Dataset Information

Perfluoro-n-octane-assisted mega Weiss-ring technique for posterior vitreous detachment induction in retinal detachment.

ABSTRACT: Induction of posterior vitreous detachment (PVD) is one of the most critical steps for the success of retinal detachment (RD) surgery. Failure to completely remove the vitreous can result in re-detachments. We describe a novel technique to induce PVD. After core vitrectomy, perfluorocarbon liquid (PFCL) is injected. The vitreous on the posterior pole is gently stroked, with a diamond-dusted membrane scraper, to create a defect in it. This defect is gradually enlarged to create a ring of rolled out vitreous. The entire vitreous is removed in form of a sheet by lifting the edges of the ring using an internal limiting membrane peeling forceps. PFCL naturally slides into the potential space, gradually extending the vitreous detachment peripherally. With this technique, the vitreous sheet in case of RD can easily, effectively and safely be removed with this technique.

SUBMITTER: Babu N

PROVIDER: S-EPMC6727732 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Perfluoro-n-octane-assisted mega Weiss-ring technique for posterior vitreous detachment induction in retinal detachment.

Babu Naresh N Kumar Jayant J Kohli Piyush P Ramasamy Kim K

Indian journal of ophthalmology 20190901 9

Induction of posterior vitreous detachment (PVD) is one of the most critical steps for the success of retinal detachment (RD) surgery. Failure to completely remove the vitreous can result in re-detachments. We describe a novel technique to induce PVD. After core vitrectomy, perfluorocarbon liquid (PFCL) is injected. The vitreous on the posterior pole is gently stroked, with a diamond-dusted membrane scraper, to create a defect in it. This defect is gradually enlarged to create a ring of rolled o ...[more]

PMID: 31436194

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Project description:IntroductionRetinal detachment is a sight-threatening emergency, with more than half of those affected suffering permanent visual impairment. A diagnostic test to identify eyes at risk before vision is threatened would enable exploration of prophylactic treatment. This report presents the use of irregularities in retinal shape, quantified from optical coherence tomography (OCT) images, as a biomarker for retinal detachment.MethodsOCT images were taken from posterior and mid-peripheral retina of 264 individuals [97 after a posterior vitreous detachment (PVD), 99 after vitrectomy for retinal detachment and 68 after laser for a retinal tear]. Diagnoses were taken from history, examination and OCT. Retinal irregularity was quantified in the frequency domain, and the distribution of irregularity across the regions of the eye was explored to identify features exhibiting the greatest difference between retinal detachment and PVD eyes. Two of these features plus axial length were used to train a quadratic discriminant analysis classifier. Classifier performance was assessed by its sensitivity and specificity in identifying retinal detachment eyes and visualised with a receiver operating characteristic (ROC) curve.ResultsValidation set specificity was 84% (44/52 PVD eyes correctly labelled) and sensitivity 35% (23/64 retinal detachment eyes identified, p = 0.02). Area under the ROC curve was 0.75 (95% confidence intervals 0.58-0.85). Retinal detachment eyes were significantly more irregular than PVD eyes in the superior retina (0.70 mm versus 0.49 mm, p < 0.05) and supero-temporal retina (1.12 mm versus 0.80 mm, p < 0.05). Lower sensitivity (16/68, 24%) was seen for eyes with a retinal tear without detachment, that were intermediate in size between retinal detachment and PVD eyes. Axial length on its own was a poor classifier. Neither irregularity nor classification were affected by surgery for retinal detachment or the development of PVD.ConclusionsThe classifier identified 1/3 of retinal detachment eyes in this sample. In future work, these features can be evaluated as a test for retinal detachment prior to PVD.

Project description:PurposeTo investigate the incidence, seasonal variation, and differences among age, sex, and race for rhegmatogenous retinal detachment (RRD) repair, retinal break (RB) treatment, and posterior vitreous detachment (PVD) in the Intelligent Research in Sight (IRIS) Registry.DesignRetrospective database study.ParticipantsPatients in the IRIS Registry who underwent RRD repair, RB treatment, or cataract surgery (CS) based on Current Procedural Terminology codes and PVD diagnosis based on International Classification of Diseases, Ninth and Tenth Revision, codes.MethodsDaily incidence rates were defined as the ratio of patients who underwent RRD repair or RB treatment and patients with a diagnosis of PVD to the total number of patients followed on a given day within the IRIS Registry. The CS group was included as a comparison for seasonal variation. Rates were stratified by decade of life, sex, and race.Main outcome measuresTime series trends for incidence rates of RRD, RB, and PVD.ResultsA total of 7 115 774 patients received a diagnosis of incident PVD, 237 646 patients underwent RRD repair, and 359 022 patients underwent RB treatment. Also included were 5 940 448 patients who underwent CS. The mean daily incidence for RRD repair, RB treatment, PVD diagnosis, and CS were 0.46 per 100 000 patients, 0.70 per 100 000 patients, 13.90 per 100 000 patients, and 11.80 per 100 000 patients, respectively. Men showed higher incidence of RRD repair and RB treatment than women, whereas women showed higher incidence of PVD diagnosis. Rhegmatogenous retinal detachment incidence was higher in White people compared with other races. Seasonal decreases in PVD, RB treatment, RRD repair, and CS corresponded to national holidays, with larger decreases in winter months. Kaplan-Meier estimates showed that RRD repair and RB treatment typically occurred within 60 days of PVD diagnosis.ConclusionsWithin the IRIS Registry, the highest incidence of RRD was in the 6th and 7th decade of life. There was a higher incidence of RRD repair and RB treatment in men compared with women. The seasonal variation associated with national holidays was less pronounced for RRD repair and RB treatment.

Dataset Information

Perfluoro-n-octane-assisted mega Weiss-ring technique for posterior vitreous detachment induction in retinal detachment.

Publications

Perfluoro-n-octane-assisted mega Weiss-ring technique for posterior vitreous detachment induction in retinal detachment.

Similar Datasets

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