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28.08.2020 | Original Paper

Two-staged surgery as an alternative to buckle–vitrectomy for rhegmatogenous retinal detachment complicated by choroidal detachment

verfasst von: Naresh Babu, Piyush Kohli, Karthik Kumar, Renu P. Rajan, Girish Baliga, Sagnik Sen, N. O. Ramachandran, S. Bhavani, Kim Ramasamy

Erschienen in: International Ophthalmology | Ausgabe 1/2021

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Abstract

Aim

To evaluate the outcome and safety profile of short-term perfluorocarbon liquids (PFCL) tamponade in comparison with buckle–vitrectomy in case of rhegmatogenous retinal detachment (RRD) associated with choroidal detachment (CD).

Methods

Records of patients who underwent surgery for RRD/CD from January 2016 to July 2019 were reviewed retrospectively. The patients were allocated into two groups—group 1 patients underwent buckle–vitrectomy, while those in group 2 underwent a two-staged vitrectomy with short-term (5 days) PFCL tamponade.

Results

The study included 33 eyes (33 patients) with mean age of 50.3 ± 17.2 years. Group 1 included 15 patients, while group 2 included 18. The pre-operative characteristics were similar in both the groups. The mean pre-operative intraocular pressure in group 1 and 2 was 9.1 ± 4.0 and 8.6 ± 5.2 mmHg, respectively (p = 0.755). Retinal re-attachment after single surgery was achieved in 10 (66.7%) and 14 eyes (77.8%), respectively. All the eyes achieved retinal re-attachment after repeat surgery in both the groups (1.40 vs 1.39 surgeries, p = 0.963). Post-surgery visual improvement was seen in 13 (86.7%) and 17 eyes (94.4%), respectively (p = 0.579). Final visual acuity of ≥ 6/60 was obtained in 7 (46.7%) and 9 eyes (50.0%), respectively (p > 0.999). None of the patients needed retinectomy during repeat surgery. None of the patients experienced exaggerated inflammation or intractable raised IOP spike which could not be controlled with medications.

Conclusion

Surgical outcomes were similar in both the groups. No clinically apparent toxicity was seen with post-operative short-term PFCL tamponade. Two-staged surgery is a good alternative to buckle–vitrectomy for eyes with RRD associated with CD.

Adelman RA, Parnes AJ, Sipperley JO, Ducournau D, European Vitreo-Retinal Society (EVRS) Retinal Detachment Study Group (2013) Strategy for the management of complex retinal detachments: the European vitreo-retinal society retinal detachment study report 2. Ophthalmology 120(9):1809–1813. https://doi.org/10.1016/j.ophtha.2013.01.056CrossRefPubMed

Adelman RA, Parnes AJ, Michalewska Z, Ducournau D, European Vitreo-Retinal Society (EVRS) Retinal Detachment Study Group (2014) Clinical variables associated with failure of retinal detachment repair: the European vitreo-retinal society retinal detachment study report number 4. Ophthalmology 121(9):1715–1719. https://doi.org/10.1016/j.ophtha.2014.03.012CrossRefPubMed

Loo A, Fitt AW, Ramchandani M, Kirkby GR (2001) Pars plana vitrectomy with silicone oil in the management of combined rhegmatogenous retinal and choroidal detachment. Eye (Lond) 15(Pt 5):612–615. https://doi.org/10.1038/eye.2001.195CrossRef

Denwattana A, Prakhunhungsit S, Thoongsuwan S, Rodanant N, Phasukkijwatana N (2018) Surgical outcomes of preoperative steroid for rhegmatogenous retinal detachment with associated choroidal detachment. Eye (Lond) 32(3):602–607. https://doi.org/10.1038/eye.2017.262CrossRef

Ghoraba HH (2001) Primary vitrectomy for the management of rhegmatogenous retinal detachment associated with choroidal detachment. Graefes Arch Clin Exp Ophthalmol 239(10):733–736. https://doi.org/10.1007/s004170100345CrossRefPubMed

Xu H, Lutrin D, Wu Z (2017) Outcomes of 23-gauge pars plana vitrectomy combined with phacoemulsification and capsulotomy without intraocular lens implantation in rhegmatogenous retinal detachment associated with choroidal detachment. Medicine (Baltimore) 96(34):e7869. https://doi.org/10.1097/MD.0000000000007869CrossRef

Sharma T, Gopal L, Badrinath SS (1998) Primary vitrectomy for rhegmatogenous retinal detachment associated with choroidal detachment. Ophthalmology 105(12):2282–2285. https://doi.org/10.1016/S0161-6420(98)91230-1CrossRefPubMed

Sharma T, Gopal L, Reddy RK, Kasinathan N, Shah NA, Sulochana KN, Miriam KC, Arvind K, Ramakrishnan S, Sukumar B (2005) Primary vitrectomy for combined rhegmatogenous retinal detachment and choroidal detachment with or without oral corticosteroids: a pilot study. Retina 25(2):152–157. https://doi.org/10.1097/00006982-200502000-00006CrossRefPubMed

Wei Y, Wang N, Chen F, Wang H, Bi C, Zu Z, Yang X (2014) Vitrectomy combined with periocular/intravitreal injection of steroids for rhegmatogenous retinal detachment associated with choroidal detachment. Retina 34(1):136–141. https://doi.org/10.1097/IAE.0b013e3182923463CrossRefPubMed

10.

Gottlieb F (1972) Combined choroidal and retinal detachment. Arch Ophthalmol 88(5):481–486. https://doi.org/10.1001/archopht.1972.01000030483003CrossRefPubMed

11.

Seelenfreund MH, Kraushar MF, Schepens CL, Freilich DB (1974) Choroidal detachment associated with primary retinal detachment. Arch Ophthalmol 91(4):254–258. https://doi.org/10.1001/archopht.1974.03900060264003CrossRefPubMed

12.

Drury B, Bourke RD (2011) Short-term intraocular tamponade with perfluorocarbon heavy liquid. Br J Ophthalmol 95(5):694–698. https://doi.org/10.1136/bjo.2009.175216CrossRefPubMed

13.

Zenoni S, Romano MR, Palmieri S, Comi N, Fiorentini E, Fontana P (2011) Ocular tolerance and efficacy of short-term tamponade with double filling of polydimethyloxane and perfluoro-n-octane. Clin Ophthalmol 5:443–449. https://doi.org/10.2147/OPTH.S17315CrossRefPubMedPubMedCentral

14.

Barthelmes D, Chandra J (2015) Perfluoro-n-octane as a temporary intraocular tamponade in a staged approach to manage complex retinal detachments. Clin Ophthalmol 9:413–418. https://doi.org/10.2147/OPTH.S76947CrossRefPubMedPubMedCentral

15.

Sigler EJ, Randolph JC, Calzada JI, Charles S (2013) 25-gauge pars plana vitrectomy with medium-term postoperative perfluoro-n-octane tamponade for inferior retinal detachment. Ophthalmic Surg Lasers Imaging Retina 44(1):34–40. https://doi.org/10.3928/23258160-20121221-10CrossRefPubMed

16.

Sigler EJ, Randolph JC, Calzada JI, Charles S (2013) Pars plana vitrectomy with medium-term postoperative perfluoro-N-octane for recurrent inferior retinal detachment complicated by advanced proliferative vitreoretinopathy. Retina 33(4):791–797. https://doi.org/10.1097/IAE.0b013e31826a6978CrossRefPubMed

17.

Sirimaharaj M, Balachandran C, Chan WC, Hunyor AP, Chang AA, Gregory-Roberts J, Hunyor AB, Playfair TJ (2005) Vitrectomy with short term postoperative tamponade using perfluorocarbon liquid for giant retinal tears. Br J Ophthalmol 89(9):1176–1179. https://doi.org/10.1136/bjo.2004.065409CrossRefPubMedPubMedCentral

18.

Mikhail MA, Mangioris G, Best RM, McGimpsey S, Chan WC (2017) Management of giant retinal tears with vitrectomy and perfluorocarbon liquid postoperatively as a short-term tamponade. Eye (Lond) 31(9):1290–1295. https://doi.org/10.1038/eye.2017.157CrossRef

19.

Sheridan AM, Essex RW, Yeoh J, Allen P, Campbell WG, Edwards TL (2019) Is post-operative perfluorocarbon liquid tamponade for macula-on giant retinal tear safer than silicone oil? Eye (Lond) 33(4):689–691. https://doi.org/10.1038/s41433-018-0287-9CrossRef

20.

Randolph JC, Diaz RI, Sigler EJ, Calzada JI, Charles S (2016) 25-gauge pars plana vitrectomy with medium-term postoperative perfluoro-n-octane for the repair of giant retinal tears. Graefes Arch Clin Exp Ophthalmol 254(2):253–257. https://doi.org/10.1007/s00417-015-3049-4CrossRefPubMed

21.

Rush R, Simunovic MP, Sheth S, Chang A, Hunyor AP (2014) 23-gauge pars plana vitrectomy versus scleral buckling versus combined pars plana vitrectomy-scleral buckling for medium-complexity retinal detachment repair. Asia Pac J Ophthalmol (Phila) 3(4):215–219. https://doi.org/10.1097/APO.0000000000000013CrossRef

22.

Storey P, Alshareef R, Khuthaila M, London N, Leiby B, DeCroos C, Kaiser R, Wills PVR Study Group (2014) Pars plana vitrectomy and scleral buckle versus pars plana vitrectomy alone for patients with rhegmatogenous retinal detachment at high risk for proliferative vitreoretinopathy. Retina 34(10):1945–1951. https://doi.org/10.1097/IAE.0000000000000216CrossRefPubMed

23.

Lai FH, Lo EC, Chan VC, Brelen M, Lo WL, Young AL (2016) Combined pars plana vitrectomy-scleral buckle versus pars plana vitrectomy for proliferative vitreoretinopathy. Int Ophthalmol 36(2):217–224. https://doi.org/10.1007/s10792-015-0104-4CrossRefPubMed

24.

Haidt S, Clark L, Ginsberg J (1982) Liquid perfluorocarbon replacement of the eye. Invest Ophthalmol Vis Sci 22:233

25.

Chang S, Sparrow JR, Iwamoto T, Gershbein A, Ross R, Ortiz R (1991) Experimental studies of tolerance to intravitreal perfluoro-n-octane liquid. Retina 11(4):367–374CrossRef

26.

Chang S, Lincoff H, Zimmerman NJ, Fuchs W (1989) Giant retinal tears: surgical techniques and results using perfluorocarbon liquids. Arch Ophthalmol 107(5):761–766. https://doi.org/10.1001/archopht.1989.01070010779046CrossRefPubMed

27.

Chang S, Ozmert E, Zimmerman NJ (1988) Intraoperative perfluorocarbon liquids in the management of proliferative vitreoretinopathy. Am J Ophthalmol 106(6):668–674. https://doi.org/10.1016/0002-9394(88)90698-8CrossRefPubMed

28.

Bottoni F, Arpa P, Vinciguerra P, Zenoni S, De Molfetta V (1992) Combined silicone and fluorosilicone oil tamponade (double filling) in the management of complicated retinal detachment. Ophthalmologica 204(2):77–81. https://doi.org/10.1159/000310273CrossRefPubMed

29.

De Molfetta V, Bottoni F, Arpa P, Vinciguerra P, Zenoni S (1992) The effect of simultaneous internal tamponade on fluid compartmentalization and its relationship to cell proliferation. Retina 12(3 Suppl):S40–S45. https://doi.org/10.1097/00006982-199212031-00009CrossRefPubMed

30.

Geiger M, Smith JM, Lynch A, Patnaik JL, Oliver SCN, Dixon JA, Mandava N, Palestine AG, University of Colorado Retina Research Group (2020) Predictors for recovery of macular function after surgery for primary macula-off rhegmatogenous retinal detachment. Int Ophthalmol 40(3):609–616. https://doi.org/10.1007/s10792-019-01219-0CrossRefPubMed

31.

Imaizumi A, Kusaka S, Noguchi H, Shimomura Y, Sawaguchi S (2014) Efficacy of short-term postoperative perfluoro-n-octane tamponade for pediatric complex retinal detachment. Am J Ophthalmol 157(2):384–389.e2. https://doi.org/10.1016/j.ajo.2013.10.002CrossRefPubMed

32.

Osterholz J, Winter M, Winkler J, Pfister G, Kovacs G, Dresp J, Menz DH, Hoerauf H (2009) Retinal damage by perfluorocarbon liquids—a question of specific gravity? Intraocular pressure peaks and shearing forces. Klin Monbl Augenheilkd 226(1):38–47. https://doi.org/10.1055/s-2008-1027764CrossRefPubMed

33.

Rush R, Sheth S, Surka S, Ho I, Gregory-Roberts J (2012) Postoperative perfluoro-N-octane tamponade for primary retinal detachment repair. Retina 32(6):1114–1120. https://doi.org/10.1097/IAE.0b013e31822f56f6CrossRefPubMed

Titel: Two-staged surgery as an alternative to buckle–vitrectomy for rhegmatogenous retinal detachment complicated by choroidal detachment
verfasst von: Naresh Babu
Piyush Kohli
Karthik Kumar
Renu P. Rajan
Girish Baliga
Sagnik Sen
N. O. Ramachandran
S. Bhavani
Kim Ramasamy
Publikationsdatum: 28.08.2020
Verlag: Springer Netherlands
Erschienen in: International Ophthalmology / Ausgabe 1/2021
Print ISSN: 0165-5701
Elektronische ISSN: 1573-2630
DOI: https://doi.org/10.1007/s10792-020-01560-9

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Two-staged surgery as an alternative to buckle–vitrectomy for rhegmatogenous retinal detachment complicated by choroidal detachment

Abstract

Aim

Methods

Results

Conclusion

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