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Background: To assess the functional and structural outcomes of macular buckling using a silicone sponge‐titanium exoplant for the treatment of foveoschisis (FS) and full‐thickness macular holes (FTMHs) in highly myopic eyes. Methods: Forty‐nine consecutive patients with high myopia who underwent macular buckling for the treatment of FS and FTMHs were included. The outcomes measured included the anatomical success rate with FS resolution, retinal reattachment, MH closure, best corrected visual acuity (BCVA), axial length (AL) and complications of surgery. Moreover, the correlations between the BCVA at year three and series of factors, including age, duration of symptoms, baseline BCVA, AL, surgical type, preoperative macular status and severity of myopic maculopathy, were analysed. Results: This study involved 28 patients (28 eyes) with FS and 21 patients (21 eyes) with FTMHs with macular detachment. Retinal reattachment was achieved in 100% of cases, while MH closure was achieved in 76.19% of cases. The BCVA significantly improved one year after macular buckling in the FS cases and two years after macular buckling in the FTMH cases, and it remained stable throughout the rest of the follow‐up period. The mean AL decreased by 2.09 mm postoperatively. No major perioperative complications were observed, although one patient needed to explant the buckling device due to intolerable diplopia. Conclusion: Macular buckling with a silicone sponge‐titanium exoplant may represent a safe and effective surgical option for the treatment of FS and FTMH in highly myopic eyes. Macular buckling showed a high closure rate and virtually no tendency to recur. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy and safety of macular buckling and vitrectomy for myopic traction maculopathy showing macular schisis (MS) and associated macular detachment (MD) but without full‐thickness macular hole (FTMH). Design: Prospective, randomized, parallel, open‐label study. Methods: Patients were randomly assigned to either buckling or vitrectomy group. Macular buckling and intravitreal C3F8 gas injection were performed in the buckling group. Small gauge vitrectomy, internal limiting membrane peeling (ILMP) and C3F8 gas tamponade were performed in the vitrectomy group. The patients were followed for 12 months. Main outcome measures: Best‐corrected visual acuity (BCVA) at 12 months. Results: A total of 85 patients were randomized, 80 eyes were included (41 receiving buckling, 39 received vitrectomy), and 78 patients completed the study. There were less eyes determined as surgical failure and required a second surgery in the buckling group than vitrectomy the group (2.4% versus 18.4%, p = 0.021). After surgery, macular buckling achieved more improvement in BCVA (+21.7 versus +4.5 Early Treatment Diabetic Retinopathy Study (ETDRS) letters, p = 0.002). FTMH development was observed in only 1 (2.4%) eye, after removing of the implant due to recurrent conjunctival erosion, in the buckling group and 10 (26.3%) eyes (seven with‐, three without MD) in the vitrectomy group (p < 0.001). More eyes developed cataracts in the vitrectomy group than did in the buckling group (28.9% versus 7.5%, p = 0.014). Macular buckling‐associated strabismus (esotropia), binocular diplopia and implant exposure were observed in limited cases. Conclusions and relevance: Macular buckling is superior to vitrectomy with ILM peeling plus gas injection for surgical treatment of MS and associated MD in high myopia. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate real‐world evidence for young Japanese patients with rhegmatogenous retinal detachment (RRD) by retrospectively examining surgical procedures and clinical outcomes in the Japan Clinical Retina Study group. Methods: This was a multicentre retrospective study of the medical records of 562 young patients (384 males and 178 females; mean age: 33.0 ± 11.8 years) who had been diagnosed with RRD and who underwent surgical procedures in participating centres during the period between April 2013 and August 2016. Results: The selected surgeries were scleral buckling (SB) for 295 eyes (49.7%) and pars plana vitrectomy (PPV) for 262 eyes (44.1%). Between the two surgical procedures, there was no significant difference in the primary anatomical reattachment rate (PARR, SB = 92.2%, PPV = 93.9%); improvements in vision were noted in both groups. The incidences of proliferative vitreoretinopathy and cataract formation within 1 year of PPV were 2.3% (p = 0.0047) and 6.5% (p = 0.0005), whereas they were 0% and 1.0% in the SB group, respectively. Conclusion: Scleral buckling (SB) and PPV were chosen with almost equal frequency for young patients with RRD. Clinical outcomes for SB and PPV exhibited a similar PARR. The incidence of cataract formation after PPV may constitute an important limitation of the procedure. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the scleral and conjunctival features in patients with rhegmatogenous retinal detachment (RRD) undergoing scleral buckling (SB), using anterior segment optical coherence tomography (AS‐OCT) and in vivo confocal microscopy (IVCM). Methods: Twenty RRD eyes were consecutively enrolled. AS‐OCT was performed at RRD diagnosis (RRD‐D) and day 1, week 1, month 1 and month 6 after SB to evaluate the sclera, in the affected and unaffected quadrants (AQ, UQ). IVCM was performed at RRD‐D, and at month 1 and month 6, to evaluate the conjunctiva in AQ and UQ. The main outcomes were as follows: mean intra‐scleral hypo‐reflective spaces area (MIHSA) at AS‐OCT; mean density and area of microcysts (MMD, MMA) at IVCM; and intra‐ocular pressure (IOP). The relations between MIHSA, MMA, MMD and IOP were evaluated. Results: Rhegmatogenous retinal detachment‐ diagnosis (RRD‐D) overall‐mean intra‐scleral hypo‐reflective spaces (MISHA), ‐MMD and ‐MMA were significantly higher in affected eye (AE) compared with UE (p < 0.05) and in AQ compared with UQ (p < 0.05). After SB, overall‐, AQ‐ and UQ‐MISHA further increased (p < 0.05), whereas overall‐MMD and ‐MMA did not change. At all follow‐up, AQ and UQ parameters did not show significant differences between them. RRD‐D IOP was 14.3 ± 2.8 and 15.5 ± 2.7 mmHg in the AE and UE, respectively (p < 0.05). After SB, week‐1, month‐1 and ‐6 IOP was significantly lower than RRD‐D (p < 0.05). Rhegmatogenous retinal detachment‐ diagnosis (RRD‐D), 1‐ and 6‐month overall and AQ‐MISHA and AQ‐MMD negatively correlated with IOP (p < 0.05). Conclusion: Rhegmatogenous retinal detachment (RRD) and SB induced scleral and conjunctival changes that suggested an activation of fluid outflow through the entire unconventional aqueous humour pathway; these modifications may in part account for the relative hypotony after RRD and SB. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the outcomes of pars plana vitrectomy with silicone oil tamponade in the management of retinal detachment associated with giant retinal tears. Methods: We reviewed 45 eyes of 42 patients with primary retinal detachment associated with giant retinal tears over 10 years at a tertiary referral centre. Patients underwent 23‐gauge vitrectomy without adjuvant scleral buckling by a single surgeon and had follow‐up at least 6 months after silicone oil removal. Results: Mean follow‐up was 37 ± 35 months. Seven eyes (16%) had grade C proliferative vitreoretinopathy, and 16 (36%) had a giant retinal tear ≥180° at baseline. The primary reattachment rate was 84%, and the overall final anatomical success rate was 98%. The mean Snellen visual acuity equivalent at the final visit was 20/58. Final visual acuity ≥20/40 was achieved in 64%. The mean duration of silicone oil tamponade was 10.5 ± 4 weeks. By the final visit, silicone oil had been removed from 44 eyes (98%). Conclusion: The high rates of anatomical and functional success support management of giant retinal tears‐associated retinal detachment with vitrectomy without adjuvant scleral buckling. Removal of silicone oil at the earliest possible time helps to avoid complications such as keratopathy, glaucoma and visual loss without apparent reason. [ABSTRACT FROM AUTHOR]

Purpose In this retrospective study we evaluated the anatomic outcomes of scleral buckling (SB) versus re-vitrectomy for the treatment of recurrent inferior retinal detachment ( RD) in silicone oil (SiO) tamponade eyes after primary vitrectomy. Methods There were 103 patients (103 eyes) enrolled in this study. All patients had recurrent inferior RD in the SiO-filled eyes within 6 months after the primary vitrectomy, and were treated by either SB or re-vitrectomy. Patients were divided into two groups based on different surgical procedures: the SB group (49 eyes) and the re-vitrectomy group (54 eyes). Anatomic reattachment of the retina was measured after reoperation. Based on different retinal proliferation states in different postoperative periods after primary vitrectomy, we also compared the anatomic outcomes of the two surgical procedures in two specific postoperative periods, early period (≤1 month) and late period (1-6 months). Results The SB and re-vitrectomy groups exhibited similar retinal reattachment rate (65.3% versus 72.2%, p = 0.449) after reoperation. In the re-vitrectomy group, the retinal reattachment rate was similar in the early period and the late period (70.8% versus 73.3%, p = 0.839). However, the retinal reattachment rate was significantly higher in the early period than that of the late period (80.8% versus 47.8%, p = 0.016) in the SB group. In the early surgery groups, the retinal reattachment rate was similar in the SB group compared to the re-vitrectomy group (80.8% versus 70.8%, p = 0.411). While in the late surgery groups, retinal reattachment rate was trended higher in the re-vitrectomy group compared to the SB group (73.3% versus 47.8%, p = 0.058). Conclusion For recurrent inferior RD in SO-filled eyes, SB surgery provides similar therapeutic effectiveness with satisfactory anatomic outcomes compared to the re-vitrectomy. For eyes with recurrent inferior RD in the early period (≤1 month) after primary vitrectomy, SB surgery may be a better choice since it causes less complication; while in the late period (1-6 months) after primary vitrectomy, re-vitrectomy may be recommended, especially for the eyes with severe anterior proliferative vitreoretinopathy and retinal foreshortening. [ABSTRACT FROM AUTHOR]

Purpose To report the results and complications of scleral buckling for the treatment of rhegmatogenous retinal detachment (RRD) using 25-gauge chandelier endoillumination. Methods A total of 61 patients (61 eyes) with RRD were treated with scleral buckling. For the sclera buckling procedure, a 25-gauge chandelier was inserted through the pars plana for intra-ocular illumination, and retinal tears were identified and treated with episcleral cryotherapy under surgical microscope. On postoperative days 1, 3 and 7, the intra-ocular pressure was measured by a non-contact tonometer. On postoperative months 1 and 3, ultrasound biomicroscopy was used to examine the pars plana incision. Results In the surgical procedure, there was no lenticular or retinal damage due to the chandelier insertion. There was no conjunctival bleb formation at pars plana incision and no incidence of endophthalmitis after surgery. The mean intra-ocular pressure was 15.74 ± 2.98, 15.83 ± 2.76 and 16.14 ± 2.52 mmHg on postoperative days 1, 3 and 7, respectively. The one-time retinal reattachment rate was 93.4%. No visible vitreous incarceration was found in the incision of the pars plana. Conclusion There was no complication found due to the chandelier insertion in early postoperative period. Chandelier endoillumination is a feasible method for retinal visualization under surgical microscope during scleral buckling. [ABSTRACT FROM AUTHOR]

The article offers information on the study on more breakdown of blood ocular barriers after vitrectomy than scleral buckling. Topics discussed include information on the advancement of smaller-gauge pars plana vitrectomy (PPV) techniques; discussions on the predictors for the development of proliferative vitreoretinopathy; and the information on the use of the scleral buckling in the population.

Purpose: To compare the anatomical results of scleral buckling with and without retinopexy and to assess the effect of retinopexy on the scleral buckling outcome. Methods: This randomized clinical trial was performed on 55 patients. Twenty-two eyes were treated with scleral buckling (segmental or encircling) with or without drainage of subretinal fluid without any type of retinopexy (group 1); 33 patients received transscleral retinal cryopexy around retinal break(s) in addition to the former procedure. The two groups were matched regarding age, sex, myopia, aphakia, stage of proliferative vitroretinopathy (PVR) and number, type and location of the break(s). Results: In the non-retinopexy group, 19 patients (86%) had complete retinal reattachment and one patient had partial reattachment after 34–48 months of follow-up. One patient did not develop attachment because of missed break out of the buckle, and one had no attachment at all because of PVR. Overall success rate was 91% (20 of 22) in this group. In the retinal cryopexy group, 26 patients (79%) had complete retinal reattachment and two had partial reattachment during 35–56 months of follow-up. In two patients, no attachment was achieved because of missed break out of the buckle; three patients developed redetachment after 1 and 3 months because of PVR. Overall success rate was 85% (28 of 33). The anatomical results in these two groups were the same statistically. Conclusion: With the permanent scleral buckling technique, retinal cryopexy adds no benefit to the success rate of anatomical retinal reattachment. [ABSTRACT FROM AUTHOR]

. Purpose: The 'Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment study' (SPR study) is a randomized multicentre trial comparing primary vitrectomy (PV) and scleral buckling surgery (SB) for rhegmatogenous retinal detachment (RRD). This subanalysis was conducted to identify risk factors associated with anatomical outcomes. Methods: Relating the anatomical success results at the 1-year follow-up visit to pre- and intraoperative findings using multivariate statistical methods. Results: In the phakic subtrial, anatomical success was negatively associated with the number of breaks (p < 0.0001), break extension > 1 clock hour (p = 0.0005) and intraoperative use of cryotherapy (p = 0.0484). It was positively associated with retinal breaks with irregular edges (p = 0.0353) and subretinal fluid drainage (p = 0.0155). In the pseudophakic/aphakic subtrial, anatomical success was negatively associated with the number of retinal breaks (p = 0.0004) and previous YAG capsulotomy (p = 0.0256), and the combined effect of the surgical procedure and intraoperative use of laser (p = 0.0229). Conclusion: Primary anatomical success is an important result for patients undergoing RRD surgery. Our data demonstrate that the final anatomical outcome is related to a higher preoperative number of breaks and cryotherapy in phakic eyes. Additional risk factors varied between phakic and pseudophakic subgroups. Our findings may be used to facilitate the prognosis of future patients with RRD. [ABSTRACT FROM AUTHOR]

. Purpose: To evaluate the anatomical success rate of scleral buckling surgery in the treatment of rhegmatogenous retinal detachment and to evaluate the differences in outcome between patients suffering macula-off retinal detachment and those without a macular involvement. Methods: As a retrospective interventional case series, Munster Study on Therapy Achievements in Retinal Detachment (MUSTARD) is one of the largest ever established of retinal detachment patients and their outcome after buckling surgery, with 4325 patients who underwent surgery between 1980 and 2001. In 53.94% ( n = 2134) of 3956 patients with nontraumatic retinal detachment, the macula was involved. The main outcome measure was the achievement of dry anatomical attachment of the retina. Results: The success rate in patients with macula-off retinal detachment is 80.46% and thus 7.78% lower (p < 0.01) than that in those patients with their macula intact whose success rate amounted to 88.24%. The overall success rate of all 4325 MUSTARD patients was 83.98%. Conclusions: Scleral buckling is an established and mostly successful method for the treatment of retinal detachment. As our case series has demonstrated, even eyes with macula-off can be treated successfully by this procedure, thereby avoiding the complications of primary vitrectomy. [ABSTRACT FROM AUTHOR]

. Purpose: To identify risk factors that may lead to reoperations following primary vitrectomy (PV) and scleral buckling surgery (SB) for rhegmatogenous retinal detachment (RRD). Methods: Analysis of the association between distinct parameters and the necessity for reoperations in the 'Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment study' (SPR Study) using an Andersen-Gill-mean intensity model. Results: The risk for recurrent reoperations is significantly reduced by primary vitrectomy (PV) compared to scleral buckling (SB) in pseudophakic eyes (p = 0.0009) and increased after PV compared to SB in phakic eyes (p < 0.0001). Additional significant risk factors were in the pseudophakic group preoperative deterioration of visual acuity (p = 0.0226), YAG capsulotomy (p = 0.0043), large breaks (p = 0.0290), number of affected quadrants (p = 0.0387), retinal incarceration during surgery (p = 0.0115), number of breaks (p < 0.0001) and symptomatic visual field defect (p = 0.0463). In the phakic group, associated risk factors were low intraocular pressure (p = 0.0013) and persistent intraoperative detachment at the buckle (p = 0.0184). Conclusion: Reoperations are used as an indicator for the quality and efficacy of surgical techniques. Using a refined multivariate survival model, distinct factors were identified and associated with one or more reoperations after PV or SB in RRD surgery. This information should be useful in the decision process regarding the surgical approach. [ABSTRACT FROM AUTHOR]

Purpose: The preoperative and intraoperative clinical variables associated with redetachment and/or a poor visual outcome following scleral buckling (SB) surgery for rhegmatogenous retinal detachment (RRD) have mainly been studied after a short follow-up. This study aimed to analyse long-term effects by following patients for at least 6 months. Methods: In a retrospective survey we evaluated the data of 436 eyes that underwent SB surgery. Postoperative data were collected at 3-month intervals. Results: After a mean follow-up period of 51 months, anatomic reattachment was achieved in 76% after one SB procedure, with a final reattachment rate of 97% after additional vitreoretinal procedures. In total, 104 eyes developed redetachment during follow-up. After more than 6 and 12 months of follow-up, 32 eyes (7%) and 20 eyes (5%), respectively, developed redetachment. Multivariate regression analysis showed that recurrent redetachment and more than 7 days of visual field loss were significant predictors for a poor postoperative visual outcome at 12 months. A cumulative size of the tear of more than three disc diameters was a significant predictor of recurrent RRD. Conclusion: Conventional SB surgery is a reliable procedure in a selected group of eyes with primary RRD. However, in eyes with a retinal tear with a cumulative size of more than three disc diameters, a primary vitrectomy should be considered. Taking into account that 7% of eyes developed redetachment after 6 months, a longer follow-up period seems necessary to evaluate the anatomical and visual outcomes after SB surgery. [ABSTRACT FROM AUTHOR]

Purpose: To assess the incidence of cystoid macular oedema (CME) diagnosed by spectral domain optical coherence tomography (SD‐OCT) after primary rhegmatogenous retinal detachment (RRD) surgery. Methods: From April 2016 to October 2017, 150 eyes of 150 patients presenting with primary RRD were included consecutively in this prospective single‐centre study. Patients with the following characteristics were excluded: previous vitreoretinal surgery, combined cataract surgery, preoperatively presentation with any intraocular or systemic inflammatory condition, visible macular oedema or epiretinal membrane (ERM) on funduscopy. SD‐OCT (Spectralis, Heidelberg Engineering) was conducted 3 and 6 weeks after surgery. Results: One hundred and twenty‐eight of the 150 patients completed the study, of whom 107 (age: 61.7 ± 11.5 years, mean ± SD) showed successful retinal attachment during follow‐up visits. The most frequent operation method was scleral buckling (54.2%), followed by vitrectomy (25.2%) and the combination of both techniques (20.6%). Postoperative SD‐OCT revealed CME, neurosensory detachment and ERM in 18.7, 31.8 and 32.7% of all cases, respectively. The risk of postoperative CME was significantly elevated in patients with ERM (42.9 versus 6.9%, p < 0.001). In addition, patients with initial detachment of the macula had more postoperative CME (26.5 versus 11.1%, p = 0.044). BCVA improvement was significantly lower in patients with CME compared to patients without 6 weeks after surgery for macula‐on RRD. Conclusions: This prospective study confirmed that postoperative CME is a frequent complication after RRD surgery; we identified ERM and macula‐off RRD as potential risk factors. As CME potentially delays visual recovery, postoperative follow‐ups should include SD‐OCT. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 67-year-old woman diagnosed with rhegmatogenous retinal detachment (RD) on the right eye with full-thickness macular hole (MH). Ophthalmic examination and optical coherence tomography (OCT) were conducted to confirm the diagnosis. Recommendations on the treatment of rhegmatogenous RD with concomitant MH are summarized.

A letter to the editor is presented on scleral buckling in rhegmatogenous retinal detachment.

Purpose To describe the modifications produced in the anterior segment of the eye after placing an encircling scleral buckling (SB) in terms of corneal morphology, biomechanics and intraocular pressure. Methods A prospective study of 15 eyes with rhegmatogenous retinal detachment who underwent pars plana vitrectomy combined with a scleral buckle (PPV/SB), and 12 eyes with vitreous hemorrhage treated with PPV alone. We measured preoperatively and 1‐month after surgery the corneal biomechanical properties using the Ocular Response Analyzer (ORA), including corneal hysteresis (CH), corneal resistance factor (CRF), intraocular pressure (IOPg), and corneal compensated IOP (IOPcc). Moreover, we defined the corneal morphology by 4 parameters provided by the topographer Orbscan IIz: mean corneal power (dioptres), standard deviation, thinnest point (µm), and anterior chamber depth (ACD) (mm). Results Mean CH values were significantly diminished following PPV/SB (p=0.003). We found no significant changes in CRF. IOPg and IOPcc mean values were significantly increased only in the PPV/SB group (p=0.019 and p=0.010, respectively) but not in PPV group (p=0.715 and p=0.273, respectively). In PPV/SB group, IOPcc mean values were significantly higher than IOPg before (p=0.001) and after surgery (p=0.003), but not in the other group. None of the morphological parameters were modified after surgery in any of the two study groups (p>0.05) Conclusion Anterior segment morphology was not modified after placing a SB. Corneal biomechanical properties showed a reduction in CH, probably due to a vascular constriction and reduction of the eye compliance. PPV might be considered a less invasive approach for the repair of noncomplex retinal detachments than PPV/SB. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate whether choroidal thickness (CT) is associated with persistent subretinal fluid (pSRF) after simple primary rhegmatogenous retinal detachment (RRD) repair. Methods: This single‐centre, retrospective, observational study included patients who underwent RRD repair with at least 12‐month follow‐up. Preoperative and postoperative parameters were evaluated for association with pSRF. CT measurements were obtained at the central 1 mm area on enhanced depth imaging (EDI) OCT scans, using a semiautomatic method. Multiple logistic regression analyses were assessed to determine predictive factors for pSRF. Results: Overall, 100 eyes of 100 patients, mean age of 59.9 ± 12.6 years were included. pSRF was found in 21.0% of eyes and resolved over time in 85.7% of eyes at 12 months. In the pSRF group both RRD and fellow eyes showed lower mean choroidal and RPE thickness values as compared to those without pSRF (p < 0.05). A significant correlation was found between pSRF occurrence and choroidal thinning (p = 0.02). After multiple regression analyses, macula‐off RRD (p = 0.005) and scleral buckling (SB) technique (p = 0.001) were retained as final predictors for pSRF. In macula‐off SB eyes, detachment duration was the only factor associated with pSRF (p = 0.046). There were no significant differences in best‐corrected visual acuity outcomes between the pSRF and the no‐pSRF eyes. Conclusions: Patients with pSRF showed lower choroidal and RPE thickness as compared to those without pSRF. CT did not turn out to be a final predictor for pSRF, as this was mainly associated with macular involvement, surgical technique and detachment duration. [ABSTRACT FROM AUTHOR]

Purpose Materials and Methods Results Conclusions To elaborate a deep learning (DL) model for automatic prediction of late recurrence (LR) of rhegmatogenous retinal detachment (RRD) using pseudocolor and fundus autofluorescence (AF) ultra‐wide field (UWF) images obtained preoperatively and postoperatively.We retrospectively included patients >18 years who underwent either scleral buckling (SB) or pars plana vitrectomy (PPV) for primary or recurrent RRD with a post‐operative follow‐up >2 years. Records of RRD recurrence between 6 weeks and 2 years after surgery served as a ground truth for the training of the deep learning (DL) models. Four separate DL models were trained to predict LR within the 2 postoperative years (binary outputs) using, respectively, UWF preoperative and postoperative pseudocolor images and UWF preoperative and postoperative AF images.A total of 412 eyes were included in the study (332 eyes treated with PPV and 80 eyes with SB). The mean follow‐up was 4.0 ± 2.1 years. The DL models based on preoperative and postoperative pseudocolor UWF imaging predicted recurrence with 85.6% (sensitivity 86.7%, specificity 85.4%) and 90.2% accuracy (sensitivity 87.0%, specificity 90.8%) in PPV‐treated eyes, and 87.0% (sensitivity 86.7%, specificity 87.0%) and 91.1% (sensitivity 88.2%, specificity 91.9%) in SB‐treated eyes, respectively. The DL models using preoperative and postoperative AF‐UWF imaging predicted recurrence with 87.6% (sensitivity 84.0% and specificity 88.3%) and 91.0% (sensitivity 88.9%, specificity 91.5%) accuracy in PPV eyes, and 86.5% (sensitivity 87.5%; specificity 86.2%) and 90.6% (sensitivity 90.0%, specificity 90.7%) in SB eyes, respectively. Among the risk factors detected with visualisation methods, potential novel ones were extensive laser retinopexy and asymmetric staphyloma.DL can accurately predict the LR of RRD based on UWF images (especially postoperative ones), which can help refine follow‐up strategies. Saliency maps might provide further insight into the dynamics of RRD recurrence. [ABSTRACT FROM AUTHOR]

Purpose: To describe the outcome of retinal detachment surgery in a population affected by rhegmatogenous retinal detachment (RRD) in southern Sweden 2011–2013. Method: All primary retinal detachments that underwent surgery at the Skåne University Hospital were registered during the period of 2011–2013. Age, sex, lens status and the different surgical methods including type of tamponade were recorded. For outcome assessment, no reoperation within 6 months was considered as primary success with one surgery except silicone oil removal. Results: In total, 918 primary retinal detachments were recorded during the 3‐year period. Pars plana vitrectomy (PPV) alone was used in 618 eyes (67.3%), whereas an external approach with scleral buckling (SB) was used in 184 cases (20.0%) and a combination of PPV + SB in 116 eyes (12.6%). Pars plana vitrectomy (PPV) in combination with phacoemulsification and IOL implantation was performed in 169 eyes (18.4%), which was 43.6% of the phakic eyes having a PPV procedure. A total of 346 eyes (37.7%) were pseudophakic preoperatively. The success rate of one surgery was 86.9% for the entire cohort. In 120 eyes (13.1%), there was a re‐detachment during the 6‐month follow‐up time. Higher age at the primary surgery turned out to be correlated to an increased risk of primary failure (p = 0.018) but gender was not (p = 0.84). Preoperative lens status did not affect the risk of re‐detachment (p = 0.36), and there were no differences in outcome between surgeons (p = 0.27). No surgical procedure – alone or in combination – showed superior outcome as primary surgical approach. Conclusions: There were no significant differences in anatomical outcome between the various surgical procedures in this large cohort of 918 RRD cases. [ABSTRACT FROM AUTHOR]

Purpose: To compare the efficacy and safety outcomes of scleral buckling (SB) and drainage–injection–pneumoretinopexy (DIP), a modified pneumatic retinopexy technique, in which, before gas injection, subretinal fluid is drained with a simultaneous injection of balanced salt solution (BSS) in the vitreous chamber, for the treatment of severe superior bullous rhegmatogenous retinal detachment (SBRD). Methods: This prospective, randomized, comparative study included 58 eyes with severe SBRD that were randomized 1:1 to undergo SB or DIP. The main outcome measures included success rate, visual acuity, mean change in refractive error and surgery duration. Results: The primary anatomic success rate was 93% for both procedures. Both groups showed significantly improved visual acuity after surgery. The change in refractive error and surgery duration was significantly higher in the SB group. Drainage–injection–pneumoretinopexy (DIP) appeared to be less traumatic, but with a longer persistence of subretinal fluid in a greater number of patients. Conclusion: Our findings suggested that both SB and DIP are safe and effective treatments yielding functional and anatomical recovery in patients with severe SBRD. However, the DIP technique may be easier and less costly, with a success rate similar to that of SB. [ABSTRACT FROM AUTHOR]

Purpose To examine the incidence of retinal detachments and to evaluate patient profiles and surgical characteristics. Methods Retrospective review of patients operated for primary retinal detachment ( RD) and redetachment between 2010 and 2012 at the Department of Ophthalmology, Odense University Hospital, Denmark. We included all RD such as rhegmatogenous retinal detachment ( RRD), tractional retinal detachment ( TRD) and exudative retinal detachment (ERD). Results In total, 779 RD surgeries were performed: 83.7% ( n = 652) primary operations and 16.3% ( n = 127) reoperation. For primary operation, pars plana vitrectomy ( PPV), scleral buckling and combined operations were performed in 95.1% ( n = 620), 4.6% ( n = 30) and 0.3% ( n = 2) respectively. Over time there was less use of silicone oil and greater use of gas tamponade (p = <0.001), less simultaneous cataract operations (p = <0.001), less use of cryotherapy (p = 0.045) and more use of peeling procedures (p = <0.001) in primary operations. The annual incidence of surgery for primary RD was 22.0 [95% confidence interval ( CI) 20.4-23.8] per 100 000 inhabitants aged >15 years. Retinal detachment (RD) was more common in males than females (1.8:1), and mean age at presentation was 61.8 years (standard deviations ± 12.3). The annual incidence for RRD and TRD operation was 20.72 (95% CI 19.11-22.43) and 1.25 (95% CI 0.9-1.7) per 100 000 inhabitants >15 years. Conclusion This study presents the first overall incidence for RD in Denmark. The highest incidence of RRD was among males aged 60 to 79 years, whereas TRD was among females at same age. Pars plana vitrectomy (PPV) was the preferred surgical technique, and during 2012 all RD patients were treated with PPV, independent of lens status and age. [ABSTRACT FROM AUTHOR]

Surgical approaches for rhegmatogenous retinal detachment (RRD) have evolved rapidly in the past century. This has resulted in an increase in the anatomical success rate from zero per cent in the beginning of the 1900s to now almost 100 per cent. Rhegmatogenous retinal detachment is regarded as an acute eye disease that needs immediate treatment. With the increasing number of cataract surgeries and an increased elderly population, the numbers of RRD occurrences are increasing. The aim of this thesis is to create knowledge on how treatment and care of RRD patients can be optimized. In the first paper, data on the incidence of RRD in Denmark are presented based on data from a nation register the National Patient Registry ( NPR). It was discovered that the incidence of RRD in Denmark is similar to previous reported numbers and that the incidence has been increasing due to increasing numbers of cataract surgeries and an increased elderly population. Using data from the NPR, we estimated that the risk of a RRD occurring on the fellow eye is 100 times larger than on the first eye and that middle aged men have the highest risk. Having an increase in the incidence of RRD we need to ensure that the patients are also treated in the most optimal way. To ensure this, an indicator is needed to monitor the quality at the different centres. This indicator presented in the second paper is based in the occurrence of redetachment. We define a detachment to be caused by poor surgery if the retina detaches within one year after initial surgery with pneumatic retinopexy, scleral buckling and VTX with gas, and one and a half years after surgery with VTX with oil. Also lack of oil removal within the first year is a failed operation. It is widely accepted that RRD is an acute disease but when should surgery be performed to attain the most optimal result? In the third paper, we evaluated the progression of posterior RRD with an optical coherence tomography to make an objective assessment of the movement. We found that the risk of a macula on RRD progressing to affect the fovea is small if the patient is postured appropriately. We found that the movement of the RRD is dynamic but the detachments will ultimately approach the fovea. Having an opportunity to postpone surgery without risking the outcome for the patient allows a more optimal surgery. The results of this thesis can be used by all health care systems to establish optimal conditions in the treatment of RRD. [ABSTRACT FROM AUTHOR]

The cover photo shows iris transillumination defects on slit-lamp examination from the paper by Armonaite and Behndig. Cataract surgery Preoperative administration of topical nepafenac was observed to reduce the inflammatory response in healthy patients undergoing uncomplicated cataract surgery one month after surgery according to Cagini et al. Retina surgery Morescalchi et al. study reveals that scleral buckling (SB) and drainage-injection-pneumoretinopexy (DIP), a modified pneumatic retinopexy technique are safe and effective treatments yielding functional and anatomical recovery in patients with severe superior bullous rhegmatogenous retinal detachment. [Extracted from the article]

. Purpose: To compare the anatomic success between repair of rhegmatogenous retinal detachment (RRD) with superior breaks and repair of RRD with inferior breaks, by performing primary vitrectomy and using similar techniques and the same gas. Methods: Eighty-two consecutive eyes of 80 patients with RRD were included in this retrospective comparative study. The eyes were divided into two groups according to the location of the breaks: superior ( n = 62) and inferior ( n = 20). All the patients underwent a standard, 3-port, 20-gauge pars plana vitrectomy with 20% sulphur hexafluoride gas tamponade performed by the same surgeon. The main outcome measured was the primary anatomic reattachment at 3 months after surgery. Results: The primary anatomic success rate in the inferior group was significantly lower than that in the superior group (80% versus 98%, p = 0.012). In the inferior group, the primary anatomic success rate in patients whose symptoms lasted for more than 2 weeks was significantly lower than that in others (5/9 versus 11/11, p = 0.026). Multivariate logistic regression analysis identified inferior break as the only independent risk factor for redetachment (odds ratio, 11.88; p = 0.034). Conclusion: The anatomic success of primary vitrectomy for RRD with inferior breaks is lower than that for RRD with superior breaks. In particular, the duration of symptoms longer than 2 weeks is associated with a worse outcome in patients who had RRD with inferior breaks. [ABSTRACT FROM AUTHOR]

Purpose: To report the surgical outcomes of pars plana vitrectomy (PPV) with inferior retinotomy without the need for scleral buckling in primary inferior rhegmatogenous retinal detachment (RRD) with inferior retinal breaks and Proliferative vitreoretinopathy (PVR) grades B or C. Methods: Retrospective, consecutive series, single‐center study of patients that underwent PPV with inferior retinotomy for primary inferior RRD with inferior retinal breaks (4:00 to 8:00 clock hours) and PVR grades B or C. Data were obtained from patients' medical records from October 2014 to November 2020. The primary outcomes of the study were retinal reattachment and visual acuity improvement. Data collected before and after surgery was compared between groups using chi‐square analysis and paired samples t‐test. The resulting p‐values significance level was set at p = 0.05. Results: Thirty‐two patients (32 eyes) met the inclusion criteria. PVR in stage B was present in 19 patients and stage C in 13 patients. Macula‐off RRD was diagnosed in 25 patients while the other 7 patients had RRD with the macula attached. Regarding primary outcomes, 31 out of 32 (97%) patients achieved retinal reattachment with no differences between PVR groups (p = 0.406). The best‐corrected visual acuity (BCVA) improved significantly in eyes with macula‐off RRD at presentation (p < 0.001). Although macula‐attached RRD eyes had higher final BCVA, its improvement was not statistically significant (p = 0.370). Besides one retinal redetachment, no other significant complications were reported after surgery. Conclusions: Inferior retinal breaks are associated with surgical failure following PPV for inferior RRD repair, especially if advanced PVR is present. Our results suggest that, in these less common and more challenging cases, PPV with an inferior retinotomy is associated with very favorable anatomic and visual outcomes. [ABSTRACT FROM AUTHOR]

. Purpose: To evaluate vitrectomy in conjunction with the use of perfluorocarbon, cerclage, laser retinopexy, lens removal and silicone oil as surgical treatment of proliferative vitreoretinopathy associated with retinal detachment. Methods: Sixty-two eyes of 62 patients were treated for complicated retinal detachment following failed prior scleral buckling. Outcome measures were; retinal reattachment rate 6 months after silicone oil removal, status of the retina, visual acuity (VA), duration of silicone tamponade and frequency of reoperations. Results: The final reattachment rate was 95%. Reoperations had to be performed in 25% of patients. Eighty-one per cent of these patients received one and 19% two or more operations following silicone oil implantation. The mean time to reoperation was 1.8 ± 1.4 months. Silicone oil was removed after 5.6 ± 4.1 months following the last vitreoretinal procedure in 90%, respectively, 95% with attached retina. Five per cent experienced retinal detachment after silicone oil removal. At the end of follow-up, the mean VA was 0.13 ± 0.26 Snellen. Seventy per cent of patients achieved a vision of 20/200 or better (mean 0.25 ± 0.27). Conclusion: Our study demonstrates good final outcomes when a rigorous surgical approach was used. Furthermore, this standard procedure reduces the need for reoperations and consequently improves the functional outcome. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate treatment effects of intravitreal gas for macular hole with localized retinal detachment (RD) in highly myopic eyes and to examine how the vitreomacular relationship and other factors may influence treatment outcomes. Twenty highly myopic patients with macular holes and localized posterior RD, treated initially with intravitreal injection of CF, were prospectively studied. Recurrent disease was treated with repeated gas injection or vitrectomy according to the extent of detachment. Length of follow-up was ≥ 12 months. Vitreomacular conditions were determined before and within 2 months after gas injection by standard optical coherence tomography. Demographics, refractive errors, axial length, the extent of chorioretinal (CR) atrophy and visual acuity were recorded. The success rate after primary gas injection was 70%. The remaining 30% of patients achieved anatomic success after further treatment, including vitrectomy with gas or silicone oil tamponade and/or scleral buckling. All cases achieved anatomic success after a mean of 1.4 surgeries. Univariate analysis showed that the patterns of the posterior vitreoretinal relationship did not differ significantly between those successfully treated with gas only (group 1) and those requiring vitrectomy (group 2) (p = 1.000). Logistic regression showed no statistically significant differences in any characteristics between groups 1 and 2. Intravitreal gas tamponade alone may achieve anatomic success in more than two-thirds of highly myopic patients with macular holes and localized RD. Patients with different clinical characteristics and vitreoretinal relationships seem to have similar opportunities to achieve reattachment through this relatively non-invasive surgery. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the clinical features and visual outcomes of non-traumatic suprachoroidal haemorrhage (SH) in Taiwan. Methods: We report a retrospective, non-comparative, interventional case series study carried out in an institutional setting. Thirty-nine eyes with non-traumatic SH were studied using a new system for grading the severity of SH. The aetiologies of SH were analysed. The correlations between grades and prognoses of SH were studied. Multiple logistic regression was used to assess factors associated with final visual outcome. Results: Conditions causing SH in the eyes considered in this study included cataract surgery (43.59%), age-related macular degeneration (AMD) (17.95%), filtering operation and vitrectomy (both 10.26%), scleral buckling (5.13%) and others. Twelve eyes (12/39, 30.77%) had a final visual outcome of no light perception. Only 12 eyes (12/39, 30.77%) had final visual acuity (VA) > 4/200. Grade of SH correlated significantly with need for surgical drainage and with final visual outcome (Spearman rank correlations 0.313 and − 0.408, p = 0.010 and p = 0.00317, respectively). ‘Good’ and ‘poor’ final VA was significantly associated with VA at the time of SH (multiple logistic regression coefficients 2.132 and − 2.809, p = 0.015 and p = 0.008, respectively), as well as initial retinal detachment (multiple logistic regression coefficients − 2.267 and 2.223, p = 0.036 and p = 0.006, respectively). Higher grades of SH and increased age were associated with poor final visual outcome (multiple logistic regression coefficients − 1.332 and − 0.122, p = 0.013 and p = 0.022, respectively). Conclusions: Suprachoroidal haemorrhage is a devastating ocular problem. Complications of intraoperative surgery and AMD are common causes. The new SH grading system provides a simple method for evaluating the need for drainage and for predicting visual prognosis. Visual acuity and retinal detachment at the time of SH are major factors associated with good and poor final VA, respectively. [ABSTRACT FROM AUTHOR]

. Purpose: To report the change in refraction in pseudophakic eyes following 23-gauge vitrectomy for epiretinal membrane (ERM), without use of silicone oil, intraocular gas or scleral buckling. Methods: Retrospective review of the records of 28 pseudophakic eyes in 28 patients undergoing 23-gauge pars plana vitrectomy for ERM. All 28 eyes had a measured preoperative refraction in their records and were seen minimum 2 months after vitrectomy for measuring their refraction. Fellow eyes (28 eyes) were used as controls. Results: The mean preoperative refraction was −0.15 ± 0.85 dioptre (D), and the mean postoperative refraction was −0.41 ± 0.93 D. Thus, a myopic shift was observed following vitrectomy with a mean change in refraction of −0.26 ± 0.60 D (range +0.75 to −2.13 D, p = 0.032). The postoperative change in refraction was within ±0.25, ±0.50 and ±1.00 D in 39%, 68% and 96% of the eyes, respectively. The mean absolute refractive error was 0.47 ± 0.44 D. The change in refraction in fellow eyes was +0.01 D (p = 0.82). Conclusion: The change in refraction following 23-gauge pars plana vitrectomy for ERM in pseudophakic eyes was −0.26 D. [ABSTRACT FROM AUTHOR]

Myopic traction maculopathy is common in highly myopic patients and characterized by different stages: macular schisis (MS),macular detachment (MD) without macular hole (MH), and MD with MH. MH-related retinal detachment is an uncommon complication associated with posterior staphyloma. Surgical management is based on transvitreal approach and posterior scleral procedure. Since the introduction of pars plana vitrectomy (PPV),retinal detachments with MH in highly myopic eyes were mostly treated with the transvitreal surgery. However,vitrectomy alone does not address the major risk factor of the macular schisis, which is the posterior staphyloma. To give a new shape and support to the posterior scleral wall by means of macular buckling has the advantage of releasing both the traction caused by the posterior staphyloma and the anteroposterior traction caused by the vitreous cortex. A more recent T-shaped scleral buckle has been proposed by Devin et al. We performed this macular buckling combined or not with PPV as a primary surgery or with a previous failed surgical approach in patients affected by MH with MD and MH with or without MS. In our opinion a combined surgical approach could be the most effective way to treat this disease. [ABSTRACT FROM AUTHOR]

An introduction is presented with topics including impact of time spent outdoors on reducing myopia risk, greater retinal nerve fiber loss in patients with neuromyelitis spectrum optic neuritis, and use of chandelier endoillumination in scleral buckling procedures for retinal detachment.

Purpose To describe the possible complications following conventional surgery for retinal detachment Scleral buckling procedure has a primary success rate of 85–90%. Complications, although rare, may occur. Some of them may be severe. In some instances, patients lose sight in the affected eye or lose the entire eye. Methods Conventional retinal detachment surgery under general anaesthesia. Results Possible, but infrequent, complications from scleral buckle surgery include failure of the operation, loss of some or all vision, loss of an eye (rare), double vision, retinal hemorrhage, cataract formation, glaucoma, further retinal detachment, proliferative vitreoretinopathy, vitreous hemorrhage, drooping of the upper lid, and infection. Drainage of the subretinal fluid during surgery, is associated with a higher risk of complications such as bleeding, perforation of the retina, incarceration of the retina at the drainage site, infection etc. Even though the incidence of such complications is low, the risks should be explained to patients. As the scleral buckle is left in place permanently and behaves as a foreign body to the eye there is a risk that there may infection and extrusion many years after the surgery. There is also the small risk of the buckle eroding into the eye, necessitating its removal. A change of patient's refraction is observed usually (increased shortsightedness) after scleral buckling surgery. In some instances, although the retina reattaches, visual acuity is not restored. The risk of surgery also rises with the use of general anesthesia. Conclusion Scleral buckling, however, is considered a safe, successful procedure. Restored vision depends largely on the location and extent of the detachment, and the length of time before the detachment was repaired. [ABSTRACT FROM AUTHOR]

Purpose To review the incidence of new and missed retinal breaks, the risk for PVR formation and the danger of other intraoperative or postoperative complications after pneumatic retinopexy (PR) for retinal detachment comparing with those after scleral buckling procedure and vitrectomy. Methods All cases having undergone PR in our clinic during the last 8 years for primary retinal detachment or redetachment were reviewed for intraoperative or / and postoperative adverse events. The findings were compared with those from the literature which studied in any prospective or retrospective way the complications after PR, scleral buckling and vitrectomy for retinal detachments without PVR. Results Improper gas entrapment (anteriorly, subretinal or subconjuctival) and high intraocular pressure were observed intraoperatively or soon after the procedure. New retinal breaks and PVR development were the most common findings in the late postoperative period. Conclusion The relatively high incidence of new breaks suggests that proper case selection and close follow‐up are probably required. PR seems to be the method of choice after retinal redetachment due to missed retinal breaks after vitrectomy. [ABSTRACT FROM AUTHOR]

Purpose In the "Scleral buckling vs. primary vitrectomy in rhegmatogenous retinal detachment study (SPR study)" two different surgical methods for the treatment of retinal detachment (RD) were compared in a randomised prospective multicentre clinical trial. This secondary analysis was conducted to investigate possible associations between pre‐ and intraoperative factors with the functional and anatomical outcomes. Methods Univariate and multivariate analysis of 48 pre‐ and intraoperative factors and their association with anatomical outcome, functional outcome and the number of secondary surgical interventions. Results In phakic patients, a significant correlation of successful outcome could be associated with number of retinal breaks, large breaks, cryotherapy, duration of symptoms, baseline visual acuity, central RD, total RD, drainage during buckling surgery and chain formation of breaks. In pseudophakic patients, factors identified were number of breaks, capsular fibrosis, Yag‐laser capsulotomy, retinal laser photocoagulation, and inferior RD. Conclusion The most important risk factor for functional and anatomical failure was a higher number of retinal breaks. Other risk factors varied between the phakic and pseudophakic patients as well as between functional and anatomical outcomes. These findings are of clinical importance for identification of patients with a higher risk for failure and for the planning of future trials on RD surgery. [ABSTRACT FROM AUTHOR]

Purpose Secondary transient or permanent elevation of intraocular pressure (IOP) is a quite common complication following vitreoretinal procedures. Methods This presentation will focus on different mechanisms, clinical diagnosis and management of the secondary glaucoma after scleral buckling, vitrectomy with or without gas or silicone oil tamponade, and application of steroids. Results In pre‐existing operated glaucoma with filtering surgery, maintenance of the bleb requires an approach for conjunctiva preservation with techniques such as small gauge vitrectomy. Secondary hypertension can occur after scleral buckling because of congestion and anterior rotation of the ciliary body. Medical therapy is usually successful in controlling IOP, however surgical intervention could also be needed. Intravitreal injection of gases (SF6, C3F8) may produce secondary angle‐closure glaucoma with or without pupillary block. Intraocular gas removal may be indicated. Secondary glaucoma can also develop after intravitreal injection of silicone oil due to pupillary block, inflammation, synechial angle closure, or migration of emulsified or nonemulsified silicone oil into the anterior chamber. Patients with medically uncontrolled glaucoma after silicone oil tamponade, with an open inferior iridectomy, may require oil removal with or without concurrent glaucoma surgery. Conclusion Diode laser transcleral cyclophotocoagulation and drainage implants constitute approved methods for long‐term IOP regulation. The underlying cause of secondary glaucoma after vitreoretinal surgery is often multifactorial. Cooperation between vitreoretinal and glaucoma specialists may be helpful in successful treatment. [ABSTRACT FROM AUTHOR]

Purpose To evaluate the clinical characteristics and surgical outcomes of paediatric retinal detachment in an Asian population. Methods A retrospective case series of all patients aged 18 years and under who underwent retinal detachment surgery at the Singapore National Eye Centre from 1994 to 2008. Results 133 eyes in 116 patients were treated for retinal detachment over 15 years. 88 patients (75.9%) were male. The mean age was 14.0 years (range 3 to 18 years; median 15 years). Retinal detachment was caused by trauma in 13.5% (18 eyes). Myopia was the most common risk factor, present in 57 eyes (42.9%). 9% (12 eyes) had pseudophakic retinal detachment and 3.0% (4 eyes) had aphakic retinal detachment. The mean duration from onset of symptoms to presentation was 43 days (+/‐92.4). Initial visual acuity (VA) was 6/12 or better in 19.5% of eyes, while 53.9% of eyes had VA worse than 6/60 at presentation. The macula was still attached in only 22.1% of eyes. 85% of eyes had one retinal detachment surgery performed. 74% of our patients were treated with a sclera buckling procedure at the first instance. 18.3% had a combined vitrectomy with sclera buckling. Only 7.6% had primary vitrectomy as the initial treatment. 85% (113) of eyes achieved anatomical success defined by a completely attached retina on last followup, at least 6 months after last surgical procedure. 43.7% of eyes achieved a final postoperative VA of 6/12 or better. 76.2% of eyes had VA 6/60 or better. Conclusion Paediatric retinal detachments are characterised by delayed diagnosis, high incidence of macular involvement on presentation and a male predominance. In our series, myopia was the most common risk factor, which is not unexpected given the high incidence of childhood myopia in our population. [ABSTRACT FROM AUTHOR]

Purpose Dealing to the localization and sealing retinal breaks, the surgical success rate for the cure of rhegmatogenous retinal detachment greatly changed with the introduction of scleral buckling (SB), intraocular gas injection, and pars plana vitrectomy (PPV). Methods In localized cases, pneumatic retinopexy and scleral buckling surgery (SB) remains the most popular surgical methods. Complicated cases with PVR grade B or C, giant tears, or macular holes are most commonly treated with primary pars plana vitrectomy. A large group of rhegmatogenous RDs with medium severity that comprise about 30% of all primary rhegmatogenous RDs in the Scleral Buckling versus Primary Vitrectomy in Rhegmatogenous Retinal Detachment recruitment study, were treated by SB and PPV. Advances in vitrectomy instrumentation and wideangle imaging systems have increased the popularity of PPV. Results The decision by the surgeon to use scleral buckling rather than PPV depends on a number of factors, including the lens status, size and location of breaks, patient compliance, and individual experience. Initial PPV may be successful for phakic patients. However, the SPR study shows a benefit of SB in phakic eyes with respect to BCVA improvement. Although no difference in BCVA was demonstrated in the pseudophakic trial, PPV was recommend for pseudophakic RD based on a better anatomical outcome. Conclusion There was a significant trend towards more frequently employing primary PPV (with or without SB) for the management of primary RRD. A significant improvement in the primary success rates for RD, were shown for all retinal surgical modalities applied for the treatment of rhegmatogenous retinal detachment. [ABSTRACT FROM AUTHOR]

The article explores ways to optimize the treatment of rhegmatogenous retinal detachment. Topics discussed include surgical approaches for rhegmatogenous retinal detachment (RRD); increase in the incidence of RRD; and use of a surgery with pneumatic retinopexy, scleral buckling and pars plana vitrectomy (PPV) with gas.

The article offers information on the complications related to vitreoretinal diseases to achieve retina stability and vitrectomy with silicone oil (SO) instillation. It discusses several facts which includes progressive lens opacity, SO and cataract extraction with intra- lens (IOL) implantation and higher rate of scleral buckling.

Purpose The aim of the study was to evaluate the anatomical success of surgical management of primary rhegmatogenous retinal detachment ( RRD) and to compare the anatomical outcomes from different surgical techniques. Methods During 2012, 517 consecutive eyes (514 patients) were operated by 11 surgeons at the Department of Ophthalmology, Oslo University Hospital. Patient records were retrospectively analysed with no exclusions. Main outcome measures were primary and final anatomical success. Primary anatomical success was defined as retinal reattachment 6 months after primary surgery with reoperations excluded. Final anatomical success was defined as retinal reattachment 6 months after primary surgery with reoperations included. Results Incidence of RRD was 18.6 eyes per 100 000 person-years. The macula was detached in 50.5% of the eyes at baseline. Of 517 operated eyes, 317 (61.3%) underwent pars plana vitrectomy ( PPV), 23 (4.5%) pars plana vitrectomy together with a scleral buckle ( PPV- SB), 175 (33.9%) scleral buckle ( SB) surgery and two (0.4%) pneumatic retinopexy ( PR). Primary anatomical success was 89.0% in the PPV group, 87.0% in the PPV- SB group and 85.7% in the SB group. Final anatomical success was 98.1% in the PPV group, 100% in the PPV- SB group and 99.4% in the SB group. Factors which were correlated to the redetachment were detachment of more than 6 clock hours (p = 0.003) and visual acuity ( VA) on Snellen chart <0.5 (p = 0.02) at baseline. Conclusion This study showed no significant differences in the surgical success rates in the treatment of RRD between pars plana vitrectomy, scleral buckle or the combined procedure of vitrectomy and buckle. Factors which were found to be correlated to the redetachment of the retina were large detachment and low VA. [ABSTRACT FROM AUTHOR]

Macular surgical diseases in myopia are consecutive to vitreoretinal interface disorders associated to stretching forces due to staphyloma on the other side. OCT have largely contributed to the recognition and the understanding of vitreoretinal interface disorders occuring in myopic condition: epiretinal membrane alone or associated to foveoschisis, lamellar or full thickness macular hole and posterior retinal detachment. Surgical management by vitrectomy associated or not to ILM peeling will be discussed according to myopic disorders. Main surgical complications are macular hole formation and foveal atrophy. Fovea-sparing internal limiting membrane peeling for myopic traction maculopathy may represent an alternative option to avoid these complications. Scleral buckling surgery associated to vitrectomy may represent an other option under investigation. [ABSTRACT FROM AUTHOR]

Purpose The initial success of vitreoretinal surgery can be annihilated by an acceleration of preexisting glaucoma or the development of secondary glaucoma. Aim of this study was to determine the incidence of and risk factors for medically uncontrollable glaucoma after vitreoretinal surgery. Methods Case-control study amongst patients who underwent vitreoretinal surgery at the University Medical Center Groningen between 1991 and 2011 (in total 14 942 interventions). Cases were all patients who received a glaucoma drainage device after vitreoretinal surgery. Controls were a subset of the patients who underwent vitreoretinal surgery without a subsequent drainage device. Cases and controls were matched (three controls per case) with regard to the year of the (first) vitreoretinal intervention. The incidence rate was calculated from the number of cases and the number of person-years corresponding to all vitreoretinal interventions performed in the study period. Risk factors were analysed with logistic regression. Results Ninety-five cases were identified after a follow-up of 101 961 person-years (one per 1000 person-years). Cases were younger (p = 0.017), were more often men (p = 0.035), underwent more interventions (p < 0.001) or were treated with silicone oil (p = 0.021), had a higher intra-ocular pressure 1 week after the intervention (p < 0.001) and had more often a history of glaucoma or ocular hypertension (p < 0.001). Conclusion Glaucoma after vitreoretinal surgery that requires a glaucoma drainage device is not very common and patients who need a device differ from those who do not. This gives the opportunity to monitor certain subgroups more closely. [ABSTRACT FROM AUTHOR]

Purpose To compare pars plana vitrectomy and 360° endolaser therapy with pars plana vitrectomy and an encircling scleral buckle for the treatment of primary rhegmatogenous retinal detachments in a randomized pilot study including 60 patients. Methods Main outcome measures were single-surgery anatomic success rate and final best-corrected visual acuity at 6 months follow-up. Cofactors analysed were complication rates, patients' comfort, refractive outcome and macula status assessed using a spectral-domain optical coherence tomography. Results With differences between both treatment groups regarding type of the retinal detachment, localization of retinal tears (p = 0.0085) and the choice of the intraocular tamponade (p < 0.0202), there were no significant differences between the single-surgery anatomic success rate (93.33% both groups, p = 1.0) and the visual acuity at final follow-up (≤0.3 logMAR [logarithm of minimum angle of resolution] in 66.67% in the endolaser group versus 40.0% in the scleral buckle group, p = 0.0514). Questionnaire responses showed lower levels of patients' discomfort in the endolaser group. A significant difference between both groups was found in the refractive error change after surgery (−0.20 ± 0.51 dioptres in the endolaser group versus −0.88 ± 0.88 dioptres in the scleral buckle group, p = 0.0003). Conclusion Primary vitrectomy combined with 360° endolaser therapy seems to be as effective as vitrectomy combined with an encircling scleral buckle in patients with rhegmatogenous retinal detachment, with possible benefits of an improved patients' comfort and a more stable refractive status after surgery. [ABSTRACT FROM AUTHOR]

The article reports on a clinical trial which evaluates the effects of oral colchicine on the prevention of proliferative vitreoretinopathy (PVR) in eyes undergoing scleral buckling (SB). It states that the subjects of the study were patients with rhegmatogenous retinal detachment undergoing SB. The findings of the study reveal that oral colchicine had no significant effect on the prevention of retinal redetachment due to PVR.

Purpose To evaluate and establish the rate of pathologic findings for patiens with acute and symptomatic floater Methods Retrospectively records of 3377eyes(2649 patients) with acute, symptomatic floater who visited Kim's Eye Hospital from January 1, 2011 to December 31, 2011 were evaluated. Patients with previous retinal detachments resulting from other ocular pathologic features, direct ocular trauma, or previous vitreoretinal, cataract surgery were excluded. Their standard examination included visual acuity, IOP, anterior segment examination, and dilated fundus examination using a slit‐lamp and indirect ophthalmoscop Results The incidence of floater symptom was common in female than male respectively(p<0.05). And the most common cause of floater was posterior vitreous detachment(10.4%). The incidence of retinal tear was 0.8%(28 eyes) and 27eyes of them were undergone barrier laser. The incidence of lattice degeneration was 1.8%(61 eyes) and 36 eyes of them were treated with barrier laser. 3 cases of all showed retinal detachment. 2 cases of them were managed with barrier laser, 1 case was treated with scleral buckling and cryotherapy. And the incidence of retinal hemorrhage and vitreous hemorrhage was 0.4%(15 eyes), 0.02%(8 eyes) each. Other pathologic findings include epiretinal membrane(0.5%, 19 eyes), uveitis(0.4%, 14 eyes), and endophthalmitis(1 eye) Conclusion The study revealed that the pathologic findings of floaters may be encountered: retinal detachment, retinal tears, lattice degeneration, vitreous hemorrhage, retinal hemorrhage, uveitis and endophthalmitis. Patients with an acute, symptomatic floater should be examined closely and if the results of an initial examination are negative for pathologic finding, the necessity of early follow‐up should be needed. [ABSTRACT FROM AUTHOR]

There are some strict lows concerning the placement of the buckle on the scleral wall mainly in accordance to the retinal pathology which created the RD. The question is whether buckling should be limited to the area of the break or extended over the retinal periphery. [ABSTRACT FROM AUTHOR]

Purpose Proliferative vitreoretinopathy (PVR) is a serious complication of any rhegmatogenous retinal detachment. Methods Besides an early intervention to close the retinal defect by either an episcleral buckling procedure or by vitrectomy and internal tamponade, additional medical regimens may be sought after to prevent the proliferation of intravitreally intruded retinal pigment epithelium cells and other cells. Results Itravitreal medical therapy, including drugs such as triamcinolone, microplasmin or anti‐VEGF drugs ma ybe discussed for their rol ein the prevention of PVR. Conclusion Potential procedures to reduce the risk of PVR will be discussed. [ABSTRACT FROM AUTHOR]