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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.

Authors+Show Affiliations

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

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 -