism (r = 0.131, P = 0.001) but had no correlation with total astigmatism. AL was negatively correlated with cornea astigmatism (r = -0.218, P < 0.001) and had no correlation with K and total astigmatism. (4) Multiple linear regression using AL, K and age as independent variable and SE as dependent variable was applied to analyze the relationship of these variables, and the equation was. CONCLUSION: The bigger the cornea K value and the longer the AL were, the more myopia the eye was. The study showed that cornea K value of high hyperopes became steeper, indicating that the corneas of high hyperopes tried to compensate for the hyperopic refractive error due to short AL so that the eye can grow toward emmetropization; but the corneas of other groups had the same trend as the AL, which caused myopia or hyperopia together. However, generally speaking, the cornea became steeper as myopia got more severe and flatter as hyperopia more severe.