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      Fortified Barrier Laser On The Vitreous Base In Vitrectomy For Rhegmatogenous Retinal Detachment

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          Abstract

          Purpose

          To investigate the efficacy of fortified barrier laser (FBL) on the vitreous base in vitrectomy for rhegmatogenous retinal detachment (RRD).

          Patients and methods

          This was a retrospective study of patients who underwent vitrectomy for RRD without proliferative vitreoretinopathy. Barrier laser was applied as 3–4 rows surrounding the break at the end of fluid-air exchange. For the FBL, 3–4 rows of laser burn were additionally made about 0.5 clock-hour long adjacent to the break along the posterior border of the vitreous base. The primary outcome was single surgery success rate (SSSR) between two groups: FBL and conventional barrier laser (CBL) groups.

          Results

          Overall, 118 eyes were included; 50 eyes in the FBL group and 68 eyes in the CBL group. SSSR was 100% (50/50) in the FBL group and 91.2% (62/68) in the CBL group with a significant difference (p=0.038). Four eyes of the recurrent cases in the CBL group were related to reopening of the break. All eyes achieved reattachment, and no differences were found in postoperative visual acuity at 6 months.

          Conclusion

          FBL on the vitreous base was efficacious in improving the anatomical success rate of vitrectomy.

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          Most cited references27

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          Vitrectomy: a pars plana approach.

          R Machemer, H Buettner, E Norton … (2015)
          Article 0 comments Cited 82 times – based on 0 reviews     Review now
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            Primary vitrectomy for rhegmatogenous retinal detachment: an analysis of 512 cases.

            Norbert Bornfeld, X Zou, Horst Helbig … (2005)
            Primary pars plana vitrectomy (PPPV) has gained widespread popularity in the treatment of rhegmatogenous retinal detachments (RRD). However, the surgical procedure is still flawed by a significant rate of anatomical and functional failures. The study was conducted to analyse the risk factors for a dissatisfying postoperative outcome. We carried out a retrospective study of 512 cases of PPPV with a minimum follow-up of 3 months from one institution over a 9-year period. Preoperatively, 24.8% of patients (127 out of 512) were pseudophakic, 16.4% (84 out of 512) highly myopic, 19.9% (102 out of 512) had preoperative proliferative vitreoretinopathy (PVR) and 14.6% (75 out of 512) had vitreous haemorrhage. The follow-up period ranged from 3 to 108 months (median 14.8). Retinal reattachment was achieved with one operation in 70.7% (362 out of 512) and after one or more operations in 97.5% of cases (499 out of 512). The major reasons for redetachments were new retinal breaks, followed by a combination of new breaks and PVR, and PVR without apparent breaks. Postoperative visual acuities of > or =0.1 and > or =0.4 were achieved in 82.8% (424 out of 512) and 48.2% (247 out of 512) respectively. Out of 376 phakic patients at study entry, 66.4% (250 out of 376) underwent cataract surgery either in combination with PPPV or during the postoperative course. Factors that were significantly associated with either anatomical or functional failure included duration of symptoms, low preoperative visual acuity, myopia, amblyopia, hypotony, macular detachment, preoperative PVR, extent of detachment, involvement of inferior quadrants, no detectable breaks, large breaks, breaks posterior to the equator, surgeon, level of surgical training, endocryotherapy, and combined scleral buckling surgery. Primary pars plana vitrectomy is still flawed by a relatively high primary redetachment rate following the initial procedure. The advantages of the technique are a high final reattachment rate and relatively good functional results in a subset of patients with more complicated types of RRD. The risk factors for postoperative failures following PPPV for RRD match to a large extent those following scleral buckling surgery (SBS). Future improvements of the technique will have to focus on modifiable risk factors, such as details of the surgical procedures, surgical training and case selection, to distinguish it from SBS.
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              Air versus gas tamponade in retinal detachment surgery.

              H. Tan, Sarit Oberstein, Marco Mura … (2013)
              To compare the outcome of air tamponade with gas tamponade in primary vitrectomy for the treatment of rhegmatogenous retinal detachment (RRD).
              Article 0 comments Cited 31 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Clin Ophthalmol
                Journal ID (iso-abbrev): Clin Ophthalmol
                Journal ID (publisher-id): OPTH
                Journal ID (pmc): clinop
                Title: Clinical Ophthalmology (Auckland, N.Z.)
                Publisher: Dove
                ISSN (Print): 1177-5467
                ISSN (Electronic): 1177-5483
                Publication date (Electronic): 31 October 2019
                Publication date Collection: 2019
                Volume: 13
                Pages: 2127-2133
                Affiliations
                [1 ]Department of Ophthalmology, School of Medicine, Pusan National University , Yangsan, South Korea
                [2 ]Biomedical Research Institute, Pusan National University Hospital , Busan, South Korea
                Author notes
                Correspondence: Jae Jung Lee Department of Ophthalmology, Pusan National University Hospital , 179 Gudeok-ro, Seo-gu, Busan49241, South KoreaTel +82-51-240-7957 Email jlee@pusan.ac.kr
                Author information
                http://orcid.org/0000-0002-9227-4791
                http://orcid.org/0000-0003-1924-9482
                http://orcid.org/0000-0002-9186-2081
                http://orcid.org/0000-0002-1820-332X
                Article
                Publisher ID: 223415
                DOI: 10.2147/OPTH.S223415
                PMC ID: 6827521
                SO-VID: 09e50670-4799-4c53-9fa6-7de34e3944cc
                Copyright © © 2019 Park et al.
                License:

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                Date received : 16 July 2019
                Date accepted : 24 September 2019
                Page count
                Figures: 3, Tables: 3, References: 28, Pages: 7
                Categories
                Subject: Original Research

                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: fortified barrier laser,vitreous base,rhegmatogenous retinal detachment,single surgery success rate,vitrectomy
                Data availability:
                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: fortified barrier laser, vitreous base, rhegmatogenous retinal detachment, single surgery success rate, vitrectomy

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