AIM： To evaluate the causes and associations of missed retinal breaks（MRBs） and posterior vitreous detachment（PVD） in patients with rhegmatogenous retinal detachment（RRD）.METHODS： Case sheets of patients under...AIM： To evaluate the causes and associations of missed retinal breaks（MRBs） and posterior vitreous detachment（PVD） in patients with rhegmatogenous retinal detachment（RRD）.METHODS： Case sheets of patients undergoing vitreo retinal surgery for RRD at a tertiary eye care centre were evaluated retrospectively. Out of the 378 records screened, 253 were included for analysis of MRBs and191 patients were included for analysis of PVD,depending on the inclusion criteria. Features of RRD and retinal breaks noted on examination were compared to the status of MRBs and PVD detected during surgery for possible associations.RESULTS： Overall, 27% patients had MRBs. Retinal holes were commonly missed in patients with lattice degeneration while missed retinal tears were associated with presence of complete PVD. Patients operated for cataract surgery were significantly associated with MRBs（P =0.033） with the odds of missing a retinal break being1.91 as compared to patients with natural lens. Advanced proliferative vitreo retinopathy（PVR） and retinal bullae were the most common reasons for missing a retinal break during examination. PVD was present in 52% of the cases and was wrongly assessed in 16%. Retinal bullae,pseudophakia/aphakia, myopia, and horse shoe retinal tears were strongly associated with presence of PVD.Traumatic RRDs were rarely associated with PVD. CONCLUSION： Pseudophakic patients, and patients with retinal bullae or advanced PVR should be carefully screened for MRBs. Though Weiss ring is a good indicator of PVD, it may still be over diagnosed in some cases. PVD is associated with retinal bullae and pseudophakia, and inversely with traumatic RRD.展开更多
· AIM: To describe a new surgical technique for managing dislocated sclerotic cataractous lens.· METHODS: Six patients with advanced posteriorly dislocated cataracts were operated at a tertiary care centre a...· AIM: To describe a new surgical technique for managing dislocated sclerotic cataractous lens.· METHODS: Six patients with advanced posteriorly dislocated cataracts were operated at a tertiary care centre and analyzed retrospectively. After standard 3 port23 G pars plana vitrectomy and perfluorocarbon liquid(PFCL) injection, the dislocated white cataract was held with occlusion using phaco fragmatome and then chopped into smaller pieces with a sharp tipped chopper using 25 G chandelier endoilluminator. Each piece was emulsified individually. Following aspiration of PFCL,Fluid Air Exchange was done in all the cases and surgery completed uneventfully.·RESULTS: Best corrected visual acuity(BCVA) in all the patients was better than 6/12 after one month of follow up. No serious complications were noted till minimum 6mo of follow up.·CONCLUSION: Four port posterior segment nucleotomy with a chandelier endoilluminator, fragmatome and a chopper appears to be a safe, easy and effective procedure for managing dislocated sclerotic cataractous nuclei. Ultrasonic energy used and adverse thermal effects of the fragmatome on the sclera may be lesser.展开更多
文摘AIM： To evaluate the causes and associations of missed retinal breaks（MRBs） and posterior vitreous detachment（PVD） in patients with rhegmatogenous retinal detachment（RRD）.METHODS： Case sheets of patients undergoing vitreo retinal surgery for RRD at a tertiary eye care centre were evaluated retrospectively. Out of the 378 records screened, 253 were included for analysis of MRBs and191 patients were included for analysis of PVD,depending on the inclusion criteria. Features of RRD and retinal breaks noted on examination were compared to the status of MRBs and PVD detected during surgery for possible associations.RESULTS： Overall, 27% patients had MRBs. Retinal holes were commonly missed in patients with lattice degeneration while missed retinal tears were associated with presence of complete PVD. Patients operated for cataract surgery were significantly associated with MRBs（P =0.033） with the odds of missing a retinal break being1.91 as compared to patients with natural lens. Advanced proliferative vitreo retinopathy（PVR） and retinal bullae were the most common reasons for missing a retinal break during examination. PVD was present in 52% of the cases and was wrongly assessed in 16%. Retinal bullae,pseudophakia/aphakia, myopia, and horse shoe retinal tears were strongly associated with presence of PVD.Traumatic RRDs were rarely associated with PVD. CONCLUSION： Pseudophakic patients, and patients with retinal bullae or advanced PVR should be carefully screened for MRBs. Though Weiss ring is a good indicator of PVD, it may still be over diagnosed in some cases. PVD is associated with retinal bullae and pseudophakia, and inversely with traumatic RRD.
文摘· AIM: To describe a new surgical technique for managing dislocated sclerotic cataractous lens.· METHODS: Six patients with advanced posteriorly dislocated cataracts were operated at a tertiary care centre and analyzed retrospectively. After standard 3 port23 G pars plana vitrectomy and perfluorocarbon liquid(PFCL) injection, the dislocated white cataract was held with occlusion using phaco fragmatome and then chopped into smaller pieces with a sharp tipped chopper using 25 G chandelier endoilluminator. Each piece was emulsified individually. Following aspiration of PFCL,Fluid Air Exchange was done in all the cases and surgery completed uneventfully.·RESULTS: Best corrected visual acuity(BCVA) in all the patients was better than 6/12 after one month of follow up. No serious complications were noted till minimum 6mo of follow up.·CONCLUSION: Four port posterior segment nucleotomy with a chandelier endoilluminator, fragmatome and a chopper appears to be a safe, easy and effective procedure for managing dislocated sclerotic cataractous nuclei. Ultrasonic energy used and adverse thermal effects of the fragmatome on the sclera may be lesser.
