Clinical effect of minimally invasive vitreoretinal surgery combined with a modified suprachoroidal drainage surgery for retinal detachment associated with choroidal detachment_Chinese Journal of Ocular Fundus Diseases

Authors：

Gao Shaohui , Lu Xiaonan , Li Zhanrong , Pei Han , Zhao Zhaoxia , Guo Xirang ,  Li Yunsui

Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Eye Hospital & Henan Eye Institute, Zhengzhou 450003, China;

Corresponding author：

Li Yunsui, Email: liysui1963@126.com

Keywords：

Retinal detachment/surgery; Vitrectomy; Treatment outcome

DOI：

10.3760/cma.j.issn.1005-1015.2018.02.003

Video：

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Objective To observe the clinical effect of minimally invasive vitreoretinal (MIV) surgery combined with a modified suprachoroidal drainage surgery for retinal detachment associated with choroidal detachment (RRDCD). Methods A prospective clinical study. A total of 27 patients (27eyes) diagnosed as RRDCD were recruited in this study. There were 16 males and 11 females, with an average of (53.67±14.82) years. The mean intraocular pressure (IOP) was (8.2±2.1) mmHg (1 mmHg=0.133 kPa) and best corrected visual acuity (BCVA) of minimum resolution angle logarithm (logMAR) was 1.87±0.58. All subjects underwent 23G MIV combined a modified suprachoroidal drainage surgery, which 23G stab knife and 1 ml syringe needle were used for surgery. The visual outcome, IOP, rate of retinal reattachment and complications were comparatively analyzed preoperatively and postoperatively. Results At 1 day, 10 days, 1 month and 3 months after surgery, the average of logMAR BCVA were 1.62±0.67, 1.51±0.63, 1.39±0.54, 1.32±0.56 and the mean of IOP were (13.47±5.06), (14.43±4.09), (14.89±4.30), (15.38±3.37) mmHg, respectively. There were significant differences of logMAR BCVA and IOP between before and after surgery (F=6.19, 15.21; P＜0.05). Retinal reattachments were achieved in 27 eyes (100%) at 1 day and 10 days after surgery. At 1 month and 3 months after surgery, the rate of retinal reattachment were 88.89% (24 eyes) and 85.19% (23 eyes), respectively. No severe complications such as endophthalmitis and choroidal hemorrhage were found at follow-up visits. Conclusion MIV combined with a modified suprachoroidal drainage surgery is an effective and safe treatment for RRDCD, which can promote retina tear closure, improve visual acuity.

Citation： Gao Shaohui, Lu Xiaonan, Li Zhanrong, Pei Han, Zhao Zhaoxia, Guo Xirang, Li Yunsui. Clinical effect of minimally invasive vitreoretinal surgery combined with a modified suprachoroidal drainage surgery for retinal detachment associated with choroidal detachment. Chinese Journal of Ocular Fundus Diseases, 2018, 34(2): 116-119. doi: 10.3760/cma.j.issn.1005-1015.2018.02.003 Copy

1.	Yu M, Wu Z, Zhang Z, et al. Metabolomic analysis of human vitreous in rhegmatogenous retinal detachment associated with choroidal detachment[J]. Invest Ophthalmol Vis Sci, 2015, 56 (9): 5706-5713. DOI: 10.1167/iovs.14-16338.
2.	Yu Y, An M, Mo B, et al. Risk factors for choroidal detachment following rhegmatogenous retinal detachment in a chinese population [J]. BMC Ophthalmol, 2016, 16: 140. DOI: 10.1186/s12886-016-0319-9.
3.	Shen L, Mao J, Sun S, et al. Perioperative pharmacological management of choroidal detachment associated with rhegmatogenous retinal detachment[J]. Acta Ophthalmol, 2016, 94(4): 391-396. DOI: 10.1111/aos.12694.
4.	Wei Y, Wang N, Chen F, et al. Vitrectomy combined with periocular/intravitreal injection of steroids for rhegmatogenous retinal detachment associated with choroidal detachment[J]. Retina, 2014, 34(1): 136-141. DOI: 10.1097/IAE.0b013e3182923463.
5.	毛剑波, 吴素兰, 陈亦棋, 等.后Tenon囊下注射曲安奈德联合玻璃体切割术在脉络膜脱离型视网膜脱离中的应用[J]. 中华实验眼科杂志, 2017;35(5): 448-452. DOI: 10.3760/cma.j.issn.2095-0160.2017.05.013.Mao JB, Wu SL, Chen YQ, et al. Application of subtenon injection of triamcinolone acetonide combined with vitrectomy in the treatment of retinal detachment with choroidal detachment[J]. Chin J Exp Ophthalmol, 2017, 35(5): 448-452. DOI: 10.3760/cma.j.issn.2095-0160.2017.05.013.
6.	The Retina Society Terminology Committee. The classification of retinal detachment with proliferative vitreoretinopathy[J]. Ophthalmology, 1983, 90(2): 121-125.
7.	刘文, 张少波, 柯治生, 等.微创玻璃体切割手术治疗脉络膜脱离型视网膜脱离临床疗效观察[J]. 中华眼底病杂志, 2012, 28(6): 593-597. DOI: 10.3760/cma.j. issn.1005-1015.2012.06.012.Liu W, Zhang SB, Ke ZS, et al. The efficacy of micro-invasive vitrectomy for retinal detachment associated with choroidai detachment[J]. Chin J Ocul Fundus Dis, 2012, 28(6): 593-597. DOI: 10.3760/cma.j.issn.1005-1015.2012.06.012.
8.	Gu YH, Ke GJ, Wang L, et al. Risk factors of rhegmatogenous retinal detachment associated with choroidal detachment in Chinese patients[J]. Int J Ophthalmol, 2016, 9(7): 989-993. DOI: 10.18240/ijo.2016.07.09.
9.	Li Z, Li Y, Huang X, et al. Quantitative analysis of rhegmatogenous retinal detachment associated with choroidal detachment in Chinese using UBM[J]. Retina, 2012, 32(10): 2020-2025. DOI: 10.1097/IAE.0b013e3182561f7c.
10.	张忠红, 赵培泉, 张琦.前房灌注玻璃体视网膜手术治疗脉络膜脱离型视网膜脱离一例[J]. 中华眼底病杂志, 2012, 28(4): 422. DOI: 10.3760/cma.j.issn.1005-1015.2012.04.032.Zhang ZH, Zhao PQ, Zhang Q. One case of vitrectomy combined anterior chamber infusion for rhegmatogenous retinal detachment associated with choroidal detachment[J]. Chin J Ocul Fundus Dis, 2012, 28(4): 422. DOI: 10.3760/cma.j.issn.1005-1015.2012.04.032.
11.	郭嘉术, 王海林, 赵秀军. 新型25-Gauge与传统20-Gauge玻璃体切除术后干眼对比[J]. 国际眼科杂志, 2009, 9(6): 1106-1108. DOI: 10.3969/j.issn.1672-5123.2009.06.031.Guo JS, Wang HL, Zhao XJ. Differences of postoperatie dry eyes between 20-gauge and 25-gauge vitrectomy[J]. Int J Ophthalmol, 2009, 9(6): 1106-1108. DOI: 10.3969/j.issn.1672-5123.2009.06.031.
12.	Kwon OW, Song JH, Roh MI. Retinal detachment and proliferative vitreoretinopathy [J]. Dev Ophthalmol, 2016, 55: 154-162. DOI: 10.1159/000438972.
13.	Adelman RA, Parnes AJ, Michalewska Z, et al. Clinical variables associated with failure of retinal detachment repair: the European vitreo-retinal society retinal detachment study report number 4 [J]. Ophthalmology, 2014, 121(9): 1715-1719. DOI: 10.1016/j.ophtha.2014.03.012.
14.	Gui JM, Jia L, Liu L, et al. Vitrectomy, lensectomy and silicone oil tamponade in the management of retinal detachment associated with choroidal detachment[J]. Int J Ophthalmol, 2013, 18;6(3): 337-341. DOI: 10.3980/j.issn.2222-3959.2013.03.15.
15.	Vaziri K, Schwartz SG, Kishor KS, et al. Tamponade in the surgical management of retinal detachment [J]. Clin Ophthalmol, 2016;10: 471-476. DOI: 10.2147/OPTH.S98529.

1. Yu M, Wu Z, Zhang Z, et al. Metabolomic analysis of human vitreous in rhegmatogenous retinal detachment associated with choroidal detachment[J]. Invest Ophthalmol Vis Sci, 2015, 56 (9): 5706-5713. DOI: 10.1167/iovs.14-16338.
2. Yu Y, An M, Mo B, et al. Risk factors for choroidal detachment following rhegmatogenous retinal detachment in a chinese population [J]. BMC Ophthalmol, 2016, 16: 140. DOI: 10.1186/s12886-016-0319-9.
3. Shen L, Mao J, Sun S, et al. Perioperative pharmacological management of choroidal detachment associated with rhegmatogenous retinal detachment[J]. Acta Ophthalmol, 2016, 94(4): 391-396. DOI: 10.1111/aos.12694.
4. Wei Y, Wang N, Chen F, et al. Vitrectomy combined with periocular/intravitreal injection of steroids for rhegmatogenous retinal detachment associated with choroidal detachment[J]. Retina, 2014, 34(1): 136-141. DOI: 10.1097/IAE.0b013e3182923463.
5. 毛剑波, 吴素兰, 陈亦棋, 等.后Tenon囊下注射曲安奈德联合玻璃体切割术在脉络膜脱离型视网膜脱离中的应用[J]. 中华实验眼科杂志, 2017;35(5): 448-452. DOI: 10.3760/cma.j.issn.2095-0160.2017.05.013.Mao JB, Wu SL, Chen YQ, et al. Application of subtenon injection of triamcinolone acetonide combined with vitrectomy in the treatment of retinal detachment with choroidal detachment[J]. Chin J Exp Ophthalmol, 2017, 35(5): 448-452. DOI: 10.3760/cma.j.issn.2095-0160.2017.05.013.
6. The Retina Society Terminology Committee. The classification of retinal detachment with proliferative vitreoretinopathy[J]. Ophthalmology, 1983, 90(2): 121-125.
7. 刘文, 张少波, 柯治生, 等.微创玻璃体切割手术治疗脉络膜脱离型视网膜脱离临床疗效观察[J]. 中华眼底病杂志, 2012, 28(6): 593-597. DOI: 10.3760/cma.j. issn.1005-1015.2012.06.012.Liu W, Zhang SB, Ke ZS, et al. The efficacy of micro-invasive vitrectomy for retinal detachment associated with choroidai detachment[J]. Chin J Ocul Fundus Dis, 2012, 28(6): 593-597. DOI: 10.3760/cma.j.issn.1005-1015.2012.06.012.
8. Gu YH, Ke GJ, Wang L, et al. Risk factors of rhegmatogenous retinal detachment associated with choroidal detachment in Chinese patients[J]. Int J Ophthalmol, 2016, 9(7): 989-993. DOI: 10.18240/ijo.2016.07.09.
9. Li Z, Li Y, Huang X, et al. Quantitative analysis of rhegmatogenous retinal detachment associated with choroidal detachment in Chinese using UBM[J]. Retina, 2012, 32(10): 2020-2025. DOI: 10.1097/IAE.0b013e3182561f7c.
10. 张忠红, 赵培泉, 张琦.前房灌注玻璃体视网膜手术治疗脉络膜脱离型视网膜脱离一例[J]. 中华眼底病杂志, 2012, 28(4): 422. DOI: 10.3760/cma.j.issn.1005-1015.2012.04.032.Zhang ZH, Zhao PQ, Zhang Q. One case of vitrectomy combined anterior chamber infusion for rhegmatogenous retinal detachment associated with choroidal detachment[J]. Chin J Ocul Fundus Dis, 2012, 28(4): 422. DOI: 10.3760/cma.j.issn.1005-1015.2012.04.032.
11. 郭嘉术, 王海林, 赵秀军. 新型25-Gauge与传统20-Gauge玻璃体切除术后干眼对比[J]. 国际眼科杂志, 2009, 9(6): 1106-1108. DOI: 10.3969/j.issn.1672-5123.2009.06.031.Guo JS, Wang HL, Zhao XJ. Differences of postoperatie dry eyes between 20-gauge and 25-gauge vitrectomy[J]. Int J Ophthalmol, 2009, 9(6): 1106-1108. DOI: 10.3969/j.issn.1672-5123.2009.06.031.
12. Kwon OW, Song JH, Roh MI. Retinal detachment and proliferative vitreoretinopathy [J]. Dev Ophthalmol, 2016, 55: 154-162. DOI: 10.1159/000438972.
13. Adelman RA, Parnes AJ, Michalewska Z, et al. Clinical variables associated with failure of retinal detachment repair: the European vitreo-retinal society retinal detachment study report number 4 [J]. Ophthalmology, 2014, 121(9): 1715-1719. DOI: 10.1016/j.ophtha.2014.03.012.
14. Gui JM, Jia L, Liu L, et al. Vitrectomy, lensectomy and silicone oil tamponade in the management of retinal detachment associated with choroidal detachment[J]. Int J Ophthalmol, 2013, 18;6(3): 337-341. DOI: 10.3980/j.issn.2222-3959.2013.03.15.
15. Vaziri K, Schwartz SG, Kishor KS, et al. Tamponade in the surgical management of retinal detachment [J]. Clin Ophthalmol, 2016;10: 471-476. DOI: 10.2147/OPTH.S98529.

Chinese Journal of Ocular Fundus Diseases

Clinical effect of minimally invasive vitreoretinal surgery combined with a modified suprachoroidal drainage surgery for retinal detachment associated with choroidal detachment

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