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ANATOMICAL OUTCOMES AFTER TRAUMATIC GIANT RETINAL TEAR (GRT) ASSOCIATED RETINAL DETACHMENTS REPAIR.

Year 2021, Volume: 3 Issue: 2, 28 - 34, 30.08.2021

Abstract

ABSTRACT:
PURPOSE:
To analyze the surgical outcomes of giant retinal tear (GRT) associated retinal detachments and their association with extent of giant retinal tear (GRT), grade of proliferative vitreoretinopathy (PVR) and type of surgical procedure performed.
MATERIALS AND METHODS:
A retrospective case analysis of 150 eyes, conducted at Lahore General Hospital’s ophthalmology department from 2003 and 2018. The research included patients who underwent different types of surgical repairs for GRT associated detachments. The data was divided into four groups based on the type of surgical procedures performed and the time period.

Patients who underwent encirclement with 20-gauge pars plana vitrectomy and 1000 centistokes silicone oil for surgical repair between 2003 and 2008 were classified as Group A. This included 36 (24%) eyes out of the total. In 10 (27.78%) eyes the extent of giant retinal tear was equal to or greater than 180 degrees and in 26 (72.22%) eyes the extent of giant retinal tear was less than 180 degrees.

Patients operated between 2009 and 2013 were classified into Group B and C differing in the surgical technique employed for repair during this time period. Those who underwent encirclement with 23-gauge pars plana vitrectomy and 5000 centistokes silicone oil for surgical repair were classified as Group B. This included 39 (26%) eyes and the extent of GRT was less than 180 degrees in all 39 (26%) eyes.

Patients who underwent correction with 23-gauge pars plana vitrectomy and 5000 centistokes silicone oil for surgical repair were classified as Group C. It included 13 (8.67%) eyes and the extent of GRT was equal to or greater than 180 degrees in all eyes operated.

Patients who underwent surgical repair with 23-gauge pars plana vitrectomy and 5000 centistokes silicone oil between the year 2014 to 2018 were classified as Group D. It included 62 (41.33%) eyes, 16 (25.81%) eyes had extent of giant retinal tear equal or greater than 180 degrees and 46 (74.19%) eyes had extent of giant retinal tear less than 180 degrees.

In all the groups the patient's demographic profile was recorded along with extent of GRT, grade of proliferative vitreoretinopathy and the surgical procedure employed for correction. The follow up period of the patients extended from 5 months to 7 years.
RESULTS:
The data included 150 patients out of which 95 were males and 55 females who were followed up after the surgery from 1 year to 7 years post-operatively. Out of 150 eyes, 39 (26%) eyes had the extent of giant retinal tear equal to or greater than 180 degrees and 111 (74%) eyes had extent of giant retinal tear less than 180 degrees. Amongst the patients 48 (32%) eyes were phakic, 75 (50%) were pseudophakic and 27 (18%) were aphakic.

Five eyes (3.33%) had a proliferative vitreoretinopathy grade A, 34 (22.67%) eyes had proliferative vitreoretinopathy grade B while proliferative vitreoretinopathy grade C was noted in 111 (74%) eyes.

In group A, primary success was achieved in 20 (55.56%) eyes out of 36 while 16 (44.44%) eyes had re-detachment for which they had repeated surgery. After revision surgery there was retinal attachment in 12 (75%) eyes while 4 (25%) cases remained unsuccessful.
In group B 30 (76.92%) had attached retina after primary surgery while 9 (23.08%) eyes had second surgery with 8 (88.89%) eyes achieving retinal attachment while 1 (11.11%) remained persistently detached.
In group C, the retinal flattening was achieved in 7 (53.85%) out of 13 eyes. Revision surgery was successful in all the 6 (100%) eyes.
In group D, 56 (90.32%) out of 62 eyes had primary successful surgery. 6 eyes had revision surgery with a 100% success rate.

In total out of 150 eyes operated in 113 (75.33%) eyes primary surgical repair was successful while 37 (24.67%) eyes had recurrent retinal detachment. These 37 cases had surgical revision procedure performed. 145 (96.67%) eyes had anatomically attached retinas on follow-ups.
Conclusion:
Primary and revision GRT associated retinal detachments with varying grades of PVR achieved high success rates of retinal attachments after undergoing surgical correction with various methods of surgical treatment.

Keywords: Proliferative vitreoretinopathy, Giant retinal tear (GRT), Pars plana vitrectomy, Silicone oil.

References

  • 1. Mehdizadeh M, Afarid M, Haqiqi MS. Risk factors for giant retinal tears. J Ophthalmic Vis Res. 2010;5(4):246–249.
  • 2. Nagpal, Manish et al. “Management of recurrent rhegmatogenous retinal detachment.” Indian journal of ophthalmology vol. 66,12 (2018): 1763-1771. doi:10.4103/ijo.IJO_1212_18.
  • 3. Ang, Ghee Soon, John Townend, and Noemi Lois. "Epidemiology of giant retinal tears in the United Kingdom: the British giant retinal tear epidemiology eye study (BGEES)." Investigative ophthalmology & visual science 51.9 (2010): 4781-4787.
  • 4. Ghosh, Y. K., et al. "Surgical treatment and outcome of patients with giant retinal tears." Eye 18.10 (2004): 996.
  • 5. Nagpal, M. "Giant retinal tears: Size does matter." Retina Today (2013): 26-28.
  • 6. Ripandelli, Guido, et al. "Posterior vitreous detachment and retinal detachment after cataract surgery." Ophthalmology 114.4 (2007): 692-697.
  • 7. Shunmugam, Manoharan, Ghee Soon Ang, and Noemi Lois. "Giant retinal tears." Survey of ophthalmology 59.2 (2014): 192-216.
  • 8. Pastor, J. Carlos. "Proliferative vitreoretinopathy: an overview." Survey of ophthalmology 43.1 (1998): 3-18.
  • 9. Vaziri, Kamyar, et al. "Tamponade in the surgical management of retinal detachment." Clinical ophthalmology (Auckland, NZ) 10 (2016): 471.
  • 10. Rodriguez, Marianeli et al. “Giant retinal tears: clinical features and outcomes of vitreoretinal surgery at a university teaching hospital (2011-2017).” Clinical ophthalmology (Auckland, N.Z.) vol. 12 2053-2058. 12 Oct. 2018, doi:10.2147/OPTH.S180353.
  • 11. Dabour, Sherif A. “The outcome of surgical management for giant retinal tear more than 180°.” BMC ophthalmology vol. 14 86. 27 Jun. 2014, doi:10.1186/1471-2415-14-86.
  • 12. Gonzalez, Marco A et al. “Giant retinal tears after prior pars plana vitrectomy: management strategies and outcomes.” Clinical ophthalmology (Auckland, N.Z.) vol. 7 (2013): 1687-91. doi:10.2147/OPTH.S48930.
  • 13. Erakgun, Tansu, and Sait Egrilmez. “Surgical outcomes of transconjunctival sutureless 23-gauge vitrectomy with silicone oil injection.” Indian journal of ophthalmology vol. 57,2 (2009): 105-9. doi:10.4103/0301-4738.44514.
  • 14. Lakhanpal RR, Humayun MS, deJuan E, Lim JI, Chong LP, Chang TS, et al. Outcomes of 140 consecutive cases of 25-gauge transconjunctival surgery for posterior segment disease. Ophthalmology. 2005;112:817–24.
  • 15. Verstraeten, Thierry, et al. "Lens-sparing vitrectomy with perfluorocarbon liquid for the primary treatment of giant retinal tears." Ophthalmology 102.1 (1995): 17-20.
  • 16. Scott IU, Murray TG, Flynn HW, Feuer WJ, Schiffman JC, Perfluoron Study Group. Outcomes and complications associated with giant retinal tear management using perfluoro-n-octane. Ophthalmology 2002; 109 (10): 1828–1833.
  • 17. GOPAL, LINGAM, and AMIT NAGPAL. "Silicone Oil and Intraocular Gases in the Management of Retinal Detachment." Clinical Ophthalmology: Contemporary Perspectives (2009): 444.
  • 18. Kreiger AE, Lewis H. Management of giant retinal tears without scleral buckling. Use of radical dissection of the vitreous base and perfluoro‐octane and intraocular tamponade. Ophthalmology 1992;99(4):491‐7.
  • 19. Al-Khairi, A. M., et al. "Prognostic factors associated with outcomes after giant retinal tear management using perfluorocarbon liquids." European journal of ophthalmology 18.2 (2008): 270-277.
  • 20. Goenzinne, F., et al. "Low redetachment rate due to encircling scleral buckle in giant retinal tears treated with vitrectomy and silicon oil." Retina 28 (2008): 485-492.
  • 21. Al-Khairi, A. M., et al. "Prognostic factors associated with outcomes after giant retinal tear management using perfluorocarbon liquids." European journal of ophthalmology 18.2 (2008): 270-277.
  • 22. Oh, Hyun Ju et al. “Efficacy and safety of active silicone oil removal through a 23-gauge transconjunctival cannula using an external vacuum pump.” International journal of ophthalmology vol. 8,2 347-52. 18 Apr. 2015, doi:10.3980/j.issn.2222-3959.2015.02.24.
  • 23. Sahoo, Niroj Kumar et al. “Retina and glaucoma: surgical complications.” International journal of retina and vitreous vol. 4 29. 5 Sep. 2018, doi:10.1186/s40942-018-0135-x.
  • 24. Saxena, Sandeep, and Lingam Gopal. "Fluid vitreous substitutes in vitreo retinal surgery." Indian journal of ophthalmology 44.4 (1996): 191.
  • 25. Scott IU Murray TG Flynn HWJr Feuer WJ Schiffman JC . Outcomes and complications associated with giant retinal tear management using perfluoro-n-octane. Ophthalmology. 2002; 109:1828–1833.
Year 2021, Volume: 3 Issue: 2, 28 - 34, 30.08.2021

Abstract

References

  • 1. Mehdizadeh M, Afarid M, Haqiqi MS. Risk factors for giant retinal tears. J Ophthalmic Vis Res. 2010;5(4):246–249.
  • 2. Nagpal, Manish et al. “Management of recurrent rhegmatogenous retinal detachment.” Indian journal of ophthalmology vol. 66,12 (2018): 1763-1771. doi:10.4103/ijo.IJO_1212_18.
  • 3. Ang, Ghee Soon, John Townend, and Noemi Lois. "Epidemiology of giant retinal tears in the United Kingdom: the British giant retinal tear epidemiology eye study (BGEES)." Investigative ophthalmology & visual science 51.9 (2010): 4781-4787.
  • 4. Ghosh, Y. K., et al. "Surgical treatment and outcome of patients with giant retinal tears." Eye 18.10 (2004): 996.
  • 5. Nagpal, M. "Giant retinal tears: Size does matter." Retina Today (2013): 26-28.
  • 6. Ripandelli, Guido, et al. "Posterior vitreous detachment and retinal detachment after cataract surgery." Ophthalmology 114.4 (2007): 692-697.
  • 7. Shunmugam, Manoharan, Ghee Soon Ang, and Noemi Lois. "Giant retinal tears." Survey of ophthalmology 59.2 (2014): 192-216.
  • 8. Pastor, J. Carlos. "Proliferative vitreoretinopathy: an overview." Survey of ophthalmology 43.1 (1998): 3-18.
  • 9. Vaziri, Kamyar, et al. "Tamponade in the surgical management of retinal detachment." Clinical ophthalmology (Auckland, NZ) 10 (2016): 471.
  • 10. Rodriguez, Marianeli et al. “Giant retinal tears: clinical features and outcomes of vitreoretinal surgery at a university teaching hospital (2011-2017).” Clinical ophthalmology (Auckland, N.Z.) vol. 12 2053-2058. 12 Oct. 2018, doi:10.2147/OPTH.S180353.
  • 11. Dabour, Sherif A. “The outcome of surgical management for giant retinal tear more than 180°.” BMC ophthalmology vol. 14 86. 27 Jun. 2014, doi:10.1186/1471-2415-14-86.
  • 12. Gonzalez, Marco A et al. “Giant retinal tears after prior pars plana vitrectomy: management strategies and outcomes.” Clinical ophthalmology (Auckland, N.Z.) vol. 7 (2013): 1687-91. doi:10.2147/OPTH.S48930.
  • 13. Erakgun, Tansu, and Sait Egrilmez. “Surgical outcomes of transconjunctival sutureless 23-gauge vitrectomy with silicone oil injection.” Indian journal of ophthalmology vol. 57,2 (2009): 105-9. doi:10.4103/0301-4738.44514.
  • 14. Lakhanpal RR, Humayun MS, deJuan E, Lim JI, Chong LP, Chang TS, et al. Outcomes of 140 consecutive cases of 25-gauge transconjunctival surgery for posterior segment disease. Ophthalmology. 2005;112:817–24.
  • 15. Verstraeten, Thierry, et al. "Lens-sparing vitrectomy with perfluorocarbon liquid for the primary treatment of giant retinal tears." Ophthalmology 102.1 (1995): 17-20.
  • 16. Scott IU, Murray TG, Flynn HW, Feuer WJ, Schiffman JC, Perfluoron Study Group. Outcomes and complications associated with giant retinal tear management using perfluoro-n-octane. Ophthalmology 2002; 109 (10): 1828–1833.
  • 17. GOPAL, LINGAM, and AMIT NAGPAL. "Silicone Oil and Intraocular Gases in the Management of Retinal Detachment." Clinical Ophthalmology: Contemporary Perspectives (2009): 444.
  • 18. Kreiger AE, Lewis H. Management of giant retinal tears without scleral buckling. Use of radical dissection of the vitreous base and perfluoro‐octane and intraocular tamponade. Ophthalmology 1992;99(4):491‐7.
  • 19. Al-Khairi, A. M., et al. "Prognostic factors associated with outcomes after giant retinal tear management using perfluorocarbon liquids." European journal of ophthalmology 18.2 (2008): 270-277.
  • 20. Goenzinne, F., et al. "Low redetachment rate due to encircling scleral buckle in giant retinal tears treated with vitrectomy and silicon oil." Retina 28 (2008): 485-492.
  • 21. Al-Khairi, A. M., et al. "Prognostic factors associated with outcomes after giant retinal tear management using perfluorocarbon liquids." European journal of ophthalmology 18.2 (2008): 270-277.
  • 22. Oh, Hyun Ju et al. “Efficacy and safety of active silicone oil removal through a 23-gauge transconjunctival cannula using an external vacuum pump.” International journal of ophthalmology vol. 8,2 347-52. 18 Apr. 2015, doi:10.3980/j.issn.2222-3959.2015.02.24.
  • 23. Sahoo, Niroj Kumar et al. “Retina and glaucoma: surgical complications.” International journal of retina and vitreous vol. 4 29. 5 Sep. 2018, doi:10.1186/s40942-018-0135-x.
  • 24. Saxena, Sandeep, and Lingam Gopal. "Fluid vitreous substitutes in vitreo retinal surgery." Indian journal of ophthalmology 44.4 (1996): 191.
  • 25. Scott IU Murray TG Flynn HWJr Feuer WJ Schiffman JC . Outcomes and complications associated with giant retinal tear management using perfluoro-n-octane. Ophthalmology. 2002; 109:1828–1833.
There are 25 citations in total.

Details

Primary Language English
Subjects Ophthalmology
Journal Section Orginal Articles
Authors

Hussain Ahmad Khaqan 0000-0002-4665-833X

Hasnain Muhammad Buksh 0000-0002-8622-2100

Muhammad Haider This is me 0000-0003-3767-1556

Hafiz Ateeq Rehman 0000-0002-4525-5440

Publication Date August 30, 2021
Acceptance Date October 6, 2021
Published in Issue Year 2021 Volume: 3 Issue: 2

Cite

APA Khaqan, H. A., Buksh, H. M., Haider, M., Rehman, H. A. (2021). ANATOMICAL OUTCOMES AFTER TRAUMATIC GIANT RETINAL TEAR (GRT) ASSOCIATED RETINAL DETACHMENTS REPAIR. Clinical and Experimental Ocular Trauma and Infection, 3(2), 28-34.
AMA Khaqan HA, Buksh HM, Haider M, Rehman HA. ANATOMICAL OUTCOMES AFTER TRAUMATIC GIANT RETINAL TEAR (GRT) ASSOCIATED RETINAL DETACHMENTS REPAIR. CEOTI. August 2021;3(2):28-34.
Chicago Khaqan, Hussain Ahmad, Hasnain Muhammad Buksh, Muhammad Haider, and Hafiz Ateeq Rehman. “ANATOMICAL OUTCOMES AFTER TRAUMATIC GIANT RETINAL TEAR (GRT) ASSOCIATED RETINAL DETACHMENTS REPAIR”. Clinical and Experimental Ocular Trauma and Infection 3, no. 2 (August 2021): 28-34.
EndNote Khaqan HA, Buksh HM, Haider M, Rehman HA (August 1, 2021) ANATOMICAL OUTCOMES AFTER TRAUMATIC GIANT RETINAL TEAR (GRT) ASSOCIATED RETINAL DETACHMENTS REPAIR. Clinical and Experimental Ocular Trauma and Infection 3 2 28–34.
IEEE H. A. Khaqan, H. M. Buksh, M. Haider, and H. A. Rehman, “ANATOMICAL OUTCOMES AFTER TRAUMATIC GIANT RETINAL TEAR (GRT) ASSOCIATED RETINAL DETACHMENTS REPAIR”., CEOTI, vol. 3, no. 2, pp. 28–34, 2021.
ISNAD Khaqan, Hussain Ahmad et al. “ANATOMICAL OUTCOMES AFTER TRAUMATIC GIANT RETINAL TEAR (GRT) ASSOCIATED RETINAL DETACHMENTS REPAIR”. Clinical and Experimental Ocular Trauma and Infection 3/2 (August 2021), 28-34.
JAMA Khaqan HA, Buksh HM, Haider M, Rehman HA. ANATOMICAL OUTCOMES AFTER TRAUMATIC GIANT RETINAL TEAR (GRT) ASSOCIATED RETINAL DETACHMENTS REPAIR. CEOTI. 2021;3:28–34.
MLA Khaqan, Hussain Ahmad et al. “ANATOMICAL OUTCOMES AFTER TRAUMATIC GIANT RETINAL TEAR (GRT) ASSOCIATED RETINAL DETACHMENTS REPAIR”. Clinical and Experimental Ocular Trauma and Infection, vol. 3, no. 2, 2021, pp. 28-34.
Vancouver Khaqan HA, Buksh HM, Haider M, Rehman HA. ANATOMICAL OUTCOMES AFTER TRAUMATIC GIANT RETINAL TEAR (GRT) ASSOCIATED RETINAL DETACHMENTS REPAIR. CEOTI. 2021;3(2):28-34.