PRİMER PSÖDOFAKİK RETİNA DEKOLMANI CERRAHİSİ SONUÇLARININ DEĞERLENDİRİLMESİ

Yıl 2021, , 488 - 494, 01.10.2021

Zeynep Yılmazabdurrahmanoğlu Kemal Turgay Özbilen , Mehmet Kocabora , Osman Çekiç

https://doi.org/10.26650/IUITFD.2021.836991

Öz

Amaç: Afakik veya psödofakik regmatojen retina dekolmanı (RRD) için tek başına pars plana vitrektomi (PPV) ve çevresel skleral çökertme (ÇSÇ) ile kombine ameliyatların sonuçlarını değerlendirmek. Gereç ve Yöntem: Psödofakik veya afakik primer RRD’ye nedeniyle tek başına veya ÇSÇ ile kombine PPV (20 ve 23 Gauge) uygulanan 37 hastanın 37 gözü çalışmaya dahil edildi. Postoperatif anatomik başarı (AB) ve fonksiyonel başarı (FB) değerlendirildi. AB, eğer kullanılmışsa silikon yağı tamponadının çıkarılmasından sonra hiç subretinal sıvının olmadığı tamamen yatışmış retina olarak tanımlandı. Ayrıca FB, Snellen görme keskinliğinin logMAR eşdeğerinde iki veya daha fazla ondalık artış olarak tanımlandı. Bulgular: Hastaların ortalama yaşı 62,43±11,40 (32-80) yıl, 21’i (%56,8) erkek, 16’sı (%43,2) kadındı. Ortalama takip süresi 21,35±16,86 (6-84) aydı. 23 hastaya ÇSÇ ile kombine PPV uygulandı. AB %86,5 (32/37), FB %49,9 (17/37) olarak bulundu. Hem AB ile hem de FB ile; preoperatif PVR varlığı (AB-p=0,61, FB-p=0,14), preoperartif maküla tutulumu (AB-p=0,98, FB-p=0,36), PPV’nin ÇSÇ ile kombine olup olmaması (AB-p=0,97, FB-p=0,29), ve kullanılan tamponad tipi (tümü p>0,05) gibi durumlara göre oluşturulan gruplar arasında istatistiksel olarak anlamlı bir fark gözlenmedi. Sonuç: Primer psödofakik retina dekolmanı olan olgularda PPV yalnız veya ÇSÇ ile kombine olarak uygulandığında, maküla tutulumundan veya PVR varlığından etkilenmeden iyi AB ulaşmak için etkili ve güvenlidir. Bununla birlikte, fonksiyonel başarı her zaman eşlik etmeyebilir.

EVALUATION OF OUTCOMES OF PRIMARY PSEUDOPHAKIC RETINAL DETACHMENT SURGERY

Öz

Objective: To evaluate the results of pars plana vitrectomy (PPV) alone and combined with circumferential scleral buckling (CSB) surgeries for aphakic or pseudophakic rhegmatogenous retinal detachment (RRD). Materials and Methods: Thirty-seven eyes of 37 patients who underwent PPV (20 and 23 Gauge) alone or PPV combined with CSB due to pseudophakic or aphakic primary RRD were included in the study. Postoperative anatomical success (AS) and functional success (FS) were evaluated. The AS was defined as a completely flattened retina without any subretinal fluids after the removal of the silicone oil tamponade, if used. The FS was defined as two or more decimal improvements in the logMAR equivalent of Snellen visual acuity. Results: The mean age of the patients was 62.43±11.40 (32-80) years, 21 (56.8%) patients were male, and 16 (43.2%) were female. The mean follow-up time was 21.35±16.86 (6-84) months. PPV combined with CSB were performed in 23 patients. AS was found to be 86.5% (32/37), FS was 49.9% (17/37). No statistically significant difference was observed in both AS and FS between the groups according to preoperative PVR presence (AS-p=0.61, FS-p=0.14), preoperative macular involvement (AS-p=0.98, FS-p=0.36), whether PPV combined with CSB (AS-p=0.97, FSp= 0.29), and the type of tamponade (p>0.05 in all). Conclusion: PPV with or without CSB is safe and effective in cases with primary pseudophakic retinal detachment and achieves good AS without being affected by the presence of PVR or macular involvement. However, functional success may not always follow. Keywords: Pseudophakic retinal detachment, pars plana vitrectomy

Anahtar Kelimeler

Pseudophakic retinal detachment, Pars plana vitrectomy, Circumferential scleral buckling

Kaynakça

• 1. Hagler WS. Pseudophakic retinal detachment. Trans Am Ophthalmol Soc 1982;80:45-63.
• 2. Wilkinson CP. Pseudophakic retinal detachments. Retina 1985;5(1):1-4. [CrossRef]
• 3. Boberg-Ans G, Henning V, Villumsen J, la Cour M. Long Term incidence of rhegmatogenous retinal detachment and survival in a defined population undergoing standardized phacoemulsification surgery. Acta Ophthalmol Scand 2006;84(5):613-8. [CrossRef]
• 4. Russell M, Gaskin B, Russell D, Polkinghorne PJ. Pseudophakic retinal detachment after phacoemulsification cataract surgery: Ten-year retrospective review. J Cataract Refract Surg 2006;32(3):442-5. [CrossRef]
• 5. Javitt JC, Tielsch JM, Canner JK, Kolb MM, Sommer A, Steinberg EP. National outcomes of cataract extraction. Increased risk of retinal complications associated with Nd:YAG laser capsulotomy. The Cataract Patient Outcomes Research Team. Ophthalmology 1992;99(10):1487-97; discussion 97-8. [CrossRef]
• 6. American Academy of Ophthalmology, The repair of rhegmatogenous retinal detachments. Ophthalmic Procedure Assessment. Ophthalmology 1996;103(8):1313- 24. [CrossRef]
• 7. Wilkinson CP. Visual results following scleral buckling for retinal detachments sparing the macula. Retina 1981;1(2):113-6. [CrossRef]
• 8. Burton TC. Recovery of visual acuity after retinal detachment involving the macula. Trans Am Ophthalmol Soc 1982;80:475-97.
• 9. Erkam N. Vitreoretinal cerrahide göz içi tampon maddeler. Medical Network Ophthalmology 1994(2):140-4.
• 10. Lois N, Wong D. Pseudophakic retinal detachment. Surv Ophthalmol 2003;48(5):467-87. [CrossRef]
• 11. Coonan P, Fung WE, Webster RG, Jr., Allen AW, Jr., Abbott RL. The incidence of retinal detachment following extracapsular cataract extraction. A ten-year study. Ophthalmology 1985;92(8):1096-101. [CrossRef]
• 12. Kraff MC, Sanders DR. Incidence of retinal detachment following posterior chamber intraocular lens surgery. J Cataract Refract Surg 1990;16(4):477-80. [CrossRef]
• 13. Smith PW, Stark WJ, Maumenee AE, Enger CL, Michels RG, Glaser BM, et al. Retinal detachment after extracapsular cataract extraction with posterior chamber intraocular lens. Ophthalmology 1987;94(5):495-504. [CrossRef]
• 14. Rowe JA, Erie JC, Baratz KH, Hodge DO, Gray DT, Butterfield L, et al. Retinal detachment in Olmsted County, Minnesota, 1976 through 1995. Ophthalmology 1999;106(1):154-9. [CrossRef]
• 15. Citirik M. Pseudophakic retinal detachment; risk factors, pathogenesis, clinic and management. Current Retinal Journal 2020;4(3):153-9. [CrossRef]
• 16. Whang US JK, Park JM. Clinical evaluation of pseudophakic retinal detachment. J Korean Ophthalmol Soc 2001;42(7):991-6.
• 17. Ho PC, Tolentino FI. Pseudophakic retinal detachment. Surgical success rate with various types of IOLs. Ophthalmology 1984;91(7):847-52. [CrossRef]
• 18. Cankurtaran V ÖS, Khaleqi Z. Evaluation of risk factors causing retinal detachment after cataract surgery. MN Oftalmoloji 2020;27(1):39-43.
• 19. Dang Burgener NP, Petropoulos IK, Stangos AN, Pournaras CJ. Recurrence after primary vitrectomy for pseudophakic retinal detachment. J Fr Ophtalmol 2006;29(10):1149-55. [CrossRef]
• 20. Li X, Beijing Rhegmatogenous Retinal Detachment Study G. Incidence and epidemiological characteristics of rhegmatogenous retinal detachment in Beijing, China. Ophthalmology 2003;110(12):2413-7. [CrossRef]
• 21. Bartz-Schmidt KU, Kirchhof B, Heimann K. Primary vitrectomy for pseudophakic retinal detachment. Br J Ophthalmol 1996;80(4):346-9. [CrossRef]
• 22. Campo RV, Sipperley JO, Sneed SR, Park DW, Dugel PU, Jacobsen J, et al. Pars plana vitrectomy without scleral buckle for pseudophakic retinal detachments. Ophthalmology 1999;106(9):1811-5; discussion 6. [CrossRef]
• 23. Devenyi RG, de Carvalho Nakamura H. Combined scleral buckle and pars plana vitrectomy as a primary procedure for pseudophakic retinal detachments. Ophthalmic Surg Lasers 1999;30(8):615-8. [CrossRef]
• 24. Kessner R, Barak A. Pseudophakic rhegmatogenous retinal detachment: combined pars plana vitrectomy and scleral buckle versus pars plana vitrectomy alone. Graefes Arch Clin Exp Ophthalmol 2016;254(11):2183-9. [CrossRef]
• 25. Joseph DP, Ryan EH, Ryan CM, Forbes NJK, Wagley S, Yonekawa Y, et al. Primary Retinal Detachment Outcomes Study: Pseudophakic Retinal Detachment Outcomes: Primary Retinal Detachment Outcomes Study Report Number 3. Ophthalmology 2020;127(11):1507-14. [CrossRef]
• 26. Figueroa MS, Lopez-Caballero C, Contreras I. Anatomical and functional outcomes of vitrectomy for the treatment of pseudophakic rhegmatogenous retinal detachment. Arch Soc Esp Oftalmol 2010;85(2):59-63. [CrossRef]
• 27. Çakır M, Çekiç O, Bayraktar Ş, Yılmaz ÖF. Surgical results of combined scleral encircling band and pars plana vitrectomy in pseudophakic retinal detachment. Retina-Vitreus 2007;15(4):249-52.
• 28. Dardenne MU, Gerten GJ, Kokkas K, Kermani O. Retrospective study of retinal detachment following neodymium:YAG laser posterior capsulotomy. J Cataract Refract Surg 1989;15(6):676-80. [CrossRef]
• 29. Ross WH. Pseudophakic retinal detachment. Can J Ophthalmol 1984;19(3):119-21.
• 30. Gedde SJ. Management of glaucoma after retinal detachment surgery. Curr Opin Ophthalmol 2002;13(2):103-9.