Table of Contents - WOC 2012

WOC2012 Abstract Book
PO-RET-184
Surgical Management of Rhegmatogenous Retinal Detachment
Associated with Choroidal Coloboma in a Child with Noonan
Syndrome
Abdul Rahman Azlie Faizal (1) , Yeong Han Teh (1) , Othman Othmaliza (1) , Bastion
Mae-Lynn Catherine
1. Department of Ophthalmology, Universiti Kebangsaan Malaysia Medical
Centre
Noonan Sydrome is associated with several ocular manifestations and this
case was chosen to illustrate the surgical challenges of its management. A
7-year-old boy with Noonan syndrome presented with left rhegmatogenous
retinal detachment, phacodonesis, dense cataract and ocular coloboma.
His vision was hand movement with good light projection. He underwent
lensectomy, 23G pars planar vitrectomy, air fluid exchange, endolaser and
silicone oil injection. The detachment was secondary to an occult break within
the optic disc itself. Post-operatively it was complicated with high intraocular
pressure (IOP), attributed to overfill of silicone oil which was released and
treated medically. The IOP was successfully controlled upon complete removal
of the silicon oil. Barricade laser to the coloboma with short term silicone oil
tamponade successfully reattached the retina up to 6 months post-operatively.
His best corrected visual acuity was 6/24 six months later. This case highlighted
that surgical management of retinal detachment with choroidal coloboma is
very challenging yet worthwhile to perform.
PO-RET-185
A new patented High Efficiency Vitrectomy Probe
Yang Xun (1)
1. Chengdu Aier Eye Hospital
Purpose: To design a new high efficiency vitrectomy probe and to explore its
exact efficiency.
Methods: A new 20G vitrectomy probe model was made according to our
ophthalmic patent. Experiment was conducted to explore the efficiency
difference between our new probe and common probe by simulating vitrectomy
with egg white. The vacuum negative pressure was kept at 600 mmHg.
Results: The efficiency of common probe was 0.027 g/minute under the work
frequency of 2500 cut per minute, while the efficiency of our new probe was
1.811 g/minute, which was almost 51 times than the former.
Conclusion: Our new vitrectomy probe is much more efficient than common
probe, especially under high work frequency. It is expected to increase
efficiency of clinic vitrectomy significantly.
PO-RET-186
The Application of Sapphire Stab Knife in 2-step Sclerotomy in 23G
Vitrectomy in Hypotonic Eyes
Yang Xun (1)
1. Chengdu Aier Eye Hospital
Object: To apply 2-step method to make the sclerotomy during 23G Vitrectomy
in hypotonic eyes, to make it convenient to drain out the liquid in the
subchoroidal space and to avoid the sclerotomy related complications. Method:
Two steps were performed to make the sclerotomy on low intraocular pressure
eyes (especially complicated with choroidal detachment or suprachoroidal
hematoma): firstly, after injecting perfusion fluid into anterior chamber to
elevate the IOP, sapphire stab knife was used to make an oblique sclera
incision on pars plana (only the sclera if subchoroidal liquid drainage was not
necessary; and did not penetrate the whole thickness of sclera if subchoroidal
liquid drainage was not necessary.) , then drained out the liquid or blood from
the subchoroidal space; secondarily, inserting 23G canula into vitreous cavity
along the previous sclera incision.
Result: All the sclerotomy were made successfully, and the liquid in subchoroidal
space was drained out conveniently. A few trocar loosed during the operation,
and needed re-insertion along the probe still in the eye.
Conclusion: Using sapphire stab knife to perform 2-step sclerotomy is
convenient, safe and effective during 23G vitrectomy in hypotonic eyes.
644
PO-RET-187
The influencing factors after Vitreoretinal Surgery in Diabetic
tractional retinal detachment
Chen Song (1) , Meng Li-zhu (1)
1. Tianjin Eye Hospital,
Objective: To evaluate the influencing factors of visual acuity after vitreoretinal
surgery in diabetic tractional retinal detachment (DTRD).
Methods: 102 eyes of 86 consecutive patients with DTRD undergoing
vitreoretinal surgery were analyzed retrospectively. All cases diagnosed via
indirect ophthalmoscope and B ultrasonic after mydriasis. Follow-up duration
varied from 12 to 56 months (mean: 23 months). Best corrected visual acuity
(BCVA) and anatomic success were observed postoperatively. The patients
were divided into visual acuity improved group and didn’t improved group.
T-test, Chi-square test and Multivariate Logistic regression analysis were
performed at the prognosis of visual acuity.
Results: After primary vitreoretinal surgery, anatomic success was achieved in
87 eyes(85.3%), while 15 eyes (14.71%) needed reoperation because of the
recurrence of retinal detachment (RD).Postoperative BCVA improved and
better than 0.05 in 49 eyes(48.04%),while BCVA reduced or increased but less
than 0.05 in 53 eyes(51.96%).Comparing natural factors of the two groups,
only combined cataract surgery and optic nerve atrophy were significantly
(χ2=5.266, 9.274, P=0.022, 0.002).Among post-operative complications only
the RD recurrence was significantly (χ2=12.059, P=0.000).Multivariate Logistic
regression revealed recurrence of RD and optic nerve atrophy were two
independent risk factors in final BCVA (P=0.003, 0.041, OR=33.518, 4.079).
Preoperative PRP was identified as the only protecting variable in final BCVA
(P=0.034, OR=0.270). Conclusion The visual prognosis may be evaluated
via the preoperative natural factors and post-operative complications. This
study also revealed the recurrence of RD and optic nerve atrophy were two
independent risk factors in poor BCVA.
Key words: Diabetic retinopathy/surgery;Retinal detachment/
surgery;Vitrectomy; Multivariate analysis
PO-RET-188
Visual Prognosis factors analysis of scleral buckling for primary
macula-off rhegmatogenous retinal detachment
Chen Song (1) , Hu Ting (1)
1. Tianjin Eye Hospital
Objective This study evaluated the relationship between scleral buckling for
primary macula-off rhegmatogenous retinal detachment and the factors
associated with postoperative visual acuity. Methods A retrospective review of
a consecutive series of 116 patients(116 eyes) who underwent scleral buckling
for primary macula-off rhegmatogenous retinal detachment was performed.
The multiple factors related with prognosis including age,preoperative
best corrected visual acuity(BCVA), duration of disease, refractive error
,the location of the hole,the number of the hole area and height of retina
detachment, surgical management of subretinal fluid and intravitreal gas
injection were analyzed.According to these factors,the patient were assigned
to two groups. Results There were significant differences between the groups
who were assigned according to preoperative BCVA (p=0.002)and duration of
disease (p=0.009). Multivariate logistic regression analysis revealed that the
preoperative BCVA was the only variable affecting the visual result (p=0.009,
r=0.400). Conclusion Preoperative BCVA and duration of disease were
assosiated with the postoperative BCVA recovery.Scleral buckling should be
performed within the first week for primary macula-off rhegmatogenous retinal
detachment ,which may result in a better BCVA .
PO-RET-189
Vitreoretinal Surgery in Omani adults
Bialasiewicz Alexander (1) , Al-Saeidi Rashid (2) , Shenoy Radha (2) , Al-Belushi
Habiba (3)
1. Department of Ophthalmology, Al Ahli Hospital
2. Department of Ophthalmology, Armed Forces Hospital
3. Sultan Qaboos University Hospital
Objectives: To report on the causes and outcomes of vitreoretinal blinding
diseases in Oman Methods. Over 6 years pars plana vitrectomies were
performed with Accurus 800CS (Alcon) and EyeLite 532 nm Laser (Alcon).
Patients were followed after 4 weeks and 1 year. Descriptive statistics were
used.
Results: 2,910 vitreoretinal surgeries were performed on 784 adult and 101
pediatric eyes. Main indications were proliferative diabetic vitreoretinopathy
(PDVR) (229/784 eyes=29%), trauma (166/784=21%), and PVR
(112/784=14.3%) in adults. Postoperative vision in trauma, PVR, epiretinal
gliosis and dislocated IOL extraction was better (p=0.003, p=0.044, p=0.029,
p=0.001) and outcome in PDVR with uncontrolled diabetes worse (p=0.001).
All patients with significant macular edema and an HbA1c of more than 9.5%
lost 5 m vision. HbA1c in postoperative blindness was 13.5%. Revision surgery
was most frequent after traumatic PVR.
Conclusions: The most frequent causes of preventable retinal blindness are
diabetes and trauma. Trauma has a better outcome than PDVR in uncontrolled
diabetes. Establishment of diabetes centers and expansion of vitreoretinal
services are recommended.