Retinal Tears

Retinal tear is defined as full-thickness defects in the retina. Retinal tears in the presence of vitreous shrinkage will cause retinal detachment associated with retinal tear is important to determine the vitreous shrinkage.

The most common peripheral retinal tears in the retina; holes, tears and dialysis. A flap or horseshoe tears always the result of vitreous shrinkage occurs.

Horseshoe tear always extends optical disc and vitreous raised the flap is attached.

Operkuluml or round holes may be atrophic. operculum with a vitreous retinal tissue shrinkage is freed by withdrawing from the retina. on the hole formed in the vitreous cavity, usually traceable.

Although there may still be free operculum vitreous shrinkage around the hole. atrophic round holes instead of vitreous shrinkage is believed to be due to loss of retinal tissue. Therefore operkuluml holes, horseshoe vary from tears.

Lattice degeneration is the most common dejeneres mints in the peripheral retina.
This dejenesares also develop atrophic changes until ultimately depends on the horse and horseshoe ripped gelişebil vitreous retraction.

The natural course of the tear in the retina reattachment of the need for treating a minority of such lesions. Clinical studies have shown that retinal breaks and lattice degeneration is common and occurs in the general population and 5% to 10%. In contrast, retinal detachment is rare. 0.005% of the general population has been reported that retinal detachment develops. The incidence of retinal detachment retinal tear is significantly much higher than that.

may develop complications related to the treatment of retinal tears just to cause retinal detachment is more likely to be treated for tear.

The prognosis of patients with asymptomatic retinal tear shows a different trend compared to the symptomatic.
clinical retinal detachment causing a risk of asymptomatic tears is very low. Therefore there is no need to treat prophylactically in these lesions.

According to the asymptomatic retinal tears stuck in a routine examination of symptomatic retinal tears are at high risk to cause retinal detachment. Symptomatic retinal tears are usually the two most important symptoms associated with vitreoretinal photopsia shrinkage (light flashes) and entops (floating objects) d.

Photopsia a result of the mechanical strength of the peripheral retina and vitreous gel on the retina anterins The oluşur.entops depending on the discharge of neural warning that occurs due to bleeding into the vitreous or vitreous detachment, retinal tear.

Is therefore symptomatic posterior vitreous detachment, retinal tear develops in 8-10% of patients with detailed retinal examination should be performed in all these patients.

As a result, they should be treated prophylactically for the prevention of symptomatic retinal tear and retinal detachment, retinal tears can be monitored safely asymptomatic.

4% of patients with retinal detachment ‘reputation in the family history is positive. If a patient is present in 6 dyoptri myopia of more than 2% risk of developing retinal detachment it is available, and 35% of patients with retinal detachment, ‘I will myopia.

the implementation of the internal lens Eye% of patients in the previous period, in 5 was developing retinal detachment. In patients with intact posterior capsule retinal detachment development rate is a rate of 0.3-0.5%. However, posterior capsule rupture, or in patients YA6 laser capsulotomy rate rises to the level of 1-2% modified. Therefore, prior to cataract surgery is recommended in patients with horseshoe tear implementation of prophylactic treatment.

Given the natural history study it was observed that developing a retinal detachment increases the risk of retinal detachment in the other eye of the patient.
careful ophthalmoscopy allows identification of patients at risk of all retinal tears. Patients should be educated about the importance of peripheral retinal examination and must be fully dilated pupil.

surgical Technique

The aim of prophylactic treatment of retinal tears to avoid retinal detachment. This is achieved by creating the environmental situation of the peripheral retina patoliji korşaretinal score in order to prevent the separation of the retina, retinal pigment epithelium below. When determining tear retinal detachment requiring treatment in an outpatient setting in performing photocoagulation is the most appropriate option. Topical anesthesia is often enough yeterlidir.periferik retinal tears should be treated from each other by wide intervals of 2 or 3 rows 1-2 burns burns. Argen green laser is usually used.

Excessive force, bleeding, rupture of Bruch’s membrane and macular be sure to use the lowest possible power can lead to wrinkles.

the occurrence of complications after photocoagulation applied to retinal tears are not uncommon. Therefore, patients should be told that sustained follow-up. The patient & 10 consists of the average new torn and 5% of the proceeds clinical retinal detachment. Macular wrinkled and Epiretinol membranes, the risk is approximately 5%. The prophylactic treatment may require additional treatment in the treated eyes. Additional insufficient closure of the original causes of retinal tear treatment requirements, development of new tears without detachment or retinal detachment caused by emerging contain tears. Therefore, prophylactic treatment should be explained the importance of follow-up for all patients.

Retinal Detachment

Is defined as the separation of the pigment epithelial layer below the retina nerve and vision should be treated as an emergency because it seriously threatens.

Depending on the emergence of retinal detachment in tears, çekintil and divided into 3 groups according to serous.
The most common retinal detachment.

Retinal detachment is the only treatment is surgery in patients with. The ability to recognize the retinal pathologies depending on the experience of the surgeon and pneumatic retino Peksan of sklval buckling and pars plana vitrectomy techniques are the techniques of choice.

Pneumatic retinopexy caused by localized rupture or tear in the retina and 2/3 is used in treating proliferative vitreo-grade B or lower retinal detachment airports.
The gases used during the operation and expansion are required to maintain a certain head position of the patient after the operation.

Scleral buckling techniques;

Most prominent non-proliferative vitreoretinopathy retinal detachments can be used successfully.
Surgical approach to localize bulunarak all the tears, the tears and chorioretinal adhesion is to ensure the apogisyon andentasyo of creation and retour pigment epithelium. Cupping is used as a material Silicone Sponge and hard silicone band.

Pars Plana Vitrectomy

Giant retinal detachment is used in the rear localized retinal detachments and tears for untreatable patients with conventional surgical methods.

In this technique, vitrectomy with vitreous and retinal membranes that shrinkage is prevented by cleaning the withdrawal of the retina. After the operation depending on the status of the phenomenon used gas or buffer agents such as silicone. Sometimes you may need a second or third operation in surgical applications. vitrectomy As with all surgical treatments and there is a risk in surgery. If untreated, it can cause permanent vision loss retinal detachment.

Dr. Hikmet BEŞTAŞ
Eye Disease Specialist