Enhanced internal search for iatrogenic retinal breaks in 20-gauge macular surgery

H. Stevie Tan, Sarit Y Lesnik Oberstein, Marco Mura, Marc D. De Smet

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate the incidence and characteristics of iatrogenic retinal breaks in 20-gauge macular surgery with an intensified search strategy. Design: Retrospective, non-comparative interventional case series. Participants: 218 consecutive operations in 209 patients who underwent 20-gauge vitrectomy vitrectomy for idiopathic macular pucker or idiopathic macular hole. Methods: Retrospective review of patient records undergoing 20-gauge vitrectomy with intensified peripheral search for retinal defects. Main outcome measures: Incidence of breaks related to the sclerotomies, the incidence of breaks occurring elsewhere, the incidence of lesions suspicious for traction, the location of identified breaks and intraoperative induction of posterior vitreous detachment. Results: Retinal breaks occurred in 24.3% of operations. In 17.4% breaks were related to the sclerotomies and in 9.6% of breaks were found elsewhere. In 6.4% of eyes, only lesions suspicious for traction were detected. Retinal detachment occurred in 1.8% of cases. The occurrence of breaks was significantly related to induction of PVD. Conclusions: With intensified intraoperative search, a much higher incidence of retinal breaks was found than previously reported in the literature. Despite the high incidence of breaks, the incidence of postoperative rhegmatogenous retinal detachment was low. These findings support the rationale that intensive intraoperative search for iatrogenic breaks is crucial for the prevention of postoperative retinal detachments in macular surgery.

Original languageEnglish (US)
Pages (from-to)1490-1492
Number of pages3
JournalBritish Journal of Ophthalmology
Volume94
Issue number11
DOIs
StatePublished - Nov 2010
Externally publishedYes

Fingerprint

Retinal Perforations
Incidence
Vitrectomy
Retinal Detachment
Traction
Vitreous Detachment
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience
  • Medicine(all)

Cite this

Enhanced internal search for iatrogenic retinal breaks in 20-gauge macular surgery. / Tan, H. Stevie; Oberstein, Sarit Y Lesnik; Mura, Marco; De Smet, Marc D.

In: British Journal of Ophthalmology, Vol. 94, No. 11, 11.2010, p. 1490-1492.

Research output: Contribution to journalArticle

Tan, H. Stevie ; Oberstein, Sarit Y Lesnik ; Mura, Marco ; De Smet, Marc D. / Enhanced internal search for iatrogenic retinal breaks in 20-gauge macular surgery. In: British Journal of Ophthalmology. 2010 ; Vol. 94, No. 11. pp. 1490-1492.
@article{0c3cfdd856c445a6b27e1a1047022ac5,
title = "Enhanced internal search for iatrogenic retinal breaks in 20-gauge macular surgery",
abstract = "Purpose: To evaluate the incidence and characteristics of iatrogenic retinal breaks in 20-gauge macular surgery with an intensified search strategy. Design: Retrospective, non-comparative interventional case series. Participants: 218 consecutive operations in 209 patients who underwent 20-gauge vitrectomy vitrectomy for idiopathic macular pucker or idiopathic macular hole. Methods: Retrospective review of patient records undergoing 20-gauge vitrectomy with intensified peripheral search for retinal defects. Main outcome measures: Incidence of breaks related to the sclerotomies, the incidence of breaks occurring elsewhere, the incidence of lesions suspicious for traction, the location of identified breaks and intraoperative induction of posterior vitreous detachment. Results: Retinal breaks occurred in 24.3{\%} of operations. In 17.4{\%} breaks were related to the sclerotomies and in 9.6{\%} of breaks were found elsewhere. In 6.4{\%} of eyes, only lesions suspicious for traction were detected. Retinal detachment occurred in 1.8{\%} of cases. The occurrence of breaks was significantly related to induction of PVD. Conclusions: With intensified intraoperative search, a much higher incidence of retinal breaks was found than previously reported in the literature. Despite the high incidence of breaks, the incidence of postoperative rhegmatogenous retinal detachment was low. These findings support the rationale that intensive intraoperative search for iatrogenic breaks is crucial for the prevention of postoperative retinal detachments in macular surgery.",
author = "Tan, {H. Stevie} and Oberstein, {Sarit Y Lesnik} and Marco Mura and {De Smet}, {Marc D.}",
year = "2010",
month = "11",
doi = "10.1136/bjo.2009.172791",
language = "English (US)",
volume = "94",
pages = "1490--1492",
journal = "British Journal of Ophthalmology",
issn = "0007-1161",
publisher = "BMJ Publishing Group",
number = "11",

}

TY - JOUR

T1 - Enhanced internal search for iatrogenic retinal breaks in 20-gauge macular surgery

AU - Tan, H. Stevie

AU - Oberstein, Sarit Y Lesnik

AU - Mura, Marco

AU - De Smet, Marc D.

PY - 2010/11

Y1 - 2010/11

N2 - Purpose: To evaluate the incidence and characteristics of iatrogenic retinal breaks in 20-gauge macular surgery with an intensified search strategy. Design: Retrospective, non-comparative interventional case series. Participants: 218 consecutive operations in 209 patients who underwent 20-gauge vitrectomy vitrectomy for idiopathic macular pucker or idiopathic macular hole. Methods: Retrospective review of patient records undergoing 20-gauge vitrectomy with intensified peripheral search for retinal defects. Main outcome measures: Incidence of breaks related to the sclerotomies, the incidence of breaks occurring elsewhere, the incidence of lesions suspicious for traction, the location of identified breaks and intraoperative induction of posterior vitreous detachment. Results: Retinal breaks occurred in 24.3% of operations. In 17.4% breaks were related to the sclerotomies and in 9.6% of breaks were found elsewhere. In 6.4% of eyes, only lesions suspicious for traction were detected. Retinal detachment occurred in 1.8% of cases. The occurrence of breaks was significantly related to induction of PVD. Conclusions: With intensified intraoperative search, a much higher incidence of retinal breaks was found than previously reported in the literature. Despite the high incidence of breaks, the incidence of postoperative rhegmatogenous retinal detachment was low. These findings support the rationale that intensive intraoperative search for iatrogenic breaks is crucial for the prevention of postoperative retinal detachments in macular surgery.

AB - Purpose: To evaluate the incidence and characteristics of iatrogenic retinal breaks in 20-gauge macular surgery with an intensified search strategy. Design: Retrospective, non-comparative interventional case series. Participants: 218 consecutive operations in 209 patients who underwent 20-gauge vitrectomy vitrectomy for idiopathic macular pucker or idiopathic macular hole. Methods: Retrospective review of patient records undergoing 20-gauge vitrectomy with intensified peripheral search for retinal defects. Main outcome measures: Incidence of breaks related to the sclerotomies, the incidence of breaks occurring elsewhere, the incidence of lesions suspicious for traction, the location of identified breaks and intraoperative induction of posterior vitreous detachment. Results: Retinal breaks occurred in 24.3% of operations. In 17.4% breaks were related to the sclerotomies and in 9.6% of breaks were found elsewhere. In 6.4% of eyes, only lesions suspicious for traction were detected. Retinal detachment occurred in 1.8% of cases. The occurrence of breaks was significantly related to induction of PVD. Conclusions: With intensified intraoperative search, a much higher incidence of retinal breaks was found than previously reported in the literature. Despite the high incidence of breaks, the incidence of postoperative rhegmatogenous retinal detachment was low. These findings support the rationale that intensive intraoperative search for iatrogenic breaks is crucial for the prevention of postoperative retinal detachments in macular surgery.

UR - http://www.scopus.com/inward/record.url?scp=78149490881&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78149490881&partnerID=8YFLogxK

U2 - 10.1136/bjo.2009.172791

DO - 10.1136/bjo.2009.172791

M3 - Article

VL - 94

SP - 1490

EP - 1492

JO - British Journal of Ophthalmology

JF - British Journal of Ophthalmology

SN - 0007-1161

IS - 11

ER -