PII: 0042-6989(95)90020-9


RETINAL, DETACHMENT SURGERY 

1121 1123 

ll22 

ANATOMICAL AND FUNCTIONAL OUTCOME IN RETINAL 
DETACHMENT COMPLICATED BY ADVANCED 
PROLIFERATIVE VITREORETINOPATHY IN CHILDHOOD 

A. KARILA, B. MASHHOUR, D. CHAUVAUD, Y. POULIQUEN 

Department of Ophthalmology, H&pita1 H&l-Dieu de Paris, France. 

eurpaSe To analyse anatomical and functional results of retinal 
detachment swery in cases complicated by proliferative 
vitreoretinopatby in childhood. 
M&Q& Thirty six consecutive cases of retinal detachment complicated 
by PVR stages Cl and more in childhood were analysed retrospectively. 
All the cases associated scleral buckling, pars plana vitrectomy, complete 
membrane peeling, injection of liquid perflomcarbon (LPFC), 
endophotocoagulation, and internal tamponade. In selected cases 
lensectomy and/or relaxing retinotomy were requiered. 
&J&S Predominant etitogies were blunt trauma and high myopia. 
Anatomical swxs was obtained with one operation in 7 cases, and 2 OI 
more operations in 14 cases. Final visual acuity was <O.l, O.l-0.4 and 0.4 
or more in 23, 10 and 3 cases respectively. 
Conelusion Complicated retinal detachment in childhood represents a 
high proportion of overall RD in childhood and could be treated wing 
agressive vitreoretinal procedures with comparative visual outcome to 
RD’s in adult. 

REOPERATIONS FOLLOWING VITRECTOMY 
FOR DIABETIC RETINOPATHY 

Helbig H. Kellner U. Bornfeld N. and Foerster M. H. 
Department of Ophthalmology, Klinikum Benjamin Franklin, 

Free University of Berlin (Germany) 

Purpose: The assess risk factors and visual outcome of reoperations 
after vitrectomy for diabetic retinopathy. 
Methods: The charts of 327 consecutive patients (412 eyes) operated 
by the authors in the last 4 years for complications of diabetic 
retinopathy were retrospectively reviewed. Preoperatively the retina 
was flat in 171 eyes, in 239 eyes it was detached. Mean follow up was 
16 months. 
Basulls; 114 eyes required vitreoretinal reoperations. 46 for recurrent 
vitreous hemorrhaae. 46 for retinal detachment and 20 for removal of 
silicone. In 34 eyed a third operation, in 11 eyes a 4th, in 5 eyes a 5th, 
and in 2 eyes 6 operations were necessary. Visual prognosis after 
reoperation for vitreous hemorrhage was good, while after 
reoperation for retinal detachment funtional results were guarded. 
Risk factors for detachment were iatrogenic retinal breaks and lack of 
endoohotocoaaulation. With increasina number of reooerations visual 
progbosis bec”ame worse. but even-after 5 operations ambulatory 
vision was preserved in some cases. Cataract surgery was performed 
in 54 out of 306 phacic eyes. No severe complications were seen after 
cataract surgery. 
Conclusions: With current indications for vitreoretinal surgery in 
diabetic retinopathy reoperations are necessary in a considerable 
proportion of cases. Although visual prognosis is guarded after 
reoperations for retinal detachment, ambulatory vision can be 
preserved in many cases even after repeated reoperations. Cataract 
surgery can be safely performed after vitrectomy in diabetic patients. 

1X24 

RETINAL DETACHMENT COMPLICATING RECURRENT OCULAR 
TOXOPLASMOSIS 

FERON EJ". MRRTENS DAE'. VAN MEURS JC'. SAARSMA GS'. 
SUTTORP MSA’. ROTHOVA A=. 
’ The Rotterdam Eye Hospital, Rotterdam 
$Netherlands) . 

The Netherlands Ophthalmic Research Institute, 
Amsterdam (Netherlands). 
’ The University Hospital of Utrecht, Utrecht 
(Netherlands) . 

Purpose Recurrent ocular toxoplasmosis is an 
important cause of blindness throughout the world. 
Permanent loss of vision can either be the result of 
direct involvement of the macula or optic nerve in 
the inflammation, or can he related to 
well-recosnized conmlications such es macular 
oedema, scbretinal neovascularisation, retinal or 
choroidal vascular occlusion. Relativelv little is 
known about the incidence and prognosis-of retinal 
detachment es a complication of the disease. 
Methods We have performed a retrospective study of 
15 immmocompetent patients with ocular toxo- 
plasmosis, complicated by retinal detachment either 
at an active or inactive stage of the disease. 
Results The retinal detachments associated with 
ocular toxoplasmosis were either rhegmatogenous 
(8 patients), tractional (2 patients) or combined 
rhegmatogenous/tracticnal (5 patients). A high 
frequency of complications was observed: 
proliferative vitreoretinopathy (5 patients), 
macular oucker I2 oatients~. aiant retinal tear 
(1 patie‘nt). * " - 
Conclusipne The complexity and the high complication 
rate of the retinal detachments described in our 
series of ocular toxoplasmosis patients contrasts 
with previous reports in the ;iterature. 

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