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At least 397 records · Page 22Linked to original sources

PubMed1988

Pars plana vitrectomy in chronic myelogenous leukemia with vitreous hemorrhage.

Pars plana vitrectomy operations were performed on two cases of vitreous hemorrhage due to chronic myelogenous leukemia. Fundus examination and fluorescein angiography revealed optic disc neovascularization in both, which is a rare fundus finding in chronic leukemias. The first case seen with vitreous hemorrhage in both eyes also had diabetes mellitus with a negative family history, and had received laser therapy on his right eye. His chronic myelogenous leukemia was diagnosed 4 months after vitrectomy was performed on this eye, when he presented with widespread subcutaneous hemorrhages. The second case showed a nonproliferative retinopathy with old laser scars in his right eye and vitreous hemorrhage in his left eye, and had no diabetes mellitus. The diagnosis of chronic myelogenous leukemia was made before the vitrectomy operation when the physical examination revealed splenomegaly. The pathogenesis of retinal and optic disc neovascularization in myeloproliferative diseases, its possible relation with chemotherapy, and the results of the vitrectomy operations were discussed with special emphasis on the importance of ruling out chronic leukemias and other blood dyscrasias in vitreal hemorrhages, retinopathies of unknown origin, and even in diabetic retinopathies with a negative family history.

Diabetic Retinopathy↗

PubMed1987

An anterior limbal approach to vitrectomy for the surgical management of infectious endophthalmitis.

We present two cases illustrating a surgical approach to the diagnosis and treatment of infectious endophthalmitis following extracapsular cataract extraction with insertion of a posterior chamber lens. In both cases, a vitrectomy was initiated through a limbal approach after clearing the anterior chamber, thus allowing improved visualization of the vitreous cavity. The vitrectomy probe was then passed through a peripheral iridotomy, the peripheral posterior capsule and/or zonules, and into the anterior vitreous. The peripheral iridotomy allowed access to the vitreous cavity for an anterior vitrectomy. The entire anterior chamber and vitreous aspirate was then analyzed for culture and sensitivity. This technique minimizes the risks of pars plana vitrectomy for endophthalmitis by improving visualization and possibly decreasing the risk of retinal detachment.

Cataract Extraction↗

PubMed1985

Electrophysiological responses after vitrectomy and intraocular tamponade.

Earlier reports of changes in the electroretinogram (ERG) following intravitreal liquid silicone in animal eyes have been conflicting. There is little information on the effects of vitrectomy and intravitreal tamponade by gas or liquid silicone on retinal function in humans. The effects on retinal function of intraocular tamponade by liquid silicone (1,000 cs) or SF6 gas (20 per cent)/mixture were studied in a series of consecutive patients undergoing vitrectomy for recent rhegmatogenous retinal detachment. Patients without retinal detachment requiring vitrectomy served as controls. Serial electroretinography was performed immediately preoperatively, postoperatively and subsequently over a period of 6 months. In the early postoperative period there was a reduction of both a- and b-waves through these recovered progressively in all the patients. The recovery of the ERG was accelerated by the absorption of the gas or by the removal of the liquid silicone. The results of our study indicate that the initial depression of the ERG is due to vitrectomy and subsequent recovery occurs even in the presence of intraocular gas or liquid silicone. It is suggested that the relative reduction of the amplitude of a- and b-waves in the study patients is due to the insulating effect of the tamponading agent and that neither intraocular gas nor liquid silicone adversely affects retinal function.

Electroretinography↗

PubMed1983

[Indications for vitrectomy in the extraction of intraocular foreign bodies].

Vitrectomy represents an important advance for the extraction of intra-ocular foreign bodies, a study of 20 cases emphasizing the advantages of the method. Pars plana vitrectomy was performed using Klöti's vitreous stripper; intra-ocular foreign bodies were extracted through the pars plana incision by a magnet or with forceps. The main indications of the technique are: posterior pole foreign bodies; old embedded metallic foreign bodies; foreign bodies with complications (traumatic cataract, vitreous hemorrhage, retinal detachment); non-magnetic oxidizable foreign bodies: these must be extracted under visual control with vitrectomy techniques, but complications and failure remain common. This technique also has its limits: extraction of non-oxidizable non-magnetic foreign bodies; foreign bodies attached to the ocular globe wall. These are preferably left in place. Vitreoretinal complications were the main reasons for failure in this study. Nevertheless, vitrectomy allows clearing of cloudy media, visualization, localization and extraction of foreign bodies under visual control through the pars plana, and reduction of complications.

Adult↗

PubMed1983

[Retinal detachment following extraction of an intraocular foreign body. Effects of vitrectomy].

Intra-ocular foreign bodies have an extremely poor prognosis, retinal detachment with vitreo-retinal retraction being the main factor of treatment failure. Vitrectomy appears to be an effective method for preventing this complication. 77 patients with intra-ocular foreign bodies were studied in two separate groups: 45 patients in group I did not have preventive vitrectomy and 23 developed retinal detachments; 32 patients in group II did have preventive vitrectomy within 3 weeks following foreign body extraction, and only 6 patients developed retinal detachment. Vitreous hemorrhage and cataract were present in all cases with retinal detachment. The retinal detachment rate was significatively different between group I and II. Early vitrectomy seems to be effective in preventing retinal detachment after an intra-ocular foreign body. However, others factors still have to be studied: cataract, hemorrhage, contusion.

Adolescent↗

PubMedDate not supplied

[The indications for vitrectomy in retinal detachment].

The modern vitreous surgery has rapidly developed during the last 2 decades, becoming an effective part of the treatment, in most retinal detachments that cannot be treated by the classical means. This study points out the main types of retinal detachment in which vitrectomy is indicated, as its place in the complex therapeutical sequence. It is based on the studies of ophthalmologists with experience in vitrectomy is indicated, as its place in the complex therapeutical sequence. It is based on the studies of ophthalmologists with experience in vitreous surgery. If there continue to be controversies on vitrectomy's indications and moment, the fact that vitrectomy has radically changed the prognosis and therapeutical attitude in severe retinal detachments, is unanimously admitted. Most retinal detachments (the rhegmatogenous, uncomplicated one) continue to be treated by the classical means: scleral buckling+Rupture's blockage.

Humans↗

PubMed1993

[Vitrectomy in oculocerebral non-Hodgkin's lymphoma].

Ocular non-Hodgkin lymphoma (NHL) is thought to be a rare intraocular tumor; the clinical diagnosis, however, is difficult, and ocular NHL might occur more frequently than we thought. Vitrectomy is essential for establishing the diagnosis. During the last 6 years, we performed vitrectomies for ocular NHL in seven eyes of four patients. We report on the visual outcome and cytological findings. In three patients, we suspected the oculocerebral form of the disease; one patient suffered from a systemic lymphoma. The mean observation time was 19 months (5-30 months). In one patient, we failed to examine the vitreous fluid; this patient has since died. The other three patients underwent radiation treatment and/or chemotherapy; they are alive, and no recurrence of the NHL has since occurred. In all five cases in which cytological examination of the vitreous fluid was performed, we were able to establish the diagnosis of NHL on the first attempt. This accuracy is due to rapid and careful processing by the cytologist. Vision improved considerably in most cases. In only one eye with heavy retinal infiltration could vision not be restored. Secondary cataract extraction was necessary in five cases; otherwise, vision remained stable. We conclude that vitrectomy has to be done early in atypical vitreous "inflammations". Immediate processing and cytological examination of the vitreous fluid establishes the diagnosis of NHL and permits accurate radiation or chemotherapy. Early vitrectomy is greatly beneficial not only for visual rehabilitation but maybe even for a longer life expectancy.

Aged↗

PubMed1993

Combined extracapsular cataract extraction, posterior chamber intraocular lens implantation, and pars plana vitrectomy.

The surgical management of coexisting cataract and vitreoretinal disease has been controversial, particularly for eyes with a history of proliferative diabetic retinopathy (PDR) or chronic uveitis. We retrospectively studied the results of combined extracapsular cataract extraction (ECCE), posterior chamber intraocular lens (PC-IOL) implantation, and pars plana vitrectomy in 20 eyes of 16 patients. The indications for combined vitrectomy included dense, nonclearing vitreous hemorrhage attributed to PDR in 10 eyes, age-related macular degeneration in 2, and trauma in 1. The remaining 7 eyes had pars plana vitrectomy to remove inflammatory vitreous cell and debris associated with chronic uveitis. Follow up ranged from 4 to 32 months (average, 17.4 months). Visual acuity improved in 19 eyes (95%)--to 20/100 or better in 12 (60%). The improvement ranged from 1 to 13 Snellen lines (average, 4.9 lines). Postoperative visual acuity improvement averaged 7.5 Snellen lines for eyes with chronic uveitis, 7.0 lines for those with age-related macular degeneration, and 3.3 lines for those with a history of PDR. Postoperative visual acuity was less than 20/100 in 8 eyes (40%). In most cases, these latter results were attributed to macular changes associated with the underlying ocular disease. Our results confirm previous studies that have shown that combined ECCE/PC-IOL implantation and pars plana vitrectomy is a well-tolerated surgical procedure for diabetics, which can provide clear anterior and posterior segment media. In addition, our results suggest that this combined procedure can be useful in restoring vision in certain eyes with uveitis in the short-term postoperative period.

Adult↗

PubMed1995

[A comparison between scleral buckling procedure and vitrectomy for the management of uncomplicated retinal detachment caused by posterior retinal break].

We reviewed conventional scleral buckling and vitrectomy for uncomplicated rhegmatogenous retinal detachment due to posterior retina break. A comparison was made for a consecutive series of 21 cases undergoing scleral buckling procedure and 15 cases receiving vitrectomy as the initial surgery. As regards surgical complications, in the scleral buckling procedure there was inadvertent severance or compression of the vortex veins in 16 (77%) of the 21 cases and postoperative choroidal detachment in 9 (43%). In vitrectomy, there were no remarkable intraoperative complications, but it led to progressive nuclear cataract in 10 (67%) of the 15 cases during the postoperative period. Both procedures produced successful retinal attachment with comparable visual recovery. The results indicate that vitrectomy is a useful procedure for cases of uncomplicated retinal detachment caused by deeply located retinal break.

Adult↗

PubMed1996

[Anterior fibrovascular proliferation. A rare complication of vitrectomy for proliferative diabetic retinopathy].

PURPOSE: To present clinical and therapeutic features of anterior fibrovascular proliferation, a severe complication of vitrectomy for diabetic retinopathy. METHODS: Among 153 vitrectomies for complication of diabetic proliferative vitreo-retinopathy, six cases of anterior fibro-vascular proliferation were found. All presented initially with a tractional retinal detachment associated in some cases with a vitreous hemorrhage. The complication occurred after a mean follow-up of three months after initial vitrectomy, marked by intravitreal bleeding, rubeosis iridis and hypotony. A reoperation with peeling of proliferation, lensectomy, extensive panretinal photocoagulation, encircling band and silicone oil injection allowed reattachment of the anterior retina in all the six cases. RESULTS: A reproliferation occurred in five cases, requiring revision of dissection. Finally, silicone oil was removed in three cases, was definitively left in one eye and was not removed in two eyes. Final visual acuities range from 1/50 to 2/10. CONCLUSION: Anterior fibrovascular proliferation is an unfrequent complication after vitrectomy for diabetic retinopathy. The prognosis is poor, in spite of aggressive vitreoretinal surgery including repeated dissection and extensive photocoagulation.

Adult↗

PubMed1997

[Results of vitrectomy for macular packer after reattachment surgery for rhegmatogenous retinal detachment].

I analyzed the visual results in 184 eyes which had undergone vitrectomy and membrane peeling for macular pucker following treatment for rhegmatogenous retinal detachment. Patient age ranged from 9 to 83 (mean : 55) years, time between reattachment surgery and vitrectomy from 3 to 63 (mean : 15) months, and follow-up from 12 to 96 (mean : 39) months. For the analysis, visual acuity was examined 12 months after the last surgery in 93 pseudophakic eyes and 38 phakic eyes (patients age < 45) and 6 months in 53 phakic eyes (patient age > or = 45). When Y = log 1.5-log (postoperative acuity) and X = log 1.5-log (preoperative acuity), the regression line Y = 0.421 X (R2 = 0.765, p < 0.0001) was obtained. The regression line was Y = 0.395 X (R2 = 0.759, p < 0.0001) for pseudophakic eyes, and Y = 0.488 X (R2 = 0.777, p < 0.0001) for phakic eyes. Thus postoperative visual acuity was higher in pseudophakic eyes than in phakic eyes. When calculated from the pseudophakic line, mean postoperative acuity was 0.2 for preoperative acuity of 0.01, 0.5 for 0.1, and > 1.0 for > 0.5. Postoperative acuity was inversely correlated with the duration between reattachment surgery and vitrectomy (R2 = 0.544, p < 0.0001), and with the patient age (R2 = 0.0046, p = 0.0033). Better postoperative acuity, therefore, was associated with earlier vitrectomy.

Adolescent↗

PubMed1996

[Endolaser photocoagulation in vitrectomy surgery].

OBJECTIVE: To verify the usefulness and effectiveness of endolaser photocoagulation in vitrectomy. METHODS: Endolaser photocoagulation was applied in 40 cases (45 eyes) of vitrectomy surgery. Indications for vitrectomy included vitreous hemorrhage 31 eyes (proliferative diabetic retinopathy 13, Eales's disease 13, retinal vein occlusion 4, and scleral penetrating injury with intraocular foreign body removal 1), complex retinal detachment 12 eyes, intraocular nonmagnetic foreign body removal and postoperative silicone oil tamponade 1 eye respectively. Treatment involved pan-retinal scatter therapy in 7 eyes, focal therapy in 22 eyes, sealing primary or iatrogenic retinal breaks in 14 eyes, draining retinotomy in 2 eyes, and encircling scleral buckle photocoagulation in 3 eyes. The follow-up times ranged from 2 to 18 months (average 9 months). RESULTS: Whitening of laser spots was not apparent in 6 eyes with retinal breaks following incomplete gas-fluid exchange. Recurrent retinal detachments occurred in 5 eyes postoperatively. CONCLUSION: Endolaser photocoagulation facilitates the performance and reduces the complications of vitrectomy surgery.

Adolescent↗

PubMed1997

Phacoemulsification for cataract following pars plana vitrectomy.

BACKGROUND AND OBJECTIVE: To determine if the technical aspects of phacoemulsification for removal of cataract following pars plana vitrectomy differ from those of phacoemulsification for removal of cataract in nonvitrectomized eyes. PATIENTS AND METHODS: Twenty-two eyes that had undergone prior vitrectomy were identified through a retrospective review of chart notes and operative records of 1039 consecutive cataract extractions performed by one surgeon. RESULTS: Complications of proliferative diabetic retinopathy was the most common indication for prior vitrectomy. The predominant lens change was nuclear sclerosis. Deep anterior chambers with large anterior to posterior excursions of the iris lens diaphragm with simultaneous fluctuation in pupil size occurred during phacoemulsification. The posterior capsule was flaccid and mobile during lens cortex removal. No posterior capsules ruptured. Postoperative visual acuity improved in 91% of the patients. CONCLUSIONS: Prior vitrectomy was associated with diabetes and nuclear sclerotic cataract. Phacoemulsification in this patient population was associated with inadequate pupillary mydriasis, superior conjunctival scarring, intraoperative anterior chamber depth, pupil size, and iris lens excursions that hindered phacoemulsification tip placement. Posterior capsules were excessively flaccid, prone to rapid anterior and posterior excursions, and may have plaques that are resistant to intraoperative removal.

Anterior Chamber↗

PubMed1998

[Long-term visual prognosis after successful vitrectomy for proliferative diabetic retinopathy].

We evaluated visual prognosis in 50 eyes of 47 patients which underwent successful vitrectomy for proliferative diabetic retinopathy and were followed for more than five years. It was found that the latest visual acuity was worse than the best visual acuity by more than three lines after vitrectomy in 14 eyes (28%) except for the eyes with decreased vision due to cataract. The causes of decrease in visual acuity were optic atrophy in seven eyes, macular degeneration in five eyes, branch retinal vein occlusion in one eye, and submacular hemorrhage in one eye. Risk factors for postoperative decrease in visual acuity were thought to be preoperative macular detachment, subretinal proliferation, and postoperative high intraocular pressure. Therefore, even after successful vitrectomy, there is some risk that the best postoperative visual acuity may deteriorate in cases with severe preoperative retinopathy with these risk factors. This finding suggests that the vitrectomy should be performed before the development of these risk factors for the maintenance of good postoperative visual acuity.

Adult↗

PubMed1998

[Surgical indications and results of primary pars plana vitrectomy for rhegmatogenous retinal detachments].

To evaluate the efficasy of primary vitrectomy for uncomplicated rhegmatogenous retinal detachment associated with posterior hyaloid separation, a series of 63 eyes were reviewed retrospectively. The criteria for vitrectomy included not only eyes with posterior retinal breaks but also those with multiple peripheral retinal breaks. The reattachment rate was 92.1% (58 eyes) after the initial surgery, and finally this increased to 100%. Of the 46 eyes with macular detachment, good visual rehabilitation, i.e., visual acuity improved by 5 or more lines, was obtained in 71.8% (33 eyes) one month postoperatively. There was no statistically significant difference in the reattachment rate whether an encircling procedure was also done or not. In eyes with lens opacity, cataract surgery was also done and intraocular lenses were implanted uneventfully in all but one myopic case. No serious complications such as proliferative vitreoretinopathy were found throughout the follow-up period except for the high incidence (53.8%) of cataractous progression. The results indicate that vitrectomy, removing the peripheral vitreo-retinal traction directly, is an effective procedure for primary rhegmatogenous retinal detachment. Vitrectomy combined with cataract surgery is also proposed as a valuable strategy in selected cases to maintain visual rehabilitation.

Cataract Extraction↗

PubMed1998

[Long-term results after simple vitrectomy for age-related macular degeneration with vitreous hemorrhage].

We reviewed the cases of 10 eyes with vitreous hemorrhage secondary to submacular hemorrhage associated with age-related macular degeneration, in which vitrectomy was performed without subretinal management. Vitreous hemorrhage occurred within 3 weeks of submacular hemorrhage. After vitrectomy, residual subretinal hemorrhage was rapidly absorbed and choroidal neovascularization was undetectable. After the surgery visual acuity improved over that of submacular hemorrhage in 5 eyes. Mean follow-up was 25 months and final visual acuity was 0.2 or better in 6 eyes (60%). Final visual outcome was highly corelated with the period from subretinal hemorrhage to vitrectomy, the thickness of subfoveal hemorrhage at vitrectomy, position of choroidal neovascularization, and duration of subretinal hemorrhage. Simple virectomy might be effective to stabilize submacular changes and improve visual acuity.

Age Factors↗

PubMed1979

Vitrectomy for injury: the effect on intraocular proliferation following perforation of the posterior segment of the rabbit eye.

Perforating injuries were produced in the posterior segments of rabbit eyes. A control group had no surgery; a second group underwent closed vitrectomy immediately after injury; and a third group had closed vitrectomy delayed two weeks following injury. The eyes were then observed for four weeks. Transvitreal proliferation, which was found in each of the control eyes, was effectively prevented in the eyes that underwent immediate vitrectomy. Established transvitreal proliferation was removed and its recurrence prevented by delayed vitrectomy. These results establish the principle that vitreous acts as a scaffold for proliferation. Removal of the vitreous eliminates the structures along which proliferation can occur and thus effectively prevents transvitreal proliferation. Early removal of vitreous in severely injured eyes with vitreous damage is recommended.

Animals↗

PubMed1982

Vitrectomy in ocular toxocariasis.

Subtotal pars plana vitrectomy was performed in four patients with chronic toxocaral endophthalmitis. In two instances, chronic intraocular inflammation proved unresponsive to intensive corticosteroid therapy, but improved dramatically following vitrectomy. In one patient, a dense retrolenticular membrane was removed, and intractable amblyopia was prevented. Vitrectomy relieved vitreoretinal traction involving the macula in two instances and cured a peripheral traction retinal detachment in a third. Information gleaned from these cases suggests new guidelines for the laboratory confirmation of ocular toxocariasis. Patients with toxocaral endophthalmitis may benefit from pars plana vitrectomy when chronic inflammation does not respond to medical measures or when such inflammation causes permanent structural changes that threaten or interfere with central vision.

Adolescent↗