Foveal reattachment after macula-off retinal detachment occurs faster after vitrectomy than after buckle surgery

Détails

ID Serval
serval:BIB_B6350AC58FD4
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Foveal reattachment after macula-off retinal detachment occurs faster after vitrectomy than after buckle surgery
Périodique
Ophthalmology
Auteur(s)
Wolfensberger  T. J.
ISSN
0161-6420 (Print)
Statut éditorial
Publié
Date de publication
07/2004
Volume
111
Numéro
7
Pages
1340-3
Notes
Clinical Trial
Comparative Study
Controlled Clinical Trial
Journal Article --- Old month value: Jul
Résumé
PURPOSE: To investigate the time course of foveal reattachment after successful surgery for macula-off retinal detachments. DESIGN: Prospective comparative nonrandomized interventional trial. PARTICIPANTS: Thirty-three patients (16 female and 17 male, 65+/-3 years old) with a spontaneous rhegmatogenous retinal detachment with peripheral breaks and a shallow elevation of the fovea. INTERVENTION: Nine patients were treated with episcleral buckle, cryotherapy, and, in selected cases, external drainage of subretinal fluid. Twenty-four patients were treated with vitrectomy, cryotherapy, and either complete (n = 8), or partial (n = 16) fluid-gas exchange. Patients with complete fluid-gas exchange were kept first in a prone position for 6 hours to help evacuation of subretinal fluid and, afterwards, on their side. Patients with partial fluid-gas exchange were kept in a supine position with the head elevated for 12 hours, allowing spontaneous absorption of submacular fluid. Patients were examined at 1, 6, and 10 to 12 months after surgery with a complete ophthalmic examination as well as optical coherence tomography (OCT). Mean follow-up was 10.0+/-0.5 months. MAIN OUTCOME MEASURE: Foveal attachment was determined clinically and by OCT. RESULTS: Postoperative OCT examination 1 month after buckle surgery (n = 9) showed a small subclinical area of subfoveal fluid in 67% of patients (n = 6). Fluid was still present in 45% of cases (n = 4) at 6 months and in 11% of cases (n = 1) even at 12 months. Optical coherence tomography examination 1 month after vitrectomy showed a completely attached fovea with no subfoveal fluid in all cases (n = 24). CONCLUSIONS: Complete foveal reattachment after macula-off retinal detachment occurs without delay after vitrectomy, whereas subfoveal fluid may persist subclinically for several months in patients operated with a buckle.
Mots-clé
Adult Aged Aged, 80 and over Cryotherapy/methods Drainage/methods Female Fovea Centralis/pathology/*surgery Humans Male Middle Aged Prone Position Prospective Studies Retinal Detachment/diagnosis/*surgery Scleral Buckling/*methods Sulfur Hexafluoride/administration & dosage Supine Position Time Factors Tomography, Optical Coherence Vitrectomy/*methods
Pubmed
Web of science
Création de la notice
28/01/2008 14:05
Dernière modification de la notice
20/08/2019 16:24
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