Vitreoretinal surgery: with 58 tables
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|---|---|
| Format: | Book |
| Language: | English |
| Published: |
Berlin [u.a.]
Springer
2008
|
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Physical Description: | XVI, 227 S. zahlr. Ill., graph. Darst. 1 DVD-ROM (12 cm) |
| ISBN: | 9783540375814 3540375813 |
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| 020 | |a 3540375813 |9 3-540-37581-3 | ||
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| 100 | 1 | |a Williamson, Thomas H. |e Verfasser |0 (DE-588)133859509 |4 aut | |
| 245 | 1 | 0 | |a Vitreoretinal surgery |b with 58 tables |c Thomas H. Williamson |
| 264 | 1 | |a Berlin [u.a.] |b Springer |c 2008 | |
| 300 | |a XVI, 227 S. |b zahlr. Ill., graph. Darst. |e 1 DVD-ROM (12 cm) | ||
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| 337 | |b n |2 rdamedia | ||
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| adam_text | Chapter
1
Anatomy and Clinical Examination of the Eye
1.1
Surgical Anatomy
of the Retina and Vitreous
.......... 1
1.1.2
The Vitreous
..................
1.1.2.1
Embryology
................... 1
1.1.2.2
Anatomy
.................... 1
1.1.2.2.1
Anatomical Attachments of the Vitreous
to the Surrounding Structures
........ 2
1.1.2
The Retina
.................... 2
1.1.2.1
Embryology
................... 2
1.1.2.2
Anatomy
.................... 2
1.1.2.2.1
Retinal Layers
.................. 3
1.1.2.2.2
Retinal Blood Vessels
............. 4
1.1.2.2.3
Other
Fundal
Structures
........... 4
1.2
The Anatomy
and the Vitreoretinal Surgeon
........ 4
1.3
Clinical Examination and Investigation.
. . 4
1.3.1
Using the Database
............... 4
1.3.2
Examination of the Eye
............ 4
1.3.2.1
Visual Acuity
.................. 4
1.3.2.2
The Slit Lamp
.................. 5
1.3.2.3
Binocular Indirect Ophthalmoscope
.... 5
1.3.2.3.1
Using the
Indentar
............... 6
1.3.2.4
Ultrasonography
................ 6
1.3.2.5
Optical Coherence Tomography
....... 9
1.3.2.5.1
Scan of Normal Features
........... 9
1.3.2.6
Subjective Tests
................. 9
1.3.2.7
The
Preoperative
Assessment
......... 10
Summary
.......................... 10
References
......................... 10
Chapter
2
Introduction to Vitreoretinal Surgery
2.1
Introduction
..................
Π
2.2
The 20-Gauge Pars
Plana Vitrectomy
.... 12
2.2.1
Sclerotomies
.................. 13
2.2.1.1
Where to Place Sderotomies
......... 13
2.2.1.2
Securing the Infusion
Cannula
........ 14
2.2.1.3
Checking the Infusion
............. 14
2.2.1.4
Where to Place the Superior Sclerotomies
. 14
2.2.1.5
Construction
.................. 14
2.2.1.6
Priming
..................... 14
2.2.2
Checking the View
............... 15
2.2.3
The Independent Viewing System
[2] .... 15
2.2.4
Removing the Vitreous
............ 15
2.2.5
Handling the Light Pipe
............ 18
2.2.6
Use of Sclerotomy Plugs
............ 18
2.2.7
The Internal Search
.............. 19
2.2.8
Endolaser
.................... 19
2.2.9
Using a Contact Lens
............. 20
2.2.10
Maintaining a View
.............. 20
2.2.11
Closing
..................... 22
2.2.12 Peroperative
Complications
.......... 22
2.2.12.1
Iatrogenic Breaks
............... 22
2.2.12.2
Choroidal Haemorrhage
........... 23
2.2.12.3
Haemorrhage from Retinal
or Other Blood Vessels
............ 24
2.2.12.4
Lens Touch
................... 24
2.2.13
Postoperative Complications
......... 24
2.3
Principles of Internal Tamponade
...... 25
2.3.1
Gases
....................... 25
2.3.1.1
Principles
.................... 25
2.3.1.2
Properties
.................... 25
2.3.2
Silicone
Oil
................... 27
2.3.2.1
Properties
.................... 28
2.3.2.2
Silicone
Oil in the Anterior Chamber
. ... 28
2.3.2.3
Complications of
Silicone
Oil
......... 29
2.3.3
Silicone
Oil Removal
.............. 31
2.3.3.1
Retinal Re-detachment Rates
after Oil Removal
................ 33
2.3.4
Heavy
Silicone
Oils
.............. 33
2.3.5
Heavy Liquids
................. 33
2.3.6
Light Heavy Liquids
............. 34
2.4
Combined Cataract Extraction and PPV
. . 35
2.5
Bimanual Surgery
............... 35
2.6
23-Gauge and 25-Gauge Vitrectomy
.... 35
2.7
Dyes
....................... 37
Summary
.......................... 38
References
......................... 38
Contents
Chapter
3
Posterior Vitreous Detachment
3.1
Introduction
.................. 41
3.2
Floaters
..................... 42
3.3
Flashes
...................... 42
3.4
Other Features
................. 43
3.5
Detection of PVD
............... 43
3.5.1
Sharer s Sign
................... 44
3.6
Treatment
.................... 44
3.7
Peripheral Retinal Degenerations
...... 45
Summary
.......................... 46
References
......................... 46
Chapter
4
Vitreous Hemorrhage
4.1
Introduction
.................. 49
4.2
Investigation
.................. 50
4.2.1
Ultrasound
................... 51
4.3
Surgery
..................... 51
Summary
.......................... 52
References
......................... 52
5.3.4.2
Postoperative Care
............... 69
5.3.4.3
Complications
................. 69
5.3.5
Drainage Air Cryotherapy
and
Expiant
(DACE)
.............. 70
5.3.5.1
Subretinal Fluid Drainage
........... 71
5.3.5.2
Air Insertion
.................. 72
5.3.5.3
Complications
................. 73
5.3.6
Pars
Plana
Vitrectomy
............. 74
5.3.6.1
Introduction
.................. 74
5.3.6.2
When To Use Heavy Liquid
.......... 75
5.3.6.3
Removal of Heavy Liquid
........... 76
5.3.6.4
Avoiding Retinal Folds
............ 76
5.3.6.5
Inferior Breaks
................. 77
5.3.6.6
Posterior Breaks
................ 77
5.3.6.7
Multiple Breaks
................. 77
5.3.6.8
Medial Opacities
................ 78
5.3.6.9
Complications
................. 78
5.3.6.10
Posturing
.................... 79
5.4
Success Rates
.................. 80
5.5
Causes of Failure
................ 81
5.6
Secondary
Macular
Holes
.......... 81
5.7
Detachment with Choroidal Effusions
... 81
Summary
.......................... 81
References
......................... 81
Chapter
5
Rhegmatogenous Retinal Detachment
5.1
Introduction
.................. 53
5.1.1
Tears with Posterior Vitreous Detachment
. 53
5.1.2
Breaks Without Posterior Vitreous
Detachment
................... 55
5.1.3
Natural History
................ 56
5.2
Clinical Features
................ 57
5.2.1
Anterior Segment Signs
............ 57
5.2.2
Signs in the Vitreous
.............. 57
5.2.3
Subretinal Fluid Accumulation
........ 58
5.2.4
Macula-Off or Macula-On
.......... 58
5.3
Surgery
..................... 59
5.3.1
Flat Retinal Breaks
............... 59
5.3.1.1
Retinopexy
................... 59
5.3.1.2
Cryotherapy
................... 60
5.3.1.3
Laser
....................... 60
5.3.2
Retinal Detachment
.............. 60
5.3.2.1
Principles
.................... 62
5.3.2.2
Break Closure
.................. 62
5.3.2.3
Relief of Traction
................ 62
5.3.2.4
Alteration of Fluid Currents
......... 62
5.3.2.5
Retinopexy
................... 63
5.3.3
Pneumatic Retinopexy
............ 63
5.3.4
The Non-Drain Procedure
.......... 64
5.3.4.1
Operative Stages
................ 64
Chapter
6
Special Rhegmatogenous Retinal Detachments
6.1
Introduction
.................. 85
6.2
Retinal Dialysis
................. 85
6.2.1
Clinical Features
................ 85
6.2.2
Surgery for Retinal Dialysis
.......... 86
6.2.2.1
Search
...................... 86
6.2.2.2
Cryotherapy
................... 86
6.2.2.3
Marking the Break
............... 86
6.2.2.4
Plombage
.................... 86
6.2.2.5
Checking the Indent
.............. 87
6.3
Giant Retinal Tear
............... 87
6.3.1
Clinical Features
................ 87
6.3.2
Stickler s Syndrome
.............. 87
6.3.3
Surgery for Giant Retinal Tear
........ 87
6.3.3.1
Heavy Liquids
................. 88
6.3.3.2
Retinopexy
................... 89
6.3.3.3
Transscleral Illumination Technique
.... 90
6.3.3.4
Silicone
Oil Insertion
............. 90
6.3.3.5
Choice of Endotamponade
.......... 90
6.3.3.6
Removal of the
Silicone
Oil
.......... 90
6.3.3.7
The Other Eye
.................. 91
6.4
Macular
Retinal Detachment
in High Myopes
................ 91
6.4.1
Clinical Features
................ 91
Contents
XI
6.4.2
Surgery
..................... 91
6.5 Retinoschisis-Related
Retinal Detachment
. 93
6.5.1
Clinical Features
................ 93
6.5.1.1
Infantile Retinoschisis
............. 93
6.5.1.2
Senile Retinoschisis
.............. 94
6.5.1.3
Differentiation
from Chronic Retinal Detachment
...... 94
6.5.2
Surgery
..................... 94
6.6
Juvenile Retinal Detachment
......... 95
6.7
Atopic Dermatitis
............... 95
6.8
Refractive Surgery
............... 95
6.9
Congenital Cataract
.............. 95
6.10
Others
...................... 95
Summary
.......................... 96
References
......................... 96
Chapter
7
Proliferative Vitreoretinopathy
7.1
Introduction
.................. 99
7.2
Pathogenesis
.................. 99
7.3
Clinical Features
................ 100
7.3.1
Grading
..................... 100
7.3.2
RiskofPVR
................... 102
7.4
Surgery
..................... 102
7.4.1
Mild PVR (Approximately C1-C2)
..... 103
7.4.2
Moderate PVR (Diffuse Grade
В, СЗ
-5) . . 104
7.4.3
Severe PVR
(C6-8)
............... 104
7.4.3.1
The Relieving Retinectomy
.......... 106
7.4.4
Very Severe PVR (C9-12)
........... 107
7.4.5
Choice of Endotamponade
.......... 108
7.4.5.1
Silicone
Oil or Perfluoropropane Gas
.... 108
7.4.5.2
Heavy Oils
................... 108
7.4.6
Adjunctive Therapies
............. 108
7.4.7
Success Rates
.................. 109
7.4.8
Postoperative Complications
......... 109
Summary
.......................... 110
References
......................... 110
Chapter
8
Macular
Disorders
8.1
Introduction
.................. 113
8.2
Idiopathic
Macular
Hole
........... 113
8.2.1
Clinical Features
................ 113
8.2.1.1
Introduction
.................. 113
8.2.1.2
Watzke-Allen Test
............... 114
8.2.1.3
Grading
..................... 114
8.2.1.4
Natural History
................ 114
8.2.2
Optical Coherence Tomography
....... 116
8.2.3
Secondary
Macular
Holes
........... 117
8.2.4
Lamellar and Partial-Thickness Holes.
... 117
8.2.5
Surgery
..................... 117
8.2.5
Introduction
.................. 118
8.2.5.2
Peeling the Posterior Hyaloid Membrane
. . 118
8.2.5.3
Adjunctive Therapies
............. 119
8.2.6
Postoperative Posturing of the Patient.
. . . 120
8.2.7
Specific Complications
............ 120
8.2.7.1
Visual Field Loss
................ 120
8.2.8
Success Rates
.................. 122
8.3
Macular
Pucker
................. 122
8.3.1
Clinical Features
................ 122
8.3.2
Secondary
Macular
Pucker
.......... 126
8.3.3
Surgery
..................... 126
8.3.4
Success Rates
.................. 128
8.3.5
Specific Complications
............ 129
8.3.6
Membrane Recurrence
............ 129
8.4
Choroidal Neovascular Membrane
..... 129
8.5.1
Clinical Features
................ 129
8.5.2
Surgery
..................... 130
8.5.2.1
Introduction
.................. 130
8.5.2.2 360°
Macular
Translocation.........
131
8.5.3
Specific Complications
............ 131
8.5.4
Success Rates
.................. 131
8.6
Choroidal Neovascular Membrane
Not From ARMD
............... 131
8.6.1
Introduction
.................. 131
8.6.2
Surgery
..................... 133
Summary
.......................... 134
References
......................... 135
Chapter
9
Diabetic Retinopathy
and Other Vascular Disorders
9.1
Introduction
.................. 141
9.2
Diabetic Retinopathy
............. 141
9.2.1
Introduction
.................. 141
9.2.1.1
Diabetic Retinopathy Grading
........ 141
9.2.2
Diabetic Vitreous Haemorrhage
....... 142
9.2.2.1
Clinical Features
................ 142
9.2.2.2
Surgery
..................... 143
9.2.3
Diabetic Retinal Detachment
......... 145
9.2.3.1
Clinical Features
................ 145
9.2.3.2
Surgery
..................... 146
9.2.3.2.1
Tractional Retinal Detachment
........ 146
9.2.3.2.2
Dealing with Bleeding Vessels
........ 149
9.2.3.2.3
Iatrogenic Breaks
................ 149
9.2.3.2.4
Silicone
Oil
................... 150
9.2.3.2.5
Combined TRD and RRD
.......... 150
9.2.4
Postoperative Complications
......... 151
хи
Contents
ι
9.2.4.1
Cataract
..................... 151
9.2.4.2
Vitreous Haemorrhage
............ 151
9.2.4.3
Rhegmatogenous Retinal Detachment
... 151
9.2.4.4
Iris Neovascularisation
............ 151
9.2.4.5
Phthisis
Bulbi
.................. 151
9.2.4.6
Survival After Surgery
............. 151
9.2.5
Success Rates
.................. 151
9.2.6
Diabetic Maculopathy
............. 151
9.3
Non-diabetic Neovascularisation
...... 152
9.3.1
Retinal Vein Occlusion
............ 152
9.3.1.1
Chorioretinal Anastomosis
.......... 152
9.3.1.2
Arteriovenous Decompression
........ 152
9.3.1.3
Radial Optic Neurotomy
........... 153
9.3.1.4
Intravitreal Steroids
.............. 153
9.3.1.5
Tissue Plasminogen Activator
........ 155
9.3.2
Sickle Cell Disease
............... 155
9.3.3
Retinal Vasculitis
................ 156
Summary
.......................... 156
References
......................... 156
Chapter
10
Trauma
10.1
Introduction
.................. 161
10.1.1
Classification
.................. 161
10.2
Contusion Injuries
............... 162
10.2.1
Clinical Presentation
............. 162
10.2.2
Surgery
..................... 163
10.2.3
Visual Outcome
................ 166
10.3
Rupture
..................... 166
10.3.1
Clinical Presentation
............. 166
10.3.2
Surgery
..................... 167
10.3.3
Visual Outcome
................ 167
10.4
Penetrating Injury
............... 168
10.4.1
Clinical Presentation
............. 168
10.4.1.1
Endophthalmitis
................ 168
10.4.1.2
Retinal Detachment
.............. 168
10.4.2
Surgery
..................... 169
10.4.3
Visual Outcome
................ 170
10.5
Intra-ocular Foreign Bodies
......... 170
10.5.1
Clinical Presentation
............. 170
10.5.2
Surgery
..................... 173
10.5.2.1
The Primary Procedure
............ 173
10.5.2.2
lhe
Lens
..................... 173
10.5.2.3
lhe
Magnet
................... 175
10.5.2.4
Other Problems
................. 175
10.5.3
Visual Outcome
................ 175
10.6
Perforating Injury
............... 175
10.7
Sympathetic Ophthalmia
........... 175
10.8
Proliferative Vitreoretinopathy
........ 175
10.9
Phthisis
Bulbi
.................. 175
Summary
.......................... 176
References
......................... 176
Chapter
Π
Complications of Anterior Segment Surgery
11.1
Introduction
.................. 179
11.2
Dropped Nucleus
................ 179
11.2.1
Clinical Features
................ 179
11.2.2
Surgery
..................... 180
11.2.2.1
Difficult Situations
............... 182
11.2.2.2
Success Rates
.................. 183
11.3
Postoperative Endophthalmitis
........ 183
11.3.1
Clinical Features
................ 183
11.3.2
Surgery
..................... 184
11.3.2.1
Vitreous Tap
.................. 184
11.3.2.2
Vitreous Biopsy
................. 184
11.3.2.3
TheRoleofVitrectomy
............ 185
11.3.2.4
Success Rates
.................. 185
11.4
Chronic Postoperative Endophthalmitis
. . 185
11.5
Needle-Stick Injury
.............. 186
11.5.1
Clinical Features
................ 186
11.5.2
Surgery
..................... 187
11.6
Intra-ocular Haemorrhage
.......... 187
11.7
Retinal Detachment
.............. 188
11.8
Chronic Uveitis
................. 188
11.9
Postoperative Cystoid
Macular
Oedema
. . 188
11.10
Postoperative Choroidal Effusion
...... 189
Summary
.......................... 189
References
......................... 189
Chapter
12
Uveitis and Allied Disorders
12.1
Introduction
.................. 193
12.2
Non-Infectious Uveitis
of the Posterior Segment
........... 193
12.2.1
Vitreous Opacification
............ 194
12.2.2
Retinal Detachment
.............. 195
12.2.3
Cystoid
Macular
Oedema
........... 196
12.2.4
Hypotony
.................... 196
12.2.5
Diagnostic Confirmation
........... 197
12.2.6
lhe
Vitreous Biopsy
.............. 198
12.2.7
Sampling at the Beginning of a PPV
..... 198
12.3
Acute Retinal Necrosis
............ 198
12.3.1
Clinical Features
................ 198
12.3.2
Surgery
..................... 200
12.3.2.1
For Diagnosis
.................. 200
12.3.2.2
For Treatment
................. 200
12.3.3
Visual Outcome
................ 201
12.4
Cytomegalovirus
Retinitis.......... 201
12.4.1
Clinical Features
................ 201
12.4.2
Surgery
.....................201
12.4.2.1
For Diagnosis
..................201
12.4.2.2
For Treatment
.................201
12.4.3
Visual Outcome
................202
12.5
Fungal Endophthalmitis
...........202
12.5.1
Clinical Features
................202
12.5.2
Surgery
.....................203
12.5.2.1
For Diagnosis
..................203
12.5.2.2
For Treatment
.................203
12.5.3
Visual Outcome
................204
12.6
Other Infections
................204
12.7
Ocular Lymphoma
..............205
12.7.1
Clinical Features
................205
12.7.2
Surgery
.....................205
12.7.2.1
For Diagnosis
..................205
12.7.2.2
For Treatment
.................205
12.7.3
Visual Outcome and Survival
........206
Summary
..........................206
References
.........................206
і
Contents
XIII
Appendix
A.I Cryotherapy
................... 221
A.2 Fluids (Both Gases and Liquids)
....... 221
A.2.1 Gases
....................... 222
A.2.2 Liquids
...................... 223
A.2.3 Emulsion
.................... 223
A.3 Ultrasound
................... 224
A.4 Visual Acuity
(VA)
............... 224
Subject Index
...................... 225
Chapter!
3
Miscellaneous Conditions
13.1
Introduction
..................211
13.2
Vitreous Anomalies
..............211
13.2.1
Persistent Hyperplastic Primary Vitreous
. 211
13.2.2
Asteroid Hyalosis
................ 211
13.2.3
Amyloidosis
................... 212
13.3
Retinal Haemangioma and Telangiectasia
. 212
13.4
Optic Disc Anomalies
............. 213
13.4.1
Optic Disc Pits and Optic Disc
Coloboma
. 213
13.4.2
Morning Glory Syndrome
.......... 214
13.5
Retinochoroidal
Coloboma
.......... 215
13.6
Marfan s Syndrome
.............. 215
13.7
Retinopathy of Prematurity
.......... 216
13.8
Uveal Effusion Syndrome
........... 217
13.8.1
Clinical Features
................ 217
13.8.2
Surgery
..................... 217
13.9
Disseminated
Intravascular
Coagulation
. . 218
Summary
.......................... 218
References
......................... 219
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Chapter
1
Anatomy and Clinical Examination of the Eye
1.1
Surgical Anatomy
of the Retina and Vitreous
. 1
1.1.2
The Vitreous
.
1.1.2.1
Embryology
. 1
1.1.2.2
Anatomy
. 1
1.1.2.2.1
Anatomical Attachments of the Vitreous
to the Surrounding Structures
. 2
1.1.2
The Retina
. 2
1.1.2.1
Embryology
. 2
1.1.2.2
Anatomy
. 2
1.1.2.2.1
Retinal Layers
. 3
1.1.2.2.2
Retinal Blood Vessels
. 4
1.1.2.2.3
Other
Fundal
Structures
. 4
1.2
The Anatomy
and the Vitreoretinal Surgeon
. 4
1.3
Clinical Examination and Investigation.
. . 4
1.3.1
Using the Database
. 4
1.3.2
Examination of the Eye
. 4
1.3.2.1
Visual Acuity
. 4
1.3.2.2
The Slit Lamp
. 5
1.3.2.3
Binocular Indirect Ophthalmoscope
. 5
1.3.2.3.1
Using the
Indentar
. 6
1.3.2.4
Ultrasonography
. 6
1.3.2.5
Optical Coherence Tomography
. 9
1.3.2.5.1
Scan of Normal Features
. 9
1.3.2.6
Subjective Tests
. 9
1.3.2.7
The
Preoperative
Assessment
. 10
Summary
. 10
References
. 10
Chapter
2
Introduction to Vitreoretinal Surgery
2.1
Introduction
.
Π
2.2
The 20-Gauge Pars
Plana Vitrectomy
. 12
2.2.1
Sclerotomies
. 13
2.2.1.1
Where to Place Sderotomies
. 13
2.2.1.2
Securing the Infusion
Cannula
. 14
2.2.1.3
Checking the Infusion
. 14
2.2.1.4
Where to Place the Superior Sclerotomies
. 14
2.2.1.5
Construction
. 14
2.2.1.6
Priming
. 14
2.2.2
Checking the View
. 15
2.2.3
The Independent Viewing System
[2] . 15
2.2.4
Removing the Vitreous
. 15
2.2.5
Handling the Light Pipe
. 18
2.2.6
Use of Sclerotomy Plugs
. 18
2.2.7
The Internal Search
. 19
2.2.8
Endolaser
. 19
2.2.9
Using a Contact Lens
. 20
2.2.10
Maintaining a View
. 20
2.2.11
Closing
. 22
2.2.12 Peroperative
Complications
. 22
2.2.12.1
Iatrogenic Breaks
. 22
2.2.12.2
Choroidal Haemorrhage
. 23
2.2.12.3
Haemorrhage from Retinal
or Other Blood Vessels
. 24
2.2.12.4
Lens Touch
. 24
2.2.13
Postoperative Complications
. 24
2.3
Principles of Internal Tamponade
. 25
2.3.1
Gases
. 25
2.3.1.1
Principles
. 25
2.3.1.2
Properties
. 25
2.3.2
Silicone
Oil
. 27
2.3.2.1
Properties
. 28
2.3.2.2
Silicone
Oil in the Anterior Chamber
. . 28
2.3.2.3
Complications of
Silicone
Oil
. 29
2.3.3
Silicone
Oil Removal
. 31
2.3.3.1
Retinal Re-detachment Rates
after Oil Removal
. 33
2.3.4
Heavy
Silicone
Oils
. 33
2.3.5
Heavy Liquids
. 33
2.3.6
"Light" Heavy Liquids
. 34
2.4
Combined Cataract Extraction and PPV
. . 35
2.5
Bimanual Surgery
. 35
2.6
23-Gauge and 25-Gauge Vitrectomy
. 35
2.7
Dyes
. 37
Summary
. 38
References
. 38
Contents
Chapter
3
Posterior Vitreous Detachment
3.1
Introduction
. 41
3.2
Floaters
. 42
3.3
Flashes
. 42
3.4
Other Features
. 43
3.5
Detection of PVD
. 43
3.5.1
Sharer's Sign
. 44
3.6
Treatment
. 44
3.7
Peripheral Retinal Degenerations
. 45
Summary
. 46
References
. 46
Chapter
4
Vitreous Hemorrhage
4.1
Introduction
. 49
4.2
Investigation
. 50
4.2.1
Ultrasound
. 51
4.3
Surgery
. 51
Summary
. 52
References
. 52
5.3.4.2
Postoperative Care
. 69
5.3.4.3
Complications
. 69
5.3.5
Drainage Air Cryotherapy
and
Expiant
(DACE)
. 70
5.3.5.1
Subretinal Fluid Drainage
. 71
5.3.5.2
Air Insertion
. 72
5.3.5.3
Complications
. 73
5.3.6
Pars
Plana
Vitrectomy
. 74
5.3.6.1
Introduction
. 74
5.3.6.2
When To Use Heavy Liquid
. 75
5.3.6.3
Removal of Heavy Liquid
. 76
5.3.6.4
Avoiding Retinal Folds
. 76
5.3.6.5
Inferior Breaks
. 77
5.3.6.6
Posterior Breaks
. 77
5.3.6.7
Multiple Breaks
. 77
5.3.6.8
Medial Opacities
. 78
5.3.6.9
Complications
. 78
5.3.6.10
Posturing
. 79
5.4
Success Rates
. 80
5.5
Causes of Failure
. 81
5.6
Secondary
Macular
Holes
. 81
5.7
Detachment with Choroidal Effusions
. 81
Summary
. 81
References
. 81
Chapter
5
Rhegmatogenous Retinal Detachment
5.1
Introduction
. 53
5.1.1
Tears with Posterior Vitreous Detachment
. 53
5.1.2
Breaks Without Posterior Vitreous
Detachment
. 55
5.1.3
Natural History
. 56
5.2
Clinical Features
. 57
5.2.1
Anterior Segment Signs
. 57
5.2.2
Signs in the Vitreous
. 57
5.2.3
Subretinal Fluid Accumulation
. 58
5.2.4
Macula-Off or Macula-On
. 58
5.3
Surgery
. 59
5.3.1
Flat Retinal Breaks
. 59
5.3.1.1
Retinopexy
. 59
5.3.1.2
Cryotherapy
. 60
5.3.1.3
Laser
. 60
5.3.2
Retinal Detachment
. 60
5.3.2.1
Principles
. 62
5.3.2.2
Break Closure
. 62
5.3.2.3
Relief of Traction
. 62
5.3.2.4
Alteration of Fluid Currents
. 62
5.3.2.5
Retinopexy
. 63
5.3.3
Pneumatic Retinopexy
. 63
5.3.4
The Non-Drain Procedure
. 64
5.3.4.1
Operative Stages
. 64
Chapter
6
Special Rhegmatogenous Retinal Detachments
6.1
Introduction
. 85
6.2
Retinal Dialysis
. 85
6.2.1
Clinical Features
. 85
6.2.2
Surgery for Retinal Dialysis
. 86
6.2.2.1
Search
. 86
6.2.2.2
Cryotherapy
. 86
6.2.2.3
Marking the Break
. 86
6.2.2.4
Plombage
. 86
6.2.2.5
Checking the Indent
. 87
6.3
Giant Retinal Tear
. 87
6.3.1
Clinical Features
. 87
6.3.2
Stickler's Syndrome
. 87
6.3.3
Surgery for Giant Retinal Tear
. 87
6.3.3.1
Heavy Liquids
. 88
6.3.3.2
Retinopexy
. 89
6.3.3.3
Transscleral Illumination Technique
. 90
6.3.3.4
Silicone
Oil Insertion
. 90
6.3.3.5
Choice of Endotamponade
. 90
6.3.3.6
Removal of the
Silicone
Oil
. 90
6.3.3.7
The Other Eye
. 91
6.4
Macular
Retinal Detachment
in High Myopes
. 91
6.4.1
Clinical Features
. 91
Contents
XI
6.4.2
Surgery
. 91
6.5 Retinoschisis-Related
Retinal Detachment
. 93
6.5.1
Clinical Features
. 93
6.5.1.1
Infantile Retinoschisis
. 93
6.5.1.2
Senile Retinoschisis
. 94
6.5.1.3
Differentiation
from Chronic Retinal Detachment
. 94
6.5.2
Surgery
. 94
6.6
Juvenile Retinal Detachment
. 95
6.7
Atopic Dermatitis
. 95
6.8
Refractive Surgery
. 95
6.9
Congenital Cataract
. 95
6.10
Others
. 95
Summary
. 96
References
. 96
Chapter
7
Proliferative Vitreoretinopathy
7.1
Introduction
. 99
7.2
Pathogenesis
. 99
7.3
Clinical Features
. 100
7.3.1
Grading
. 100
7.3.2
RiskofPVR
. 102
7.4
Surgery
. 102
7.4.1
Mild PVR (Approximately C1-C2)
. 103
7.4.2
Moderate PVR (Diffuse Grade
В, СЗ
-5) . . 104
7.4.3
Severe PVR
(C6-8)
. 104
7.4.3.1
The Relieving Retinectomy
. 106
7.4.4
Very Severe PVR (C9-12)
. 107
7.4.5
Choice of Endotamponade
. 108
7.4.5.1
Silicone
Oil or Perfluoropropane Gas
. 108
7.4.5.2
Heavy Oils
. 108
7.4.6
Adjunctive Therapies
. 108
7.4.7
Success Rates
. 109
7.4.8
Postoperative Complications
. 109
Summary
. 110
References
. 110
Chapter
8
Macular
Disorders
8.1
Introduction
. 113
8.2
Idiopathic
Macular
Hole
. 113
8.2.1
Clinical Features
. 113
8.2.1.1
Introduction
. 113
8.2.1.2
Watzke-Allen Test
. 114
8.2.1.3
Grading
. 114
8.2.1.4
Natural History
. 114
8.2.2
Optical Coherence Tomography
. 116
8.2.3
Secondary
Macular
Holes
. 117
8.2.4
Lamellar and Partial-Thickness Holes.
. 117
8.2.5
Surgery
. 117
8.2.5
Introduction
. 118
8.2.5.2
Peeling the Posterior Hyaloid Membrane
. . 118
8.2.5.3
Adjunctive Therapies
. 119
8.2.6
Postoperative Posturing of the Patient.
. . . 120
8.2.7
Specific Complications
. 120
8.2.7.1
Visual Field Loss
. 120
8.2.8
Success Rates
. 122
8.3
Macular
Pucker
. 122
8.3.1
Clinical Features
. 122
8.3.2
Secondary
Macular
Pucker
. 126
8.3.3
Surgery
. 126
8.3.4
Success Rates
. 128
8.3.5
Specific Complications
. 129
8.3.6
Membrane Recurrence
. 129
8.4
Choroidal Neovascular Membrane
. 129
8.5.1
Clinical Features
. 129
8.5.2
Surgery
. 130
8.5.2.1
Introduction
. 130
8.5.2.2 360°
Macular
Translocation.
131
8.5.3
Specific Complications
. 131
8.5.4
Success Rates
. 131
8.6
Choroidal Neovascular Membrane
Not From ARMD
. 131
8.6.1
Introduction
. 131
8.6.2
Surgery
. 133
Summary
. 134
References
. 135
Chapter
9
Diabetic Retinopathy
and Other Vascular Disorders
9.1
Introduction
. 141
9.2
Diabetic Retinopathy
. 141
9.2.1
Introduction
. 141
9.2.1.1
Diabetic Retinopathy Grading
. 141
9.2.2
Diabetic Vitreous Haemorrhage
. 142
9.2.2.1
Clinical Features
. 142
9.2.2.2
Surgery
. 143
9.2.3
Diabetic Retinal Detachment
. 145
9.2.3.1
Clinical Features
. 145
9.2.3.2
Surgery
. 146
9.2.3.2.1
Tractional Retinal Detachment
. 146
9.2.3.2.2
Dealing with Bleeding Vessels
. 149
9.2.3.2.3
Iatrogenic Breaks
. 149
9.2.3.2.4
Silicone
Oil
. 150
9.2.3.2.5
Combined TRD and RRD
. 150
9.2.4
Postoperative Complications
. 151
хи
Contents
ι
9.2.4.1
Cataract
. 151
9.2.4.2
Vitreous Haemorrhage
. 151
9.2.4.3
Rhegmatogenous Retinal Detachment
. 151
9.2.4.4
Iris Neovascularisation
. 151
9.2.4.5
Phthisis
Bulbi
. 151
9.2.4.6
Survival After Surgery
. 151
9.2.5
Success Rates
. 151
9.2.6
Diabetic Maculopathy
. 151
9.3
Non-diabetic Neovascularisation
. 152
9.3.1
Retinal Vein Occlusion
. 152
9.3.1.1
Chorioretinal Anastomosis
. 152
9.3.1.2
Arteriovenous Decompression
. 152
9.3.1.3
Radial Optic Neurotomy
. 153
9.3.1.4
Intravitreal Steroids
. 153
9.3.1.5
Tissue Plasminogen Activator
. 155
9.3.2
Sickle Cell Disease
. 155
9.3.3
Retinal Vasculitis
. 156
Summary
. 156
References
. 156
Chapter
10
Trauma
10.1
Introduction
. 161
10.1.1
Classification
. 161
10.2
Contusion Injuries
. 162
10.2.1
Clinical Presentation
. 162
10.2.2
Surgery
. 163
10.2.3
Visual Outcome
. 166
10.3
Rupture
. 166
10.3.1
Clinical Presentation
. 166
10.3.2
Surgery
. 167
10.3.3
Visual Outcome
. 167
10.4
Penetrating Injury
. 168
10.4.1
Clinical Presentation
. 168
10.4.1.1
Endophthalmitis
. 168
10.4.1.2
Retinal Detachment
. 168
10.4.2
Surgery
. 169
10.4.3
Visual Outcome
. 170
10.5
Intra-ocular Foreign Bodies
. 170
10.5.1
Clinical Presentation
. 170
10.5.2
Surgery
. 173
10.5.2.1
The Primary Procedure
. 173
10.5.2.2
lhe
Lens
. 173
10.5.2.3
lhe
Magnet
. 175
10.5.2.4
Other Problems
. 175
10.5.3
Visual Outcome
. 175
10.6
Perforating Injury
. 175
10.7
Sympathetic Ophthalmia
. 175
10.8
Proliferative Vitreoretinopathy
. 175
10.9
Phthisis
Bulbi
. 175
Summary
. 176
References
. 176
Chapter
Π
Complications of Anterior Segment Surgery
11.1
Introduction
. 179
11.2
Dropped Nucleus
. 179
11.2.1
Clinical Features
. 179
11.2.2
Surgery
. 180
11.2.2.1
Difficult Situations
. 182
11.2.2.2
Success Rates
. 183
11.3
Postoperative Endophthalmitis
. 183
11.3.1
Clinical Features
. 183
11.3.2
Surgery
. 184
11.3.2.1
Vitreous Tap
. 184
11.3.2.2
Vitreous Biopsy
. 184
11.3.2.3
TheRoleofVitrectomy
. 185
11.3.2.4
Success Rates
. 185
11.4
Chronic Postoperative Endophthalmitis
. . 185
11.5
Needle-Stick Injury
. 186
11.5.1
Clinical Features
. 186
11.5.2
Surgery
. 187
11.6
Intra-ocular Haemorrhage
. 187
11.7
Retinal Detachment
. 188
11.8
Chronic Uveitis
. 188
11.9
Postoperative Cystoid
Macular
Oedema
. . 188
11.10
Postoperative Choroidal Effusion
. 189
Summary
. 189
References
. 189
Chapter
12
Uveitis and Allied Disorders
12.1
Introduction
. 193
12.2
Non-Infectious Uveitis
of the Posterior Segment
. 193
12.2.1
Vitreous Opacification
. 194
12.2.2
Retinal Detachment
. 195
12.2.3
Cystoid
Macular
Oedema
. 196
12.2.4
Hypotony
. 196
12.2.5
Diagnostic Confirmation
. 197
12.2.6
lhe
Vitreous Biopsy
. 198
12.2.7
Sampling at the Beginning of a PPV
. 198
12.3
Acute Retinal Necrosis
. 198
12.3.1
Clinical Features
. 198
12.3.2
Surgery
. 200
12.3.2.1
For Diagnosis
. 200
12.3.2.2
For Treatment
. 200
12.3.3
Visual Outcome
. 201
12.4
Cytomegalovirus
Retinitis. 201
12.4.1
Clinical Features
. 201
12.4.2
Surgery
.201
12.4.2.1
For Diagnosis
.201
12.4.2.2
For Treatment
.201
12.4.3
Visual Outcome
.202
12.5
Fungal Endophthalmitis
.202
12.5.1
Clinical Features
.202
12.5.2
Surgery
.203
12.5.2.1
For Diagnosis
.203
12.5.2.2
For Treatment
.203
12.5.3
Visual Outcome
.204
12.6
Other Infections
.204
12.7
Ocular Lymphoma
.205
12.7.1
Clinical Features
.205
12.7.2
Surgery
.205
12.7.2.1
For Diagnosis
.205
12.7.2.2
For Treatment
.205
12.7.3
Visual Outcome and Survival
.206
Summary
.206
References
.206
і
Contents
XIII
Appendix
A.I Cryotherapy
. 221
A.2 Fluids (Both Gases and Liquids)
. 221
A.2.1 Gases
. 222
A.2.2 Liquids
. 223
A.2.3 Emulsion
. 223
A.3 Ultrasound
. 224
A.4 Visual Acuity
(VA)
. 224
Subject Index
. 225
Chapter!
3
Miscellaneous Conditions
13.1
Introduction
.211
13.2
Vitreous Anomalies
.211
13.2.1
Persistent Hyperplastic Primary Vitreous
. 211
13.2.2
Asteroid Hyalosis
. 211
13.2.3
Amyloidosis
. 212
13.3
Retinal Haemangioma and Telangiectasia
. 212
13.4
Optic Disc Anomalies
. 213
13.4.1
Optic Disc Pits and Optic Disc
Coloboma
. 213
13.4.2
Morning Glory Syndrome
. 214
13.5
Retinochoroidal
Coloboma
. 215
13.6
Marfan's Syndrome
. 215
13.7
Retinopathy of Prematurity
. 216
13.8
Uveal Effusion Syndrome
. 217
13.8.1
Clinical Features
. 217
13.8.2
Surgery
. 217
13.9
Disseminated
Intravascular
Coagulation
. . 218
Summary
. 218
References
. 219 |
| any_adam_object | 1 |
| any_adam_object_boolean | 1 |
| author | Williamson, Thomas H. |
| author_GND | (DE-588)133859509 |
| author_facet | Williamson, Thomas H. |
| author_role | aut |
| author_sort | Williamson, Thomas H. |
| author_variant | t h w th thw |
| building | Verbundindex |
| bvnumber | BV023090512 |
| classification_rvk | YO 8323 |
| ctrlnum | (OCoLC)634485779 (DE-599)BVBBV023090512 |
| discipline | Medizin |
| discipline_str_mv | Medizin |
| format | Book |
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| genre | 1\p (DE-588)4143413-4 Aufsatzsammlung gnd-content |
| genre_facet | Aufsatzsammlung |
| id | DE-604.BV023090512 |
| illustrated | Illustrated |
| index_date | 2024-07-02T19:40:44Z |
| indexdate | 2024-07-09T21:10:47Z |
| institution | BVB |
| isbn | 9783540375814 3540375813 |
| language | English |
| oai_aleph_id | oai:aleph.bib-bvb.de:BVB01-016293388 |
| oclc_num | 634485779 |
| open_access_boolean | |
| owner | DE-20 DE-355 DE-BY-UBR |
| owner_facet | DE-20 DE-355 DE-BY-UBR |
| physical | XVI, 227 S. zahlr. Ill., graph. Darst. 1 DVD-ROM (12 cm) |
| publishDate | 2008 |
| publishDateSearch | 2008 |
| publishDateSort | 2008 |
| publisher | Springer |
| record_format | marc |
| spelling | Williamson, Thomas H. Verfasser (DE-588)133859509 aut Vitreoretinal surgery with 58 tables Thomas H. Williamson Berlin [u.a.] Springer 2008 XVI, 227 S. zahlr. Ill., graph. Darst. 1 DVD-ROM (12 cm) txt rdacontent n rdamedia nc rdacarrier Vitreoretinopathie (DE-588)4196481-0 gnd rswk-swf Chirurgie (DE-588)4009987-8 gnd rswk-swf 1\p (DE-588)4143413-4 Aufsatzsammlung gnd-content Vitreoretinopathie (DE-588)4196481-0 s Chirurgie (DE-588)4009987-8 s DE-604 Digitalisierung UB Regensburg application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=016293388&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis 1\p cgwrk 20201028 DE-101 https://d-nb.info/provenance/plan#cgwrk |
| spellingShingle | Williamson, Thomas H. Vitreoretinal surgery with 58 tables Vitreoretinopathie (DE-588)4196481-0 gnd Chirurgie (DE-588)4009987-8 gnd |
| subject_GND | (DE-588)4196481-0 (DE-588)4009987-8 (DE-588)4143413-4 |
| title | Vitreoretinal surgery with 58 tables |
| title_auth | Vitreoretinal surgery with 58 tables |
| title_exact_search | Vitreoretinal surgery with 58 tables |
| title_exact_search_txtP | Vitreoretinal surgery with 58 tables |
| title_full | Vitreoretinal surgery with 58 tables Thomas H. Williamson |
| title_fullStr | Vitreoretinal surgery with 58 tables Thomas H. Williamson |
| title_full_unstemmed | Vitreoretinal surgery with 58 tables Thomas H. Williamson |
| title_short | Vitreoretinal surgery |
| title_sort | vitreoretinal surgery with 58 tables |
| title_sub | with 58 tables |
| topic | Vitreoretinopathie (DE-588)4196481-0 gnd Chirurgie (DE-588)4009987-8 gnd |
| topic_facet | Vitreoretinopathie Chirurgie Aufsatzsammlung |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=016293388&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
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