COMBINED IMMEDIATE PARS PLANA VITRECTOMY AND PHACOEMULSIFICATION AS AN EFFECTIVE TREATMENT ON MACULA-OFF RHEGMATOGENOUS RETINAL DETACHMENT A CASE REPORT
Article Sidebar
Main Article Content
Abstract
Introduction: Macula-off rhegmatogenous retinal detachment (RRD) is a complicated condition which can caused poor visual prognosis if not treated properly. Recent studies have been proposed an early surgical treatment on this condition to get better anatomical and functional outcomes.
Case Report: A 55-year-old male patient presented with history of blurred vision in left eye of 18 hours duration. Patient had history of seeing flashing light and black dots prior to the symptoms. On evaluation there was a macula-off RRD with immature senile cataract. Immediate phacoemulsification followed by pars plana vitrectomy was done. Good visual recovery with best corrected visual acuity 0.00 logMAR was obtained 3 months after the initial surgery.
Discussion: In patient with macula-off RRD, delaying the surgical treatment could possibly worsen the visual prognosis. Accurate diagnosis with timely surgical intervention give a good visual outcome by allowing faster rearrangement of macula anatomy.
Conclusion: Early surgical intervention is required to provide better visual outcome on macula-off RRD. In the presents of cataract, combined phacoemulsification with PPV as the main intervention may be considered an appropriate approach. The development of ERM is one of the difficulties that RRD patients face, and it needs to be carefully evaluated to avoid the need for additional surgery.
Keywords
macula-off, RRD, early intervention, visual outcome
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
References
2. Helmy YAH, Dahab AA, Abdelhakim MA, Khattab AM, Hamza HSE. Vitrectomy and silicone oil tamponade with and without phacoemulsification in the management of rhegmatogenous retinal detachment: A comparative study. African Vision and Eye Health. 2020 Jul 1;79(1):1–8.
3. Lee CS, Shaver K, Yun SH, Kim D, Wen S, Ghorayeb G. Comparison of the visual outcome between macula-on and macula-off rhegmatogenous retinal detachment based on the duration of macular detachment. BMJ Open Ophthalmol. 2021 Mar 11;6(1).
4. Evangelista C. In the Right Place, at the Right Time: Autobiographical Case Report of an Ophthalmologist Who Had a Rhegmatogenous Retinal Detachment. Cureus. 2022 Jan 14;
5. Baba T, Tatsumi T, Oshitari T, Yamamoto S. Four Cases of Rhegmatogenous Retinal Detachment That Recurred More than 10 Years after Initial Reattachment by Pars Plana Vitrectomy. Case Rep Ophthalmol. 2021 Jan 1;12(1):219–26.
6. Christou EE, Stavrakas P, Georgalas I, Batsos G, Christodoulou E, Stefaniotou M. Macular microcirculation changes after macula-off rhegmatogenous retinal detachment repair with silicone oil tamponade evaluated by OCT-A: preliminary results. Ther Adv Ophthalmol. 2022 Jan 1;14.
7. Mete M, Maggio E, Ramanzini F, Guerriero M, Airaghi G, Pertile G. Microstructural Macular Changes after Pars Plana Vitrectomy for Primary Rhegmatogenous Retinal Detachment. Ophthalmologica [Internet]. 2021 Jun 24;244(6):551–9. Available from: https://doi.org/10.1159/000517880
8. Roshanshad A, Shirzadi S, Binder S, Arevalo JF. Pneumatic Retinopexy Versus Pars Plana Vitrectomy for the Management of Retinal Detachment: A Systematic Review and Meta-Analysis. Vol. 12, Ophthalmology and Therapy. Adis; 2023. p. 705–19.
9. van Bussel EM, van der Valk R, Bijlsma WR, La Heij EC. IMPACT OF DURATION OF MACULA-OFF RETINAL DETACHMENT ON VISUAL OUTCOME: A Systematic Review and Meta-analysis of Literature. RETINA [Internet]. 2014;34(10). Available from: https://journals.lww.com/retinajournal/fulltext/2014/10000/impact_of_duration_of_macula_off_retinal.1.aspx
10. Miyake M, Nakao S ya, Morino K, Yasukura S, Mori Y, Ishihara K, et al. Effect of Duration of Macular Detachment on Visual Prognosis after Surgery for Macula-Off Retinal Detachment: Japan-Retinal Detachment Registry. Ophthalmol Retina. 2023 May 1;7(5):375–82.
11. Milner DC, Le C, Marin AI, Smith JM, Manoharan N. Outcomes of chronic macula-off retinal detachment repair. Graefe’s Archive for Clinical and Experimental Ophthalmology. 2023 Mar 1;261(3):709–14.
12. Moussa G, Sachdev A, Mohite AA, Hero M, Ch’ng SW, Andreatta W. ASSESSING REFRACTIVE OUTCOMES AND ACCURACY OF BIOMETRY IN PHACOVITRECTOMY AND SEQUENTIAL OPERATIONS IN PATIENTS WITH RETINAL DETACHMENT COMPARED WITH ROUTINE CATARACT SURGERY. RETINA [Internet]. 2021;41(8). Available from: https://journals.lww.com/retinajournal/fulltext/2021/08000/assessing_refractive_outcomes_and_accuracy_of.4.aspx
13. Kim YK, Woo SJ, Hyon JY, Ahn J, Park KH. Refractive outcomes of combined phacovitrectomy and delayed cataract surgery in retinal detachment. Canadian Journal of Ophthalmology. 2015 Oct 1;50(5):360–6.
14. Tan A, Bertrand-Boiché M, Angioi-Duprez K, Berrod JP, Conart JB. Outcomes of combined phacoemulsification and pars plana vitrectomy for rhegmatogenous retinal detachment: A Comparative Study. RETINA [Internet]. 2021;41(1). Available from: https://journals.lww.com/retinajournal/fulltext/2021/01000/outcomes_of_combined_phacoemulsification_and_pars.8.aspx
15. Hirakata T, Hiratsuka Y, Yamamoto S, Kanbayashi K, Kobayashi H, Murakami A. Risk factors for macular pucker after rhegmatogenous retinal detachment surgery. Sci Rep. 2021 Dec 1;11(1).
16. Ishida Y, Iwama Y, Nakashima H, Ikeda T, Emi K. Risk Factors, Onset, and Progression of Epiretinal Membrane after 25-Gauge Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment. Ophthalmol Retina. 2020 Mar 1;4(3):284–8.
17. Takamidou Y, Mizuguchi T, Sakurai R, Sugimoto M, Tanikawa A, Horiguchi M. Risk factors for epiretinal membrane surgery after initial pars plana vitrectomy for rhegmatogenous retinal detachment. Fujita medical journal [Internet]. 2022 Feb;8(1):25–30. Available from: http://www.ncbi.nlm.nih.gov/pubmed/35233344
18. Szigiato AA, Antaki F, Javidi S, Touma S, Duval R, Cordahi G, et al. Risk factors for epiretinal membrane formation and peeling following pars plana vitrectomy for primary rhegmatogenous retinal detachment, an OCT guided analysis. Int J Retina Vitreous. 2022 Dec 1;8(1).
19. Pan Q, Gao Z, Hu X, Wu Q, Zheng JW, Zhang ZD. Risk factors for epiretinal membrane in eyes with primary rhegmatogenous retinal detachment that received silicone oil tamponade. British Journal of Ophthalmology. 2023;107(6):856–61.
20. Lee IJ, Benjamin JE, Ghorayeb GR. Incidence of Epiretinal Membrane Formation After Pars Plana Vitrectomy for Giant Retinal Tear-Associated Retinal Detachment. Clinical Ophthalmology. 2023;17:1415–20.