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1.
Retina ; 40(11): 2070-2076, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31876884

RESUMO

PURPOSE: To determine factors associated with 360-degree laser retinopexy (360LR) during primary pars plana vitrectomy ± scleral buckle for rhegmatogenous retinal detachment (RRD) and its impact on surgical outcomes. METHODS: This is a multicenter, retrospective, interventional study. Patients undergoing primary pars plana vitrectomy or primary pars plana vitrectomy + scleral buckle for noncomplex primary RRD in 2015 were evaluated. Primary outcomes were single surgery anatomical success (SSAS) and final anatomical success. Secondary outcomes included final logarithm of the minimum angle of resolution visual acuity, epiretinal membrane formation, cystoid macular edema development, and number of subsequent vitrectomies. Multivariate regressions were performed. RESULTS: Two thousand two hundred and forty-eight surgeries by 61 surgeons were included; of which, 516 underwent 360LR. Younger age (P = 0.01), more retinal breaks (P = 0.01), more extensive RRD (P < 0.001), and surgeon ID (P < 0.001) were significantly associated with 360LR. No significant associations between 360LR and single surgery anatomical success (P = 0.44), epiretinal membrane formation (P = 0.14), cystoid macular edema development (P = 0.28), or number of subsequent vitrectomies (P = 0.41) were found. Controlling for case complexity, 360LR was significantly associated with lower final anatomical success (P < 0.001) and worse final logarithm of the minimum angle of resolution visual acuity (P < 0.001). CONCLUSION: Multiple factors influenced whether 360LR was performed during primary pars plana vitrectomy ± scleral buckle for RRD. However, 360LR was not associated with improved surgical outcomes, and in fact, it may be associated with poorer outcomes.


Assuntos
Terapia a Laser/métodos , Descolamento Retiniano/cirurgia , Recurvamento da Esclera , Vitrectomia , Idoso , Drenagem , Tamponamento Interno , Membrana Epirretiniana/fisiopatologia , Feminino , Humanos , Edema Macular/fisiopatologia , Masculino , Pessoa de Meia-Idade , Descolamento Retiniano/fisiopatologia , Estudos Retrospectivos , Óleos de Silicone , Resultado do Tratamento , Acuidade Visual/fisiologia
2.
Ann Med Surg (Lond) ; 62: 460-462, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33552506

RESUMO

•All three vaccines have substantial efficacy in preventing symptomatic and severe Sars-CoV-2 infection.•Vaccine dissemination is important due to the rapid mutagenic nature of the virus and continuing decline in the health and economies around the world.•Further attempts to achieve widespread access of the vaccine is vital for all preventative measures to be maximally successful.

3.
Br J Ophthalmol ; 105(3): 410-413, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-32409294

RESUMO

BACKGROUND/AIMS: Vitrectomy to repair retinal detachment is often performed with either non-contact wide-angle viewing systems or wide-angle contact viewing systems. The purpose of this study is to assess whether the viewing system used is associated with any differences in surgical outcomes of vitrectomy for primary non-complex retinal detachment repair. METHODS: This is a multicenter, interventional, retrospective, comparative study. Eyes that underwent non-complex primary retinal detachment repair by either pars plana vitrectomy (PPV) alone or in combination with scleral buckle/PPV in 2015 were evaluated. The viewing system at the time of the retinal detachment repair was identified and preoperative patient characteristics, intraoperative findings and postoperative outcomes were recorded. RESULTS: A total of 2256 eyes were included in our analysis. Of those, 1893 surgeries used a non-contact viewing system, while 363 used a contact lens system. There was no statistically significant difference in single surgery anatomic success at 3 months (p=0.72), or final anatomic success (p=0.40). Average postoperative visual acuity for the contact-based cases was logMAR 0.345 (20/44 Snellen equivalent) compared with 0.475 (20/60 Snellen equivalent) for non-contact (p=0.001). After controlling for numerous confounding variables in multivariable analysis, viewing system choice was no longer statistically significant (p=0.097). CONCLUSION: There was no statistically significant difference in anatomic success achieved for primary retinal detachment repair when comparing non-contact viewing systems to contact lens systems. Postoperative visual acuity was better in the contact-based group but this was not statistically significant when confounding factors were controlled for.


Assuntos
Lentes de Contato , Descolamento Retiniano/cirurgia , Recurvamento da Esclera/instrumentação , Cirurgia Assistida por Computador/instrumentação , Acuidade Visual , Vitrectomia/instrumentação , Desenho de Equipamento , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Descolamento Retiniano/diagnóstico , Estudos Retrospectivos
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