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C.Y. Lowder, A. Galor, V.L. Perez, P.K. Kaiser, J. Sears; To Evaluate The Anatomical And Visual Efficacy Of Surgical Drainage Of Chronic Serous Retinal Detachment In Uveitis Patients . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2440.
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To evaluate the anatomical and visual efficacy of surgical drainage in uveitis patients with long standing serous retinal detachment.
A retrospective analysis was performed on the case records of uveitis patients who underwent drainage of a serous retinal detachment at the Cole Eye Institute, Cleveland Clinic Foundation. Patient evaluation included a comprehensive ophthalmic and medical assessment including indirect ophthalmoscopy with scleral depression, 3–mirror contact lens biomicroscopy, B–scan ultrasonography, and extensive medical work–up including physical exam, internal medicine evaluation and physical exam and serum uveitis panel. Surgical technique utilized a three–port pars plana vitrectomy, encircling scleral buckle (41 or 42 band), PFO–assisted peripheral superior drainage retinotomy on the crest of the scleral buckle, focal endolaser, and SF6/C3F8 insufflation.
Eight patients were identified with a serous retinal detachment associated with uveitis that required surgical drainage. Our patient cohort included 5 females and 4 males; average age at presentation was 55 (range 15 to 82, SD 24). Only one patient had a known systemic diagnosis (juvenile rheumatoid arthritis) at time of presentation. All but one patient were initially treated with prednisone; three patients received further adjuvant treatment. Average time from presentation to surgical drainage was 5 months (range 0 to 15 months, SD 5). A retinal tear was found in two pseudophakic patients (25%) intraoperatively. Average follow up after surgery was 34 months (range 1 to 61, SD 25). Anatomical reattachment was achieved in all patients with no further retinal detachments occurring. Three patients had visual improvement after surgery.
Our data suggests that in patients with a non–resolving, serous retinal detachment associated with uveitis, who have undergone extensive medical evaluation and treatment, surgical drainage can achieve successful longterm retinal reattachment. A high percentage of pseudophakic patients with shifting subretinal fluid and dome shaped detachment and uveitis had rhegmatogenous retinal detachment presumed to be serous after a detailed preoperative examination.
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