Journal article
Foveal reattachment after macula-off retinal detachment occurs faster after vitrectomy than after buckle surgery.
- Wolfensberger TJ Jules Gonin Eye Hospital, University of Lausanne, Lausanne, Switzerland. thomas.wolfensberger@ophtal.vd.ch
- 2004-07-06
Published in:
- Ophthalmology. - 2004
Adult
Aged
Aged, 80 and over
Cryotherapy
Drainage
Female
Fovea Centralis
Humans
Male
Middle Aged
Prone Position
Prospective Studies
Retinal Detachment
Scleral Buckling
Sulfur Hexafluoride
Supine Position
Time Factors
Tomography, Optical Coherence
Vitrectomy
English
PURPOSE
To investigate the time course of foveal reattachment after successful surgery for macula-off retinal detachments.
DESIGN
Prospective comparative nonrandomized interventional trial.
PARTICIPANTS
Thirty-three patients (16 female and 17 male, 65+/-3 years old) with a spontaneous rhegmatogenous retinal detachment with peripheral breaks and a shallow elevation of the fovea.
INTERVENTION
Nine patients were treated with episcleral buckle, cryotherapy, and, in selected cases, external drainage of subretinal fluid. Twenty-four patients were treated with vitrectomy, cryotherapy, and either complete (n = 8), or partial (n = 16) fluid-gas exchange. Patients with complete fluid-gas exchange were kept first in a prone position for 6 hours to help evacuation of subretinal fluid and, afterwards, on their side. Patients with partial fluid-gas exchange were kept in a supine position with the head elevated for 12 hours, allowing spontaneous absorption of submacular fluid. Patients were examined at 1, 6, and 10 to 12 months after surgery with a complete ophthalmic examination as well as optical coherence tomography (OCT). Mean follow-up was 10.0+/-0.5 months.
MAIN OUTCOME MEASURE
Foveal attachment was determined clinically and by OCT.
RESULTS
Postoperative OCT examination 1 month after buckle surgery (n = 9) showed a small subclinical area of subfoveal fluid in 67% of patients (n = 6). Fluid was still present in 45% of cases (n = 4) at 6 months and in 11% of cases (n = 1) even at 12 months. Optical coherence tomography examination 1 month after vitrectomy showed a completely attached fovea with no subfoveal fluid in all cases (n = 24).
CONCLUSIONS
Complete foveal reattachment after macula-off retinal detachment occurs without delay after vitrectomy, whereas subfoveal fluid may persist subclinically for several months in patients operated with a buckle.
To investigate the time course of foveal reattachment after successful surgery for macula-off retinal detachments.
DESIGN
Prospective comparative nonrandomized interventional trial.
PARTICIPANTS
Thirty-three patients (16 female and 17 male, 65+/-3 years old) with a spontaneous rhegmatogenous retinal detachment with peripheral breaks and a shallow elevation of the fovea.
INTERVENTION
Nine patients were treated with episcleral buckle, cryotherapy, and, in selected cases, external drainage of subretinal fluid. Twenty-four patients were treated with vitrectomy, cryotherapy, and either complete (n = 8), or partial (n = 16) fluid-gas exchange. Patients with complete fluid-gas exchange were kept first in a prone position for 6 hours to help evacuation of subretinal fluid and, afterwards, on their side. Patients with partial fluid-gas exchange were kept in a supine position with the head elevated for 12 hours, allowing spontaneous absorption of submacular fluid. Patients were examined at 1, 6, and 10 to 12 months after surgery with a complete ophthalmic examination as well as optical coherence tomography (OCT). Mean follow-up was 10.0+/-0.5 months.
MAIN OUTCOME MEASURE
Foveal attachment was determined clinically and by OCT.
RESULTS
Postoperative OCT examination 1 month after buckle surgery (n = 9) showed a small subclinical area of subfoveal fluid in 67% of patients (n = 6). Fluid was still present in 45% of cases (n = 4) at 6 months and in 11% of cases (n = 1) even at 12 months. Optical coherence tomography examination 1 month after vitrectomy showed a completely attached fovea with no subfoveal fluid in all cases (n = 24).
CONCLUSIONS
Complete foveal reattachment after macula-off retinal detachment occurs without delay after vitrectomy, whereas subfoveal fluid may persist subclinically for several months in patients operated with a buckle.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.ophtha.2003.12.049
- PMID 15234134
- Persistent URL
- https://sonar.ch/global/documents/2487
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