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    Comparison of anatomical and functional outcomes of pars plana vitrectomy for rhegmatogenous retinal detachment with phaco-vitrectomy
    (Gazi Eye Foundation, 2024) Tanriverdi, Abdulbaki; Ozer, Omer; Eroz, Pinar; Dinc, Erdem; Dursun, Ozer; Adiguzel, Ufuk
    Purpose: The aim of the present study was to compare the anatomical and functional outcomes in patients who underwent pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RD) with those who underwent cataract surgery combined with PPV. Materials and Methods: A total of 159 eyes of 159 patients who presented to our outpatient clinic with the complaint of vision loss and underwent surgery with the diagnosis of rhegmatogenous RD were included in this study. Patients who underwent 23 gauge PPV combined with standard cataract surgery were included in group 1 (n=62) and patients who underwent 23 gauge PPV alone were included in group 2 (n=97). Demographic data, preoperative and postoperative best corrected visual acuity (BCVA), anatomical success rates, optical coherence tomography findings and complications were recorded. Results: The median BCVA value before surgery was 0.003 in group 1 and 0.016 in group 2 and the difference was not significant (p=0.69). After surgery, the median visual acuity value in both groups was 0.3 and the increase was significant in both groups (p<0.001 for both groups). Similarly, the postoperative manifest spherical equivalents were similar between the two groups and there was no statistically significant difference (p=0.92). Reoperation was required in 4 patients (6.5%) in group 1 and 15 patients (15.5%) in group 2 due to recurrent detachment and there was no significant difference between the two groups in terms of reoperation rates (p=0.087). Conclusion: Combined surgery in the treatment of rhegmatogenous RD can be safely performed without serious complications. © 2024 The author(s).
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    The effect of subretinal recombinant tissue plasminogen activator application for submacular hemorrhage
    (Gazi Eye Foundation, 2024) Ozer, Omer; Dinc, Erdem; Dursun, Ozer; Yilmaz, Emre Can; Turkmen, Ismail; Eroz, Pinar
    Purpose: The aim of the present study was to evaluate the outcomes of subretinal tissue plasminogen activator (r-tPA) injection with pars plana vitrectomy (PPV) in patients with submacular hemorrhage (SMH) extending towards the fovea. Materials and Methods: The study included 10 eyes of 10 patients who underwent subretinal r-tPA injection with 23 G PPV due to SMH extending towards the fovea. Following standard 23 G PPV, r-tPA (Actilyse, 10 mg/mL, Boehringer-Ingelheim, Germany) at a concentration of 25 µg/0.1 ml was injected into the subretinal space with a 41 G needle at a concentration of 0.2-0.3 ml. Subsequently, fluid-air-12% C3F8 exchange was performed and intravitreal 1.25 mg bevacizumab was administered. After surgery, the patient was given appropriate head position according to the bleeding site. Results: The mean age of the patients was 73.9 ± 4.7 years, 4 (40%) were male and 6 (60%) were female. Two patients (20%) developed SMH due to retinal macroaneurysm rupture, while choroidal neovascular membrane was the cause of hemorrhage in 8 patients (80%). Best corrected visual acuity was 2.53 ± 0.49 logMAR preoperatively, 1.28 ± 0.66 at one month, 1.08 ± 0.64 at three months and 1.04 ± 0.62 at six months postoperatively and the difference was significant (p<0.001 for each parameter). Conclusions: In patients with submacular hemorrhage, r-tPA administered subretinally provides significant visual acuity improvement without serious complications. Copyright © 2024 The author(s).