Retinal Detachment Surgery and Proliferative Vitreoretinopathy: From Scleral Buckling to Small Gauge Vitrectomy

Preface
Introduction
Contents
List of Videos
Contributors
Basics of Retinal Detachment Surgery
1 Surgery of Vitreoretinal Disorders—Past, Present, and Future
1.1 The Beginning of Retinal Surgery—Jules Gonin
1.2 Scleral Indentation
1.3 Intraocular Tamponade
1.4 The New Concept
2 Lincoff Rules and Surgical Techniques for Retinal Detachment
2.1 Lincoff Rules for Retinal Detachment
2.2 Short Introduction to Surgical Methods
2.3 Which Technique for Which Detachment
2.4 Assessment at the University of Stockholm
References
3 Basics of Small Gauge Vitrectomy
3.1 Does Size Matter?
3.2 The Dilemma of the Law of Hagen–Poiseuille
3.3 27G and Double-Cut Vitreous Cutter
3.4 History of Double-Cut Vitrector
3.5 The New TDC Cutter is Much Faster Than the Regular Cutter
3.6 27G and PVR Detachment
3.7 Conclusion
4 Devices and Instruments
4.1 Chandelier Light Fiber
4.2 Laser Photocoagulation and Cryopexy
4.3 Instruments for Dissection of Membranes
4.4 Instruments for Removal of Membranes
4.5 Instruments for Subretinal Peeling
4.6 Instruments for Retinotomy
4.7 Dyes
4.8 Episcleral Buckling
4.8.1 Sutures for Episcleral Buckling
4.9 Surgical Setup
5 Gases and Liquids and Their Physiological Properties for Surgery
5.1 Physiologic Characteristics of Gases and Liquids: Specific Gravity
5.2 Physiologic Characteristics of Gases and Liquids: Surface Tension Pressure
5.3 All Gases and Liquids in Detail
5.3.1 Air
5.3.2 Expanding Gases
5.3.2.1 SF6 (Sulphur Hexafluoride)
5.3.2.2 C2F6 (Perfluoroethane)
5.3.2.3 C3F8 (Perfluoropropane)
5.3.3 Liquids
5.3.3.1 Perfluorocarbon
5.3.3.2 Light Silicone Oils
5.3.3.3 Heavy Silicone Oils (Densiron Xtra® and Oxane Hd®)
6 Hot Topics Within Retinal Detachment Surgery
6.1 Timing for Macula off Detachments
6.2 Cerclage or No Cerclage, That is the Question
6.3 ILM Peeling or Not, That is the Question
6.4 Gas or Silicone Oil, That is the Question
6.5 Sf6 Versus C2F6 and C3F8
6.6 Summary
References
7 Biometry and Anaesthesia
7.1 Biometry
7.2 Anaesthesia
Surgical Techniques for Retinal Detachment
8 What is the Best Surgical Technique?
8.1 What Surgical Technique Do We Use in Daily Practice?
8.2 Best Surgical Technique
8.2.1 Best Reattachment Rate
8.2.2 Primary Outcome Parameter: Reattachment Rate
8.2.3 Primary Outcome Parameter: Visual Acuity
8.3 Friday 4 o’clock Detachment and Binocular Occlusion
8.4 Summary
References
9 Special Surgical Techniques for Vitrectomy of Retinal Detachment
9.1 Surgery of an Encircling Band
9.2 Usage of a Chandelier Light
9.3 Use of Heavy Liquid or Posterior Retinotomy
Bibliography
10 Pneumatic Retinopexy (Toronto Technique)
10.1 Introduction
10.2 The surgery
10.4 Complications
10.5 FAQ
11 Vitrectomy with Cryopexy and Gas (Moorfield Technique)
11.1 Introduction
11.2 Surgery
11.3 Postoperative Posture
11.4 Helpful Tips
11.5 Questions and Answers
12 Combined Phaco/Vitrectomy (Frankfurt Technique)
12.1 PFCL or no PFCL?
12.2 25G or 27G?
12.3 The Surgery Step-by-Step (Figs. 12.2, 12.3, 12.4, 12.5, 12.6, 12.7, 12.8, 12.9, 12.10, 12.11, 12.12, 12.13, 12.14, 12.15 and 12.16)
12.4 Postoperative Posture
12.5 Complications
12.6 How to Remove Submacular Fluid
12.7 Tips for PFCL Injections
12.9 FAQ
References
13 Inferior Retinal Detachment with Densiron Xtra
13.1 Surgery
13.2 Complications
Reference
14 Encircling Band, Vitrectomy, Retinotomy and C3F8 (Stockholm Technique)
14.1 Surgery
14.2 FAQ
15 Episcleral Buckling for Detachment Surgery with BIOM
15.1 Introduction
15.3 Material
15.4 Complications
15.5 FAQ
15.6 Case Reports
Special Cases
16 Special Cases—Giant Tear, Ora Dialysis, Young Myope, Chronic Detachments
16.1 Giant Tear
16.2 Young Myopic RD and Ora Dialysis
16.3 Ora Dialysis
16.4 Chronic Detachments
16.4.1 Old Retinal Detachment Without PVR
16.4.2 Chronic Retinal Detachment with PVR
17 Recurrent Retinal Detachment
18 Schisis Detachment Associated with Rhegmatogenous Retinal Detachment
Reference
19 Rhegmatogenous Retinal Detachment in Children
19.1 Episcleral Buckling
19.2 Vitrectomy of a Pediatric Retinal Detachment
References
PVR Detachment
20 How to Approach Surgical Treatment of PVR
20.1 Introduction
20.2 Surgical Setup and Identification of Retinal Breaks and Membranes
20.2.1 Release Of Vitreoretinal Traction, Membrane Peeling, and Dissection
20.2.2 Circumferential Encircling Buckle
20.2.3 Retinectomy
20.2.4 Drainage of SRF, Sealing of Retinal Breaks, and Tamponade
20.2.5 Slow Fluid-Air Exchange
20.2.6 Direct PFO-Oil Exchange
References
21 Vitrectomy for PVR Detachment Stage C
21.1 Introduction
21.2 Instruments for PVR detachment
21.3 The Main Surgical Steps
21.4 Every Surgical Step in Detail
21.5 Removal of Epiretinal Membranes (Fig. 21.8) (See Video)
21.6 Removal of Subretinal Proliferations (See Video)
21.7 Retinotomy
21.8 Instillation of PFCL
21.9 Laser Photocoagulation
21.10 Prepare the Anterior Chamber (See Video)
21.11 Tamponade
Referencess
22 Vitrectomy for PVR Stage D
22.1 Introduction
22.2 Surgery
22.3 Tips and Tricks
23 Special Surgical Techniques for PVR Detachment
23.1 Staining of Peripheral Membranes
23.2 Removal of Subretinal Membranes (See Video)
23.3 180° Retinotomy
References
Anterior and Intraretinal PVR Detachment
24 Vitreous Anatomy, Anterior PVR, and Hypotony
24.1 Introduction
24.2 Hypotony Physiopathology
24.3 Chronic Hypotony Treatments
24.4 Anterior Vitreous Base Anatomy
24.5 Anterior Hyaloid Dissection
24.6 Anterior PVR
24.7 Surgical Technique to Remove Anterior PVR
References
25 Surgical Management of Anterior PVR
25.1 Introduction
25.2 Surgical Treatment of Focal Anterior PVR
25.3 Surgical Treatment of Advanced Anterior PVR (3–4 Quadrants)
26 Pathogenesis, Histopathology, and Classification of PVR
26.1 Overview of the Disease. Pathogenesis
26.2 Histopathology
26.3 The Problem of the Classification
26.4 The Problem of the Intraretinal Changes
26.5 OCT Imaging
References
27 Surgical Management of Intraretinal PVR
27.1 Introduction
27.2 Inferior Detachment with PVR
27.3 Combined Buckle/Vitrectomy
27.4 Retinotomy and Retinectomy
References
Difficult Cases
28 Traumatic Retinal Detachment Secondary to Open Globe
28.1 General Introduction
Reference
29 Choroidal Detachment: Surgical Management of a Serous Choroidal Detachment
30 Suprachoroidal Haemorrhage
31 Surgical Techniques for Silicone Oil and PFCL
31.1 Silicone Oil Injection
31.1.1 Silicone Oil Injection with Chandelier Light (Under BIOM View)
31.1.2 Silicone Oil Tamponade Without Chandelier Light
31.2 PFCL Against Silicone Oil Exchange (with DORC Infusion Line)
31.3 Silicone Oil, Densiron Xtra® Removal
31.3.1 Light Silicone Oil (1000, 1300 and 5000 Csts) Removal
31.3.2 Heavy Silicone Oil (Densiron Xtra®) Removal
International Video Cases
32 Video Cases Reports
32.1 Chronic Retinal Detachment with Anterior and Posterior PVR and Peripapillar Subretinal Strands in a Napkin Ring Configuration
32.1.1 Case Description (Fig. 32.1)
32.1.2 Surgery (Fig. 32.2)
32.1.3 Follow-Up
32.2 Retinal Detachment with PVR, Subretinal Strands, and Luxated IOL
32.2.1 Case Description (Fig. 32.3)
32.2.2 Surgical Procedure
32.2.3 Follow-Up (Fig. 32.4)
32.3 PVR Reoperation Under Silicone Oil
32.3.1 Case Description
32.3.2 Surgery Description (Figs. 32.5 and 32.6)
32.4 Retinal Detachment with PVR CP6 and Hypotony
32.4.1 Case Description (Fig. 32.7)
32.4.2 Surgery Description
32.4.3 Follow-Up (Fig. 32.8)
32.5 Macular PVR Membranes Developing Acutely After Macula-On Retinal Detachment Surgery
32.5.1 Case Description (Fig. 32.9)
32.5.2 Surgery Description (Fig. 32.10)
32.5.3 Follow-Up (Fig. 32.11)
32.6 Long-Standing Retinal Detachment with PVR and Hypotony
32.6.1 Case Description (Fig. 32.12)
32.6.2 Surgery Description (Fig. 32.13)
32.6.3 Follow-Up
32.7 Peripheral RD with Initial Immature Membranes Over 360º Peripheral Retina
32.7.1 Case Description (Fig. 32.14)
32.7.2 Surgery Description (Fig. 32.15)
32.7.3 Follow-Up
32.8 Localized Inferior Retinal Redetachment Due to PVR CA4 with Macular ERM
32.8.1 Case Description (Fig. 32.16)
32.8.2 Surgery
32.8.3 Follow-Up (Fig. 32.17)
32.9 PVR RD with Napkin Ring, Subretinal Membranes and Subretinal Clot
32.9.1 Case Description (Fig. 32.18)
32.9.2 Surgery Description (Figs. 32.18, 32.19, 32.20)
32.9.3 Follow-Up
32.10 Retinal Detachment in Perforating Ocular Trauma
32.10.1 Case Description
32.10.2 Surgical Procedure (Fig. 32.21)
32.10.3 Follow-Up (Fig. 32.22)
32.11 Inferior Retinal Detachment with Subretinal Strands
32.11.1 Case Description (Fig. 32.23)
32.11.3 Follow-Up (Fig. 32.25)
32.12 Retinal Detachment Under Silicone Oil with PVR
32.12.1 Case Description (Fig. 32.26)
32.12.3 Follow-Up (Fig. 32.28)
32.13 Chronic Retinal Detachment with PVR
32.13.1 Case Description (Fig. 32.29)
32.13.2 Surgical Procedure
32.13.3 Follow-Up (Fig. 32.30)
32.14 Complete Retinal Detachment with PVR and Retinal New Vessels Secondary to Branch Retinal Vein Occlusion
32.14.1 Case Description (Fig. 32.31)
32.14.2 Surgery Description
32.14.3 Follow-Up (Fig. 32.32)
32.15 Pediatric Retinal Detachment with PVR and Closed Funnel Retinal Configuration
32.15.1 Case Description (Fig. 32.33)
32.15.2 Surgery Description (Fig. 32.34)
32.15.3 Follow-Up
32.16 Retinal Redetachment PVR CA6 and Intraretinal PVR with Posterior Pole Breaks
32.16.1 Case Description (Fig. 32.36)
32.16.2 Surgery Description (Fig. 32.37)
32.16.3 Follow-Up
32.17 Long-Standing Retinal Detachment with PVR CP6
32.17.1 Case Description (Fig. 32.39)
32.17.2 Surgery Description (Fig. 32.40)
32.17.3 Follow-Up (Fig. 32.40)
32.18 Retinal Detachment with PVR CP6 + CA9 and Traumatic Cataract
32.18.1 Case Description
32.18.2 Surgery Description (Fig. 32.41)
32.18.3 Follow-Up (Fig. 32.42)
32.19 Retinal Detachment After Penetrating Ocular Trauma
32.19.1 Case Description
32.19.2 Surgery Description (Figs. 32.43, 32.44)
32.19.3 Follow-Up
32.20 Retinal Detachment Under Silicone Oil with PVR CP2 + CA6
32.20.1 Case Description (Fig. 32.45)
32.20.2 Surgery Description (Fig. 32.46)
32.20.3 Follow-Up
32.21 Myopic Retinal Detachment Without Posterior Vitreous Detachment
32.21.1 Case Description (Fig. 32.47)
32.21.2 Surgery Description (Fig. 32.48)
32.21.3 Follow-Up
32.22 Retinal Detachment with PVR CA4 and Subretinal Strands
32.22.1 Case Description (Fig. 32.49)
32.22.2 Surgery Description (Fig. 32.50)
32.22.3 Follow-Up
32.23 Traumatic Retinal Detachment with Retinal Incarceration and Ora Dialysis
32.23.1 Case Description (Fig. 32.51)
32.23.2 Surgery Description (Fig. 32.52)
32.23.3 Follow-Up
32.24 Traumatic Retinal Detachment CP12 + CA12 with Closed Funnel Shape
32.24.1 Case Description (Fig. 32.53)
32.24.2 Surgery Description (Fig. 32.54)
32.24.3 Follow-Up
32.25 Retinal Redetachment with PVR CP12
32.25.1 Case Description (Fig. 32.55)
32.25.2 Surgical Strategy
32.25.3 Surgical Procedure
32.25.4 Follow-Up
Appendix
Retinal Detachment with Epiretinal and Subretinal PVR Removal
Case Description (Fig. 32.56)
Surgical Procedure (Fig. 32.57)
Follow-Up (Fig. 32.58)
References
Postoperative Follow-Up and Complications and Tipps and Tricks for RD Surgery
33 After Surgery and Complications
34 Postoperative Complications After Vitreoretinal Surgery
34.1 Changes of the Cornea
34.2 Complications Related to Surgical Wounds
34.3 Hemorrhage
34.4 Inflammation
34.5 Secondary Glaucoma
34.6 More Complications Related to Silicone Oil Tamponade
34.7 Residual Perfluorocarbon
34.8 Buckling Procedure Complications
References
35 Tipps and Tricks for Retinal Detachment Surgery
35.1 Anterior Chamber
35.1.1 Surgical Pearls No. 1
35.1.1.1 Insertion of a Synergetics Chandelier Light
35.2 Posterior Chamber
35.3 Tamponade
Appendix_1