SEARCH · PubMed Health

Results for “Vitrectomy”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 235 records · Page 13Linked to original sources

PubMed2006

[Pars plana vitrectomy and intravitreal triamcinolone for chronic pseudophakic cystoid macular edema].

AIM: To report on the results of pars plana vitrectomy and intravitreal triamcinolone in patients with chronic pseudophakic cystoid macular edema unresponsive to medical treatment. PATIENTS AND METHODS: A retrospective analysis of 9 eyes in 9 patients with chronic pseudophakic cystoid macular edema was performed. All patients had cystoid macular edema confirmed on fluorescein angiography, and were unresponsive to medical treatment. In all patients pars plana vitrectomy and intravitreal application of 4 mg of triamcinolone was performed. In one patient with vitreous prolapse into the anterior chamber, anterior vitrectomy was also required. RESULTS: The mean interval between cataract surgery and vitrectomy was 16.28 +/- 2.1 months. The mean preoperative best corrected visual acuity was 0.1 +/- 0.11, and the mean final best corrected visual acuity 0.25 +/- 0.24, after a mean follow up of 6.6 +/- 3.5 months. In all 9 eyes there was a marked reduction of cystoid macular edema, as verified on fluorescein angiography. Intraocular pressure was raised in 4 patients, and it was controlled by topical antiglaucomatous treatment. CONCLUSION: Pars plana vitrectomy and intravitreal triamcinolone in eyes with chronic pseudophakic cystoid macular edema resulted in a reduction of cystoid macular edema, and visual acuity improvement.

Aged↗

PubMed1990

[The efficacy of vitrectomy in severe complicated proliferating diabetic retinopathy].

Vitrectomy was made in 69 patients (71 eyes) with proliferative retinopathy complicated by hemorrhage into the vitreous body. In most cases (90.1%), visual acuity didn't exceed 0.05. To prevent possible complications at the time of operation and in the postoperative period preliminary cryocoagulation before vitrectomy was made in a part of the patients (47 patients, 49 eyes). Comparative analysis of results after vitrectomy with and without cryocoagulation has shown that the incidence of operative complications was remarkably lower, than in the first group of patients. Hemorrhage into the vitreous body was observed in combined intervention in 4.0%, and in vitrectomy without preliminary intervention--in 22.7% of cases. Restoration of transparency of the vitreous body was recorded to be more frequent in group I (48.9% against 35.2%). In remote terms, visual acuity improved in 85.7% in group I, and in 45.5%--in group II. Vitrectomy with preliminary cryocoagulation is indicated to all patients with complicated far-advanced proliferative diabetic retinopathy.

Adult↗

PubMed1990

[Vitrectomy in proliferative diabetic retinopathy. Preoperative factors for surgical procedure and postoperative results].

In this study we evaluated the impact of preoperative factors on the choice of intraocular tamponades (balanced salt solution and gas or silicone oil) and postsurgical visual function in cases of vitrectomy for proliferative diabetic retinopathy. We studied 150 consecutive vitrectomies for proliferative diabetic retinopathy, which were carried out from October 1987 to February 1989. The extent of central or peripheral traction and retinal detachment were found to have a major influence on the choice of intraocular tamponades. Different types of diabetes, renal failure, and the time interval since the last vitreous hemorrhage showed no influence on the choice of intraocular tamponades. Visual acuity was improved after vitrectomy in the group with silicone oil tamponade, as well as in the control group with BSS or gas tamponade. Patients receiving silicone oil had more advanced stages of proliferative diabetic retinopathy and therefore more complicated postsurgical courses. Silicone oil is more likely to be avoided in cases without retinal detachment, where the risk of further vitreous hemorrhage is felt to be low and in cases with complete panretinal photocoagulation. The present study supports the therapeutic value of complete panretinal photocoagulation for proliferative diabetic retinopathy--even in cases where the proliferative retinopathy progresses and a vitrectomy is needed. It is demonstrated that many patients requiring vitrectomy did not receive sufficient photocoagulation earlier.

Adult↗

PubMed1990

Vitrectomy prevents retinal hypoxia in branch retinal vein occlusion.

Vitrectomy has been shown to halt diabetic retinal neovascularization, but the mechanism of this process is unknown. We propose that vitrectomy improves the oxygen supply to ischemic inner retina by way of fluid currents in the vitreous cavity. In order to test this hypothesis, we induced branch retinal vein occlusion in cats and measured preretinal oxygen tension before and after branch retinal vein occlusion in ten nonvitrectomized and five vitrectomized eyes. Branch retinal vein occlusion caused a significant decrease in preretinal oxygen tension in nonvitrectomized eyes, in which the oxygen tension fell from 20 +/- 7 to 6 +/- 5 mmHg (P = 0.001). Conversely, in vitrectomized eyes the oxygen tension was not significantly reduced after branch retinal vein occlusion. The data demonstrate that branch retinal vein occlusion causes retinal hypoxia in nonvitrectomized eyes, whereas after vitrectomy the hypoxic effect of branch retinal vein occlusion is reduced. The relief of retinal hypoxia that follows vitrectomy may be responsible for halting retinal neovascularization after vitrectomy in diabetic patients.

Animals↗

PubMed1986

Corneal endothelial cell damage associated with intraocular gas tamponade during pars plana vitrectomy.

A prospective study was conducted of corneal endothelial damage associated with intraocular gas tamponade during pars plana vitrectomy performed in 44 patients. In addition to vitrectomy or combined vitrectomy-lensectomy, 25 patients (the gas-treated group) underwent intraocular gas tamponade, which was not performed in 19 patients (the control group). The central corneal endothelium was examined with a specular microscope preoperatively and 3 months postoperatively. Endothelial changes were quantitated by computerized morphometric analysis of individual cells. A total of 20 eyes were phakic after vitrectomy, 13 eyes in the gas-treated group and 7 eyes in the control group. The mean endothelial cell loss for the gas-treated group (1.9%) did not differ significantly from that for the control group (1.8%). Twenty-four eyes were aphakic after vitrectomy, 12 eyes in the gas-treated group and 12 eyes in the control group. The gas-treated group had a significantly greater cell loss (28.3%) than those in the control group (16.3%).

Air↗

PubMed1984

[Favorable development of bilateral Candida albicans endophthalmitis. Value of early vitrectomy].

A chronic bilateral endogenous Candida albicans endophthalmitis in a heroin addict was treated by vitrectomy, argon laser photocoagulation and endodiathermy. In the left eye with a visual acuity of 6/6 there was a totally asymptomatic retinal tear due to vitreous traction. The eye was treated by argon laser photocoagulation immediately, and then underwent a vitrectomy several weeks later. Analysis of the vitrectomy specimen was negative for any organism. In the vitreous of the right eye a "fungus ball" was noted nasally. Visual acuity was also 6/6. Fluorescein angiography demonstrated the presence of a small area of retinal involvement above the optic disc. During vitrectomy and membrane peeling the area of retinal involvement was torn away. The tear was then treated by endodiathermy. Vitreous analysis showed the presence of Candida albicans, sensitive to 5-fluorocytosine which was then used in treatment. All other cultures and stains were negative for Candida. The patient had negative serology for Candida, but normal immune responses based on cutaneous testing to several antigens and dosage of serum immunoglobulins and complement. A negative serology to Candida is most likely explained by the supposition that an episode of blood stream infection occurred only briefly and long before the eye involvement became clinically significant. At 4 months after bilateral vitrectomy, the patient has maintained 6/6 vision in each eye.

Adult↗

PubMedDate not supplied

[Vitreous hemorrhage: attitudes in therapy, vitrectomy].

Vitreous haemorrhage is a serious complication of proliferative diabetic retinopathy: it provides evidence of the severity of at proliferative retinopathy at stake and precludes laser photocoagulation. In some cases of moderate vitreous haemorrhage, panretinal photocoagulation remains possible especially using longer wavelengths such as krypton red; cryotherapy under ophthalmoscopic control may be an alternative to panretinal photocoagulation. Development of pars plana vitrectomy, however, has been the main break the rough in the management of severe vitreous haemorrhage. Pars plana vitrectomy was first reserved to massive, long-standing vitreous haemorrhage; improvements in instrumentation and techniques, as well as observations of the favourable effect of vitrectomy on the progression of proliferative retinopathy led to enlarged indications for pars plana vitrectomy. Beyond severity and duration of visual loss, main arguments for pars plana vitrectomy are bilaterality, lack of previous panretinal photocoagulation, iris neovascularization, Type 1 diabetes, and severity of fibrovascular proliferation.

Cryotherapy↗

PubMedDate not supplied

[Time factors in the performance of closed vitrectomy in traumatic hemophthalmos].

The authors analyze the results of 447 vitrectomies in patients with traumatic hemophthalmia and its aftereffects, carried out in various periods after trauma. The best vision and the least number of complications (retinal detachment, hemophthalmia recurrence) were attained when vitrectomy was carried out in 1 to 3 months after the injury. An earlier vitrectomy involved a high risk of complications, and the vision results were poor; vitrectomy carried out later than 4 months after the injury was as ineffective because of irreversible posttraumatic changes in the retina. These results bring the authors to a conclusion that closed vitrectomy with optic purposes should be carried out in periods from 1 to 3 months after the injury.

Adolescent↗

PubMed1993

Vitrectomy in multifocal chorioretinitis.

In nine patients suffering from multifocal chorioretinitis with panuveitis, we obtained no impressive therapeutic benefit from vitrectomy. Seven women and two men ranging in age from 63 to 86 years underwent pars plana vitrectomy at 3-28 months after the first signs of uveitis had appeared. Previous medical treatment had always been unsuccessful. Vitrectomy was performed in one eye of eight patients and in both eyes of one patient. In addition, in two patients a cataract was removed by phacoemulsification and an intraocular lens was implanted. A visual improvement of one or two lines was achieved postoperatively in most cases, but the visual acuity decreased to preoperative values or less within 6 months. The surgical treatment showed no obvious effect on the intensity or frequency of uveitis relapse. In all cases, vitrectomy specimens were serologically negative for herpes-group viruses. Histologically, no malignancy was detectable. Immunohistochemistry studies revealed that a large number of the vitreous cells bore T-lymphocyte markers (mostly CD2-, CD3-, and CD4-positive); about one-third of the vitreous cells were macrophages, and B-lymphocytes were only rarely detected. In conclusion, pars plana vitrectomy in multifocal chorioretinitis achieved no positive long-term result. There was no diagnostic hint as to whether the cause of the uveitis might have been of a viral, malignant, or autoimmune origin. Therefore, multifocal chorioretinitis remains poorly understood in terms of its etiology and adequate treatment.

Aged↗

PubMed1996

[Visual functional changes in idiopathic macular holes treated by vitrectomy].

We evaluated visual functional measurements, visual acuity, central retinal sensitivity in a Humphrey field analyzer, and binocular function in Stereotest, Amsler grid testing, of 51 idiopathic macular holes before and after vitrectomy. In 36 of 51 eyes (71%) where the macular hole was closed after vitrectomy, there were improvements in all visual functional measurements postoperatively. The eyes in which the macular hole was closed had significantly better visual acuity before vitrectomy than those in which the hole was not closed. In 16 of 51 eyes that had visual acuity of less than 20/200 preoperatively, central retinal sensitivity before vitrectomy was higher in the eyes where the macular hole was closed than in those in which it was not closed. These measurements are useful for evaluation of visual functional improvements after vitrectomy and can help to choose candidates for macular hole surgery.

Adult↗

PubMed1996

[Vitrectomy with autoserum for idiopathic macular hole].

Using autoserum, we operated on eyes with full thickness macular hole and achieved greater anatomic and visual success than with eyes that underwent vitrectomy alone. A total of 34 eyes were treated with vitrectomy and fluid-gas exchange: 14 eyes with autoserum instillation and 15 eyes without autoserum. Five eyes with macular holes persisting after initial vitrectomy underwent reoperation with autoserum. After vitrectomy and fluid-air exchange, 0.1 to 0.3 ml of autoserum was placed for about 7 minutes over the hole, and then 30% SF6 was instilled. After treatment, successful anatomic closure occurred in 53% of the eyes without autoserum, in 86% of those with autoserum, and in 80% of those which underwent reoperation with autoserum. Visual acuity improved 2 lines or more in 53% of the eyes without autoserum, in 79% of those with autoserum, and in 60% of those that underwent reoperation with autoserum. The results of the current preliminary study shows that treatment of full-thickness macular holes with autoserum seems to be more beneficial than vitrectomy alone.

Blood↗

PubMed1995

[Primary vitrectomy in rhegmatogenous retinal detachment].

For therapy of uncomplicated rhegmatogenous retinal detachment, a buckling procedure is the standard surgical technique today. In complicated cases, e.g., retinal redetachment after a failed buckling procedure, vitrectomy is established. Meanwhile it is being discussed whether or not certain retinal detachments, e.g., with atypically large tears, should be treated with primary vitrectomy. We studied retrospectively all primary vitrectomies for retinal detachment without proliferative vitreoretinopathy (PVR) that were operated upon during 1992 in Würzburg Eye Hospital (32 patients). In 56% (18 eyes) of the patients a subtotal or total retinal detachment was seen preoperatively; in 47% (15 eyes) the macular region was detached. In 25% (8 eyes) large retinal tears were seen (> 1 h). The other patients showed atypical horseshoe tears partly central to the equator or multiple holes. Seventy-eight percent (25 eyes) of all cases were successfully vitrectomized with one operation and revealed good results using intraocular tamponade (SF-6/air mixture). Seven patients needed further vitrectomy partly using silicone oil as an intraocular tamponade. In cases of rhegmatogenous retinal detachment with atypical tears or non-identified holes, vitrectomy without the buckling procedure is a good alternative, because the rate of successful results is as high as what is achieved with buckling procedure in uncomplicated cases.

Adult↗

PubMed1996

Outcome of functioning filtering blebs after pars plana vitrectomy.

BACKGROUND AND OBJECTIVE: To determine the status of filtering bleb function following pars plana vitrectomy. PATIENTS AND METHODS: The authors retrospectively reviewed patients with functioning filtering blebs undergoing pars plana vitrectomy. RESULTS: Twenty-three eyes with functioning filtering blebs underwent pars plana vitrectomy. Postoperatively, 7/23 (30 percent) of the eyes had moderate (5 to 20 mm Hg) intraocular pressure (IOP), 8/23 of the eyes had IOP persistently greater than 20 mm Hg, and 7/23 of the eyes had IOP of less than 5 mm Hg. One of 7 eyes that underwent vitrectomy within 6 weeks after trabeculectomy maintained bleb function, whereas 6 of 16 eyes that underwent trabeculectomy 6 weeks or later maintained bleb function. Loss of bleb function occurred in the early postoperative period in the majority of the patients. Prior antimetabolite therapy was not associated with preservation of bleb function. CONCLUSION: There is a substantial risk of bleb failure following vitrectomy, which is in part related to the often severe nature of the diseases requiring vitreoretinal surgery.

Adult↗

PubMed1996

Prediction of visual acuity after early vitrectomy in diabetics.

In proliferative diabetic retinopathy the indication of early vitrectomy remains controversial. At present, no decision rule exists for the assessment of the various factors predicting the postoperative visual outcome. We reviewed 75 vitrectomies in 68 diabetics from our clinic. All vitrectomies were done by one surgeon. In all cases, vitrectomy was indicated because of nonclearing vitreous hemorrhage and/or fibrovascular proliferation. A linear regression model was used to identify factors correlating with the visual outcome. By means of univariate analysis, six of nine clinical variables were found to be associated with the final visual outcome. Dividing the patients into two groups according to their preoperative visual acuity (group 1 hand movement, group 2 better than hand movement), we identified two predictors that were independently associated with the postoperative visual acuity: group 1-the visual acuity of the fellow eye (P < 0.05) and rubeosis iridis (P < 0.05); group 2-the visual acuity of the fellow eye (P < 0.001) and preexisting systemic diabetic vascular disorders (P < 0.01). Based on this model, a formula was derived to predict the visual acuity at 6 months postsurgery. For easier handling the prognostic factors of a poor visual outcome (less than 0.1) were summarized in a flow chart. The test is a useful tool for the preoperative evaluation of various risk factors and, hence, for more reliable prediction of a poor visual outcome. Thus, it may be especially useful to objectify the risk-benefit ratio for early vitrectomy in diabetics.

Diabetic Retinopathy↗

PubMed1996

[Vitrectomy in Terson's Syndrome].

AIM OF THE STUDY: The authors present results of vitrectomy in the treatment of a 50 year old woman with Terson's Syndrome. MATERIAL: Pars plana vitrectomy was performed in two eyes of a 50 year old woman with vitreous hemorrhage caused by the rupture of cerebral arteries aneurysms. The vitreous hemorrhage occurred two days after the neurosurgery procedure. Visual acuity in both eyes was hand movement and did not change after pharmacotherapy and cryotherapy. Pars plana vitrectomy was performed in the right eye 3, 5 months after the hemorrhage and in the left eye 5 months after the hemorrhage. Visual acuity 5/12 in the right eye and 5/7 in the left eye was achieved after the vitrectomy and 5/50 (the decrease caused by cataract) and 5/7 after 11 and 7 months of follow-up. CONCLUSION: Pars plana vitrectomy is a method of choice in the cases of binocular Terson's Syndrome and accelerates returning of useful visual acuity.

Aneurysm, Ruptured↗

PubMed1997

Pars plana vitrectomy in the treatment of combined rhegmatogenous retinal detachment and choroidal detachment in aphakic or pseudophakic patients.

BACKGROUND AND OBJECTIVE: The presence of extensive choroidal detachment (CD) in eyes with rhegmatogenous retinal detachment (RRD) is a major preoperative complication. Conventional treatment consists of 7 days to a few weeks of systemic and topical steroids followed by scleral buckling and drainage of suprachoroidal fluid. The author studied the usefulness of pars plana vitrectomy in the management of RRD combined with CD. PATIENTS AND METHODS: Ten consecutive patients with RRD complicated by CD were treated with pars plana vitrectomy. Nine had had previous cataract extraction, and one patient had pars plana lensectomy at the time of the surgery. The severity of the CD was evaluated with preoperative ophthalmologic echography. Sclerotomy sites for infusion cannulas were chosen in the area with less CD. Six-millimeter infusion cannulas were used. Pars plana vitrectomy, membrane peeling, and internal fluid-gas exchange with encircling scleral buckle placement were performed in a standard fashion. One patient had silicone oil injected. RESULTS: In each case, suprachoroidal fluid drained spontaneously through the sclerotomy sites around the vitrectomy instruments during the initial course of the operation without extra sclerotomy. Immediate intraoperative retinal reattachment was achieved in 10 cases. The retina remained attached in 9 cases during at least 6 months of follow-up without additional surgery. CONCLUSION: These cases demonstrate the usefulness of pars plana vitrectomy in treating RRD with CD in aphakic or pseudophakic eyes. This method may be an favorable alternative to conventional treatment.

Adult↗

PubMed1996

Cataract surgery and YAG-laser capsulotomy following vitrectomy for diabetic retinopathy.

The present study was initiated to assess time-course and risk factors for the development of cataract and posterior-capsule opacification as well as complications of cataract surgery and YAG-laser capsulotomy following vitrectomy for diabetic retinopathy. The charts of all patients undergoing vitrectomy for diabetic retinopathy during a 5-year period in a university eye hospital were retrospectively reviewed. The course of 306 consecutive eyes in which the lens was retained during vitrectomy was analyzed for subsequent cataract surgery and YAG-laser capsulotomy. The first 6 months after cataract or YAG-laser surgery were examined for the occurrence of complications. Data were analyzed with regard to the time course using Kaplan-Meier life-table analysis. The proportion of eyes that underwent cataract surgery after vitrectomy increased nearly linearly with time, approaching 75% after 5 years. Silicone tamponade (relative risk 1.9; P = 0.0005) and transscleral retinal cryotherapy (relative risk 1.4; P = 0.003) were risk factors for subsequent cataract surgery. No significant cataractogenous effect of intravitreal gas as compared with balanced salt solution was found. YAG-laser capsulotomy was performed in 60% of vitrectomized diabetic eyes within 2 years but in only 10% of nondiabetic controls (P < 0.0001). Within 6 months of extracapsular cataract surgery with implantation of an intraocular lens (IOL) in 54 eyes, no serious complication was observed. After YAG-laser capsulotomy, vitreous hemorrhage occurred within 6 months in 6 of 21 eyes. In conclusion, cataract surgery was performed in 75% of the phakic eyes within 5 years of vitrectomy for diabetic retinopathy. Posterior capsular opacification is particularly common in this subset of eyes. No serious complication was observed after extracapsular cataract surgery with IOL implantation, but YAG-laser capsulotomy was associated with an increased risk for vitreous hemorrhage.

Adult↗

PubMed1998

The role of vitrectomy for diabetic retinopathy.

BACKGROUND: Diabetic retinopathy is an important cause of severe vision loss. The risk of vision loss from diabetic retinopathy is substantially reduced by intensive control of diabetes and appropriate laser surgery for proliferative diabetic retinopathy and diabetic macular edema. METHODS: The Diabetic Retinopathy Vitrectomy Study (DRVS) helped identify the indications and most propitious time for performing diabetic vitrectomy for nonresolving vitreous hemorrhage. The DRVS also highlighted the risks and potential complications of vitrectomy surgery. RESULTS: Diabetic persons with severe vision loss from severe proliferative diabetic retinopathy are candidates for vitrectomy after vitreous hemorrhage and severe fibrous changes in the retina. CONCLUSION: In cases in which vision loss occurs, pars plana vitrectomy frequently can restore useful vision, and reduce the risk of vision loss from traction retinal detachment.

Diabetic Retinopathy↗