Document Detail


Rhegmatogenous retinal detachment after block excision of epithelial implantation cysts and tumors of the anterior uvea.
MedLine Citation:
PMID:  10519589     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To report on frequency, time of occurrence, treatment, and final outcome of rhegmatogenous retinal detachment after block excision, combined with corneoscleral tectonic grafts, of intraocular epithelial implantation cysts and tumors of the anterior uvea involving the anterior chamber angle. DESIGN: Noncomparative case series. PARTICIPANTS: The study included 144 patients who had consecutively undergone scleral full-thickness block excision of tumors of the anterior uvea (n = 87) or intraocular epithelial implantation cysts (n = 57). Diameter of the block excision ranged between 5.5 and 20 mm. In 39 patients, the tumor extended posterior to the ora serrata. INTERVENTIONS: Retinal detachment surgery. MAIN OUTCOME MEASURES: Retinal detachment rate, visual acuity, risk factors. RESULTS: Retinal detachment occurred in 10 (6.9%) of 144 patients (2 of 57, or 3.5% of patients with cysts; 8 of 87 or 9.2% of patients with tumors) 3 to 12 months after block excision. Six patients underwent primary pars plana vitrectomy with temporary endotamponade by silicone oil, which was removed 3 to 9 months later. In four patients, a scleral buckling procedure only was performed. After a mean follow-up of 31 months after silicone oil removal or the buckling procedure (median, 30 months; range, 13-42 months), the retina has remained attached in all patients operated on. Visual acuity increased from 2/20 (median; range, light perception-6/20) to 8/20 (median; range, 2/20-12/20). In the eyes with retinal detachment compared to the eyes without retinal detachment, the block excision was significantly larger (13.75+/-4.86 mm vs. 9.41+/-3.02; P = 0.01) and was located significantly more posteriorly (limbus distance of posterior excision margin: 6.75+/-2.87 vs. 4.35+/-3.24 mm; P = 0.01). CONCLUSIONS: Scleral buckling procedures and primary pars plana vitrectomy with temporary ocular endotamponade can give acceptable results in eyes with rhegmatogenous retinal detachment occurring after block excision of epithelial implantation cysts or tumors of the anterior uvea. Despite intraoperative vitreous prolapse or tumor extension posterior to the ciliary body, rhegmatogenous retinal detachment occurs in fewer than 10% of patients undergoing block excision of cysts or tumors of the anterior uvea. Size and posterior location of the block excision are the main risk factors for rhegmatogenous retinal detachment, which becomes unlikely later than 12 months after surgery.
Authors:
J B Jonas; M J Groh; V Rummelt; G O Naumann
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Ophthalmology     Volume:  106     ISSN:  0161-6420     ISO Abbreviation:  Ophthalmology     Publication Date:  1999 Oct 
Date Detail:
Created Date:  1999-10-18     Completed Date:  1999-10-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7802443     Medline TA:  Ophthalmology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1942-6     Citation Subset:  IM    
Affiliation:
Department of Ophthalmology and Eye Hospital, University Erlangen-Nürnberg, Erlangen, Germany. Jost.Jonas@augen.med.unierlangen.de
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Anterior Eye Segment*
Cysts / surgery*
Drainage
Epithelial Cells / pathology*
Female
Fluorocarbons
Humans
Male
Melanoma / surgery*
Middle Aged
Postoperative Complications* / surgery
Retinal Detachment / etiology*,  surgery
Scleral Buckling
Silicone Oils
Uveal Neoplasms / surgery*
Visual Acuity
Vitrectomy
Chemical
Reg. No./Substance:
0/Fluorocarbons; 0/Silicone Oils

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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