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At least 253 records · Page 14Linked to original sources

PubMed1980

Vitreous loss managed by anterior vitrectomy. Long-term follow-up of 59 cases.

Fifty-nine cases of vitreous loss managed by anterior vitrectomy were followed up for an average of 26 months. Thirty-seven cases were managed by automated anterior vitrectomy and 22 by cellulose sponge anterior vitrectomy. Both techniques, when performed by resident ophthalmologists, give equivalent results. Anterior vitrectomy for vitreous loss gives significantly better results than nontreatment of vitreous loss but significantly poorer results than uncomplicated intracapsular cataract extraction. This is largely caused by the increased incidence of chronic cystoid macular edema after vitreous loss. Vitreous loss treated by anterior vitrectomy is associated with 10% to 15% greater endothelial cell loss than uncomplicated intracapsular cataract extraction.

Cataract Extraction↗

PubMed1983

Specular microscopy in pars plana vitrectomy.

A prospective study of endothelial cell loss following pars plana vitrectomy and pars plana vitrectomy with lensectomy was performed in 21 eyes. Fifteen diabetic patients had either vitrectomy alone or vitrectomy with lensectomy. Six nondiabetic eyes were also included in this study. The average cell loss was between 2.3% and 3.9% in all cases. This difference was not statistically significant from the preoperative measurements of endothelial cell counts. These data suggest that pars plana vitrectomy does not result in significant endothelial cell loss, especially when eyes remain phakic or when the anterior capsule is maintained until the end of the case.

Diabetic Retinopathy↗

PubMed1982

Sympathetic ophthalmia following vitrectomy.

A survey of 26 eye pathology laboratories for a five-year period ending in 1980 disclosed that sympathetic ophthalmia occurred in two of every 1,000 eyes examined. Of the 53 eyes with sympathetic ophthalmia, 29 (55%) had posttraumatic and 24 (45%) had postsurgical sympathetic ophthalmia. Ten of the 53 eyes (19%) had undergone one or more operations that included vitrectomy. Sympathetic ophthalmia developed after surgery in eight of the ten eyes and after accidental trauma in the other two. A survey of 34 retinal surgeons who had done 14,915 vitrectomies (10,000 of which were estimated to have been done in eyes with no other penetrating wound) disclosed that sympathetic ophthalmia occurred in nine patients (an incidence of 0.06%). In one of these, the only operative procedure and penetrating wound was a vitrectomy (an incidence of 0.01%). The risk of sympathetic ophthalmia after a vitrectomy alone in an eye without a previous penetrating wound is approximately the same as that for other surgical procedures involving penetration of the uveal tract. The risk increases if vitrectomy is accompanied by accidental penetrating wounds or other surgical procedures.

Adult↗

PubMed1981

The place for vitrectomy in posterior segment infection.

The paper reviews experience with vitrectomy in five cases of endophthalmitis in which vision was severely reduced because of vitreous opacification. In two of the cases vitrectomy was performed after the infection had been aborted, and in three of the cases vitrectomy was performed during the stage of acute endophthalmitis when there was evidence that the condition was not responding to conservative medical treatment. In all cases, vitrectomy resulted in a dramatic improvement in vision. It is suggested that vitrectomy represents a major advance in the management of bacterial and fungal endophthalmitis.

Aged↗

PubMed1980

Vitrectomy in the management of intraocular foreign bodies and their complications.

Twenty-six eyes with intraocular foreign bodies (IOFB) and/or their sequelae were treated by pars plana vitrectomy and associated surgery. One-step removal of the IOFB in combination with pars plana vitrectomy resulted in early visual rehabilitation and minimal complications. Of 11 eyes with IOFB treated by primary vitrectomy at the time of IOFB removal 20/50 or better visual acuity was obtained in 10 (91%). Four of these eyes had retinal injury, 3 of which were successfully repaired without subsequent complication and with retention of good visual function. In 3 eyes IOFBs were not removed owing to chronic retinal encapsulation. These eyes continue to retain good visual acuity, and ERG studies show no evidence of retinal toxicity. Of 12 eyes in which vitrectomy was performed for sequelae of IOFB only 5 (41%) showed visual improvement better than 20/50. Only in 2 of 7 eyes with tractional retinal detachment could the retina be reattached. In cases of retinal injury primary vitrectomy, cryocoagulation, and scleral buckling are suggested for prevention of late traction retinal detachment.

Adolescent↗

PubMed1975

Present surgical approaches to vitrectomy.

The present techniques of vitrectomy employ the open sky method (anterior approach) which is usually performed using cellulose sponges and blunt scissors, or the pars plana approach (transcleral approach) which uses a vitreous nibbler. The indications for each technique and the techniques themselves are briefly discussed. In addition, mechanical vitreous nibblers used for the open sky approach are reviewed. The results of present techniques of anterior vitrectomy are better than the results obtained when no vitrectomy was performed for vitreous loss. The results of pars plana vitrectomy for certain pathologic entities compare favorably to results obtained in vitrectomies performed during keratoplasties. Newer surgical approaches to the vitreous and other technical advances promise to greatly improve the results of vitreous surgery.

Ciliary Body↗

PubMed1984

Sympathetic ophthalmia: induced by vitrectomy not by trauma.

A case of sympathetic ophthalmia that occurred after corneoscleral laceration due to blunt trauma and after vitrectomy was encountered, and the patient was treated without enucleation of the exciting eye; this is the sixteenth case of sympathetic ophthalmia reported to occur after vitrectomy. In the reported cases including the present one, the intervals between the primary trauma or primary intraocular surgery and secondary vitrectomy and the onset of sympathetic ophthalmia were compared with those in patients who suffered from this disease without vitrectomy. The statistical analysis by the probit method revealed that the onset of sympathetic ophthalmia was critically influenced by the secondarily delivered operation, ie, vitrectomy (P less than 0.05).

Aged↗

PubMed2004

Late retinal detachment in patients born prematurely: outcome of primary pars plana vitrectomy.

OBJECTIVE: To describe the indications and results of pars plana vitrectomy for rhegmatogenous retinal detachment in patients born prematurely. PATIENTS AND METHODS: Between 1995 and 2001, primary vitrectomy for retinal detachment was performed in a consecutive series of 11 eyes of 10 patients. Gestational age ranged from 26 to 30 weeks, and birth weight ranged from 810 g to 1475 g. RESULTS: Myopia was found in 9 of 11 eyes. Two patients initially had a vitreous hemorrhage. One of these children was previously treated with cryotherapy during the acute phase of stage 3+ retinopathy of prematurity. Three eyes had a normal posterior pole and only mild peripheral retinal changes. Primary vitrectomy was performed in all 11 eyes. Patients received follow-up for 7.2 months to 6.6 years (mean, 2.7 years). Three eyes with severe cicatricial changes due to retinopathy of prematurity needed multiple procedures with silicone oil tamponade for reattachment. In 10 (90%) of 11 eyes, the retina was completely attached at the last follow-up visit. Visual acuity ranged from light perception to 20/25 in the affected eye. CONCLUSIONS: Patients born prematurely may develop late-onset retinal detachment due to vitreoretinal changes caused by retinopathy of prematurity. Primary vitrectomy is an effective treatment technique for retinal detachment in patients born prematurely.

Adolescent↗

PubMedDate not supplied

Vitrectomy for macular detachment associated with optic nerve pits.

OBJECTIVE: To describe the pathogenic mechanism for a central retinal detachment in eyes with a pit of the optic disc. DESIGN: Three patients with macular detachment associated with optic nerve head pits were prospectively controlled following pars plana vitrectomy. METHODS: Three cases of macular detachment associated with congenital optic nerve pit were treated with pars plana vitrectomy and air-fluid exchange and sulphur hexafloride (SF6) gas injection. During vitrectomy posterior hyaloid removal caused visible traction on the elevated retina, when the hyaloid detached. Removing the posterior hyaloid resulted in reattachment of the macular and an increase in the visual acuity without laser treatment. CONCLUSION: We recommend the removal of the posterior hyaloid face during pars plana vitrectomy in patients with central macular detachment associated with a pit of the optic disc.

Adolescent↗

PubMed1994

Encircling panretinal laser photocoagulation may prevent macular detachment after vitrectomy for proliferative diabetic retinopathy.

Macular detachment due to peripheral retinal tears that occur after pars plana vitrectomy for proliferative diabetic retinopathy can result in severe visual loss despite successful retinal reattachment. The authors reviewed the records of three patients who developed peripheral sclerotomy-related rhegmatogenous retinal detachments one to six months after vitrectomy for proliferative diabetic retinopathy, despite the absence of detectable sclerotomy-related retinal tears by indirect ophthalmoscopy and scleral depression at the conclusion of surgery. All three patients had received standard panretinal laser photocoagulation in a complete encircling pattern either prior to or during the initial vitrectomy. Clinically or echographically, each patient was seen to have a partial or complete annual peripheral sclerotomy-related rhegmatogenous retinal detachment delimited to the equator. In each of these three cases, posterior extension of the peripheral retinal detachment into the macular area was prevented by the most anterior row of the photocoagulation scars. Standard panretinal laser photocoagulation applied in a complete encircling pattern may be useful in the prophylaxis of macular detachment from sclerotomy-related retinal tears that occur after vitrectomy for proliferative diabetic retinopathy.

Aged↗

PubMed1997

Vitrectomy for traction macular detachment in diabetic retinopathy.

BACKGROUND: A small number of eyes with proliferative diabetic retinopathy develop massive central fibrovascular membranes characterized by vitreoretinal tractions along the arcades and optic disk and retinal traction lines extending through the macula. The aim of our study was first to present the results of vitrectomy for removal of these central membranes and second to determine the correlation between preoperative parameters and postoperative visual outcome. SUBJECTS AND METHODS: We treated 28 eyes with severe central fibrovascular diabetic membranes by a modified bi-manual en bloc excision technique during vitrectomy. Preoperative examination included general status, visual acuity, slit-lamp investigation, binocular funduscopy, ultrasound investigation and visual evoked potentials (VEP). Further, we analyzed intraoperative complications and postoperative anatomic and functional outcomes. RESULTS: The retinas of 27 eyes with central traction retinal detachments were reattached by surgery. With a minimum of 6 months' follow-up, the macula remained attached in 24 eyes, while the retinas were completely attached in 22 eyes. Preoperative visual acuity was defective light perception to 0.1; an increase in visual acuity to maximal 0.1 was seen in 50% of the patients postoperatively. Preoperative visual acuity of light perception was associated with no functional improvement. Preoperative ultrasound investigation gave information about the real anatomic situation of the retina, especially if funduscopy was not possible. The other preoperative parameters could not predict correctly the functional outcome of vitrectomy in diabetics with severe central fibrovascular membranes because of the damage of the optic nerve and the retina. CONCLUSIONS: The high rate of anatomical reattachment after vitrectomy in diabetic eyes with severe central fibrovascular membranes is associated with a slight improvement of function; only preoperative visual acuity of hand motions or better was associated with an improvement of function.

Adult↗

PubMed2003

[Vitreous body floaters and vitrectomy with full visual acuity].

PURPOSE: To evaluate the role of vitrectomy in patients with visually disturbing vitreous body floaters and full visual acuity (VA). METHODS: A total of 9 eyes from 8 patients (2 female, 7 male, median age 57 years) with a preoperative VA of 1.0 were analysed retrospectively. The median duration of symptoms was 12 months. In all eyes a pars plana vitrectomy was performed. The median follow-up period was 13 months. RESULTS: No intraoperative or postoperative complications were observed. In all patients vision improved subjectively and objective VA remained unchanged. In 2 out of 5 phacic patients a cataract extraction was performed during the follow-up period. CONCLUSIONS: In a selected group of patients vitrectomy can improve subjective vision even in eyes with full objective VA. A critical patient selection with respect to psychological criteria and the individual risk of vitrectomy is extremely important.

Adult↗

PubMed1996

[Temporary keratoprosthesis, vitrectomy and autokeratoplasty in endophthalmitis treatment].

Postsurgical endophthalmitis frequently requires emergency vitrectomy. Loss of corneal transparency can preclude vitreoretinal surgery. Due to the narrow time frame in which surgical treatment needs to be performed, donor corneas are often not available for grafting. In addition, the risk of primary graft failure is higher in eyes with acute endophthalmitis. Later regrafting after primary graft failure carries a higher risk of graft rejection. By a clinical case of endophthalmitis after cataract surgery, we demonstrate the surgical technique of combined pars plana vitrectomy, keratoprosthesis, and autokeratoplasty. Loss of corneal transparency precluded standard pars plana vitrectomy with fundus contact lenses. The cornea was trephined and replaced by a keratoprosthesis. The trephined cornea was stored in tissue culture medium and pars plana vitrectomy was performed. At the end of the procedure, the keratoprosthesis was removed and the patient's own cornea was re-implanted. The transparency of the cornea improved during the postoperative course, permitting slit-lamp biomicroscopy of the anterior segment.

Aged↗

PubMed2000

[Motion artifacts in the vitreous body during vitrectomy].

BACKGROUND: Movements and vibrations of intraocular structures can be observed during vitrectomy with mechanical cutting systems. We experimentally compared these intraocular motion artifacts between mechanical and erbium:YAG laser vitrectomy. MATERIAL AND METHODS: The intraocular structures were reliably simulated by a 0.9-mm-wide foil (thickness 10 microns) in a water-filled cuvette. The movements caused by commercial mechanical cutter systems were compared with vibration induced by means of laser surgery probes (laser pulse energy 20 mJ). Laser triangulation was used to measure the movement amplitudes at various cutting rates of 2, 5, and 10 Hz and a constant suction force of 50 mmHg. RESULTS: At all cutting rates the amplitude with the laser was less than that with the mechanical system. The ratio of the maximal amplitude between laser surgery probes (AL) and mechanical cutter system (AM) was AL/AM = 0.29 at 10 Hz, AL/AM = 0.33 at 5 Hz, and AL/AM = 0.45 at 2 Hz. CONCLUSION: The reduced intraocular movements with erbium:YAG laser vitrectomy constitutes a potential advantage for the nonpulsatile vitrectomy.

Erbium↗

PubMed2001

[Phacoemulsification and vitrectomy with the erbium:YAG laser and phacoemulsification with the neodymium:YAG laser].

There are an increasing number of possible applications for the use of Erbium:YAG and Neodymium:YAG lasers in ophthalmology. Laser-phacoemulsification as well as Erbium-laser vitrectomy is of major interest. We report on the underlying technology and more than 1-year-experience using the PHACOLASE (Asclepion-Meditec, Jena, Germany, 10-100 Hz frequency, 5-50 mJ single pulse energy) for phacoemulsification and pars plana vitrectomy and the Lyla-Dodick laser photolysis (A.R.C. Laser, Eckental-Forth, Germany, 1-20 Hz, up to 8 mJ single pulse energy). The Erbium:YAG-laser as well as the Neodymium:YAG-laser enabled us to extract lenses with up to medium hard nuclei. Moreover, the Erbium laser enabled fast vitrectomy with little mechanical traction. In many of our initial surgical operations we had to change to mechanical vitrectomy due to initial technical problems. No new complications occurred intra- or postoperatively. The handpiece worked well in removing vitreous bodies, but was not feasible for cutting membranes. Modified handpieces for this purpose are under development.

Equipment Design↗

PubMed2001

[Erbium:YAG laser vitrectomy. Initial clinical results].

BACKGROUND: Much interest has been expressed in recent years in the use of erbium:YAG lasers in ophthalmology, particularly for vitrectomy and phacoemulsification. PATIENTS AND METHODS: We performed 54 operations (49 primary, 5 secondary) for pars plana vitrectomy on 53 eyes of 53 patients using the Phacolase erbium:YAG laser at a frequency of 10-100 Hz single-pulse energy of 5-50 mJ. RESULTS: The operation was successful in 51 cases,while in three we had to resort to mechanical vitrectomy due to initial technical problems. CONCLUSION: Erbium:YAG laser vitrectomy was generally fast and caused little mechanical stress to the retina. Complications were only those known from mechanical vitrectomy.The handpiece showed good properties for removing vitreous but not for cutting membranes, although new handpieces specifically for the cutting of membranes are under development.

Adult↗

PubMed2003

Evaluation of vitrectomy specimens and chorioretinal biopsies in the diagnosis of primary intraocular lymphoma in patients with Masquerade syndrome.

PURPOSE: To correlate the histopathological diagnoses established by diagnostic vitrectomy and chorioretinal biopsy in patients with clinically suspected primary intraocular lymphoma (PIOL) or chronic idiopathic uveitis, and the clinical follow-up data. METHODS: Eighty-four consecutive pars plana vitrectomy (PPV) specimens, three chorioretinal biopsies and two enucleated eyes taken from 80 patients were evaluated. All PPV specimens were unfixed; these were centrifuged, the "cytospins" being stained conventionally (May-Grünwald-Giemsa) and using immunocytology (CD79a, CD3, CD68, immunoglobulin (Ig) light chains). An extended immunohistochemical panel, as well as polymerase chain reaction (PCR) for rearrangements of the Ig heavy chain gene (IgH-PCR), were used to investigate the chorioretinal biopsies and the enucleated eyes. Diagnoses, made on the basis of morphology and immunophenotype, included "reactive cellular infiltrate", "malignant lymphoma", "suspicious of neoplastic disease", and "insufficient for diagnosis". The corresponding clinical data were collected and compared with the diagnosis. RESULTS: The 80 patients consisted of 46 women and 34 men. The patients' age range varied from 21 to 100 years (mean age 62 years). Sixty-two (74%) of the 84 vitrectomy specimens were diagnosed as "reactive cellular infiltrate", 12 (14%) as definite "malignant lymphoma", 5 (6%) as "suspicious of neoplastic disease" and 5 (6%) specimens were considered "insufficient for diagnosis". An additional chorioretinal biopsy enabled an unequivocal diagnosis of PIOL to be reached in 3 patients. All PIOL were diffuse large cell B-cell lymphoma (DLBCL), with the immunophenotype CD79+, CD20+, BCL-2+, BCL-6+, MUM1+ and monotypical expression for IgM+. A monoclonal IgH-PCR amplification product was obtained in four vitrectomy specimens, two chorioretinal biopsies and one of the enucleated eyes. Comparison of the diagnoses with long-term follow-up clinical data resulted in concordance in 77 (96%) cases and discrepancies ("false-negative" diagnoses) in 3 patients (4%). The patients diagnosed with lymphoma were treated with either radiotherapy, chemotherapy or both. At final follow-up (mean 35 months), 5 patients (6%) had developed cerebral lymphomatous manifestation, and 7 (9%) had succumbed to their disease. CONCLUSION: The diagnosis of PIOL is often extremely difficult, requiring sufficient rapidly transported good-quality material, and experienced interpretation. Although cytological examination of vitreal aspirates remains the gold standard in diagnosis, examination of chorioretinal biopsies increase the reliability of diagnosing or excluding a PIOL that involves the retina or choroid. Most PIOL are DLBCL with an immunophenotype suggesting a cellular origin from germinal centre cells.

Adult↗

PubMed2004

Morphological changes in the optic disc after vitrectomy and fluid-air exchange.

BACKGROUND: Although many investigators have previously reported various ocular complications induced by vitrectomy, little is known about post-operative morphological changes in the optic disc. The purpose of this study is to evaluate the effect of vitrectomy and fluid-air (F-A) exchange on the post-operative morphology of the optic disc. METHODS: We examined 31 eyes that had undergone vitrectomy for macular holes (22 eyes) or epiretinal membranes (9 eyes). Only the patients with macular holes were treated by fluid-air exchange. Morphological changes in the optic disc were evaluated using the Heidelberg Retina Tomograph. RESULTS: C/D area ratios significantly decreased for 6 months post-operatively. The rim volumes significantly increased for 1 month following surgery. Cup volumes significantly decreased at 3 months after surgery. No significant change of mean cup depth was observed post-operatively. The eyes that had not been subjected to F-A exchange showed no significant morphological change following surgery. In contrast, the eyes that had undergone F-A exchange showed significant decrease in C/D area ratio and cup volume and an increase in rim volume and mean cup depth for considerable periods following surgery. Any of the patients showed no post-operative visual field loss. CONCLUSION: Whereas no visual field loss is observed, vitrectomy with F-A exchange induces morphological changes in the optic disc for significant periods following surgery.

Adult↗