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Ulrich Thelen, Heinrich Gerding; Hole Position In Rhegmatogenous Retinal Detachment: A Analysis Of Mustard, A Retrospective Interventional Case Series Of 4325 Participants In Relation To The Lincoff-rules". Invest. Ophthalmol. Vis. Sci. 2012;53(14):5795.
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The success of retinal surgery for rhegmatogenous retinal detachment depends on findings the retinal break. A precise drawing of the fundus and the position of the break will guide the surgeon at the time of surgery. Attempts should be made to search for additional breaks that might be present in addition to the primary break. There is one break in about 50% of detachments but 2 breaks in 30% and 3 or more breaks in 20% of the cases.The objective of this analysis was to determine the ,,Lincoff-Rules" to verify their validity and applicability in our patients, in consideration of different variables such as pseudophakia, aphakia, refractive error, the number of holes.
The Münster Study, a retrospective interventional case series, on therapy achievements in retinal detachment (MUSTARD) is one of the largest case series of patients with retinal detachment and their outcome after buckling surgery ever established. 4325 subjects who underwent surgery between 1980 and 2001 at the departement of ophthalmology University of MünsterAll 4325 patients with retinal detachment underwent scleral buckling surgery.Patients with a history of traumatic retinal detachment were not considered and finally 3733 cases were analyzed
in 54.7% of all cases investigated was the highest retinal hole, which is considered by Lincoff as the primary hole, located in the superior temporal quadrant.The further distribution of the highest hole was as follows: nasal below 5.5%, up 24.3% nasal, temporal down 15.5%.The hole location of the highest hole depending on the lens status is as follows: aphakic nasal inferior 7.6%, 4.9% phakic (p = 0.02); aphakic nasal superior 33.7% and 22.8% phakic (p = 0.0001), aphakic temporal inferior 8.9%, phakic 16.3% (p = 0.0002). In cases of pseudophakic and phakic significant differences in the temporal distribution showed superior and and inferior nasal quadrant (p = 0.04, p = 0.003). At 45.4% (n = 1693) of the collective of 3733 patients, there was an one-hole situation, 54.6% (n = 2040) for retinal detachments with multiple foramina. Temporal superior and nasal superior quadrant were preferred localizations.
Our results are consistent in their tendency to rules by Lincoff, but not withstanding all expectation. It could iremains that the retrospective character of this study, the more necessary requirements for precision in the investigation of the retina compared with the exact methodology Lincoff not always meet.
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