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At least 487 records · Page 27Linked to original sources

PubMed2006

Vitrectomy for macular holes associated with myopic foveoschisis.

PURPOSE: We reviewed the surgical results of vitrectomy for macular holes (MHs) associated with myopic foveoschisis (MF). DESIGN: Noncomparative, interventional case series. METHODS: setting: Institutional. participants: Eight eyes of eight patients with MHs associated with MF. intervention procedure: All patients underwent vitrectomy, internal limiting membrane peeling, and gas tamponade. main outcome measures: Slit-lamp-based biomicroscopy, optical coherence tomography examinations, and best-corrected visual acuity (BCVA) measurement. RESULTS: The MHs closed in two eyes (25%), and the BCVA improved more than 2 lines in three (37.5%) eyes, remained unchanged in three (37.5%), and worsened in two (25%). The MH size increased significantly in a case with an unresolved MH (P < .05). The postoperative BCVA was significantly correlated with the preoperative BCVA (P < .05). CONCLUSIONS: Although significant visual improvement occurs in less than 50% of cases, vitrectomy can be beneficial for some cases.

Aged↗

PubMed2006

Systemic absorption of 5-fluorouracil during vitrectomy.

PURPOSE: The aim of this study is to determine if systemic absorption is present after 5-fluorouracil (5FU) is used in the vitrectomy infusion. DESIGN: A two-case clinical study. METHODS: A catabolite of 5FU, alpha-fluoro-beta-alanine (FBAL), was measured in urine samples of two patients who underwent vitrectomy using 5FU in the infusion fluid. RESULTS: In both patients, FBAL was found in the urine samples collected up to 48 hours after the surgery, although in significantly different concentrations. CONCLUSIONS: The use of 5FU in the vitrectomy infusion fluid to prevent the formation of proliferative vitreoretinopathy may lead to significant general absorption and may be avoided in children and young adults.

Absorption↗

PubMed2004

Anti-inflammatory effects of topical ocular MAXIDEX administration to rabbits following vitrectomy or lensectomy.

We conducted a series of surgical studies (n=155) to find out the possible utility of the Dutch Belted rabbits as an ocular test model. Following either vitrectomy (n=59) or lensectomy (n=96) studies using either BSS or BSS Plus, we characterized the corresponding magnitude and duration of inflammatory response of selected endpoints over a one-week period. Preoperative Dutch Belted rabbits served as controls for baseline determination (n=27). Inflammatory endpoints included clinical inflammation, blood aqueous barrier (BAB) changes measured by particle-scatter and fluorophotometry, corneal edema, and prostaglandin-E2 (PGE2). Topical ocular 0.1% dexamethasone (MAXIDEX) served as a positive treatment group. We compared the inflammatory features (treated and untreated) to determine significance. Using either irrigating solution, the endpoints (n=101) were shown increased in both models. While the clinical scores were similar following both types of surgery (ns; p=0.51), the lensectomy study caused a more marked effect on corneal edema (p=0.0004) and PGE2 production (p=0.002) compared with the vitrectomy study. After the lensectomy procedure, BSS Plus (n=52) compared with BSS (n=24) showed a significant improvement (p=0.004) of clinical score during the recovery phase. Further improvement was gained over BSS Plus (n=52) using MAXIDEX treatment. Topical MAXIDEX (lensectomy, n=20/group; vitrectomy, n=12/group) reduced clinical score (p<0.001), decreased BAB breakdown to fluorescein (p<0.01), lessened particle flare (p<0.05), inhibited aqueous PGE2 levels (p<0.001), and reduced corneal edema (p=0.01) in the lensectomy group. The use of the rabbit model offers a convenient test to identify therapeutic agents that could lessen ocular complications after these common ocular surgeries.

Acetates↗

PubMed2004

Foveal reattachment after macula-off retinal detachment occurs faster after vitrectomy than after buckle surgery.

PURPOSE: To investigate the time course of foveal reattachment after successful surgery for macula-off retinal detachments. DESIGN: Prospective comparative nonrandomized interventional trial. PARTICIPANTS: Thirty-three patients (16 female and 17 male, 65+/-3 years old) with a spontaneous rhegmatogenous retinal detachment with peripheral breaks and a shallow elevation of the fovea. INTERVENTION: Nine patients were treated with episcleral buckle, cryotherapy, and, in selected cases, external drainage of subretinal fluid. Twenty-four patients were treated with vitrectomy, cryotherapy, and either complete (n = 8), or partial (n = 16) fluid-gas exchange. Patients with complete fluid-gas exchange were kept first in a prone position for 6 hours to help evacuation of subretinal fluid and, afterwards, on their side. Patients with partial fluid-gas exchange were kept in a supine position with the head elevated for 12 hours, allowing spontaneous absorption of submacular fluid. Patients were examined at 1, 6, and 10 to 12 months after surgery with a complete ophthalmic examination as well as optical coherence tomography (OCT). Mean follow-up was 10.0+/-0.5 months. MAIN OUTCOME MEASURE: Foveal attachment was determined clinically and by OCT. RESULTS: Postoperative OCT examination 1 month after buckle surgery (n = 9) showed a small subclinical area of subfoveal fluid in 67% of patients (n = 6). Fluid was still present in 45% of cases (n = 4) at 6 months and in 11% of cases (n = 1) even at 12 months. Optical coherence tomography examination 1 month after vitrectomy showed a completely attached fovea with no subfoveal fluid in all cases (n = 24). CONCLUSIONS: Complete foveal reattachment after macula-off retinal detachment occurs without delay after vitrectomy, whereas subfoveal fluid may persist subclinically for several months in patients operated with a buckle.

Adult↗

PubMed2004

Lens-sparing vitrectomy for stage 4 retinopathy of prematurity.

PURPOSE: To investigate the anatomic results of lens-sparing vitrectomy for tractional stage 4 retinopathy of prematurity (ROP). DESIGN: Retrospective, noncomparative consecutive case series. PARTICIPANTS: Thirty-seven eyes (24 patients) with tractional stage 4 ROP. INTERVENTION: Lens-sparing vitrectomy. MAIN OUTCOME MEASURE: Anatomic status of the retina. RESULTS: Twenty-five eyes had stage 4A ROP, and 12 eyes had stage 4B ROP. With a median follow-up of 13 months (range, 6-27), 32 of 37 eyes (86%) had complete reattachment of the retina. Among eyes with 4A ROP, 21 of 25 eyes (84%) had complete retinal reattachment. Among eyes with 4B ROP, 11 of 12 eyes (92%) had complete retinal reattachment. At last follow-up, 29 of 37 eyes (78%) were able to fix and follow. CONCLUSIONS: These results indicate that lens-sparing vitrectomy is effective for achieving retinal reattachment in tractional stage 4 ROP. This article contains additional online-only material available at .

Female↗

PubMed2005

Long-term results of vitrectomy without laser treatment for macular detachment associated with an optic disc pit.

PURPOSE: To evaluate the efficacy of vitrectomy and gas tamponade, without laser photocoagulation to the margin of the optic nerve, for the treatment of macular detachment associated with an optic disc pit. DESIGN: Noncomparative interventional case series. PARTICIPANTS: Eleven consecutive patients (8-47 years of age) who presented with unilateral macular detachment associated with an optic disc pit. INTERVENTION: Pars plana vitrectomy, induction of posterior vitreous detachment (PVD), and gas tamponade were performed, with postoperative facedown positioning for 1 week. The presence of a double-layer detachment consisting of an inner layer separation and an outer layer detachment was observed in 10 of 11 eyes either preoperatively or postoperatively. Patients were observed for 10 to 98 months (mean, 47) after surgery. MAIN OUTCOME MEASURES: Anatomic outcome and visual acuity were retrospectively analyzed for all eyes. Optical coherence tomography was used to observe anatomic changes in the macula in some eyes. RESULTS: Complete retinal reattachment was achieved in 10 of 11 eyes, although these eyes required nearly 1 year to reach this state. The one eye with persistent retinal detachment was observed to have a marked reduction of the detachment by 10 months postoperatively. No recurrences were observed. Visual acuity improvement was documented in 7 of 11 eyes. CONCLUSIONS: These results suggest that vitrectomy with induction of PVD and gas tamponade, without additional laser treatment, is successful in reattaching the macula and improving central vision in most patients with optic disc pit maculopathy.

Adolescent↗

PubMed2001

Vitrectomy for large vitreous opacity in retinitis pigmentosa.

PURPOSE: To describe a patient with bilateral retinitis pigmentosa and visually disabling vitreous opacities, who benefited from vitrectomy in both eyes. METHODS: A 37-year-old man with retinitis pigmentosa and severely constricted visual fields developed a large, dense, vitreous floater and visual obscuration in the right eye. Subsequently, diffuse vitreous opacification and visual obscuration developed in the left eye. RESULTS: Bilateral pars plana vitrectomy relieved the patient's visual obscurations. Electron micrographs of the excised vitreous opacity from the left eye showed collagen fibrils and cellular debris. CONCLUSION: Visually significant vitreous opacities may develop as a complication of retinitis pigmentosa. The visual impact of such opacities may be magnified by its superimposition on limited visual fields. Vitrectomy may be of benefit in such cases.

Adult↗

PubMed2001

Acrylic intraocular lens placement in conjunction with pars plana vitrectomy.

PURPOSE: To report the results of placing a foldable acrylic intraocular lens through a clear cornea incision in eyes undergoing pars plana vitrectomy. METHODS: This interventional case series is a retrospective report of 15 eyes of 15 consecutive patients undergoing foldable (acrylic) intraocular lens insertion in conjunction with pars plana vitrectomy in a single academic institution. Outcome measures included visual acuity and complications. RESULTS: The intraocular lens was successfully implanted and retained in position in all 15 cases. The intraocular lens did not pose difficulty in examining the fundus or cause any vitreoretinal complications. With mean follow-up of 4.5 months (range, 1--10 months), final median postoperative visual acuity range was 20/200 (range, 20/40--2/200) and consistent with the level of vitreoretinal disease. CONCLUSION: Acrylic intraocular lenses may be safely implanted in conjunction with pars plana vitrectomy in selected cases.

Acrylates↗

PubMed2001

Massive suprachoroidal hemorrhage during pars plana vitrectomy associated with Valsalva maneuver.

PURPOSE: To report the intraoperative occurrence of massive intraocular suprachoroidal hemorrhage associated with Valsalva maneuver. METHODS: Retrospective, multicenter study of patients who developed massive choroidal hemorrhage associated with Valsalva maneuver during vitrectomy. RESULTS: Massive intraoperative suprachoroidal hemorrhage in seven patients (seven eyes) involved three men and four women with a median age of 52 years (range, 26 to 82 years). General anesthesia was used in six of seven cases. Coughing or "bucking" on the endotracheal tube during general anesthesia or severe coughing during the one vitrectomy performed under local anesthesia was associated with massive suprachoroidal hemorrhage. In five of seven eyes, this occurred near the end of surgery, after air-fluid exchange but before sclerotomy closure. Scleral plugs were immediately placed, and sclerotomy closure was performed exigently. Immediate posterior sclerotomy was performed on five of seven eyes; an additional patient underwent posterior sclerotomy postoperatively. After median follow-up of 18 months (range, 3 to 36 months), final visual acuity was no light perception in four eyes, light perception in one eye, 20/250 in one eye, and 20/20 in one eye. Four eyes became phthisical. CONCLUSIONS: Valsalva maneuver during pars plana vitrectomy may result in massive suprachoroidal hemorrhage with disastrous visual consequences. Precautionary measures to prevent coughing or "bucking" on the endotracheal tube during general anesthesia, or a prolonged episode of coughing during local anesthesia, may prevent this potentially devastating complication.

Adult↗

PubMed2003

Submacular deposition of triamcinolone acetonide after triamcinolone-assisted vitrectomy.

PURPOSE: We describe a case demonstrating a submacular deposition of triamcinolone acetonide (TA) after a TA-assisted vitrectomy for retinal detachment. DESIGN: Interventional case report. METHODS: A 48-year-old Japanese man with rhegmatogenous retinal detachment in his left eye underwent a TA-assisted vitrectomy, endolaser photocoagulation, and sulfur hexafluoride (SF(6)) gas tamponade. RESULTS: At the end of the surgery and the day after undergoing vitrectomy, the deposition of TA was observed between the retinal pigment epithelium and neurosensory retina in the submacular area. These TA granules disappeared after 2 weeks. Two months after the operation, the retina was observed to be successfully attached and no abnormality was observed in the macula. The patient's visual acuity improved to 20/16, and no ophthalmoscopic or functional damage was observed. CONCLUSION: No apparent adverse effect was found in this case demonstrating a submacular deposition of TA.

Fluorescein Angiography↗

PubMed2003

Combined phacoemulsification, intraocular lens implantation, and vitrectomy for eyes with coexisting cataract and vitreoretinal pathology.

PURPOSE: To report the preoperative, intraoperative, and postoperative outcomes of combining phacoemulsification and posterior chamber intraocular lens (IOL) implantation with pars plana vitrectomy in eyes with significant cataract and coexisting vitreoretinal pathology. DESIGN: Retrospective, consecutive, interventional case series. METHODS: Charts of patients undergoing combined procedures at the Wilmer Ophthalmologic Institute between March 1995 and May 2000 were reviewed. RESULTS: In all, 122 eyes of 111 patients were identified. Patient ages ranged from 27 to 89 years (mean 65). Forty-three eyes had diabetic retinopathy; 11 had undergone vitrectomy previously. Macular pathology (hole, membrane, choridal neovascularization) was present in 69 eyes. The most common indications for surgery were diabetic vitreous hemorrhage, macular hole, epiretinal membrane, and retinal detachment. In all cases, phacoemulsification and IOL implantation were performed before vitreoretinal surgery. Preoperative vision ranged from 20/30 to light perception and postoperative vision ranged from 20/20 to no light perception. In 105 patients vision improved, in 7 there was no change, and in 10 vision decreased. Postoperative complications included opacification of the posterior capsule, increased intraocular pressure, corneal epithelial defects, vitreous hemorrhage, retinal detachment and iris capture by the IOL. CONCLUSIONS: Combined surgery is a reasonable alternative in selected patients. Techniques that may simplify surgery and reduce complications include: careful, limited, curvilinear capsulorhexis; in-the-bag placement of IOLs; use of IOLs with larger optics; suturing of cataract wounds before vitrectomy; use of miotics and avoidance of long-acting dilating drops in patients with intravitreal gas; and use of wide-field viewing systems.

Adult↗

PubMed2003

Frequency of epithelial debridement during diabetic vitrectomy.

PURPOSE: To survey active vitreoretinal surgeons to determine how often they intentionally debride the corneal epithelium during vitrectomy surgery for diabetic patients and to ascertain whether the selection of the surgical lens type influences the debridement rate. DESIGN: Observational retrospective case series. METHODS: Fifty-five vitreoretinal surgeons were asked to retrospectively report how many pars plana vitrectomies they performed in 1 year on diabetic eyes and in what percent of the cases was debridement of the cornea necessary. In a second query, they were asked to note which specific type of surgical lens system (hand-held irrigating, Landers sew-on, or Oculus BIOM noncontact) was used for their surgical intervention. RESULTS: The total number of diabetic vitrectomies performed in 1 year by the respondents was 8,002. The frequency of epithelial debridement was 17.4%, with a range of 0% to 90%. The use of irrigating contact lenses was associated with a significantly higher rate of debridement compared with the use of sew-on or BIOM noncontact lenses (23.5% vs 12.1%, P <.001). Regarding the 41 surgeons who indicated a specific type of lens used, we found that the debridement rate for infusion lenses was 23.8% compared with 13.0% for sew-on lenses and 15.6% for noncontact BIOM lenses. The difference between these groups was statistically significant (P <.025). CONCLUSIONS: Irrigating contact lenses appear to increase the need for epithelial debridement compared with other alternatives. Sew-on lenses with a viscoelastic cushion may provide the best corneal protection.

Debridement↗

PubMed2003

Long-term results following pars plana vitrectomy with platelet concentrate in pediatric patients with traumatic macular hole.

PURPOSE: To describe the long-term clinical course in children with a traumatic macular hole after vitrectomy with platelet concentrate. DESIGN: Interventional case series. METHODS: Four pediatric patients with a mean age of 13.2 years (range, 10-15 years) underwent pars plana vitrectomy with platelet concentrate, internal limiting membrane peeling, and SF6 gas tamponade for stage 3 traumatic macular hole repair. RESULTS: Primary closure was achieved by a single intervention in all patients with a marked visual improvement of three to seven lines after surgery. The surgically achieved visual improvement remained stable and no vision-threatening complications occurred during the mean follow up of 35.2 months (range, 27-51 months). CONCLUSION: We regard pars plana vitrectomy with platelet concentrate and SF6 gas instillation as safe and effective and, therefore, as the therapy of choice for traumatic macular holes particularly in children after a period of observation no longer than 3 to 4 months.

Adolescent↗

PubMed2003

Visual field defects after uneventful vitrectomy for epiretinal membrane with indocyanine green-assisted internal limiting membrane peeling.

PURPOSE: To report visual field defects after vitrectomy for epiretinal membrane with indocyanine green (ICG)-assisted internal limiting membrane (ILM) peeling. DESIGN: Interventional consecutive case series. METHODS: A retrospective review of 16 eyes of 16 patients who underwent vitrectomy for idiopathic epiretinal membrane. Indocyanine green-assisted ILM peeling was performed in 7 of 16 eyes. The main outcome measure was postoperative visual field. RESULTS: Four of seven eyes (57%) with ICG-assisted ILM peeling had visual field defects postoperatively. The field defects identified were nasal in three eyes; in the fourth eye, the visual field was constricted to approximately 30 degrees. None of the nine eyes without ICG-assisted ILM peeling had a visual field defect. CONCLUSIONS: Peripheral visual field defects may occur after vitrectomy with ICG-assisted ILM peeling. Although the cause of the defects is unclear, the potential role of ICG toxicity requires further investigation.

Aged↗

PubMed2003

Residual triamcinolone acetonide in the macular hole after vitrectomy.

PURPOSE: To report a case of vitrectomy using intraocular triamcinolone acetonide (TA), in which TA remained in the macular hole after surgery. DESIGN: Observational case report. METHODS: A 60-year-old Japanese man had a Stage II macular hole in the right eye with best-corrected visual acuity of 20/50. A pars plana vitrectomy using TA was performed. Visual acuity and anatomic results were followed up for a period of 8 weeks. RESULTS: On the sixth postoperative day, residual TA deposition was observed in the macular hole. On the 14th postoperative day, no residual TA was found and the macular hole was successfully closed. The best-corrected visual acuity of the right eye improved to 20/15. CONCLUSIONS: Residual TA in the macular hole after vitrectomy did not interfere with macular hole repair either anatomically or functionally.

Combined Modality Therapy↗

PubMed1997

Visual field loss caused by retinal vascular occlusion after vitrectomy surgery.

PURPOSE: To report complete superonasal retinal arterial occlusion with resulting temporal visual field loss after uneventful pars plana vitrectomy with gas-fluid exchange. METHOD: Case report. RESULTS: Superonasal retinal arterial occlusion was observed 12 days after vitrectomy surgery. Within 10 weeks, the artery reperfused, leaving minimal vascular attenuation and mild optic atrophy. CONCLUSIONS: Uneventful vitrectomy surgery can be associated with notable peripheral visual field loss caused by arterial occlusion in the immediate postoperative period. Rapid resorption of the intraocular gas and timely postoperative examination may disclose retinal arteriolar occlusion; otherwise, subsequent reperfusion may leave little evidence of the vascular event.

Female↗

PubMed1995

Pars plana Baerveldt tube insertion with vitrectomy in glaucomas associated with pseudophakia and aphakia.

PURPOSE: We reviewed the course of intraocular pressure, visual acuity, and complications in patients with shallow anterior chambers or vitreous prolapse who underwent insertion of glaucoma drainage tubes through the pars plana (after a complete posterior vitrectomy). METHODS: Thirteen patients (13 eyes) with uncontrolled glaucoma associated with shallow anterior chamber or vitreous prolapse and aphakia or pseudophakia underwent pars plana Baerveldt tube insertion after vitrectomy. RESULTS: In 11 eyes the intraocular pressure was less than or equal to 15 mm Hg at a minimum follow-up of one year; the other two eyes underwent additional glaucoma surgery. Two of the 11 eyes with controlled intraocular pressure had limitation of ocular motility postoperatively. No retinal complications had occurred in any of the 13 eyes. CONCLUSION: This technique of combined pars plana vitrectomy and pars plana insertion of a Baerveldt tube provides intraocular pressure control in eyes with shallow anterior chamber or vitreous prolapse and glaucoma associated with pseudophakia or aphakia.

Adolescent↗

PubMed1996

Vitrectomy for diffuse macular edema in cases of diabetic retinopathy.

PURPOSE: To ascertain the effects of posterior vitreous detachment for diffuse diabetic macular edema. METHODS: We performed vitrectomy on 58 eyes of 41 consecutive patients with diabetic macular edema without posterior vitreous detachment. Follow-up was done at 12 months postoperatively. RESULTS: In 57 of 58 eyes after vitrectomy and posterior vitreous detachment, macular edema resolved, and diffuse fluorescein leakage disappeared in 35 of 36 eyes examined at the 12th month. Visual improvement was statistically significant (P < .0001, paired t test). CONCLUSION: In eyes with diffuse diabetic macular edema and without posterior vitreous detachment, vitrectomy with posterior vitreous detachment may be effective.

Adult↗