9 Recently, long-term (7-11 years after surgery) complications have been reported in 8.5% of patients after an intrascleral buckling procedure 10 and in 1 patient after episcleral buckle, 11 related to the swelling properties of the hydrophilic implant. Hydrogel implants (originally MAI and then commercialized as MIRAgel ) seemed to be the ideal implant material 7, 8 when observed 6 to 53 months after surgery. 5, 6 These complications also are more common for patients with explants than for those with implants. 1, 2 Postoperative extrusion or infection with exposure of the scleral buckling material has been more common 3, 4 with use of silicone sponge explants (2.7%-18.0%) than with use of hard silicone explants (0.2%-1.4%). Silicone rubber was removed 1 year after surgery with symptoms of chronic infection and positive cultures, and MIRAgel implants were removed after long-term follow-up (7-10 years), showing positive cultures in only 20%.Ĭonclusion Periodic long-term follow-up previously recommended for use of other materials also must be recommended for MIRAgel use because of long-term alterations in its chemical composition and eventual swelling of material.ĬOMPLICATIONS after retinal detachment surgery that lead to removal of the scleral buckling element have been reported. Silicone sponge needed to be removed a short time after surgery, showing symptoms of acute infection and positive cultures. Silicone sponge (3 of 32 patients) was more frequently removed than was silicone rubber (2 of 360 patients) or MIRAgel (5 of 386 patients). Removal of the implant was necessary in 10 patients (1.3%). Results A total of 757 patients were included in the study. Care was taken in buckling element removal, considering the material used for scleral buckling (detailed operative note), duration of the buckle, cause of removal, and culture of the removed element. Symptoms and signs of infection or rejection were considered. Methods Medical reports were reviewed of 805 patients with cryotherapy and episcleral buckle for rhegmatogenous retinal detachment who were operated on by 1 of us (M.R.-P.) between March 1984 and December 1997. Objective To compare long-term complications of silicone sponge, silicone rubber, and MIRAgel used as episcleral buckling elements. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment. Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.Our guide to making the most of your vision is a good place to start, and you can ask your ophthalmologist about a low vision assessment. The practical support you need can vary depending on how good the vision is in your other eye and whether your peripheral vision (side vision), central vision or both have been affected. Practical tips for coping with retinal detachment sight loss They'll be able to share their tips and reassure you that you'll still be able to do the things you enjoy in everyday life with some adjustments. It can help to hear stories from other people who've had a detached retina. If retinal detachment has caused a permanent change to your sight, it's natural to worry about what this will mean for you. It also depends on how much of the retina was affected and whether the macula was involved. This is more likely the sooner a detached retina is treated. Many people recover from treatment with a good level of vision. They're responsible for making reasonable adjustments to help you manage at work. If your sight has been permanently affected by retinal detachment, talk to your employer about the impact it's had and what useful vision you do have. Your job involves strenuous activities.When you go back to work will depend on whether: It can take anywhere between two to eight weeks to recover from surgery. Retinal detachment is a medical emergency, so you'll probably need time off work at short notice to have treatment. You drive a bus, coach or lorry, even if you've had surgery on only one eye.Treatment in one eye might have affected your sight for driving (check with your optician).However, it could be up to eight weeks after the procedure until your eyes have fully recovered. If your retinal detachment affects your sight, you shouldn't drive until an optician has checked your eyes.Īfter surgery, your eyesight will need to be checked by an eye doctor to ensure it meets the DVLA's minimum standard for driving.įor many people, surgery can successfully restore their sight enough to allow them to drive. Learn more about recovering from detached retina surgery. Your ophthalmologist (eye doctor) will review the outcome of the operation on your sight after around six to eight weeks. Recovering from retinal detachment surgery
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