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Retinotomy with retinal turnover to remove subretinal membranes under direct visualization for proliferative vitreoretinopathy.

Kimura M, Nishimura A, Saito Y, Ikeda H, Sugiyama K - Clin Ophthalmol (2012)

Bottom Line: The mean logarithm of the minimal angle of resolution (logMAR) BCVA was significantly improved (P = 0.001).Negative correlation was found between preoperative logMAR BCVA and the change in logMAR BCVA (r = -0.587, P = 0.008).Removal of subretinal proliferative tissue with retinal turnover seems to be an effective procedure.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology and Visual Science, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.

ABSTRACT

Purpose: The purpose of the study was to report the outcomes for cases of proliferative vitreoretinopathy (PVR) that received retinotomy and removal of subretinal proliferative tissue under direct visualization using retinal turnover.

Methods: Nineteen eyes with posterior and/or anterior grade C1-12 PVR that had undergone retinotomy and retinal turnover were reviewed. Main outcomes included the retinal reattachment rate, final best-corrected visual acuity (BCVA), postoperative intraocular pressure, extent of retinotomy, and complications.

Results: Final retinal reattachment rates with silicone oil tamponade were 100%. The mean logarithm of the minimal angle of resolution (logMAR) BCVA was significantly improved (P = 0.001). Positive correlation was found between the extent of retinotomy and both preoperative logMAR BCVA (r = 0.663, P = 0.002) and postoperative logMAR BCVA (r = 0.619, P = 0.005). There was no correlation between the extent of retinotomy and the change in preoperative and postoperative logMAR BCVA (r = -0.267, P = 0.268). Negative correlation was found between preoperative logMAR BCVA and the change in logMAR BCVA (r = -0.587, P = 0.008). There was no correlation between the extent of retinotomy and the intraocular pressure at the final visit (r = -0.316, P = 0.188). Corneal decompensation due to silicone oil in the anterior chamber occurred in one eye.

Conclusion: Removal of subretinal proliferative tissue with retinal turnover seems to be an effective procedure.

No MeSH data available.


Related in: MedlinePlus

Intraoperative and postoperative view of a 61-year-old male with long-standing rhegmatogenous retinal detachment with epiretinal and subretinal proliferation. The preoperative visual acuity was counting fingers. He was diagnosed with posterior grade C12 and anterior grade C12 proliferative vitreoretinopathy (type 3: subretinal) and underwent pars plana vitrectomy with retinotomy for retinal turnover and retinal relaxing. (A) Intraoperative view. The retina lacked elasticity despite removal of epiretinal proliferative tissue. (B) Intraoperative view. The 360-degree retinotomy allowed for retinal turnover and removal of a diffuse sheet of subretinal proliferative tissue under direct visualization. Almost the entire subretinal space is covered with a diffuse sheet of subretinal tissue (white arrows) and the area at the lower left is the turned-over retina (yellow arrows). (C) Postoperative fundus photograph 4 months after surgery. (D) The postoperative spectral-domain optical coherence tomography image 3 months after surgery shows loss of the photoreceptor inner and outer segment junction and the external limiting membrane of the macula. White arrowheads show the migrated perfluorocarbon liquid. (E) Histopathological examination of the surgically excised subretinal tissue reveals fibrous connective tissue with pigmented cells. There are small epithelial cells with ovary-shaped nucleus, arranged in clumps (hematoxylin and eosin).
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f1-opth-6-781: Intraoperative and postoperative view of a 61-year-old male with long-standing rhegmatogenous retinal detachment with epiretinal and subretinal proliferation. The preoperative visual acuity was counting fingers. He was diagnosed with posterior grade C12 and anterior grade C12 proliferative vitreoretinopathy (type 3: subretinal) and underwent pars plana vitrectomy with retinotomy for retinal turnover and retinal relaxing. (A) Intraoperative view. The retina lacked elasticity despite removal of epiretinal proliferative tissue. (B) Intraoperative view. The 360-degree retinotomy allowed for retinal turnover and removal of a diffuse sheet of subretinal proliferative tissue under direct visualization. Almost the entire subretinal space is covered with a diffuse sheet of subretinal tissue (white arrows) and the area at the lower left is the turned-over retina (yellow arrows). (C) Postoperative fundus photograph 4 months after surgery. (D) The postoperative spectral-domain optical coherence tomography image 3 months after surgery shows loss of the photoreceptor inner and outer segment junction and the external limiting membrane of the macula. White arrowheads show the migrated perfluorocarbon liquid. (E) Histopathological examination of the surgically excised subretinal tissue reveals fibrous connective tissue with pigmented cells. There are small epithelial cells with ovary-shaped nucleus, arranged in clumps (hematoxylin and eosin).

Mentions: In this study, 19 eyes of 19 patients were enrolled. Preoperative characteristics are shown in Table 1. Performed treatments are shown in Table 2. The median follow-up time was 41 months (range 7–64 months). The representative case is shown in Figure 1. A video file is also available.


Retinotomy with retinal turnover to remove subretinal membranes under direct visualization for proliferative vitreoretinopathy.

Kimura M, Nishimura A, Saito Y, Ikeda H, Sugiyama K - Clin Ophthalmol (2012)

Intraoperative and postoperative view of a 61-year-old male with long-standing rhegmatogenous retinal detachment with epiretinal and subretinal proliferation. The preoperative visual acuity was counting fingers. He was diagnosed with posterior grade C12 and anterior grade C12 proliferative vitreoretinopathy (type 3: subretinal) and underwent pars plana vitrectomy with retinotomy for retinal turnover and retinal relaxing. (A) Intraoperative view. The retina lacked elasticity despite removal of epiretinal proliferative tissue. (B) Intraoperative view. The 360-degree retinotomy allowed for retinal turnover and removal of a diffuse sheet of subretinal proliferative tissue under direct visualization. Almost the entire subretinal space is covered with a diffuse sheet of subretinal tissue (white arrows) and the area at the lower left is the turned-over retina (yellow arrows). (C) Postoperative fundus photograph 4 months after surgery. (D) The postoperative spectral-domain optical coherence tomography image 3 months after surgery shows loss of the photoreceptor inner and outer segment junction and the external limiting membrane of the macula. White arrowheads show the migrated perfluorocarbon liquid. (E) Histopathological examination of the surgically excised subretinal tissue reveals fibrous connective tissue with pigmented cells. There are small epithelial cells with ovary-shaped nucleus, arranged in clumps (hematoxylin and eosin).
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC3367433&req=5

f1-opth-6-781: Intraoperative and postoperative view of a 61-year-old male with long-standing rhegmatogenous retinal detachment with epiretinal and subretinal proliferation. The preoperative visual acuity was counting fingers. He was diagnosed with posterior grade C12 and anterior grade C12 proliferative vitreoretinopathy (type 3: subretinal) and underwent pars plana vitrectomy with retinotomy for retinal turnover and retinal relaxing. (A) Intraoperative view. The retina lacked elasticity despite removal of epiretinal proliferative tissue. (B) Intraoperative view. The 360-degree retinotomy allowed for retinal turnover and removal of a diffuse sheet of subretinal proliferative tissue under direct visualization. Almost the entire subretinal space is covered with a diffuse sheet of subretinal tissue (white arrows) and the area at the lower left is the turned-over retina (yellow arrows). (C) Postoperative fundus photograph 4 months after surgery. (D) The postoperative spectral-domain optical coherence tomography image 3 months after surgery shows loss of the photoreceptor inner and outer segment junction and the external limiting membrane of the macula. White arrowheads show the migrated perfluorocarbon liquid. (E) Histopathological examination of the surgically excised subretinal tissue reveals fibrous connective tissue with pigmented cells. There are small epithelial cells with ovary-shaped nucleus, arranged in clumps (hematoxylin and eosin).
Mentions: In this study, 19 eyes of 19 patients were enrolled. Preoperative characteristics are shown in Table 1. Performed treatments are shown in Table 2. The median follow-up time was 41 months (range 7–64 months). The representative case is shown in Figure 1. A video file is also available.

Bottom Line: The mean logarithm of the minimal angle of resolution (logMAR) BCVA was significantly improved (P = 0.001).Negative correlation was found between preoperative logMAR BCVA and the change in logMAR BCVA (r = -0.587, P = 0.008).Removal of subretinal proliferative tissue with retinal turnover seems to be an effective procedure.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology and Visual Science, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.

ABSTRACT

Purpose: The purpose of the study was to report the outcomes for cases of proliferative vitreoretinopathy (PVR) that received retinotomy and removal of subretinal proliferative tissue under direct visualization using retinal turnover.

Methods: Nineteen eyes with posterior and/or anterior grade C1-12 PVR that had undergone retinotomy and retinal turnover were reviewed. Main outcomes included the retinal reattachment rate, final best-corrected visual acuity (BCVA), postoperative intraocular pressure, extent of retinotomy, and complications.

Results: Final retinal reattachment rates with silicone oil tamponade were 100%. The mean logarithm of the minimal angle of resolution (logMAR) BCVA was significantly improved (P = 0.001). Positive correlation was found between the extent of retinotomy and both preoperative logMAR BCVA (r = 0.663, P = 0.002) and postoperative logMAR BCVA (r = 0.619, P = 0.005). There was no correlation between the extent of retinotomy and the change in preoperative and postoperative logMAR BCVA (r = -0.267, P = 0.268). Negative correlation was found between preoperative logMAR BCVA and the change in logMAR BCVA (r = -0.587, P = 0.008). There was no correlation between the extent of retinotomy and the intraocular pressure at the final visit (r = -0.316, P = 0.188). Corneal decompensation due to silicone oil in the anterior chamber occurred in one eye.

Conclusion: Removal of subretinal proliferative tissue with retinal turnover seems to be an effective procedure.

No MeSH data available.


Related in: MedlinePlus