Management of giant retinal tears with vitrectomy, internal tamponade, and peripheral 360 degrees retinal photocoagulation

Details

Serval ID
serval:BIB_FCB746ED450D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Management of giant retinal tears with vitrectomy, internal tamponade, and peripheral 360 degrees retinal photocoagulation
Journal
Retina
Author(s)
Ambresin A., Wolfensberger T. J., Bovey E. H.
ISSN
0275-004X (Print)
Publication state
Published
Issued date
10/2003
Peer-reviewed
Oui
Volume
23
Number
5
Pages
622-8
Notes
Journal Article --- Old month value: Oct
Abstract
PURPOSE: To determine the effectiveness of vitrectomy, internal tamponade, and peripheral 360 degrees retinal photocoagulation in the management of giant retinal tears (GRTs). PARTICIPANTS: Eighteen eyes of 18 consecutive patients with GRTs were operated on at Jules Gonin Eye Hospital between 1992 and 1999. None of them had previous vitreoretinal surgery. METHODS: Eyes in the series underwent pars plana vitrectomy, perfluorocarbon liquid and silicone oil (17 eyes) or gas (one eye) exchange, and retinopexy. Retinopexy was applied to the edges of the tear using photocoagulation, and it was extended over 360 degrees to the peripheral attached retina. No scleral buckle was placed, even if proliferative vitreoretinopathy (PVR) was present. RESULTS: The GRT was 180 degrees or greater in seven eyes and 90 degrees to 180 degrees in 11 eyes. The lower edge of the GRT was located in an inferior quadrant in 15 eyes. PVR was grade A in seven eyes, grade B in eight eyes, and grade C in three eyes. In the last three eyes, PVR was anterior (C-A9, Patient 4) and posterior (C-P6 subretinal, Patient 11; C-P3, Patient 13). In 16 (88.8%) of the 18 eyes, the retina was successfully reattached after surgery, and silicone oil was removed after a mean period of 7.7 weeks. In the other two eyes, the retina remained detached or redetached despite the silicon oil tamponade. One of these two eyes underwent three further surgeries, but the retina did not reattach. The other eye was successfully reoperated on with an encircling and radial scleral buckle, and silicone oil was removed later. At the end of the follow-up, the retina was attached in 17 (94.4%) of the 18 eyes. The mean follow-up was 28.6 months (range, 4.5-73 months). CONCLUSIONS: The success rate of management of GRTs with vitrectomy, internal tamponade, and peripheral 360 degrees photocoagulation of the retina without scleral buckle is high. Photocoagulation of the peripheral retina over 360 degrees appears to decrease the risk of secondary peripheral retinal tears.
Keywords
Adult Aged Child Female Fluorocarbons/administration & dosage Follow-Up Studies Humans Laser Coagulation/*methods Male Middle Aged Postoperative Complications Retinal Perforations/*surgery Silicone Oils/administration & dosage Visual Acuity Vitrectomy/*methods
Pubmed
Web of science
Create date
28/01/2008 13:05
Last modification date
20/08/2019 16:27
Usage data