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Advancements and Challenges in Retina Surgery
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Advancements and Challenges in Retina Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: 25 March 2025 | Viewed by 5265

Special Issue Editors

Dr. Joaquín Marticorena

E-Mail Website
Guest Editor
Ophthalmology Department, Hospital Provincial de Conxo, University Hospital Complex of Santiago de Compostela, Rúa Ramón Baltar, Santiago de Compostela, Spain
Interests: vitreoretinal surgery; medical retina; ocular trauma; uvel melanoma; cataract surgery
Dr. Cristina Irigoyen

E-Mail Website
Guest Editor
Department of Ophthalmology, Donostia University Hospital (HUD), Donostia San-Sebastián, Spain
Interests: retinal dystrophies; retinal disease
Dr. Javier Zarranz-Ventura

E-Mail Website
Guest Editor
Institut Clínic of Ophthalmology (ICOF), Hospital Clínic, Barcelona, Spain
Interests: retinal care; intravitreal injection
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Over the last decade, retinal specialists have contributed to important advances in the management of different vitreoretinal diseases. This knowledge, accumulated from basic and clinical studies, has arised in conjunction with the development of new technologies. In this context, multimodal imaging has led to a significant improvement in the diagnosis, understanding and classification of already-known pathologies, as well as the description of new entities. Moreover, the presence of small-gauge vitreotomes with ultra-high-speed cut rates, microscopes with incorporated OCT together with the possibility of administering different drugs and therapies in the vitreous cavity, subretinal and suprachoroidal spaces have revolutionized vitreoretinal surgery, paving a road to treat more complex and challenging cases in a safer manner.

This Special Issue aims to publish original articles that guide ophthalmologists in the surgical treatment of vitreoretinal diseases. Submissions of review articles of high interest are welcome.

Dr. Joaquín Marticorena
Dr. Cristina Irigoyen
Dr. Javier Zarranz-Ventura
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • retina
  • vitreoretinal diseases
  • vitreotomes
  • optical coherence tomography
  • vitreoretinal surgery

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Published Papers (5 papers)

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8 pages, 858 KiB  
Article
Comparison of Refractive Outcomes After Phacoemulsification and Combined 25-Gauge Phacovitrectomy with Implantation of Plate-Haptic Toric Intraocular Lenses
by Lara Buhl, Julian Langer, Franziska Kruse, Niklas Mohr, Thomas Kreutzer, Wolfgang Mayer, Stefan Kassumeh and Siegfried Priglinger
J. Clin. Med. 2024, 13(22), 6861; https://doi.org/10.3390/jcm13226861 - 14 Nov 2024
Viewed by 305
Abstract
Objectives: To compare intraocular lens (IOL) position and refractive outcomes between eyes that underwent sole phacoemulsification with those that underwent combined 25-gauge phacovitrectomy with a plate-haptic toric IOL implantation. Methods: This retrospective study included 60 eyes of 60 patients. Of these, [...] Read more.
Objectives: To compare intraocular lens (IOL) position and refractive outcomes between eyes that underwent sole phacoemulsification with those that underwent combined 25-gauge phacovitrectomy with a plate-haptic toric IOL implantation. Methods: This retrospective study included 60 eyes of 60 patients. Of these, 30 eyes underwent 25-gauge phacovitrectomy, while the other 30 eyes received phacoemulsification alone. In both groups, a plate-haptic toric intraocular lens (AT Torbi 709M, Carl Zeiss Meditec AG) was implanted. The main outcome measures were the refractive outcome, the refraction prediction error (PE), the difference in the postoperative anatomical lens position (ALP) change, and rotational stability. Results: The mean spherical equivalent decreased considerably from −2 ± 4.4 diopters (D) to −0.6 ± 1.4 D after phacovitrectomy (p = 0.05) and −0.7 D ± 5.5 D to −0.1 ± 1.1 D after phacoemulsification (p = 0.5). The prediction error (PE) was comparable between the two groups for all formulas (Haigis-T: p = 0.8, Barrett TK Toric: p = 0.8, Z CALC: p = 0.7). No significant difference in absolute ALP change and postoperative rotational stability was observed between the phacovitrectomy and phacoemulsification group (1.4 mm vs. 1.4 mm, p = 0.96; 2.9° vs. 2.1°, p = 0.5). Conclusions: The implantation of plate-haptic toric IOLs in the combined phacovitrectomy group resulted in refraction and IOL positioning outcomes comparable to those in the phacoemulsification-only group. Full article
(This article belongs to the Special Issue Advancements and Challenges in Retina Surgery)
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11 pages, 1598 KiB  
Article
Two-Decade Retrospective Analysis of Endogenous Endophthalmitis in Spain and Mexico: A Comprehensive Study
by Elia de Esteban Maciñeira, Manuel F. Bande, Jorge Ivan Soberanes-Pérez, Laura Paniagua, Maria F. Golzarri, Jans Fromow-Guerra, María José Blanco Teijeiro and Rosario Touriño Peralba
J. Clin. Med. 2024, 13(17), 4990; https://doi.org/10.3390/jcm13174990 - 23 Aug 2024
Viewed by 617
Abstract
Objectives: The aim of this study was to investigate endogenous endophthalmitis (EE) in Spain and Mexico, focusing on microbial patterns, antibiotic resistance, infection sources, risk factors, and patient outcomes. Methods: Over 20 years, 705 endophthalmitis cases were reviewed, and we identified 78 cases [...] Read more.
Objectives: The aim of this study was to investigate endogenous endophthalmitis (EE) in Spain and Mexico, focusing on microbial patterns, antibiotic resistance, infection sources, risk factors, and patient outcomes. Methods: Over 20 years, 705 endophthalmitis cases were reviewed, and we identified 78 cases of EE in Santiago de Compostela, Spain, and Mexico City, Mexico. Microbial etiology, infection sources, antibiotic resistance, and treatment outcomes were compared between patients from Spain and Mexico. Results: Among the 78 EE cases, 47 (60.25%) were from Spain and primarily had bacterial infections (57.1%, mainly Staphylococcus and Streptococcus). In contrast, 31 cases (39.74%) were from Mexico and had a higher prevalence of fungal infections, particularly Candida (47.1%). Diabetes mellitus was a significant risk factor, and was more common in Mexico (61.3%) than in Spain (37.0%). The Spanish cohort exhibited notable antibiotic resistance, especially in Staphylococcus. Treatment typically involved systemic and intraocular antibiotics, with vitrectomy performed in 61.5% cases. Post-treatment, bacterial infections had higher success rates (approximately 50%) compared with fungal infections (approximately 30%). Evisceration was necessary in 9% cases, and the overall mortality rate was approximately 4.4%; it was slightly higher in Mexico than in Spain. Conclusions: The study highlights significant regional differences in EE between Spain and Mexico, particularly regarding microbial etiology and antibiotic resistance. The findings emphasize the need to adapt healthcare practices to specific regions to improve EE treatment outcomes, underscoring the importance of ongoing research and interregional collaboration to better understand and manage this complex condition. Full article
(This article belongs to the Special Issue Advancements and Challenges in Retina Surgery)
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15 pages, 2087 KiB  
Article
Quantitative Microvascular Change Analysis Using a Semi-Automated Software in Macula-off Rhegmatogenous Retinal Detachment Assessed by Swept-Source Optical Coherence Tomography Angiography
by Pablo Díaz-Aljaro, Javier Zarranz-Ventura, Laura Broc-Iturralde, Nevena Romanic-Bubalo, Ignacio Díaz-Aljaro, Zhongdi Chu, Ruikang K. Wang and Xavier Valldeperas
J. Clin. Med. 2024, 13(10), 2835; https://doi.org/10.3390/jcm13102835 - 11 May 2024
Viewed by 753
Abstract
Objective: To analyze the performance of custom semi-automated software for quantitative analysis of retinal capillaries in eyes with macula-off rhegmatogenous retinal detachment (RRD) and the role of these microvascular measures as potential biomarkers of postoperative visual outcomes. Methods: A prospective, observational, [...] Read more.
Objective: To analyze the performance of custom semi-automated software for quantitative analysis of retinal capillaries in eyes with macula-off rhegmatogenous retinal detachment (RRD) and the role of these microvascular measures as potential biomarkers of postoperative visual outcomes. Methods: A prospective, observational, and single-center study was conducted on consecutive patients who underwent 25G pars-plana vitrectomy for primary uncomplicated macula-off RRD. Optical coherence tomography angiography (OCTA) was performed in the fellow and RRD eyes before surgery and in months 1, 3, and 6 after surgery. The preoperative values of the fellow eyes were used as surrogates of macula-off ones. The primary endpoints were the mean vessel diameter index (VDI); vessel area density (VAD); and vessel skeleton density (VSD) at month 6. Results: Forty-four eyes (44 patients) were included in the study. Considering the fellow eyes as a surrogate of preoperative values of macula-off eyes, VDI in superficial (SCP) and deep (DCP) capillary plexuses was significantly reduced at month 6 (p = 0.0087 and p = 0.0402, respectively); whereas VSD in SCP increased significantly from preoperative values (p = 0.0278). OCTA built-in software parameters were significantly reduced from month 1 to month 6 in both SCP and DCP (p values ranged between 0.0235 and <0.0001). At month 6, 25 (56.8%) eyes achieved a best-corrected visual acuity BCVA ≥ 0.3 (LogMAR). The greater the preoperative BCVA, the greater the probability of achieving good visual outcomes (Odds ratio: 11.06; p = 0.0037). However, none of the OCTA parameters were associated with the probability of achieving a BCVA improvement ≥ 0.3. Conclusions: Quantitative evaluation of capillary density and morphology through OCTA and semi-automated software represents a valuable tool for clinical assessment and managing the disease comprehensively. Full article
(This article belongs to the Special Issue Advancements and Challenges in Retina Surgery)
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10 pages, 3789 KiB  
Article
Optimizing Surgical Management for Rhegmatogenous Retinal Detachment in Eyes with Active Retinoblastoma: A Safety-Driven Approach
by Yacoub A. Yousef, Omar AlHabahbeh, Mona Mohammad, Hadeel Halalsheh, Mustafa Mehyar, Mario Damiano Toro and Ibrahim AlNawaiseh
J. Clin. Med. 2024, 13(9), 2511; https://doi.org/10.3390/jcm13092511 - 25 Apr 2024
Viewed by 1205
Abstract
Introduction: Intraocular surgeries are conventionally contraindicated for patients with active retinoblastoma (Rb) due to the potential risk of tumor dissemination. However, surgery is occasionally necessary to preserve vision in patients with a single eye when the eye is complicated by rhegmatogenous retinal detachment [...] Read more.
Introduction: Intraocular surgeries are conventionally contraindicated for patients with active retinoblastoma (Rb) due to the potential risk of tumor dissemination. However, surgery is occasionally necessary to preserve vision in patients with a single eye when the eye is complicated by rhegmatogenous retinal detachment (RRD). Objective: This study aims to evaluate the outcomes of surgical repair for RRD in pediatric patients with active Rb utilizing a non-drainage scleral buckling approach. Results: This cohort included six eyes from six patients who harbored active Rb and presented with RRD; one had a concurrent tractional component. All eyes (100%) had active intraocular Rb and were undergoing active therapy (systemic chemotherapy, cryotherapy, and thermal laser therapy) when RRD developed. RRD consistently manifested at the site of recent cryotherapy in all cases. RRD repair in the affected eyes was performed by scleral buckling without subretinal fluid drainage. Five of the six eyes (83%) achieved complete retinal reattachment. One eye (17%) with a tractional component exhibited partial reattachment and was eventually enucleated due to persistent active disease. At a median follow-up of 15 months (range 12–180 months) after scleral buckling, all five eyes had persistent retinal attachment, and no case developed orbital or distant metastasis. Conclusions: Our study demonstrates that nondrainage scleral buckling is an effective and safe method for the surgical repair of RRD in eyes harboring active Rb, as most cases achieved persistent complete retinal reattachment without the risk of tumor spread. Full article
(This article belongs to the Special Issue Advancements and Challenges in Retina Surgery)
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Other

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21 pages, 661 KiB  
Systematic Review
Retinitis Pigmentosa and Therapeutic Approaches: A Systematic Review
by Filippo Confalonieri, Antonio La Rosa, Giovanni Ottonelli, Gianmaria Barone, Vanessa Ferraro, Alessandra Di Maria, Mary Romano, Alessandro Randazzo, Josè Luis Vallejo-Garcia, Paolo Vinciguerra and Goran Petrovski
J. Clin. Med. 2024, 13(16), 4680; https://doi.org/10.3390/jcm13164680 - 9 Aug 2024
Viewed by 1792
Abstract
Background: Retinitis pigmentosa (RP) is a group of hereditary retinal dystrophies characterized by progressive degeneration of photoreceptor cells, which results in debilitating visual impairment. This systematic review aims to evaluate the efficacy and safety of emerging treatment modalities for RP, including gene therapy, [...] Read more.
Background: Retinitis pigmentosa (RP) is a group of hereditary retinal dystrophies characterized by progressive degeneration of photoreceptor cells, which results in debilitating visual impairment. This systematic review aims to evaluate the efficacy and safety of emerging treatment modalities for RP, including gene therapy, mesenchymal-cell-based approaches, and supplementary interventions. Methods: A comprehensive search of electronic databases was conducted to identify relevant studies published up to February 2024. Studies reporting outcomes of treatment interventions for RP, including randomized controlled trials, non-randomized studies, and case series, were included. Data extraction and synthesis were performed according to predefined criteria, focusing on assessing the quality of evidence and summarizing key findings. Results: The search yielded 13 studies meeting inclusion criteria, encompassing diverse treatment modalities and study designs. Gene therapy emerged as a promising therapeutic approach, with several studies reporting favorable outcomes regarding visual function preservation and disease stabilization. Mesenchymal-cell-based therapies also demonstrated potential benefits, although evidence remains limited and heterogeneous. Supplementary interventions, including nutritional supplements and neuroprotective agents, exhibited variable efficacy, with conflicting findings across studies. Conclusions: Despite the lack of definitive curative treatments, emerging therapeutic modalities promise to slow disease progression and preserve visual function in individuals with RP. However, substantial gaps in evidence and heterogeneity in study methodologies underscore the need for further research to elucidate optimal treatment strategies, refine patient selection criteria, and enhance long-term outcomes. This systematic review provides a comprehensive synthesis of current evidence and highlights directions for future research to advance the care and management of individuals with RP. Full article
(This article belongs to the Special Issue Advancements and Challenges in Retina Surgery)
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