Primary Retinal Detachment

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130 Choroidals In 4 of the 1,462 detachments, a postoperative choroidal effusion developed. These four eyes were highly myopic. Choroidals were the cause of primary failure and final failure in 0.3%. This is less than the reported 2% to 8.6% after cerclage with drainage [10]. Complications Intraocular Minimal extraocular surgery is performed without drainage of subretinal fluid. As a result, the intraocular complications of drainage, such as hemorrhage, intraocular infection, incarceration of retina or vitreous, do not occur. In addition, the need for a subsequent intraocular injection of gas or saline to restore intraocular pressure with its complications is also eliminated. Secondary glaucoma, cataract, or anterior ischemia did not occur, and because the procedure was extraocular, there were no iatrogenic breaks. Intraocular complications from cryopexy did not occur,because all applications were monitored by indirect ophthalmoscopy for a medium lesion (first appearance of white in the retina) [43]. There was a rare choroidal in highly myopic eyes. Extraocular 6 Minimal Segmental Buckling With Sponges and Balloons The extraocular complications that might occur with minimal segmental buckling without drainage are reversible. After using the Lincoff sponge-2 in 210 eyes (series 2 to 4), one sponge (
Functional Results 131 to either side of the sponge. When a very anterior circumferential buckle was needed, it was placed external to the muscle [44]. Most important were daily ocular motility exercises during the first postoperative week to counteract the development of adhesions around the muscle. This was done independent of the state of the retina.As a result, no sponge had to be removed because of diplopia. In the fifth series (n=500), a temporary balloon buckle was applied, which was removed after 1 week. In this series, there was no buckle infection or exposure. Diplopia was sometimes present when the balloon was in place, but diplopia remitted in all eyes within hours after the balloon was removed. Functional Results Since the end of the 1960s, detachment surgery has been concentrating not only on anatomical results, but also on visual function [45–49] – both short-term recovery after surgery and long-term visual acuity. In the first series, visual function was not described. In the remaining four series, treated with sponges or balloons, the mean visual acuity was 0.67 after 2 years (Table 6.4). The two questions that arise are: (1) Would visual acuity decline over years? (2) Would the presence of a segmental buckle over years cause a secondary deterioration of visual function? These pending questions can be answered by the second series of 107 primary retinal detachments treated by minimal segmental sponge buckle(s) without drainage and with a complete follow-up of 15 years [40]. The mean preoperative visual acuity was 0.3; it improved to 0.5 during the first 6 months after surgery, and reached a maximum of 0.6 at 1 year. The increase was statistically significant (P
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Ingrid Kreissig (Ed.) Primary Retin
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Professor Dr. med. Ingrid Kreissig
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Contents 1 The History of Retinal D
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List of Contributors Gary W. Abrams
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List of Contributors XI Hermann D.
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2 Helmholz in 1850 made an accurate
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4 (vitreous, gelatin) into the ante
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6 with scleral resection that set t
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8 ditis [72-74].Temperatures up to
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10 1 The History of Retinal Detachm
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16 ion [147]. Perfluorocarbon liqui
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26 2 Prophylaxis in Fellow Eye of P
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32 found that eyes with pre-existin
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36 3 Encircling Operation with Drai
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Chapter 4 Pneumatic Retinopexy for
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Technique 57 Case Selection Proper
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Technique 59 Table 4.1. Gas charact
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Technique 61 solution; however,thes
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Technique 63 gas reflux. Following
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Complications: Prevention and Manag
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New Possibilities 67 ing on type an
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Results 69 Table 4.7 (continued) Au
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Discussion 71 surgical failures. Fa
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Discussion 73 Disadvantages of PR A
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References 75 situations, then to p
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References 77 24. Tornambe PE, Hilt
Page 88 and 89: References 79 51. Pournaras CJ, Don
Page 90 and 91: Chapter 5 Vitrectomy for the Primar
Page 92 and 93: Indications 83 Table 5.1. Indicatio
Page 94 and 95: Indications 85 Fig. 5.2. The vitreo
Page 96 and 97: Surgical Technique 87 vitrectomy an
Page 98 and 99: Outcomes 89 will be visible under a
Page 100 and 101: Outcomes 91 almost no persistent su
Page 102 and 103: References 93 7. Heimann H, Bornfel
Page 104 and 105: 96 6 Minimal Segmental Buckling Wit
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Page 108 and 109: 100 the operating table with the re
Page 110 and 111: 102 6 Minimal Segmental Buckling Wi
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Page 130 and 131: 122 c d 6 Minimal Segmental Bucklin
Page 132 and 133: 124 c Fig. 6.14c 6 Minimal Segmenta
Page 134 and 135: Table 6.1. Preoperative characteris
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Page 140 and 141: Table 6.4. Visual acuity at 2 years
Page 148 and 149: 140 Probably, the future question n
Page 154 and 155: 146 7 Pharmacological Approaches to
Page 160 and 161: 152 heparin was published in eyes u
Page 162 and 163: 154 search for compounds with hepar
Page 168 and 169: Chapter 8 Systematic Review of Effi
Page 170 and 171: Materials and Methods 163 Table 8.2
Page 172 and 173: Discussion 165 30% 25% 20% 15% 10%
Page 174 and 175: Discussion 167 Fig. 8.2. The small
Page 176 and 177: Conclusion 169 vitrectomy and searc
Page 178 and 179: References 171 8. Brazitikos PD, D
Page 180 and 181: References 173 34. Gunduz K, Gunalp
Page 182 and 183: References 175 63. Schepens CL (195
Page 184 and 185: 178 9 Repair of Primary Retinal Det
Page 186 and 187: 180 a b Fig. 9.3a,b. Legend see pag
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182 9 Repair of Primary Retinal Det
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186 a b 9 Repair of Primary Retinal
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188 might eliminate traction on the
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Chapter 10 Retinal Detachment Repai
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Retinal Detachment Repair: Outlook
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References 207 It is impossible to
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210 C Campbell 7 case selection 57,
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212 M Machemer 13 macular - complic
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214 retinal - detachment - - bilate
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