A chemical analysis of subretinal fluid was made in 15 patients (16 eyes) who had undergone retinal detachment surgery from March 1, 1991 to July 31, 1991 at St. Mary's Hospital, Catholic University Medical College. The protein concentration of subretinal fluid ranged from 1.0gm/dl to 7.1gm/dl, and the average protein concentration of subretinal fluid of retinal detachment for 90 days or more showed 5.13 +/- 1.71gm/dl and that of subretinal fluid of retinal detachment for less than 90 days was 2.06 +/- 1.29gm/dl. This revealed increasing tendency of protein concentration in proportion to the duration of detachment (p<.05), and the protein concentration of subretinal fluid did not show any differences according to the size of retinal detachment. Sugar ranged from 32mg/dl to 96mg/dl, and chloride was from 92mEq/L to 126mEq/L. From this study, we found that the protein concentration of subretinal fluid increased in proportion to the duration of retinal detachment. On the contrary, sugar and chloride concentration was not related to the duration of retinal detachment.
Humans ; Retinal Detachment* ; Retinaldehyde* ; Subretinal Fluid*

An anaysis has been made of 86 eyes of retinal detachment treated surgically in our hospital during the last 3yrs. The final complete failure rate was 16.6% (14 eyes), and the failure rate in the first operation was 25.5% (24 eyes). The preoperative factors that were found to be significant in leading to failure were young age, delay of surgery over 6 months, large extent of detachment, giant tear and fibrosis of vitreous or retina. The failure rate in the first operation due to inadequate surgical techniques was 32%, and subretinal fluid drainage was not contributory to the failure rate. It was noteworthy that 64% of failed cases were due to M.V.R. Adnavces in knowledge of pathophysiology of vitreous in complicated retinal detachment and in technique of vitreous surgery may reduce the failure rate.
Drainage ; Fibrosis ; Retina ; Retinal Detachment* ; Retinaldehyde* ; Subretinal Fluid

PURPOSE: To evaluate outcomes of intravitreal aflibercept in cases resistant to bevacizumab and ranibizumab in neovascular age-related macular degeneration. METHODS: Twenty patients with neovascular age-related macular generation who were resistant to treatment with bevacizumab and ranibizumab were evaluated. After switching to aflibercept the best corrected visual acuity (BCVA) and central retinal thickness (CRT) were compared at baseline and at 1 month after injection. Additionally, changes in the intraretinal fluid, subretinal fluid and pigment epithelial detachment were evaluated. RESULTS: The mean BCVA was 0.83 +/- 0.56 log MAR and the mean CRT was 294.20 +/- 12.99 microm before aflibercept treatment. After switching to aflibercept the mean BCVA was 0.86 +/- 0.61 log MAR with no statistical difference (p = 0.406) and the mean CRT was decreased to 232.45 +/- 12.05 microm (p = 0.011). After 1 month of aflibercept injections, a reduction of intraretinal fluid in 4 eyes (80%), reduction of subretinal fluid in 11 eyes (78.6%) and reduction of pigment epithelial detachment in 5 eyes (50%) were observed. Increases in fluid or new lesions were not observed. CONCLUSIONS: Aflibercept injection appears beneficial in patients with neovascular age-related macular generation who are resistant to bavacizumab and ranibizumab treatment.
Humans ; Macular Degeneration* ; Retinaldehyde ; Subretinal Fluid ; Visual Acuity ; Bevacizumab ; Ranibizumab

Description histopathologic pictures of rhegmatogenous retinal dctachment in its early stase to late stage is reviewed. Histology on the results of experimental retinal detachment and reattachment is introduced with short comment. Formatlon of subretinal fluid in retinal detachment is a complex and dynamic processes involving alterations in retinal and choroidal structures and metabolism of vitreal components. Peripheral retinal degenerations as predispoing features of retinal detachment are listed. Some pathologic findings following retinal detachment surgeries of clinical importances are noted briefly.
Choroid ; Metabolism ; Pathology* ; Retinal Degeneration ; Retinal Detachment* ; Retinaldehyde* ; Subretinal Fluid

Objective: This study determined the incidence of macular abnormalities detected by optical coherence tomography (OCT) among patients who have undergone retinal-detachment surgery and investigated the association between pre- and postoperative vision, macular thickness, duration of detachment, and type of surgery done with respect to OCT findings. Methods: This is a noncomparative, nonconsecutive prospective case series of 41 eyes with unsatisfactory vision after scleral buckling, vitrectomy, or pneumatic retinopexy. OCT of the macula were taken and pre- and postoperative visual acuity (VA), time until retinal repair, time until OCT, and type of surgery were analyzed. Results: The mean postoperative VA was 20/130. There was a positive linear relationship between pre- and postoperative VA. The average macular thickness was 254 ± 60 µ, and a strong positive correlation with postoperative logMAR VA was observed. Nineteen (49%) eyes exhibited pockets of subretinal fluid (SRF), 6 had foveal thinning, 5 had macular hole, and 1 each had foveal cyst, cystoid macular edema, and epiretinal membrane. Six patients had worse vision after surgery, 2 of whom had SRF on OCT, 2 foveal thinning, 1 mild macular thickening, and 1 normal image. Conclusion OCT images of various macular abnormalities may explain post-detachmentsurgery visual complaints. There was a positive correlation between pre- and postoperative VA, and an inverse correlation between macular thickness and postoperative VA.
Tomography ; Optical Coherence Visual Acuity Subretinal Fluid Vitrectomy Scleral Buckling

Majority of the eyes with subfoveal neovascular membrane loss the central vision. We observed two patients who regained significant central vision as the result of the involution of subfoveal neovascularization. On follow-up fundus examination, the subretinal lesions revealed grayish neovascular membranes stained with fluorescein, but did not show the fluid leakage. And subretinal hemorrhage and subretinal fluid were gradually resolved. We assumed that functioning retinal pigment epithelium within the macula and young age were the important factors of the spontaneous improvement of visual outcome.
Fluorescein ; Follow-Up Studies ; Hemorrhage ; Humans ; Membranes ; Retinal Pigment Epithelium ; Subretinal Fluid

We would like to introduce endoscope assisted ophthalmic microsurgery. The endoscope system is made of endoscope body, colored moniter, handpiece. The handpiece consists of a 19G or 20G probe housing a fiber optic cable for the camera of a 380.000 pixel resolution, a fiber optic cable for a xenon light source and a working channel. The endoscope was useful to visualize the areas, such as the peripheral retina, posterior side of iris, that were not readily seen by conventional nor wide angle viewing techniques without indentation. Also it gave us good results in the hard visual field cases of corneal opacification or during fluid-gas exchange. using the endoscope permitted the vitreous base to be accurately observed and managed surgically through good visualization of peripheral retina. Intraocular procedure such as vitrectomy, subretinal fluid drainge, endophotocoahulation was performed easily under the endoscopic view, With the improvement of resolution power of the endoscope and the development of stereovision, the range of clinical usage of this technique will be expanded.
Endoscopes* ; Housing ; Iris ; Microsurgery* ; Nerve Fibers, Myelinated ; Retina ; Subretinal Fluid ; Visual Fields ; Vitrectomy ; Xenon

Whether or not to drain the subretinal fluid in retinal detachment surgery remains controversial. The primary advantage of nondrainage procedure is the avoidance of the possible complications associated with transchoroidal drainage, such as choroidal hemorrhage, retinal perforation and loss of formed vitreous. Does the drainage of subretinal fluid itself affect the outcome of surgery? If any, what is the mandatory indication? The authors compared the surgical results of drainate vs. nondrainage of subretinal fluid in scleral buckling procedure to answer these questions. We reviewed preand postoperative characteristics of retinal detachments and the course of subretinal fluid absorption in the 66 eyes of 65 patients who received scleral buckling procedure and were followed up at least 6 months. Retinal reattachment was achieved in 23 eyes of SRF drained 26 eyes(88.4%) and 32 eyes of SRF non-drained 40 eyes(80.0%) after primary operation. The average of time for complete resorption of SFR was 8.04 significant difference was observed between the two groups. Complications associated with drainage were 2 cases of localized subretinal hemorrhage and one case of retinal perforation but did not disturb reattachment of retina. On the basis of these results, we think that placing the buckle correctly is more essential than drainage for successful retinal detachment surgery.
Absorption ; Choroid Hemorrhage ; Drainage ; Hemorrhage ; Humans ; Retina ; Retinal Detachment ; Retinal Perforations ; Retinaldehyde ; Scleral Buckling* ; Subretinal Fluid

Pneumatic retinopexy(PR) is an alternative procedure to treat an uncomplicated rhegmatogenous retinal detachment with the retinal tear(s) within the superior 8 clock hours of the retina. To determine the efficacy of the PR, the authors treated 45 consecutive retinal detachment not exceeding proliferative vitreoretinopathy grade C2 with PR(PR group) and compared the results with those of 63 similar cases treated with scleral buckling procedure(SB group). Initially, 87% of PR group and 91% of SB group were reattached. However, overall cure rates with single operation decreased to 789,6 and 83%, respectively. With subsequent procedures, retinas were finally reattached in 98% and 94%, respectively. In eyes with preoperative macular detachment, vision was similarly improved 2 lines or more in 73% of PR group and in 77% of SB group after surgery. The incidence of the new breaks was higher in PR group than in SB group(9% vs 5%). Other postoperative complications including reopening of original tear, proliferative vitreoretinopathy, and delayed resorption of subretinal fluid were also noted with similar frequency in both group. These data suggest that PR would be a good alternative procedure in the selected cases of retinal detachments and initial failure with this procedure does not adversely affect the final retinal attachment.
Incidence ; Postoperative Complications ; Retina ; Retinal Detachment* ; Retinaldehyde* ; Scleral Buckling* ; Subretinal Fluid ; Vitreoretinopathy, Proliferative

PURPOSE: This study analyzes the factors influencing anatomical failure of the primary operation for simple rhegmatogenous retinal detachment. METHODS: The patients in this study were diagnosed with simple rhegmatogenous retinal detachment and operated on by a single physician. The success group comprised 251 eyes and the failure group comprised 29 eyes. The factors analyzed between the two groups were the type of primary procedure, the type of retinal defect; the numbers of retinal defects; the extent of retinal detachment; the duration of retinal detachment; the existence of peripheral degeneration; carrying out of subretinal fluid drainage; the type of tamponade material used and the position of retinal defects. RESULTS: The anatomical success rate of the primary operation for simple rhegmatogenous retinal detachment was 89.64%. Patient sex, the type of tamponade material used and the position of the retinal defect showed significant differences between the success and failure groups. There was a higher percentage of male patients in the failure group than in success group (p=0.034). Silicone oil used as the tamponade material resulted in a greater chance of failure than success (p=0.017). Analysis of the position of the retinal defect showed that, defects distributed in the inferior retina or through multiple area led to a greater likelihood of anatomical failure (p=0.036). CONCLUSIONS: Due ti the greater possibility of anatomical failure of the primary operation when retinal defects are distributed in the inferior retina or through multiple area, clinicians should consider intensive treatment for such cases.
Drainage ; Humans ; Male ; Retina ; Retinal Detachment* ; Retinaldehyde* ; Silicone Oils ; Subretinal Fluid