Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 9.068
Filtrar
1.
Cesk Slov Oftalmol ; 77(4): 202-206, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34507496

RESUMO

PURPOSE: Purpose of this article is to present a case report of a patient with uveal effusion syndrome who underwent deep posterior sclerotomy. CASE REPORT: A 73-year-old patient with unilateral decrease in the best corrected visual acuity, ablation of choroid and secondary retinal detachment in the right eye was admitted to our clinic for examination in November 2017. At the first examination, the best corrected visual acuity in the right eye was 0.3, in the left eye 1.0. Intraocular pressure was 16 mmHg in the right eye and 21 mmHg in the left eye. After performing ultrasound biomicroscopy of the anterior segment (Accutome, Keeler, USA), ultrasound sonography of the affected eye (Accutome, Keeler, USA), magnetic resonance imaging, computed tomography, abdominal ultrasound and blood tests, we concluded the finding as uveal effusion syndrome. We initiated a conservative treatment consisting of oral administration of carbonic anhydrase inhibitor in combination with topical use of prostaglandin analogue. Despite conservative treatment the best corrected visual acuity of the affected eye decreased to 0.05 so we proceeded to a surgical procedure - deep posterior sclerotomy with perioperative scleral sampling for histological examination (detection of glycosaminoglycans in the sclera wall by Alcian blue staining), which was negative. This histological result ranks the patient as the third type of uveal effusion syndrome (ie, non-nanophthalmic with a normal sclera). After the operation both the ablation of choroid and retinal detachment reattached and the best corrected visual acuity in the right eye improved to 0.3. After the subsequent cataract surgery, the ablation of choroid and retinal detachment occurred again, this time with spontaneous recovery. Postoperatively, the best corrected visual acuity in the right eye was 0.5 and at the last check-up at our clinic 0.6. CONCLUSION: Deep posterior sclerotomy is a method of choice of surgical treatment for uveal effusion syndrome that does not respond to conservative therapy.


Assuntos
Doenças da Coroide , Descolamento Retiniano , Síndrome da Efusão da Úvea , Idoso , Doenças da Coroide/diagnóstico , Doenças da Coroide/terapia , Exsudatos e Transudatos , Humanos , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/cirurgia , Esclera
3.
J Int Med Res ; 49(8): 3000605211032782, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34382463

RESUMO

Sympathetic ophthalmia (SO) is a panuveitis that usually occurs after trauma to one eye. We describe two cases of SO occurring after 23-gauge vitrectomy. Case 1 involved a 66-year-old woman who underwent pars plana vitrectomy (PPV) for a rhegmatogenous retinal detachment. Two months later, she presented with decreased visual acuity (VA) and bilateral uveitis. Case 2 involved a 43-year-old woman who underwent a second PPV for recurrent retinal detachment. Two months later, she presented with bilateral panuveitis. Both patients were diagnosed with SO and were treated with methylprednisolone and cyclosporine. The first patient was further treated with a dexamethasone intravitreal implant (Ozurdex®) owing to the side effects of methylprednisolone. The VA and symptoms improved significantly after treatment in both patients. Bilateral granulomatous panuveitis following PPV should alert surgeons to consider SO. Appropriate interventions for SO can produce positive outcomes.


Assuntos
Oftalmia Simpática , Descolamento Retiniano , Cirurgia Vitreorretiniana , Adulto , Idoso , Ciclosporina , Feminino , Humanos , Oftalmia Simpática/tratamento farmacológico , Oftalmia Simpática/etiologia , Descolamento Retiniano/cirurgia , Estudos Retrospectivos , Vitrectomia
4.
BMC Ophthalmol ; 21(1): 295, 2021 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-34380451

RESUMO

PURPOSE: To analyze the characteristics, related risk factors, and prognosis of suprachoroidal hemorrhage (SCH) associated with pars plana vitrectomy (PPV). METHODS: Cases of SCH associated with PPV excluding trauma were retrospectively analyzed in Beijing Tongren Hospital between January 2010 and June 2020. The data collected included general data, myopia status, axial length, state of the crystalline lens, SCH onset time, range, treatment method, visual prognosis, and methods of operation and anesthesia. Patients were divided into those with SCH related to the first PPV (Group 1), and SCH related to second intraocular surgery in the vitrectomized eye (Group 2). Patients were also classified by the SCH onset time into either the expulsive suprachoroidal hemorrhage group (ESCH) and the delayed suprachoroidal hemorrhage group (DSCH). The general data, related risk factors, and the visual prognosis of SCH in the different groups were analyzed. RESULTS: SCH associated with PPV was studied in 28 cases with an incidence of 0.06 %; 16 males and 12 females. The mean age of the patients was (53.51 ± 10.21) years old, the mean follow-up time was (24.94 ± 14.60) days, and the mean axial length was (28.21 ± 3.14) mm. Of these cases, 21 were classified as high myopia, 25 as aphakia/ pseudophakic, and 7 as focal hemorrhage. Silicone oil removal occurred in 12 cases (43 %). Patients in Group 2 were younger than Group 1 (P = 0.005). In terms of treatment and prognosis, 5 eyes were simply closely observed, 4 were given single suprachoroidal drainage, 15 were given suprachoroidal drainage combined with silicone tamponade, 2 underwent anterior chamber puncture, and 2 gave up treatment. A follow-up vision: NLP ~ 20/30; among them, 2 eyes with NLP (7.14 %), 6 of ≥ 20/200 (21.43 %). The final outcomes presented a significantly positive correlation with baseline vision but no significant correlation with age or axial length. CONCLUSIONS: SCH has a higher incidence rate after a second intraocular surgery in a vitrectomized eye which is associated with the lack of vitreous support and easier fluctuation of intraocular pressure. SCH associated with PPV is more localized and has a relatively good prognosis; high myopia and aphakic/ pseudophakic eyes are risk factors. Active treatment can effectively improve visual prognosis. TRIAL REGISTRATION: Retrospective case series study, not applicable.


Assuntos
Hemorragia da Coroide , Descolamento Retiniano , Adulto , Hemorragia da Coroide/diagnóstico , Hemorragia da Coroide/epidemiologia , Hemorragia da Coroide/etiologia , Feminino , Humanos , Pressão Intraocular , Masculino , Pessoa de Meia-Idade , Descolamento Retiniano/cirurgia , Estudos Retrospectivos , Acuidade Visual , Vitrectomia
5.
Vestn Oftalmol ; 137(4): 18-23, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34410052

RESUMO

PURPOSE: To develop a method of viscodissection involving staining of epiretinal membranes, and to evaluate its efficacy and safety in surgical treatment of proliferative diabetic retinopathy (PDR). MATERIAL AND METHODS: The study included 30 patients with type 1 diabetes mellitus and PDR with tractional retinal detachment (TRD). All patients were divided into two groups. In the first (main) group, at the initial stages of the operation, viscodissection with staining of epiretinal structures was performed, followed by segmentation and removal of membranes; in the second (control) group, segmentation and removal of membranes was performed using a vitreotome and endovitreal forceps. RESULTS: During the follow-up, all patients showed positive trends of morphological and functional indicators. While the number of intraoperative stages was the same in both groups, the total operation time in patients of the main group was significantly lower (p≤0.001) than in patients of the control group (main - 41.3±2.8 min; control - 53.8±6.2 min). With equal number of posterior hyaloid membrane to inner limiting membrane (PHM to ILM) fixation points in both groups, iatrogenic retinal rupture occurred significantly less frequently in patients of the main group (main - 0.6±0.7, control - 3.1±2.9) (p≤0.001). In this regard, among the patients of the control group, in the overwhelming majority of cases, it was necessary to use a silicone oil tamponade (60%) or gas-air mixture (33%), while in the first group the main postoperative media were sterile BSS solution (73%) and gas-air mixture (27%).


Assuntos
Diabetes Mellitus , Retinopatia Diabética , Membrana Epirretiniana , Descolamento Retiniano , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/cirurgia , Membrana Epirretiniana/diagnóstico , Membrana Epirretiniana/cirurgia , Humanos , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/etiologia , Descolamento Retiniano/cirurgia , Coloração e Rotulagem , Vitrectomia
6.
PLoS One ; 16(8): e0254751, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34411135

RESUMO

PURPOSE: To investigate the impact on services for rhegmatogenous retinal detachment (RRD) patients during the COVID-19 (2019coronal virus disease) pandemic in one tertiary center in Beijing. METHODS: A retrospective cohort study. Two reviewed consecutive RRD patients cohorts of the same length were treated during two different periods: the COVID-19 pandemic and the pre-COVID-19 group. The characteristics of patients, surgery, anesthesia methods, length of hospital stay, and the latest follow-up were recorded and analyzed. RESULTS: There were 79 patients in the COVID-19 pandemic group with a 55.9% reduction (179). Compared to patients in the pre-COVID-19, patients in the COVID-19 pandemic had a longer presurgical waiting times (28days, 3days, p<0.001), a higher percentage of patients with presurgical poor (less than 0.02) visual acuity (55.7%, 32.4%, p = 0.009), and a higher percentage of patients with presurgical choroidal detachment (34.2%, 19.6%, p = 0.01). There was no significant difference in the severity of presurgical proliferative vitreoretinopathy between the two groups (p = 0.64). Surgeries on pathological myopia patients with macular hole retinal detachment were postponed in the COVID-19 pandemic. There was a lower percentage of scleral buckling (27.8%, 41.3%, p = 0.02) and a lower rate of subretinal fluid drainage (45.4%, 75.7%, p = 0.01) in the COVID-19 pandemic. There was no significant difference in either postoperative visual acuity (p = 0.73) or the rate of single-surgery retinal attachment (p = 1) between the two groups. Patients in the COVID-19 pandemic had a shorter length of hospital stay (3hours, 35 hours, p<0.001), and a lower percentage of patients received general anesthesia (48.1%, 83.2%, p<0.001). None was infected with COVID-19 disease during the pandemic. CONCLUSION: The COVID-19 pandemic lockdown caused prolonged presurgical waiting times, shorter hospital stays, less general anesthesia, and a significant reduction of RRD surgeries. The RD were more complicated, the surgeons were more conservative on procedures and patients selection, while the surgery outcomes were comparable.


Assuntos
COVID-19 , Atenção à Saúde , Tempo de Internação , Quarentena , Descolamento Retiniano/cirurgia , SARS-CoV-2 , Adulto , COVID-19/epidemiologia , COVID-19/prevenção & controle , China , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Centros de Atenção Terciária , Vitreorretinopatia Proliferativa/cirurgia
7.
Indian J Ophthalmol ; 69(9): 2311-2316, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34427208

RESUMO

Purpose: To evaluate the outcomes of combined microincision phacoemulsification with sutureless transpupillary silicone oil (SO) removal using an irrigation probe of bimanual irrigation/aspiration. Methods: We conducted a single-center retrospective study, including patients who had undergone phacoemulsification with transpupillary removal of SO, which had been used for intraocular tamponade after a previous pars plana vitrectomy. Outcome measures were corrected distance visual acuity (CDVA), refractive error, intraocular pressure (IOP), and endothelial cell count (ECC) evaluated preoperatively and postoperatively at 3-month follow-up. Any intraoperative or postoperative complications, duration of surgery, and final retinal status at 3 months were also noted. Results: Seventy-four eyes (74 patients) were analyzed. The mean interval between SO placement and cataract surgery was 4.73 months (standard deviation [SD]: 1.02). CDVA improved in 66 (89.2%) eyes and remained the same in 8 (10.8%) eyes (P < 0.001). The mean postoperative spherical equivalent was -0.96D (SD: 0.75) at 3 months (P < 0.001). There was a significant drop in IOP from 15.08 mmHg (SD: 2.67) preoperatively to 11.64 mmHg (SD: 2.02) postoperatively (P < 0.001). The average ECC loss was only 5.7% at 3 months postoperatively. The mean surgical duration was 17.20 min (SD: 7.02). One patient had retinal redetachment and required resurgery. At 3 months, the retina was attached in all patients. Conclusion: Combined microincision phacoemulsification with transpupillary passive SO removal using irrigation probe of bimanual irrigation/aspiration is a safe, effective, and less invasive technique that offers the main advantage of reduced surgical trauma, and should be reserved for patients with a stable retina, not requiring additional surgical intervention.


Assuntos
Facoemulsificação , Descolamento Retiniano , Drenagem , Humanos , Retina , Descolamento Retiniano/cirurgia , Estudos Retrospectivos , Óleos de Silicone
8.
Indian J Ophthalmol ; 69(9): 2361-2366, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34427223

RESUMO

Purpose: The purpose of this study is to evaluate the anatomical and functional outcomes of 25-gauge (G) pars plana vitrectomy (PPV) in patients with cytomegalovirus retinitis (CMVR)-related rhegmatogenous retinal detachment (RRD). Methods: Single-center retrospective consecutive case series of patients who underwent 25-G PPV for CMVR-related RRD repair with a minimum follow-up of 3 months. Complete anatomic success was defined as the complete attachment of retina including the periphery. Best-corrected visual acuity (BCVA) of ≥20/400 was defined as functional success. Results: Sixteen eyes of 15 patients were included in the study. Eleven patients were human immunodeficiency virus positive, three patients had hematological malignancies, and one patient suffered from dyskeratosis congenita. The mean follow-up was 20.5 ± 17.4 months (range 3-60 months). Complete anatomical success was seen in 15 eyes (93.75%). One eye had a residual inferior detachment with attached macula. Silicone oil was used as tamponade in 15 eyes and C3F8 gas in one eye. The mean change in BCVA was statistically significant, preoperative LogMAR BCVA was 2.05 ± 0.94 while the final follow-up postoperative LogMAR BCVA was 1.03 ± 0.61 (P < 0.001). Thirteen eyes (81.25%) had final BCVA ≥20/400. Conclusion: Microincision vitrectomy surgery can achieve excellent retinal reattachment rates in post-CMVR RRDs without significant intraoperative and postoperative complications. The visual outcome varies depending on the status of the optic disc and macula. Majority of the patients maintained functional vision.


Assuntos
Retinite por Citomegalovirus , Macula Lutea , Descolamento Retiniano , Retinite por Citomegalovirus/complicações , Retinite por Citomegalovirus/diagnóstico , Humanos , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/cirurgia , Estudos Retrospectivos , Acuidade Visual , Vitrectomia
10.
Middle East Afr J Ophthalmol ; 28(1): 57-59, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34321823

RESUMO

The purpose of the study is to report a case of peripheral exudative hemorrhagic chorioretinopathy (PEHCR), managed surgically with favorable visual outcome. A 66-year-old female presented with painless visual loss due to dense vitreous and subretinal hemorrhage extending from the far periphery to the macula. Pars plana vitrectomy (PPV) with subretinal tissue plasminogen activator (TPA) injection was performed resulting in good anatomical and visual outcome. PEHCR can present with severe visual loss. Surgical management with PPV and subretinal TPA injection might result in favorable anatomical and visual outcome.


Assuntos
Diabetes Mellitus Tipo 2 , Descolamento Retiniano , Hemorragia Retiniana , Idoso , Feminino , Angiofluoresceinografia , Humanos , Descolamento Retiniano/etiologia , Descolamento Retiniano/cirurgia , Hemorragia Retiniana/complicações , Hemorragia Retiniana/diagnóstico , Hemorragia Retiniana/cirurgia , Estudos Retrospectivos , Ativador de Plasminogênio Tecidual/uso terapêutico , Vitrectomia
12.
Transl Vis Sci Technol ; 10(8): 22, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34313726

RESUMO

Purpose: To investigate the behavior of silicone oil (SiO) at the steady equilibrium and during saccades and calculate SiO-retina contact, shear stress (SS), and shear rate (SR). Methods: A 24 mm phakic eye mesh model underwent 50°/0.137s saccade. The vitreous chamber compartment was divided into superior and inferior 180° sectors: lens, pre-equator, postequator, and macula. SiO-retina contact was evaluated as a function of fill percentages between 80% and 90% for a standing patient, 45° upward gaze, and supine. SS and SR for 1000 mPa-s (SiO1000) and 5000 mPa-s (SiO5000) silicon oil were calculated. Results: SiO fill between 80% to 90% allowed 55% to 78% retinal contact. The superior retina always kept better contact with SiO, regardless of the fill percentage (P < 0.01). SiO interface thoroughly contacted the macula only in standing position. SS followed a bimodal behavior and was always significantly higher for SiO5000 compared to SiO1000 (P < 0.01) throughout the saccade. The macula suffered the highest mean SS in standing position, while throughout the saccade the average SS was maximum at the SiO-aqueous interface. SR was significantly higher for SiO1000 compared to SiO5000 (P < 0.001). Conclusions: SS on the retinal surface may instantaneously exceed reported retinal adhesiveness values especially at the SiO-aqueous interface and possibly favor redetachment. Despite 90% SiO fill the inferior retina remains extremely difficult to tamponade. Translational Relevance: Accurate assessment of retina-tamponade interaction may explain recurrent inferior retinal redetachment, silicone oil emulsification, and help to develop better vitreous substitutes.


Assuntos
Descolamento Retiniano , Óleos de Silicone , Humanos , Hidrodinâmica , Retina , Descolamento Retiniano/cirurgia , Vitrectomia
13.
BMJ Case Rep ; 14(7)2021 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-34315752

RESUMO

Morning glory disc (MGD) is known to develop secondary maculopathy and vision loss. We followed a 7-year-old girl with MGD in right eye from 2010 to 2021. Her best-corrected Snellen visual acuity (BCVA) was 20/20 in both eyes till 2017. She presented with reduced vision in right eye with BCVA of 20/80 in 2018. Optical Coherence Tomography (OCT) revealed maculopathy related to MGD in right eye and arcuate Vitelliform neurosensory detachment (V-NSD) temporal to fovea. She underwent 25G vitrectomy with internal limiting membrane peeling. Resolution of retinoschisis and V-NSD was analysed by OCT and fundus autofluorescence (FAF) postoperatively. Arcuate V-NSD was hyperfluorescent on FAF and concentric to optic disc. It resolved slowly with BCVA improving to 20/20 at 18 and 30 months postoperatively. We report excellent outcome following early vitrectomy for MGD-related maculopathy and recommend serial follow-up and considering early vitrectomy whenever traction and BCVA worsens. We also describe arcuate V-NSD with MGD.


Assuntos
Degeneração Macular , Disco Óptico , Descolamento Retiniano , Retinosquise , Criança , Feminino , Humanos , Descolamento Retiniano/etiologia , Descolamento Retiniano/cirurgia , Retinosquise/cirurgia , Estudos Retrospectivos , Tomografia de Coerência Óptica , Vitrectomia
14.
Indian J Ophthalmol ; 69(8): 2116-2121, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34304189

RESUMO

Purpose: Morning glory disc anomaly (MGDA) is associated with a high prevalence of retinal detachment (RD), sometimes requiring multiple surgeries. The study aimed to establish the outcomes of RD surgery in such eyes and predict factors influencing the outcome, if any. Methods: It was a retrospective observational study of 9 eyes that underwent pars plana vitrectomy (PPV) for RD associated with MGDA. Clinical and surgical details were correlated with outcomes of surgery as noted at the final follow-up. Results: PPV was performed in 9 eyes. Lensectomy was done in 5 of 9 eyes (55.5%) during PPV. Laser photocoagulation around the disc was performed in 55.5% (5/9) of the eyes. Silicone oil tamponade was used in 77.7% (7/9) of eyes and gas tamponade (14% C3F8) was used in 22.3% (2/9) of eyes. Attached retina at final visit was observed in 66% of the eyes (6/9). Two out of 3 eyes that were seen to have preoperative glial tissue at the disc had poor outcome (odds ratio 10, P = 0.16). Five out of 7 (71%) eyes that had silicone oil tamponade, had an attached retina. No identifiable breaks were noted preoperatively in 5 eyes, of which 4 (80%) had an attached retina postoperatively. Vision improved by 1 line in 67% of the eyes that underwent surgery. Conclusion: MGDA related RD presents a unique set of challenges; meticulous PPV with or without lensectomy can help in achieving a successful anatomical and functional outcome in about two-thirds of patients.


Assuntos
Descolamento Retiniano , Cirurgia Vitreorretiniana , Humanos , Retina , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/cirurgia , Estudos Retrospectivos , Óleos de Silicone , Resultado do Tratamento , Acuidade Visual , Vitrectomia
16.
BMJ Case Rep ; 14(7)2021 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-34244187

RESUMO

We report a case of a 57-year-old man, who underwent right eye silicone oil injection as a part of his surgical treatment for rhegmatogenous retinal detachment. Following this, on the first postoperative day, he developed acute postoperative intraocular inflammation. There was circumciliary congestion, diffuse corneal oedema, anterior chamber (AC) reaction, hypopyon and a pupillary membrane. The AC had not been entered during the surgery. No patients, who had been operated on the same day, or with the materials having the same batch number, developed similar reactions. We started the patient on hourly topical steroids and cycloplegics after which the patient's condition showed gradual improvement. At the 2 weeks follow-up appointment, his pupillary membrane had completely contracted and the AC was quiet. This case highlights a clinical picture of acute postoperative silicone oil-induced ocular inflammation, which was resolved through medical management.


Assuntos
Descolamento Retiniano , Óleos de Silicone , Olho , Humanos , Inflamação , Masculino , Pessoa de Meia-Idade , Descolamento Retiniano/induzido quimicamente , Descolamento Retiniano/cirurgia , Óleos de Silicone/efeitos adversos , Vitrectomia
17.
J Coll Physicians Surg Pak ; 31(8): 953-958, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34320714

RESUMO

The aim of this study was to compare as to which treatment achieves better outcomes in the management of giant retinal tears (GRTs) - pars plana vitrectomy (PPV) alone or combined with scleral buckle (SB)? The Web of Science, PubMed, and Cochrane Library databases were searched from January 1, 1950 to October 1, 2020. Pooled odds ratios (ORs), 95% confidence intervals (CIs), heterogeneity, and publication bias were determined with Review Manager software. PPV combined with SB significantly decreased the risk of recurrent retinal detachment (RRD, OR = 0.39, 95% CI = 0.20-0.77, I2 = 35%, p = 0.006) in GRT management compared with PPV alone. However, the final anatomical success (OR = 0.74, 95% CI = 0.23-2.39, I2 = 0%, p = 0.61), final visual acuity (OR = 1.11, 95% CI = 0.48-2.58, I2=13%, p = 0.81), and risk factors of GRT ≥180° (OR = 0.43, 95% CI = 0.15-1.22, I2 = 0%, p = 0.11) were not significantly different between the two approaches. According to the final anatomical success, final visual acuity, and risk factors of GRT ≥180°, there were no significant differences between PPV combined with SB and PPV alone for the management of GRT in the current study, except in decreasing the risk of RRD. Key Words: Giant retinal tear, Pars plana vitrectomy, Scleral buckling, Recurrent retinal detachment.


Assuntos
Descolamento Retiniano , Perfurações Retinianas , Humanos , Descolamento Retiniano/cirurgia , Perfurações Retinianas/cirurgia , Estudos Retrospectivos , Recurvamento da Esclera , Resultado do Tratamento , Vitrectomia
18.
Zhonghua Yan Ke Za Zhi ; 57(6): 426-432, 2021 Jun 11.
Artigo em Chinês | MEDLINE | ID: mdl-34098691

RESUMO

Objective: To identify factors associated with persistent subretinal fluid (SRF) after scleral buckling and to evaluate surgical outcomes of patients with primary rhegmatogenous retinal detachment (RRD). Methods: Cross-sectional study and cohort study. This study included 104 patients (104 eyes) who underwent scleral buckling for repair of RRD between January 2016 and June 2017. Several statistically significant risk factors associated with SRF were screened out with univariate analysis. Then independent risk factors were determined with multivariate stepwise logistic regression analysis. Examinations were taken preoperatively, at 1, 3, 6, and 12 months postoperatively, and thereafter every six months. Patients were divided into two groups depending on the presence or absence of persistent SRF on optical coherence tomography at 1 month. Results: Persistent SRF occurred in 69.2% (72/104) of patients. In multivariate analysis, younger age (OR=32.860, 95%CI=3.636-296.986, P=0.002), high myopia (OR=7.229, 95%CI=1.217-42.94, P=0.03) and macula-involving retinal detachment (OR=357.397, 95%CI=29.761-4292.0, P=0.000) were associated with persistent SRF. Best corrected visual acuity in patients with SRF at 1 month (0.71±0.18 vs. 0.58±0.11; t=4.047, P<0.01) and 3 months (0.55±0.15 vs. 0.43±0.12; t=3.914, P<0.01) was worse than that in patients with absence of SRF. Best corrected visual acuity in patients with SRF was 0.44±0.16 at 6 months, 0.37±0.12 at 12 months and 0.36±0.10 at the last follow-up, with no significant difference from patients without SRF at the three time points (0.39±0.13, 0.38±0.12 and 0.35±0.09; t=1.643, -0.202, 0.464; P>0.05). Conclusions: RRD patients with younger age, high myopia and macular involvement were more likely to develop persistent SRF after scleral buckling. The presence of persistent SRF slowed visual recovery but did not influence the final visual outcomes. (Chin J Ophthalmol, 2021, 57: 426-432).


Assuntos
Descolamento Retiniano , Líquido Sub-Retiniano , Estudos de Coortes , Estudos Transversais , Humanos , Modelos Logísticos , Descolamento Retiniano/cirurgia , Estudos Retrospectivos , Fatores de Risco , Recurvamento da Esclera , Tomografia de Coerência Óptica , Acuidade Visual
19.
Zhonghua Yan Ke Za Zhi ; 57(6): 433-439, 2021 Jun 11.
Artigo em Chinês | MEDLINE | ID: mdl-34098692

RESUMO

Objective: To observe the efficacy of macular buckling in the treatment of highly myopic traction maculopathy. Methods: Retrospective case series study. The patients with high myopia who underwent macular buckling at the Zhongshan Ophthalmic Center of Sun Yat-sen University from June 2014 to June 2019 were enrolled, including 136 males and 212 females. The age was (56.68±11.59) years old. The outcomes measured included retinal reattachment rate, foveoschisis recovery rate, macular hole closure rate, postoperative best corrected visual acuity (BCVA), axial length (AL), and complications. The measurements were recorded preoperatively and at 1 month, 6 months, 1 year, 2 years, and 3 years postoperatively. The data was statistically analyzed using paired t test. Results: A total of 378 eyes were included, including 216 eyes with foveoschisis and macular detachment and 162 eyes with macular holes and macular detachment. Among them, 296 eyes underwent macular buckling, and the other 82 eyes underwent macular buckling combined with pars plana vitrectomy. During the follow-up period, 373 eyes (98.68%) achieved retinal reattachment; in patients with foveoschisis, 204 eyes (94.44%) were recovered; in patients with macular holes, 89 eyes (54.09%) achieved closure. All the postoperative results of BCVA were better than the preoperative value (1.459±0.841). BCVA continued to increase from postoperative month 1, remained stable at 1 year, and reached 0.908±0.606 at 3 years (t=6.896, P<0.01). All the postoperative results of AL were shorter than the preoperative value. The AL shortened by (4.423±1.740)mm at one month (t=33.144, P<0.01), increased gradually thereafter, remained stable at 1 year, and shortened by (2.101±1.643) mm at three years (t=6.392, P<0.01). The common complications included transient high intraocular pressure in 98 eyes (25.92%), epiretinal hemorrhage in 67 eyes (17.72%), and vitreous hemorrhage in 9 eyes (2.38%), which all resolved spontaneously within 1 month. In the early postoperative period, all patients had a certain degree of eye movement limitation, and 39 eyes (10.31%) had diplopia which resolved within 6 months without treatment. The strabismus surgery was arranged to treat esotropia in 6 eyes (1.58%). The macular buckle was removed from 1 eye (0.26%) because of the inability to tolerate diplopia. There were 8 eyes (2.11%) requiring a second operation to adjust the position of the buckle. The macular buckle was also removed from 4 eyes (1.05%) due to the implant rejection. Conclusion: Macular buckling can effectively shorten the AL, resolve posterior scleral staphyloma, and improve vision in the treatment of highly myopic traction maculopathy. (Chin J Ophthalmol, 2021, 57: 433-439).


Assuntos
Degeneração Macular , Miopia Degenerativa , Descolamento Retiniano , Perfurações Retinianas , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Miopia Degenerativa/cirurgia , Descolamento Retiniano/cirurgia , Perfurações Retinianas/cirurgia , Estudos Retrospectivos , Recurvamento da Esclera , Tração , Acuidade Visual , Vitrectomia
20.
Zhonghua Yan Ke Za Zhi ; 57(6): 440-446, 2021 Jun 11.
Artigo em Chinês | MEDLINE | ID: mdl-34098693

RESUMO

Objective: To report the efficacy and safety of minimally invasive vitrectomy for the treatment of severe proliferative diabetic retinopathy (PDR) and the effect of preoperative retinal photocoagulation on prognosis. Methods: Case-series study and cohort study. This study included 48 severe PDR patients (53 eyes). There are 28 males and 20 females. The average age was 53.5 (range, 40.0 to 59.0) years old. Patients were divided into two groups according to whether preoperative retinal photocoagulation was performed. Under the guidance of the concept of minimally invasive vitrectomy, all patients received intravitreal injection of conbercept 3 days before standard pars plana vitrectomy with a 27G+ vitrectomy system. To relieve traction, the proliferative fibrovascular membrane was divided into islands as small as possible. It was not necessary to pursue a complete removal of the proliferative membrane. The 27G+ vitrector was flexibly applied as a multifunctional tool for membrane removal by reducing frequencies at which the device entered and left the eye. Intraocular retinal photocoagulation was performed in the main area. The primary outcome measures were best corrected visual acuity (BCVA) and retinal reattachment rate, and the secondary outcome measures were intraoperative and postoperative complications. Statistical analysis was performed using t test, rank sum test and χ² test. Results: All patients tolerated intravitreal conbercept, with no serious intraoperative or postoperative adverse events. Postoperative BCVA values were improved significantly compared with preoperative values (χ²=125.11, P<0.01). The mean logMAR BCVA improved from 1.90 (1.30, 2.30) preoperatively to 1.00 (0.70, 1.90) at 1 week postoperatively, 0.8 (0.5, 1.3) at 1 month postoperatively, 0.7 (0.40, 1.20) at 3 months postoperatively, and 0.70 (0.40, 1.20) at 6 months postoperatively. The visual function increased progressively with time. Postoperatively, the primary and final reattachment rates were 92.5% (50/53) and 96.2% (51/53), respectively. Abnormal intraocular pressure lasted for more than one week occurred in 2 eyes; Vitreous hemorrhage recurred in 5 eyes; Retinal detachment occurred in 4 eyes (7.5%); No postoperative endophthalmitis, choroidal detachment or incision related retinal hole occurred. The intraoperative and postoperative parameters in the preoperative retinal photocoagulation group were better than the preoperative non-photocoagulation group, but the difference was not significant (P>0.05). Conclusions: Minimally invasive vitrectomy is fully qualified for the management of severe PDR, with maximized benefits. (Chin J Ophthalmol, 2021, 57:440-446).


Assuntos
Diabetes Mellitus , Retinopatia Diabética , Descolamento Retiniano , Adulto , Estudos de Coortes , Retinopatia Diabética/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Descolamento Retiniano/cirurgia , Resultado do Tratamento , Acuidade Visual , Vitrectomia , Hemorragia Vítrea/cirurgia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...