Complex retinal detachments

  • 文章类型: Case Reports
    本研究旨在描述一系列患者的病例,其中在视网膜完全脱离并发增生性玻璃体视网膜病变的情况下,使用粘性眼用粘性装置(OVD)进行粘性解剖并向后移位视网膜。采用微创玻璃体切除术。
    本研究包括3名平均年龄为67岁的患者。一只眼睛是无晶状体的,而其他人是假的。OVD注射是通过无晶状体眼的角膜缘和假晶状体眼的平坦部进行的。在所有情况下,OVD注射导致脱离的视网膜向后移位,并进行了平滑的解剖。未观察到与手术相关的并发症。在最后一次后续访问中,视网膜在所有情况下都是附着的,随着视力的提高。
    总而言之,在脱离的视网膜前注射粘性OVD,可以在一定程度上对视网膜进行后变性和粘性解剖,促进套管针的植入。
    UNASSIGNED: The present study aimed to describe a case series of patients in which a cohesive ophthalmic viscous device (OVD) was used to viscodissect and posteriorly displace the retina in cases of total retinal detachment complicated by proliferative vitreoretinopathy, operated with minimally invasive pars plana vitrectomy.
    UNASSIGNED: Three patients with a mean age of 67 years were included in the present study. One eye was aphakic, while the others were pseudophakic. OVD injection was performed through the limbus in the aphakic eye and via pars plana in the pseudophakic eyes. In all cases, the OVD injection led to a posterior displacement of the detached retina with a smooth dissection. No complications related to the surgery were observed. At the last follow-up visit, the retina was attached in all cases, with an improvement in visual acuity.
    UNASSIGNED: To conclude, the injection of a cohesive OVD anterior to the detached retina allowed to posteriorize and viscodissect to some extent the retina, facilitating the implant of trocars.
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  • 文章类型: Journal Article
    OBJECTIVE: To evaluate outcomes in patients with complex retinal detachments (RD) with proliferative vitreoretinopathy (PVR) requiring retinectomy using a staged approach utilizing perfluoro-n-octane (PFO) as a short-term postoperative intraocular tamponade.
    METHODS: Retrospective analysis. Patients who underwent 23G pars plana vitrectomy for the management of complicated RD where PFO was used as a primary temporary intraocular tamponade. Only eyes with PVR in rhegmatogenous RD or eyes with penetrating injuries or globe ruptures (ocular trauma) and subsequent RD with PVR were included. Analysis of 17 eyes of 17 consecutive patients with a minimum follow-up of 12 months during a period of 5 years. The primary outcome measure was the reattachment rate after at least 12 months of follow-up after the PFO removal. Secondary outcome measures were changes in visual acuity, complications due to PFO use, and necessity for further surgeries.
    RESULTS: Eight eyes with prior penetrating injuries or globe rupture and nine eyes with rhegmatogenous pathology were included. All eyes had PFO as temporary tamponade for 14 days (median), which was replaced by silicon oil. Sixteen eyes (94%) had complete and one eye partial reattachment. No redetachments occurred. All eyes retained or improved visual acuity. On average, only 2.5 procedures, including silicon oil removal, were performed. Two eyes had long-term intraocular pressure of 5 mmHg and no eye had intraocular pressure of ≥21 mmHg. No long-term inflammation was observed.
    CONCLUSIONS: PFO seems to be beneficial in a staged approach to repair complex detachments when used as short-term tamponade. A median period of 14 days allowed for both sufficient retinal support plus a reduction in side effects seen in long-term endotamponades.
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