Prophylactic vitrectomy in acute retinal necrosis syndrome
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Acute retinal necrosis
Acute retinal necrosis
Cytomegalovirus retinitis
Fulminant
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A consecutive series of 114 eyes (112 patients) undergoing pars plana vitrectomy for rhegmatogenous retinal detachment not complicated by severe proliferative vitreoretinopathy is presented (follow up 1 to 4 years; mean 19 months). The indications for vitrectomy fell into two main groups: (1) where the retinal view was poor and vitrectomy was required to clear media opacities to allow identification of retinal breaks (n = 62); and (2) where technically difficult breaks existed and vitrectomy with internal tamponade was used to relieve vitreoretinal traction and facilitate retinal break closure (n = 44). In some of these cases the need for scleral buckling was eliminated. A smaller third group (n = 8) existed where the position of the break(s) was uncertain in the presence of an adequate view. The success rate with one procedure was 74% and with further surgery retinal reattachment was achieved in 92%. At 6 months after further surgery, beyond which interval no new failures were encountered, best corrected visual acuity was improved in 92 eyes (81%), unchanged in 14(12%), and worse in eight (7%). We conclude that pars plana vitrectomy is an effective method for treatment of selected cases of rhegmatogenous retinal detachment not complicated by proliferative vitreoretinopathy.
Proliferative Vitreoretinopathy
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To investigate the clinical results of vitrectomy alone as the primary treatment for rhegmatogenous retinal detachment (RD) in patients with atopic dermatitis (AD).The medical records of patients with AD treated for rhegmatogenous retinal detachment (RD) were retrospectively reviewed. We investigated the characteristics of retinal breaks and detachments, applied surgical methods, and results.Twenty eyes of 14 patients with AD who presented with rhegmatogenous RD and treated by vitrectomy were included in this analysis. Sixteen eyes (80%) were treated with vitrectomy, either alone or in combination with cataract surgery, and the retina was successfully attached to 94% of the eyes. There were four cases in which vitrectomy was combined with encircling. Reoperation was needed in half of the eyes that received vitrectomy with encircling, which presented nearly total detachment, severe proliferative vitreoretinopathy, and pseudophakia.Vitrectomy alone, in combination with cataract surgery, may be sufficient to treat rhegmatogenous RD in patients with AD. Additional encircling or buckling should still be considered in complicated cases.
Proliferative Vitreoretinopathy
Pseudophakia
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To determine the role of vitrectomy be used in retinal detachment uncomplicated by proliferative vitreoretinopathy (PVR).We studied 54 cases who had undergone vitrectomy for retinal detachment uncomplicated by severe proliferative vitreoretinopathy. The indications for vitrectomy fell into three main groups: 1) retineal detachment of PVR-B (n = 15), 2) Retinal breaks at the posterior of PVR-C1 or C2 (n = 11), 3) retinal view was poor (n = 28).The success rate with one procedure was 74% and with further surgery retinal reattachment was achieved in 96%. After surgery, the visual acuity was improved in 43 eyes (79.6%) unchanged in 9 eyes (16.7%), and worse in 2 eyes (3.7%).Vitrectomy is an effective method for treatment of selected cases of retinal detachment uncomplicated by proliferative vitreoretinopathy.
Proliferative Vitreoretinopathy
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Several conditions, such as detachment from posterior breaks or detachment with significant media opacities, may warrant vitrectomy as the primary procedure. In cases in which the preoperative retinal view is clear and a posterior break is definitively excluded, vitrectomy does not appear to offer significant advantage over scleral buckling other than a theoretically improved ability to examine the retina microscopically with scleral depression. Performing a vitrectomy for an uncomplicated retinal detachment from a small peripheral break in which scleral buckling would be the usual procedure of choice remains controversial. Although it may avoid the complications of scleral buckling, vitrectomy does have its own potential complications. The status of the lens, cornea, and configuration of the retinal tears and detachment should carefully be considered before vitrectomy. Proper patient selection and appropriate education are important factors in a successful outcome. Finally, from an economic viewpoint, the likelihood of success with vitrectomy in one procedure compared with other less expensive procedures should be considered.
Retinal Tear
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INTRODUCTION: This study aimed to comprehensively describe the primary clinical manifestations of herpetic retinitis.EVIDENCE ACQUISITION: A narrative review approach was employed to synthesize and analyze existing literature on herpetic retinitis and its clinical presentations. Electronic databases such as PubMed, Scopus, and Web of Science were searched using specific key words and phrases related to herpetic retinitis, herpes simplex, varicella-zoster, cytomegalovirus, acute retinal necrosis, and progressive outer retinal necrosis. Data on clinical manifestations were categorized and summarized.EVIDENCE SYNTHESIS: Herpetic retinitis exhibits diverse clinical presentations. Herpes simplex and varicella-zoster infections are associated with acute retinal necrosis, progressive outer retinal necrosis, and non-necrotizing herpetic retinopathies. Cytomegalovirus infection is linked to fulminant retinitis characterized by confluent areas of retinal necrosis and retinal hemorrhages, indolent/granular retinitis, and frosted branch angiitis. These clinical manifestations often correlate with specific risk factors and the host's immunological profiles.CONCLUSIONS: Herpetic viruses lead to panuveitis with a wide array of clinical manifestations. Differential diagnosis and therapeutic management can be facilitated by carefully considering the distinct ocular manifestations and the immunological status of the host. This knowledge enhances our understanding of herpetic retinitis, aiding clinicians in providing effective and tailored treatment strategies.
Acute retinal necrosis
Fulminant
Varicella zoster virus
Cytomegalovirus retinitis
Cytomegalovirus
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Retinal Tear
Proliferative Vitreoretinopathy
Silicone oil
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The surgical management of rhegmatogenous retinal detachment has evolved dramatically during the past 2 decades. Investigators have introduced and refined alternative techniques to scleral buckling surgery including pneumatic retinopexy and primary pars plana vitrectomy (PPV). Rapid parallel developments in instrumentation, including wide-angle viewing systems, perfluorocarbon liquids, novel vitrectomy machines, intraocular tamponades, and endolaser photocoagulators have led to increasing sophistication in primary PPV surgical techniques for the treatment of rhegmatogenous uncomplicated retinal detachment. However, the precise role of primary PPV in new uncomplicated retinal detachment remains debatable owing to the lack of controlled randomized trials. This article examines primary vitrectomy treatment for rhegmatogenous uncomplicated retinal detachment and presents the specific types of retinal detachments for which primary PPV may be optimal, according to personal and reported results, the surgical instrumentation and technique, as well as the complications and limitations of this surgical method
Proliferative Vitreoretinopathy
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Objective
To diagnose retinal detachment with International Classification of Diseases-10 (ICD-10) and to analyze the surgical modalities of vitrectomy for the disease.
Methods
The clinical data of 1 648 hospitalized patients with retinal detachment undergoing vitrectomy in our hospital in 2013 were retrospectively analyzed.
Results
The ICD etiological classification showed that primary retinal detachment accounted for 50.18% (827/1 648), tractional retinal detachment accounted for 32.52% (536/1 648), exudative retinal detachment accounted for 0.61%(10/1 648)and other types accounted for 16.69% (275/1 648). The top 5 common etiological diagnoses were simple rhegmatogenous retinal detachment (25.73%, 424/1 648), diabetic tractional retinal detachment (12.62%, 208/1 648), traumatic retinal detachment (12.08%, 199/1 648), other primary retinal detachment (11.23%, 185/1 648) and retinal detachment after intraocular surgery (10.62%, 175/1 648). The top 4 modalities of vitrectomy were combined silicone oil implanting surgery (54.73%, 902/1 648), basic vitrectomy (21.97%, 362/1 648), combined silicone oil and lenticular surgery (14.38%, 237/1 648) and combined lenticular surgery (5.58%, 92/1 648).
Conclusions
Modern vitrectomy is used mainly for the treatment of primary retinal detachment and the treatment of retinal detachment related to diabetes, ocular trauma and intraocular surgeries.The complexity of various retinal detachment diseases requires different surgical modalities of vitrectomy for treatment.
Key words:
Vitrectomy; Retinal detachment; International Classification of Diseases
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Objective To evaluate application of fluid-gas exchange in retinal detachment after vitrectomy. Methods 8 cases ocular injury,retinal detachment after vitrectomy.all of 8 cases retinal detachment is happen of a short time,no PVR.reattachment of retinal after fluid-gas exchange,and operated by scleral burcle. Results All of 8 cases reattachment of retinal. Conclusions Application of fluid-gas exchange in retinal detachment after vitrectomy,is very effective and safe.
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