Year : 1979 | Volume
: 27 | Issue : 4 | Page : 82--83
Aphakic retinal detachment
M Satapathy, Raghavender Rao
S.D. Eye Hospital, Hyderabad, India
Civil Surgeon, S.D. Eye Hospital, Hyderabad
|How to cite this article:|
Satapathy M, Rao R. Aphakic retinal detachment.Indian J Ophthalmol 1979;27:82-83
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Satapathy M, Rao R. Aphakic retinal detachment. Indian J Ophthalmol [serial online] 1979 [cited 2020 Jun 1 ];27:82-83
Available from: http://www.ijo.in/text.asp?1979/27/4/82/32583
Retinal detachment in aphakic patients cannot be considered as a simple clinical entity. It represents a complex problem. Hence attempts have been made to explore the different etiological factors and their management.
There were 720 cases of retinal detachment (1%) among a total of 82,171 cases attending the out patient department of Sarojini Devi eye hospital and institute of ophthalmology, Hyderabad. During this period, 165 cases were admitted for treatment. Among these 45 cases (27%) were aphakics.
Out of a total of 4529 cases operated for cataract 45 (1% returned with retinal detachment. The detachment developed at variable interval after cataract surgery [Table 1]. The maximum number of cases developed detachment within first 12 months.
These forty five cases were admitted as inpatients and subjected to routine examination like visual acuity, slit lamp examination, indirect ophthalmoscopy, 3 mirrored contact lens, tonometry and field charting where ever it was possible.
The maximum number of patients showed detachment in 2 or more quadrants [Table 2].
They seem to have sought treatment after macular detachment.
The different surgical procedures followed for retinal detachment in the present series were:
1. Encirclage with cryo-30 (66%), 2. Local buckling with cryo--8 (18%), 3. Custodis technique-5 (11%), 4. with vitreous injection-2(5%).
The complications encountered in the present series were:
1. Choroidal/retinal haemorrhage-5 (12%), 2. Secondary glaucoma-2 (5%) 3. Infection 2 (5%) and 4. Recurrence-7 (17%).
The haemorrhages have cleared in a period of 15 to 20 days. The secondary glaucoma responded very well with diamox and the tension came to normal in a week's time.
Results of surgery
The visual results are grouped in 3 categories [Table 3]. The final assessment is done only 3 weeks after surgery, when the correction of glasses are advised.
3 cases (9%) are the failures in the series. The subnormal vision is due to the macular pathology even though the reposition of the retina has taken place.
1. The incidence of retinal detachment (Rhegmotogenous type) was 1 % of the total out patient attendance. The ratio between phakic and aphakic retinal detachment was 3:1.
The incidence of retinal detachment among the aphakics actually varied from 7% to 25% according to previous authors. In the present series it was very low (1%). This may be due to poor follow-up and negligence on the part of the patients for not subjecting themselves for checkup. Vitreous disturbance was the main factor associated with 77% of cases. The maximum number of cases developed detachment within 12 months of cataract operation. Cases with macular involvement attend the hospitalvery early even though the extent of the detachment was two quadrants. Encircling with cryo was a suitable remedy for most of the cases but in selected cases with single tear with one quadrant detachment other simple methods were also successful. The factor of recurrence and therefore non-visualisation of peripheral retina. Incomplete closure of the holes was also contributory factor for the failure of retinal surgery.
45 cases of aphakic retinal detachments were analysed in respect of incidence, etiological factors, duration, extent of detachment and their management.