Key Factors to Improve the Outcome of Retinal Reattachment Surgery in Proliferative Vitreoretinopathy and Proliferative Diabetic Retinopathy
Introduction. For management of complicated retinal detachments, a pars plana vitrectomy with temporary silicone oil (SO) fill is the method of choice. According to literature, the retinal redetachment rate varies between <10% and >70% with around 36% in our own group (retrospective data analy...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Journal of Ophthalmology |
| Online Access: | http://dx.doi.org/10.1155/2017/2323897 |
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| author | Svenja Deuchler Hanns Ackermann Pankaj Singh Thomas Kohnen Clemens Wagner Frank Koch |
| author_facet | Svenja Deuchler Hanns Ackermann Pankaj Singh Thomas Kohnen Clemens Wagner Frank Koch |
| author_sort | Svenja Deuchler |
| collection | DOAJ |
| description | Introduction. For management of complicated retinal detachments, a pars plana vitrectomy with temporary silicone oil (SO) fill is the method of choice. According to literature, the retinal redetachment rate varies between <10% and >70% with around 36% in our own group (retrospective data analysis, n=119 eyes). Methods. The main goal was to reduce the retinal redetachment rate. Standard operating procedures (SOPs) and evaluation protocols (EVALPs) were developed to prospectively analyse risk factors. Lab analysis of SO was performed, and the role of surgical experience was evaluated and investigated with Eyesi®. Results. We achieved a significant reduction of the retinal redetachment rate (to 6.80%, n=101, p=0.002). After surgery with SO injection, neither further membrane peeling (in 16.5%) nor retinal laser coagulation (in 100%) during revision surgery had a significant effect on the reattachment rate (p=0.167, p=0.23), while extensive additional laser coagulation reduced visual acuity (p=0.01). A 3-port approach had to be set up to complete SO removal. A difference in success rate depending on surgical experience was confirmed, and the performance in Eyesi correlated with that in the patients’ eye. Conclusions. A SOP- and EVALP-based management and new strategies to secure the surgical performance seem to be essential for successful surgery. |
| format | Article |
| id | doaj-art-54c3af46150a4dabb65161c0fb2326c3 |
| institution | OA Journals |
| issn | 2090-004X 2090-0058 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Ophthalmology |
| spelling | doaj-art-54c3af46150a4dabb65161c0fb2326c32025-08-20T02:05:04ZengWileyJournal of Ophthalmology2090-004X2090-00582017-01-01201710.1155/2017/23238972323897Key Factors to Improve the Outcome of Retinal Reattachment Surgery in Proliferative Vitreoretinopathy and Proliferative Diabetic RetinopathySvenja Deuchler0Hanns Ackermann1Pankaj Singh2Thomas Kohnen3Clemens Wagner4Frank Koch5Vitreoretinal Unit, Department of Ophthalmology, Goethe University, Frankfurt am Main, GermanyInstitute of Biostatistics and Mathematical Modelling, University Hospital, 60590 Frankfurt am Main, Hessen, GermanyVitreoretinal Unit, Department of Ophthalmology, Goethe University, Frankfurt am Main, GermanyDepartment of Ophthalmology, Goethe University, Frankfurt am Main, GermanyVRmagic GmbH, 68167 Mannheim, Baden-Württemberg, GermanyVitreoretinal Unit, Department of Ophthalmology, Goethe University, Frankfurt am Main, GermanyIntroduction. For management of complicated retinal detachments, a pars plana vitrectomy with temporary silicone oil (SO) fill is the method of choice. According to literature, the retinal redetachment rate varies between <10% and >70% with around 36% in our own group (retrospective data analysis, n=119 eyes). Methods. The main goal was to reduce the retinal redetachment rate. Standard operating procedures (SOPs) and evaluation protocols (EVALPs) were developed to prospectively analyse risk factors. Lab analysis of SO was performed, and the role of surgical experience was evaluated and investigated with Eyesi®. Results. We achieved a significant reduction of the retinal redetachment rate (to 6.80%, n=101, p=0.002). After surgery with SO injection, neither further membrane peeling (in 16.5%) nor retinal laser coagulation (in 100%) during revision surgery had a significant effect on the reattachment rate (p=0.167, p=0.23), while extensive additional laser coagulation reduced visual acuity (p=0.01). A 3-port approach had to be set up to complete SO removal. A difference in success rate depending on surgical experience was confirmed, and the performance in Eyesi correlated with that in the patients’ eye. Conclusions. A SOP- and EVALP-based management and new strategies to secure the surgical performance seem to be essential for successful surgery.http://dx.doi.org/10.1155/2017/2323897 |
| spellingShingle | Svenja Deuchler Hanns Ackermann Pankaj Singh Thomas Kohnen Clemens Wagner Frank Koch Key Factors to Improve the Outcome of Retinal Reattachment Surgery in Proliferative Vitreoretinopathy and Proliferative Diabetic Retinopathy Journal of Ophthalmology |
| title | Key Factors to Improve the Outcome of Retinal Reattachment Surgery in Proliferative Vitreoretinopathy and Proliferative Diabetic Retinopathy |
| title_full | Key Factors to Improve the Outcome of Retinal Reattachment Surgery in Proliferative Vitreoretinopathy and Proliferative Diabetic Retinopathy |
| title_fullStr | Key Factors to Improve the Outcome of Retinal Reattachment Surgery in Proliferative Vitreoretinopathy and Proliferative Diabetic Retinopathy |
| title_full_unstemmed | Key Factors to Improve the Outcome of Retinal Reattachment Surgery in Proliferative Vitreoretinopathy and Proliferative Diabetic Retinopathy |
| title_short | Key Factors to Improve the Outcome of Retinal Reattachment Surgery in Proliferative Vitreoretinopathy and Proliferative Diabetic Retinopathy |
| title_sort | key factors to improve the outcome of retinal reattachment surgery in proliferative vitreoretinopathy and proliferative diabetic retinopathy |
| url | http://dx.doi.org/10.1155/2017/2323897 |
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