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Foveal reattachment after macula-off retinal detachment occurs faster after vitrectomy than after buckle surgery.
Ophthalmology. 2004 Jul; 111(7):1340-3.O

Abstract

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.

Links

Publisher Full Text

Authors+Show Affiliations

Wolfensberger TJ
Jules Gonin Eye Hospital, University of Lausanne, Lausanne, Switzerland. thomas.wolfensberger@ophtal.vd.ch

MeSH

AdultAgedAged, 80 and overCryotherapyDrainageFemaleFovea CentralisHumansMaleMiddle AgedProne PositionProspective StudiesRetinal DetachmentScleral BucklingSulfur HexafluorideSupine PositionTime FactorsTomography, Optical CoherenceVitrectomy

Pub Type(s)

Clinical Trial
Comparative Study
Controlled Clinical Trial
Journal Article

Language

eng

PubMed ID

15234134

Citation

Wolfensberger, Thomas J.. "Foveal Reattachment After Macula-off Retinal Detachment Occurs Faster After Vitrectomy Than After Buckle Surgery." Ophthalmology, vol. 111, no. 7, 2004, pp. 1340-3.
Wolfensberger TJ. Foveal reattachment after macula-off retinal detachment occurs faster after vitrectomy than after buckle surgery. Ophthalmology. 2004;111(7):1340-3.
Wolfensberger, T. J. (2004). Foveal reattachment after macula-off retinal detachment occurs faster after vitrectomy than after buckle surgery. Ophthalmology, 111(7), 1340-3.
Wolfensberger TJ. Foveal Reattachment After Macula-off Retinal Detachment Occurs Faster After Vitrectomy Than After Buckle Surgery. Ophthalmology. 2004;111(7):1340-3. PubMed PMID: 15234134.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Foveal reattachment after macula-off retinal detachment occurs faster after vitrectomy than after buckle surgery. A1 - Wolfensberger,Thomas J, PY - 2002/10/20/received PY - 2003/12/06/accepted PY - 2004/7/6/pubmed PY - 2004/7/28/medline PY - 2004/7/6/entrez SP - 1340 EP - 3 JF - Ophthalmology JO - Ophthalmology VL - 111 IS - 7 N2 - 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. SN - 0161-6420 UR - https://www.unboundmedicine.com/medline/citation/15234134/Foveal_reattachment_after_macula_off_retinal_detachment_occurs_faster_after_vitrectomy_than_after_buckle_surgery_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(04)00310-0 DB - PRIME DP - Unbound Medicine ER -