Retinal detachment postoperative

In the absence of other pathology, the patient s vision should be fully correctable within a few weeks after cataract surgery. Vision that is initially clear after cataract extraction but then deteriorates is suggestive of a postoperative complication, such as capsular opacification, bullous keratopathy, CME, or retinal detachment. 

Postoperative patients who are found to have symptomatic tears or frank retinal detachment should be referred immediately to a vitreoretinal surgeon for treatment. Repair of a rhegmatogenous retinal detachment involves locating retinal breaks, draining subretinal fluid, and sealing the breaks with cryotherapy, endolaser, or diathermy in conjunction with application of a scleral buckle or sponge or pneumatic retinopexy. 

PYR is a serious complication of retinal detachment surgery. Inhibition of cellular proliferation and postoperative inflammation may reduce the development of PYR. Inhibition of postoperative inflammation would eliminate one of the components of PVR and biodegradable sustained delivery systems that contain anti-inflammatory agents may be useful. 

Jonas et al. (47) performed an uncontrolled study of intravitreal triamcinolone acetonide to treat exudative AMD. Of 71 treated eyes, 68 had predominantly or totally occult CNV, as determined by fluorescein angiography. With a mean follow-up of seven months, the visual acuity increased from a preinjection mean of 0.16 to a maximum of 0.23 (P < 0.001). The maximal visual acuity was attained at 1-3 months postinjection. However, there was no significant visual acuity difference by 7.5 months, when compared with pretreatment visual acuity. The average intraocular pressure (IOP) increased from a baseline of 15.1 to 23.0 mmHg. There were no significant postoperative complications such as endophthalmitis and retinal detachment. 

Bonnet M, Fleury J, Guenoun S, Yaniali A, Dumas C, Hajjar C. Cryopexy in primary rhegmatogenous retinal detachment a risk factor for postoperative proliferative vitreoretinopathy Graefes Arch Clin Exp Ophthalmol 1996 234 739-743. 

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