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 betwee
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.
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Author:Svenja Deuchler, Hanns Ackermann, Pankaj Singh, Thomas Kohnen, Clemens Wagner, Frank H. Koch
URN:urn:nbn:de:hebis:30:3-439447
DOI:http://dx.doi.org/10.1155/2017/2323897
ISSN:2090-0058
ISSN:2090-004X
Pubmed Id:http://www.ncbi.nlm.nih.gov/pubmed?term=28770107
Parent Title (English):Journal of ophthalmology
Publisher:Hindawi
Place of publication:New York, NY
Contributor(s):Anat Loewenstein
Document Type:Article
Language:English
Date of Publication (online):2017/08/21
Date of first Publication:2017/07/09
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2017/08/21
Volume:2017
Issue:Art. 2323897
Pagenumber:23
First Page:1
Last Page:22
Note:
Copyright © 2017 Svenja Deuchler et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
HeBIS PPN:425321894
Institutes:Medizin
Dewey Decimal Classification:610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (German):License LogoCreative Commons - Namensnennung 4.0

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