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Angle Closure Glaucoma: Treatment01:28

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Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
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Unplanned Reoperation following Vitreoretinal Surgery.

Ali Akbarzadeh1, Amin Zand1, Masoud Rahimi1

  • 1Eye Research Center, Department of Ophthalmology, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

Journal of Current Ophthalmology
|September 8, 2023
PubMed
Summary

Unplanned reoperations after vitreoretinal surgery occur in 14% of cases, primarily due to recurrent retinal detachment with proliferative vitreoretinopathy (PVR). Lower preoperative visual acuity is linked to a higher risk of reoperation.

Keywords:
ReoperationRetinal detachmentVitrectomyVitreoretinal surgery

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Area of Science:

  • Ophthalmology
  • Retinal Surgery
  • Surgical Outcomes

Background:

  • Unplanned reoperations after vitreoretinal surgery can impact patient outcomes and healthcare resource utilization.
  • Understanding the incidence and causes of these reoperations is crucial for improving surgical strategies and patient care.

Purpose of the Study:

  • To determine the frequency of unplanned returns to the operating room after vitreoretinal surgery.
  • To identify the specific reasons for early and late unplanned reoperations.

Main Methods:

  • A retrospective review of medical records for patients undergoing vitreoretinal surgery was conducted.
  • Data on primary diagnoses, surgical procedures, and reasons for unplanned reoperations were analyzed.

Main Results:

  • Fourteen percent of 488 eyes (68/488) required unplanned reoperations.
  • Late reoperations (10.0%) were more common than early reoperations (3.9%).
  • Recurrent retinal detachment with proliferative vitreoretinopathy (PVR) was the most frequent cause for both primary surgery and reoperations, particularly for late reoperations. Other causes included silicone oil in the anterior chamber and endophthalmitis for early reoperations.
  • Lower preoperative best-corrected visual acuity (BCVA) was associated with an increased likelihood of unplanned reoperation (P = 0.011).

Conclusions:

  • Unplanned reoperations following vitreoretinal surgery are relatively uncommon.
  • The primary drivers for reoperation are related to retinal detachment (RD) with proliferative vitreoretinopathy (PVR), rhegmatogenous retinal detachment (RRD), and tractional RD (TRD).
  • Preoperative visual status is a significant predictor for the need for subsequent unplanned surgical interventions.