OBJECTIVESTo explore the changes of multifocal electroretinograms (mfERG) before and after retinal detachment surgery and to evaluate its clinical significance.

METHODSTwenty-three patients (23 eyes) with rhegmatogenous retinal detachment underwent mfERG before and after surgery. The latencies and average response densities of N(1)-wave and P(1)-wave of mfERGs in detached areas, attached areas, fovea and the entire tested area were compared before and after surgery.

RESULTSPreoperatively, the average response densities of N(1)-wave and P(1)-wave in the detached area were significantly smaller than those in attached areas (t = 3.68, t = 4.26, P < 0.01), and the latencies of N(1)-wave and P(1)-wave in detached areas were significantly longer than those in attached areas (t = 3.07, t = 3.89, P < 0.01). Postoperatively, the average response densities of N(1)-wave and P(1)-wave in detached areas, fovea and the entire tested area increased, and there were significant differences pre- and postoperatively (P < 0.05). However, the latencies of N(1)-wave and P(1)-wave before and after surgery showed no significant differences (P > 0.05).

CONCLUSIONSThe mfERG is a useful tool to evaluate the recovery of posterior retinal function after retinal detachment surgery. The response density is a more sensitive index than latency to evaluate retinal function of retinal detachment.

Adult ; Aged ; Electroretinography ; Female ; Humans ; Male ; Middle Aged ; Retinal Detachment ; physiopathology ; surgery ; Visual Acuity

Changes in the scotopic electroretinogram (ERG) and oscillatory potentials (Ops) were examined in patients who had rhegmatogenous retinal detachment within 3 days before and also at regular intervals after a successful reattachment operation. Electroretinograms were recorded in 38 patients (age 10 to 62 years) for the recent 5 year period. The amplitudes of the scotopic a-wave and b-wave in the detached eye were significantly decreased compared to the fellow normal eye preoperatively. Statistically significant differences were found between the preoperative and the postoperative recordings of the diseased eye. However, postoperative interocular differences in the amplitude of the a-wave between the reattached and normal fellow eye were not statistically significant. The amplitudes of the a-wave and b-wave were inversely related to the extent of the retinal detachment area, the duration of the detachment, and the extent of the buckles that were applied. Significant interocular differences in the b/a wave amplitude ratio and the Ops amplitude were observed. These results strongly suggest that the retinal function, even after successful reattachment surgery, might be compromised mainly by an inner retinal malfunction rather than from a photoreceptor dysfunction.
Adolescent ; Adult ; Child ; *Electroretinography ; Human ; Middle Age ; Oscillometry ; Postoperative Period ; Retinal Detachment/etiology/*physiopathology/*surgery ; Retinal Perforations/*complications

Adolescent ; Adult ; Aged ; Humans ; Middle Aged ; Pupil Disorders ; diagnosis ; etiology ; Refraction, Ocular ; Retina ; physiopathology ; Retinal Detachment ; surgery ; Scleral Buckling ; Visual Acuity ; Vitreoretinopathy, Proliferative ; surgery

PURPOSE: To evaluate the clinical features and surgical outcomes for primary rhegmatogenous retinal detachments (RDs) in patients with pseudophakia after phacoemulsification. METHODS: The medical records of patients with pseudophakia after phacoemulsification and intraocular lens implantation who had undergone surgery for primary rhegmatogenous RDs with a minimum duration of follow-up of 12 months were reviewed retrospectively. RESULTS: A total of 104 patients were enrolled in this study and 106 eyes were analyzed. Post-operative retinal attachment was achieved in 87 of the eyes (82.1%) and the final visual acuities (logarithm of the minimum angle of resolution) were improved to 0.65 +/- 0.49 from the baseline measurement of 1.51 +/- 1.14 (p < 0.001). Re-operations were performed in 24 of the eyes (22.6%) and there were no visible retinal breaks in 30 of the eyes (28.3%). The failure to identify a retinal break during surgery was associated with a lower rate of retinal reattachment, worse final visual acuity, and a higher rate of re-operation (p = 0.002, p = 0.02, and p = 0.002, respectively). The location of the identified retinal break was more common in the superotemporal quadrant than in the other quadrants. CONCLUSIONS: The inability to identify a retinal break during surgery was associated with a poor final outcome. Other factors were less important for the functional and anatomic success in patients with pseudophakic RDs.
Adult ; Aged ; Aged, 80 and over ; Cataract/*etiology/physiopathology ; Female ; Follow-Up Studies ; Humans ; *Lens Implantation, Intraocular ; Male ; Middle Aged ; *Phacoemulsification ; Retinal Detachment/physiopathology/*surgery ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate corneal refractive changes after scleral buckling surgery.

METHODSIn a prospective self-controlled clinical study, we investigated the changes of refractive power, astigmatic power, astigmatic axis, and irregular astigmatic power of anterior corneal surface following scleral buckling surgery for retinal detachment in 30 patients (30 eyes). The corneal shapes were detected by Orbscan II topography at 1 day before surgery, and 1 week, 1 month, and 3 months after surgery. The effects of some surgical factors on the anterior corneal refractive changes were analyzed.

RESULTSAfter surgery, refractive power on corneal anterior surface decreased significantly in peripheral zone at 1 week (P < 0.01). Astigmatic power increased obviously in central zone. The direction of astigmatic axis matched the direction of the buckle, and changed obviously in central zone after 1 week (P < 0.05). Irregular astigmatic power did not change significantly. There was a significant correlation between the encircling length/the buckle width and the refractive changes of corneal anterior surface.

CONCLUSIONRefractive changes of corneal anterior surface following scleral buckling surgery was mainly temporary. Changes in the shape of corneal should be minimized to ensure a favorable postoperative visual acuity.

Adolescent ; Adult ; Aged ; Cornea ; pathology ; physiopathology ; Corneal Topography ; Female ; Humans ; Male ; Middle Aged ; Postoperative Period ; Prospective Studies ; Refraction, Ocular ; Refractive Errors ; etiology ; prevention & control ; Retinal Detachment ; physiopathology ; surgery ; Scleral Buckling ; adverse effects ; methods ; Time Factors

PURPOSE: To evaluate the visual outcome of combined phacoemulsification, intraocular lens implantation, and vitrectomy for macula-sparing rhegmatogenous retinal detachment. METHODS: The results of combined vitrectomy with cataract extraction were retrospectively analyzed in patients with preexisting cataracts and new-onset rhegmatogenous retinal detachment. To qualify, patients must also have had macular sparing in a region 6,000 microm in diameter on optical coherence tomography. The anatomical success rate, visual outcomes, and postoperative complications relating to visual acuity were evaluated. RESULTS: In 56 patients followed postoperatively for more than 12 months, the initial and final surgical success rate was 96.4% and 100%, respectively. The mean preoperative logarithm of the minimum angle of resolution visual acuity was 0.05 and decreased to 0.11 postoperatively (p < 0.001). Of the 56 patients, 20 (35.7%) had worse visual acuity postoperatively, compared with preoperatively (0.06 vs. 0.27, p < 0.001); these cases were comprised of six patients with epiretinal membranes, 12 patients with a posterior capsule opacity, and two patients with cystoid macular edema. In the remaining 36 patients, there were no significant differences in visual acuity preoperatively and postoperatively (0.04 vs. 0.03, p = 0.324). CONCLUSIONS: In patients with cataracts who develop macula-sparing rhegmatogenous retinal detachment and whose visual prognosis is excellent assuming the retina can be reattached successfully, combined phacoemulsification, intraocular lens implantation, and vitrectomy might be an effective treatment. However, the visual prognosis is significantly affected by postoperative complications such as an epiretinal membranes, posterior capsule opacity, and cystoid macular edema. Therefore, further studies should examine methods to prevent these postoperative complications.
Adult ; Female ; Humans ; *Lens Implantation, Intraocular/adverse effects ; Male ; Middle Aged ; *Phacoemulsification/adverse effects ; Postoperative Complications/prevention & control ; Retinal Detachment/physiopathology/*surgery ; Retrospective Studies ; Tomography, Optical Coherence ; Treatment Outcome ; Visual Acuity ; *Vitrectomy/adverse effects

No abstract available.
Angiogenesis Inhibitors/*therapeutic use ; Bevacizumab/*therapeutic use ; Choroid/*blood supply ; Ciliary Arteries/pathology ; Fluorescein Angiography ; Humans ; Intravitreal Injections ; Ischemia/*drug therapy/etiology/physiopathology ; Male ; Meningeal Neoplasms/surgery ; Meningioma/surgery ; Neurosurgical Procedures/*adverse effects ; Retinal Detachment/*drug therapy/etiology/physiopathology ; Subretinal Fluid ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Visual Acuity/physiology ; Young Adult