It was not until 1919 that the treatment of retinal detachment began to plan on rationale line by Jule Gonin, Who was the first to appriciate the pathological significance of retinal break and therapeutic effect of closing these. Since after the first Gonin's suggestion, various surgical techniques for rhegmatogenous retinal detachment was reoprted in the literatures. Recently the authors had been experienced good surgical results of 45 eyes, beililg operated. The authors employed encircling procedurs and segmental buckling procedure with implants. The segmental buckling procedure was modified from the pocket technique, being employed in the case of simple posterior vitreous detachment. The encircling procedure followed the Crock and Galbraith technique modified from Schepens, being employed in the case of to tal posterior vitreous detachment with collapse. 36 eyes out of 45 eyes was much successful, and no postoperative complication was occurred.
Postoperative Complications ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Vitreous Detachment

The Neurosensory retinal detachment contributes to the visual loss in the idiopathaic macular holes. Vitrectomy can be performed to reattach the retina by removing anterior-posterior and tangential traction between cortical vitreous and macular surface. Also bioadhesives, like autologous serum or platelets aggregates are used to flatten of surrounding rim detachment of macular holes. Among 22 eyes that underwent vitrectomy for the treatment of macular holes, anatomic success was achieved in 12 eyes (59.1%), and visual improvement in 10 eyes (45.5%). The time interval between diagnosis and operation was well-correlated to the functional success rate, while the type of surgical procedures was not. Postoperative complications included 2 cases of cataract, and 1 case of retinal detachment.
Cataract ; Diagnosis ; Postoperative Complications ; Retina ; Retinal Detachment ; Retinal Perforations* ; Traction ; Vitrectomy*

PURPOSE: To evaluate the success rate of pneumatic retinopexy and the preoperative factors influencing the results in the rhegmatogenous retinal detachment patients. METHODS: We analyzed retrospectively the preoperative and postoperative retinal findings and postoperative complication in 152 eyes of 150 patients with uncomplicated rhegmatogenous retinal detachment, who had undergone pneumatic retinopexy and were followed up for at least 3 months. We analyzed preoperative factors, including age, sex, location and numbers of retinal tears, duration of retinal detachment, lens status, and refractive error. RESULTS: The success rate of the initial surgery was 72.37%. The success rate was significantly higher in non-high myopic and phakic eyes, and when the retinal detachment was less than 3 quadrants with the retinal break located superiorly. Accordingly, the success rate was 85.87% (79 of 92 eyes). CONCLUSIONS: In the present study, the anatomical success rate of primary pneumatic retinopexy was more than 70%. If pneumatic retinopexy is performed to non-high myopic, phakic eyes, and retinal detachment is less than 3 quadrants with superior retinal break, the surgeon can expect good anatomical outcomes and consider pneumatic retinopexy as a first management in rhegmatogenous retinal detachment patients.
Eye ; Humans ; Postoperative Complications ; Retinal Detachment ; Retinal Perforations ; Retinaldehyde ; Retrospective Studies

Total vitrectomy and removal of the posterior hyaloid membrane were done in 7 patients who were diagnosed as macular hole with specific causative factors. The causative factor of 2 patients is high myopia and of remainers is trauma. Of the 7 patients treated by removal of the posterior hyaloid membrane during total vitrectomy, 3 patients showed anatomical and functional success, 2 patients only the anatomical success, and 2 patients failure. The postoperative complications included phthisis bulbi, proliferative vitreoreinopathy, optic atrophy, and macular degeneration, and iatrogenic rhegmatogenous retinal detachment. Two patients of the 3 success cases complained of mild diplopia after operation.
Diplopia ; Humans ; Macular Degeneration ; Membranes* ; Myopia ; Optic Atrophy ; Postoperative Complications ; Retinal Detachment ; Retinal Perforations* ; Vitrectomy*

Perfluorocarbon liquids(PFCLs) have recently been used to facilitate surgery in a variety of condition, including proliferative vitreoretinopathy, giant retinal tears, diabetic tractions, retinal detachment with a rhegmatous component, dislocated crystalline lenses. Although the ocular toxicity of PFCLs has been evaluated in a number of animal studies, few reports have focused on ocular complications associated with their clinical use. We evaluated complications of PFCLs as an intraoperative tool in a series of 55 patients. We had used two kinds of PFCLs, Vitreon(perfluorophenanthrene) and DK-line(perfluorodecaline) intraoperatively. 10 eyes had intraoperative complications. Subretinal PFCLs(6 eyes), subretinal hemorrhage(3 eyes), subretinal hemorrhage with subretinal PFCLs(1 eye) were observed. Postoperative complications of PFCLs as an only intraoperative tool were preretinal small dreplets(4 eyes), subretinal small droplets(4 eyes) and small dreplets in anterior chamber(2 eyes). In case of posterior retinal break, careful injection should be considered. Postoperative small residual droplet of perfluorocarbon in sub- and preretinal space did not cause any toxic effects in these patients. But remained droplet in anterior chamber should be removed to avoid significant corneal toxity.
Animals ; Anterior Chamber ; Hemorrhage ; Humans ; Intraoperative Complications ; Lens, Crystalline ; Postoperative Complications ; Retinal Detachment ; Retinal Perforations ; Traction ; Vitreoretinopathy, Proliferative

The occurrence of a retinal detachment in a patient with a macular hole is quite rare unless the patient is a high myope or has experienced ocular trauma. The incidence of spontaneous reattachment of retinal detachment with a macular hole is not uncommon in the highly myopic patients. However, data on nonmyopic cases are lacking. I herein describe two nonmyopic cases of retinal detachment with a macular hole, of which retinas reattached spontaneously.
Adult ; Aged ; Female ; Humans ; Male ; Myopia/complications ; Remission, Spontaneous ; Retinal Detachment/*physiopathology ; Retinal Perforations/*complications/physiopathology ; Visual Acuity

PURPOSE: To evaluate the preoperative factors influencing results of pneumatic retinopexy in patients with rhegmatogenous retinal detachment. METHODS: We analyzed retrospectively the preoperative and postoperative retinal findings, visual results, postoperative complications in 98 eyes of 98 patients who had undergone pneumatic retinopexy and followed for at least 3 months. RESULTS: Postoperatively visual acuity improved in 46 out of 59 patients whose preoperative visual acuity was equal to or less than 0.08, and in 20 out of 27 patients whose preoperative visual acuity was equal to or less than 0.5. The success rate of initial surgery was 75.5% and the final reattachment rate 99.0%. The anatomic success rate of each group did not differ in terms of the duration of retinal detachment, the size or quadrantal location of retinal break. The success rate was decreased when retinal detachment was broader or retinal breaks were multiple, although the difference was not statistically significant. The success rate was significantly lower when retinal break was located posterior to the equator than when retinal break was located on or anterior to the equator (40.0% vs 80.3%, 70.4%) (p=0.02). The main causes of failure in primary retinal reattachment were as follows: reopened retinal break in 8 eyes, new retinal break in 7 eyes, delayed absorption or shift of subretinal fluid in 5 eyes, proliferative vitreoretinopathy in 2 eyes, subretinal gas in 1 eye and endophthalmitis in 1 eye. CONCLUSIONS: Our results showed that the axial location of retinal break was the only preoperative factor influencing the success rate of pneumatic retinopexy. However, other factors may not be completely ruled out as influence factors for success rate considering the small number of patients in our study. Further study including larger series will be needed.
Absorption ; Endophthalmitis ; Humans ; Postoperative Complications ; Retinal Detachment ; Retinal Perforations ; Retinaldehyde ; Retrospective Studies ; Subretinal Fluid ; Visual Acuity ; Vitreoretinopathy, Proliferative

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

We reviewed the hospital records of 104 consecutive eyes in 101 patients who underwent pars plana vitrectomy at Presbyterian Medical Center from January 1993 to December 1995 and studied the postoperative visual acuity and postoperative complications. Possible indications for pars plana vitrectomy were follows: complications of proliferative diabetic retinopathy (30.7%),complications of other types of proliferative retinopathy except proliferative diabetic retinopathy(25.0%),complications of anterior segment surgeries (14.4%), complex retinal detachments(8.7%), intraocular inflammations and uveitis (8.7%), macular diseases (6.7%), and complications of ocular trauma (5.8%), Regarding postoperative final visual acuity, 53 eyes(51.0%) were improved, 30eyes(28.8%) were stabilized, 21eyes(20.2%) were worsened. Intraoperative or postopertive cataract, retinal breaks or retinal detachment were most frequent complications. We expected that pars plana vitrectomy might be indicated in various ocular diseases containing proliferative diabetic retinopathy.
Cataract ; Diabetic Retinopathy ; Hospital Records ; Humans ; Inflammation ; Postoperative Complications ; Protestantism ; Retinal Detachment ; Retinal Perforations ; Retinaldehyde ; Uveitis ; Visual Acuity ; Vitrectomy*

PURPOSE: To evaluate the clinical presentation, surgical outcome of rhegmatogenous retinal detachment(RRD) after laser refractive surgery and the relationship between RRD and laser refractive surgery. METHODS: We examined age distribution, refractive error, time interval of RRD onset after refractive surgery, shape and location of retinal break, extent of RD, refractive change and postoperative complications in fifteen patients who experienced RRD after LASIK(9 eyes), or PRK(6 eyes) from March 1993 to August 2001. RESULTS: 66% of patents were in twenties, 47% of patients developed RD within 1 year after refractive surgery, 80% of patients had horse shoe type retinal tear and refractive changes after RD surgery were within 2 diopters. Patients who had undergone LASIK had shorter time interval in developing RRD, more refractive change, and more complications than those with PRK. CONCLUSIONS: These results suggest that laser refractive surgery can be one of the cause of RD. LASIK had more association with RD than PRK. Thorough retinal exam will be needed in patients undergoing LASIK.
Age Distribution ; Horses ; Humans ; Keratomileusis, Laser In Situ ; Postoperative Complications ; Refractive Errors ; Refractive Surgical Procedures* ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Shoes