DefinePK

Research Objective

To study the outcome of surgeries performed for retinal detachments associated with chorioretinal colobomas.

Methodology

This retrospective study enrolled 16 eyes of 16 patients with retinal detachments associated with chorioretinal colobomas. Standard 3-ports 23-gauge Pars plana vitrectomy (PPV) with silicon oil tamponade and endo-laser was performed along the rim of colobomas in all cases. In 4 (25.0%) eyes, buckling was performed with 240 silicon bands and vitrectomy to support the vitreous base. In 12 eyes (75.0%), the natural lens was removed with phaco / lensectomy and intra-ocular lens implantation.

Methodology Flowchart

                        graph TD
    A["Patient Selection 16 eyes"] --> B["Retrospective Data Review"];
    B --> C["Surgical Procedure"];
    C --> D["Pars Plana Vitrectomy PPV"];
    D --> E["Additional Procedures"];
    E --> F["Silicon Oil Tamponade"];
    E --> G["Endo-laser Retinopexy"];
    E --> H["Buckling 4 eyes"];
    E --> I["Phaco/Lensectomy with IOL 12 eyes"];
    F --> J["Post-operative Assessment"];
    G --> J;
    H --> J;
    I --> J;
    J --> K["Data Analysis"];
    K --> L["Conclusion"];                    

Discussion

Retinal detachment associated with chorio-retinal coloboma is a rare but challenging condition. The study found that PPV with endo-laser photocoagulation and silicon oil tamponade is an effective surgical procedure for achieving retinal reattachment and improving visual acuity in these cases. The authors discuss the historical approaches to treating such detachments and highlight the advantages of PPV in providing better visualization and access. They also note the transient increase in IOP as a manageable complication.

Key Findings

The retina was re-attached in 15 eyes (93.75%) after the first operation. One eye needed a second surgery, which was successful anatomically after the second surgery. Mean pre-operative best-corrected visual acuity (BCVA) was 3.36 (±0.52), while 2-weeks post-operative BCVA was 1.92 (±0.88), which was statistically significant (P<.001) improvement. Complications observed post-operatively included increased intra-ocular pressure (IOP), silicone oil in the anterior chamber (AC), recurrent retinal detachment, and epiretinal membrane (ERM) formation.

Conclusion

Pars plana vitrectomy with internal tamponade and endo-laser retinopexy along the rim of coloboma is a considerably effective procedure for anatomically reattaching the retina and improving final best-corrected visual acuity in cases of rhegmatogenous retinal detachment associated with chorioretinal colobomas. Some patients may encounter transient and manageable intra-ocular pressure rise.

Fact Check

1. Retinal Reattachment Rate: The study reports that the retina was re-attached in 15 out of 16 eyes (93.75%) after the first operation.
2. Visual Acuity Improvement: Pre-operative BCVA was 3.36 (±0.52), and 2-week post-operative BCVA was 1.92 (±0.88), a statistically significant improvement (P<.001).
3. Patient Demographics: The study included 16 eyes of 16 patients, with 8 women and 8 men, and a mean age of 30 years.

Mind Map