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      Transscleral diode laser retinopexy in retinal reattachment surgery Translated title: Retinopexia com laser de diodo transescleral na cirurgia de descolamento de retina

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          Abstract

          PURPOSE: Transscleral diode retinal photocoagulation (diopexy) is becoming an accepted technique in the treatment of selected retinal diseases. The objective of this study is to evaluate diopexy technique in the production of adhesive chorioretinal lesions during the surgical treatment of the rhegmatogenous retinal detachment. METHODS: 25 patients with rhegmatogenous retinal detachment were enrolled in a prospective clinical-surgical study to evaluate the technique of transscleral diode laser photocoagulation to obtain adhesive chorioretinal lesions during retinal reattachment surgery. The surgery consisted of the placement of an exoplant silicon to produce a buckle effect combined with a drainage of subretinal fluid in most cases. RESULTS: By a mean follow-up of 10 months, 21 of 25 eyes had their retinas reattached after only one surgery with diopexy used in all cases. CONCLUSION: Transscleral diode laser photocoagulation was a technically easy, controlled, effective, reproducible and safe means of obtaining chorioretinal adhesion in retinal reattachment surgery.

          Translated abstract

          OBJETIVO: Fotocoagulação transescleral com laser de diodo (diopexia) está se tornando técnica utilizada no tratamento de algumas doenças retinianas. O objetivo deste estudo é avaliar a técnica de diopexia na produção de lesões coriorretinianas aderentes durante o tratamento cirúrgico do descolamento de retina regmatogênico. MÉTODOS: Vinte e cinco pacientes com descolamento de retina regmatogênico participaram deste estudo clínico-cirúrgico prospectivo para avaliar a técnica de fotocoagulação com laser de diodo transescleral para obter lesões coriorretinianas aderentes durante a cirurgia de descolamento de retina. A cirurgia consistiu de colocação de explante de silicone para produzir efeito de introflexão escleral combinado com drenagem do líquido subretiniano na maioria dos casos. RESULTADOS: Após um período médio de seguimento de 10 meses, em 21 dos 25 olhos houve reaplicação da retina após um único procedimento cirúrgico com diopexia aplicada em todos os casos. CONCLUSÃO: Fotocoagulação com laser de diodo transescleral foi uma forma tecnicamente fácil, controlada, efetiva, reprodutível e segura na obtenção de adesão coriorretiniana na cirurgia de descolamento de retina.

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          An updated classification of retinal detachment with proliferative vitreoretinopathy.

          The Retinal Society classification on proliferative vitreoretinopathy of 1983 has been updated to accommodate major progress in understanding of this disease. There are three grades describing increasing severity of the disease. Posterior and anterior location of the proliferations have been emphasized. A more detailed description of posterior and anterior contractions has been made possible by adding contraction types such as focal, diffuse, subretinal, circumferential contraction, and anterior displacement. The extent of the abnormality has been detailed by using clock hours instead of quadrants.
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            Cryotherapy enhances intravitreal dispersion of viable retinal pigment epithelial cells.

            Proliferative vitreoretinopathy (PVR) is the most common cause of failure in retinal reattachment surgery. Giant retinal tears are associated with a particularly high incidence of PVR. It involves the formation of cellular membranes that contract and cause traction retinal detachments. Retinal pigment epithelial (RPE) cells are a major component of these cellular membranes. Displacement of viable RPE cells from their normal position into the vitreous cavity is necessary for membrane formation to occur. This study demonstrates that cryotherapy, but not diathermy, enhances intravitreal dispersion of viable RPE cells in bovine eyes in vitro. This suggests that in some circumstances, excessive cryotherapy may play an exacerbating role in the initiation of PVR.
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              Long-term results after scleral buckling surgery in uncomplicated juvenile retinal detachment without proliferative vitreoretinopathy.

              To evaluate long-term anatomic and functional results of scleral buckling surgery in retinal detachment without proliferative vitreoretinopathy in juvenile patients.
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                Author and article information

                Journal
                abo
                Arquivos Brasileiros de Oftalmologia
                Arq. Bras. Oftalmol.
                Conselho Brasileiro de Oftalmologia (São Paulo, SP, Brazil )
                0004-2749
                1678-2925
                February 2004
                : 67
                : 1
                : 23-26
                Affiliations
                [02] orgnameUniversidade Federal de São Paulo orgdiv1Departamento de Oftalmologia
                [01] orgnameUniversidade Federal de São Paulo
                Article
                S0004-27492004000100004 S0004-2749(04)06700104
                10.1590/S0004-27492004000100004
                0b2807c0-0d55-49d2-a5c0-a90fbc0b0333

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 06 December 2002
                : 09 May 2003
                : 08 March 2003
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 14, Pages: 4
                Product

                SciELO Brazil


                Laser coagulation,Retinal detachment,Drainage,Esclera,Retina,Coróide,Coagulação por laser,Drenagem,Descolamento retiniano,Sclera,Choroid

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