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 541 records · Page 30Linked to original sources

PubMed1999

A malignant glaucoma-like syndrome following pars plana vitrectomy.

OBJECTIVE: To report two cases of a malignant glaucoma-like syndrome following pars plana vitrectomy. DESIGN: Two interventional case reports. INTERVENTION: The first patient was treated with a neodymium:YAG laser peripheral iridectomy with hyaloidectomy and with intracameral tissue plasminogen activator. The second patient was treated with a posterior approach iridectomy through residual hyaloid, zonules, and iris. MAIN OUTCOME MEASURES: Axial anterior chamber depth and intraocular pressure (IOP). RESULTS: The interventions resulted in deepening of the anterior chambers and normalization of IOPs. CONCLUSION: A pseudomalignant glaucoma syndrome may be related to obstruction of aqueous flow, either by residual anterior hyaloid or by fibrin and other inflammatory debris at the level of the ciliary body-zonular apparatus. Treatment of this syndrome involves restoring aqueous flow to the anterior chamber by disrupting the residual anterior hyaloid or clearing fibrin or inflammatory debris. The clinician should not disregard the possibility of a pseudomalignant glaucoma syndrome following vitrectomy despite the fact that vitrectomy has traditionally been considered a curative treatment for malignant glaucoma.

Aged↗

PubMed2004

[Vitrectomy for floaters].

PURPOSE: To clarify vitrectomy indications in the treatment of vitreous floaters. METHODS: This is a retrospective study of four patients, four eyes (age, 42-65 years), who underwent vitrectomy for the treatment of vitreous floaters. Two patients had a total posterior vitreous detachment. All patients were required to think about the intervention for several months before consenting. RESULTS: Preoperative visual acuity ranged from 20/40 to 30/30 and after the operation it ranged from 20/40 to 10/10. Minimum follow-up was 1 year. Visual acuity did not decrease after treatment in any patients. All patients expressed satisfaction with their postoperative visual function. DISCUSSION-CONCLUSION: Visual acuity measures do not always accurately reflect patients' visual discomfort. Vitrectomy has been known for many years. It can be proposed as a last resort after thorough retina examination, after patients have received adequate information and they are psychologically ready for the procedure.

Adult↗

PubMed2001

Posterior subcapsular and nuclear cataract after vitrectomy.

PURPOSE: To examine the morphological changes in the postvitrectomy lens and to monitor the development of these changes over time. SETTING: Oxford Eye Hospital, Oxford, United Kingdom. METHODS: In this prospective study, 33 consecutive phakic patients having pars plana vitrectomy were recruited. Cataract development was quantified by clinical grading and digital Scheimpflug image analysis. Slitlamp biomicroscopy and photography were used to document the morphological appearance. The main outcome measures were the incidence, morphology, and development of posterior subcapsular and nuclear cataract. RESULTS: A characteristic, transient posterior subcapsular cataract (PSC) was present in 89% (17 of 19) of tamponade patients within 24 hours of surgery. Of the patients who had vitrectomy without tamponade, 9% (1 of 11) developed similar changes. Nuclear opacity developed in 61% (11 of 18) of tamponade patients and in 50% (3 of 6) of nontamponade patients. A longer term retrospective review of the same patients' case notes revealed nuclear cataract in 67% (12 of 18) of tamponade cases and 30% (3 of 10) of nontamponade cases. Eighteen percent (2 of 11) of nontamponade cases and 67% (14 of 21) of tamponade cases had cataract surgery after a 10.7 month and a 12.4 month follow-up, respectively. CONCLUSIONS: Vitrectomy and tamponade produced a characteristic transient PSC in the immediate postoperative period. Disruption of fluid balance in the region of the posterior lens was suggested by the morphological appearance. The acute changes resolved but were followed by accelerated nuclear opacification.

Aged↗

PubMed2001

Corneal surface changes after pars plana vitrectomy and scleral buckling surgery.

PURPOSE: To evaluate the changes in corneal shape after pars plana vitrectomy, encircling buckling surgery, and a combination of the 2 procedures. SETTING: Assaf Harofeh Medical Center, Zrifin, and Goldshlager Eye Institute, Tel Hashomer, Israel. METHODS: In a prospective clinical study, 61 eyes of 61 patients were assigned to 1 of 3 groups based on the type of procedure: pars plana vitrectomy, encircling buckle and pars plana vitrectomy, or encircling buckle. The eyes had corneal keratometry (TMS-1), visual acuity measurement, and videokeratography (TMS-1) preoperatively and 2 days, 1 week, and 1 and 3 months postoperatively. The topographic parameters statistically analyzed were the corneal surface cylinder, simulated keratometry, surface regularity index, surface asymmetry index, standard deviation of corneal power, average corneal power, and irregular astigmatism index. RESULTS: The measurements of all topographic indices were statistically significantly different from baseline measures 2 and 7 days postoperatively in all 3 groups. However, at 1 and 3 months, there was no significant difference from preoperatively in any index. Postoperative best corrected visual acuity was statistically significantly different from preoperatively. CONCLUSIONS: All corneal surface indices were significantly altered after all 3 types of surgery. Corneal surface measurements returned to preoperative values by 1 month postoperatively and remained stable until the final follow-up at 3 months.

Adolescent↗

PubMedDate not supplied

Posterior chamber lens implantation combined with pars plana vitrectomy.

PURPOSE: To assess the outcome of cataract extraction and posterior chamber intraocular lens (IOL) implantation combined with pars plana vitrectomy. SETTING: Ophthalmic ward in a district general hospital. METHODS: This study evaluated seven consecutive patients who had cataract extraction, IOL implantation, and pars plana vitrectomy in one procedure. Four patients were diabetic, and three had perforating eye injuries with cataract formation and intraocular foreign bodies. RESULTS: No significant postoperative complications occurred, and the posterior chamber lenses were well tolerated. In all cases, good subjective visual improvement was achieved and visualization of the posterior pole was excellent. CONCLUSION: Combining cataract extraction with posterior chamber IOL implantation and vitrectomy in one procedure may be indicated, especially if there is traumatic rupture of the lens capsule.

Adult↗

PubMed1999

Primary posterior capsulorhexis without anterior vitrectomy in pediatric cataract surgery: longer-term outcome.

PURPOSE: To assess the effectiveness of primary posterior capsulorhexis without anterior vitrectomy in preventing posterior capsule opacification (PCO) in pediatric cataract surgery. SETTING: Children's Hospital, Dublin, Republic of Ireland. METHODS: The study comprised 32 eyes of 22 pediatric patients who had cataract extraction between 1994 and 1998. Extracapsular cataract extraction was performed using radiofrequency diathermy capsulorhexis to the anterior and posterior capsules without an anterior vitrectomy. Posterior chamber intraocular lens implantation was performed in 20 eyes. There were 23 congenital, 6 developmental, and 3 traumatic cataracts. RESULTS: Patient age ranged from 1 month to 12 years. Mean follow-up was 19 months (range 6 to 50 months). Twenty-seven of 32 eyes (84.4%) had a clear visual axis at last follow-up. Five eyes required a neodymium: YAG capsulotomy, which was performed a mean of 5 months postoperatively (range 1 to 9 months). The incidence of PCO requiring capsulotomy was 15.6%. CONCLUSION: Primary posterior capsulorhexis without anterior vitrectomy was safe and effective, with a low reopacification rate. Long-term follow-up of this patient cohort is necessary.

Anterior Eye Segment↗

PubMed1999

Primary capsulectomy, anterior vitrectomy, lensectomy, and posterior chamber lens implantation in children: limbal versus pars plana.

PURPOSE: To compare the results of a limbal versus a pars plana approach for primary posterior capsulectomy and anterior vitrectomy in the management of childhood cataract. SETTING: Department of Ophthalmology, Labbafinejad Medical Center, Tehran, Iran. METHODS: A randomized, controlled, double-masked clinical trial of 45 eyes was conducted. After being matched, 38 eyes were included in the study and were divided into 2 equal groups for data analysis. All eyes had lensectomy and posterior chamber intraocular lens (PC IOL) implantation. Primary posterior capsulectomy and anterior vitrectomy were performed through the limbus in half of the eyes and the pars plana in the other half. Main outcome measures included visual acuity, estimated red reflex, postsurgical inflammatory reaction, corneal clarity, posterior synechias, iris capture, IOL position, capsulectomy size, glaucoma, cystoid macular edema, retinal tear, and postoperative refraction. RESULTS: No statistically significant differences were found between the 2 approaches in the outcome measures. CONCLUSION: The anatomic and visual results were encouraging when posterior capsulectomy and anterior vitrectomy, using a limbal or pars plana approach, were combined with lensectomy and PC IOL implantation in children. The application of these techniques depends on surgeon experience and skill.

Anterior Eye Segment↗

PubMed1999

Topical anesthesia for phacoemulsification, intraocular lens implantation, and posterior vitrectomy.

PURPOSE: To evaluate the efficacy of topical anesthesia as an alternative to peribulbar or retrobulbar anesthesia in phacoemulsification and intraocular lens (IOL) implantation combined with pars plana vitrectomy. SETTING: Clinica de Ojos de Maracaibo, Maracaibo, and the Retina and Vitreous Service, Clinica Oftalmologica Centro Caracas, Caracas, Venezuela. METHODS: In this prospective study, phacoemulsification, IOL implantation, and posterior vitrectomy using topical anesthesia (lidocaine 4% drops) were prospectively performed in 45 eyes (45 patients) with varied vitreoretinal pathology including macular holes, epiretinal membranes, subfoveal neovascular membranes, proliferative diabetic retinopathy, and vitreous hemorrhage. Preoperative and intraoperative sedation of varying degrees was necessary. Subjective pain and discomfort were graded from 1 (no pain or discomfort) to 4 (severe pain and discomfort). RESULTS: All patients had grade 1 pain and discomfort during most of the procedure. All patients had grade 2 (mild) pain and discomfort during pars plana sclerotomies, external bipolar cautery, and conjunctival closure. The mean amount of lidocaine 4% drops required during each procedure was 0.5 mL. No patient required additional retrobulbar, peribulbar, or sub-Tenon's anesthesia. CONCLUSIONS: This technique avoids the risks of globe perforation, retrobulbar hemorrhage, and prolonged postoperative akinesia of the eye at a lower cost. With appropriate case selection, topical anesthesia was a safe and effective alternative to peribulbar or retrobulbar anesthesia in phacoemulsification and IOL implantation combined with posterior 3-port pars plana vitrectomy.

Aged↗

PubMed1999

Vitrectomy for macular edema combined with retinal vein occlusion.

This study was performed in order to evaluate the effect of vitrectomy in eyes with retinal vein occlusion associated with macular edema. Twenty-nine years eyes (27 patients) with branch retinal vein occlusion (BRVO), and 14 eyes (13 patients) with central retinal vein occlusion (CRVO) both associated with macular edema underwent phacoemulsification, intraocular lens implantation, pars plana vitrectomy and peeling of the posterior hyaloid membrane. Follow-up ranged from 12 to 32 months. Macular edema was reduced, and visual improvement was observed (p < 0.0001 in BRVO, p = 0.0257 in CRVO, paired t-test). Visual outcome was better in eyes with better visual acuity before surgery. Early vitrectomy may be recommended for retinal vein occlusion associated with macular edema.

Aged↗

PubMed1999

Pars plana vitrectomy in diabetic macular edema.

PURPOSE: To ascertain the association between the improvement of diabetic macular edema and increased visual acuity after pars plana vitrectomy. METHODS: From January 1994 to December 1996 we prospectively studied 18 patients (18 eyes, 7 women and 11 men, mean age 52 years, range 37-68) with type II diabetes and clinically significant macular edema. One group was composed of 9 patients presenting diffuse macular edema (DME); a second group with 9 patients presented cystoid macular edema (CME). All patients underwent pars plana vitrectomy. RESULTS: Preoperative Snellen visual acuity was 20/143 in DME and 20/441 in CME. In both groups vision increased to 20/136 and 20/205, respectively, postoperatively. For the DME this difference was statistically significant (p<0.05) at 1 month after the surgery, but vision decreased again after 10 months reaching preoperative values. CONCLUSIONS: Our results suggest that pars plana vitrectomy for diabetic macular edema may increase visual acuity in diffuse macular edema, although this increase is only short lived.

Adult↗

PubMed1998

Long term visual results of vitrectomy for Eales disease complications.

BACKGROUND AND OBJECTIVES: Complications of Eales disease can cause visual loss. Long term visual prognosis following vitrectomy for Eales disease complications has been studied. PATIENTS AND METHODS: Retrospective analysis of 64 eyes of 57 patients who underwent vitrectomy for Eales disease complications with a minimum follow-up of 60 months. RESULTS: 62.4% eyes at 2 months and 71.8% at 60 months had 6/60 or better visual acuity. Visual acuities for individual cases were quite stable at the 60 month follow up with 50 eyes (78.5%) either maintaining or improving upon their 2 month post operative visual acuity. CONCLUSION: Visual acuity improves after vitrectomy in majority of patients with Eales disease complications and remains stable on long term follow-up.

Adolescent↗

PubMedDate not supplied

Prophylaxis of experimental Pseudomonas aeruginosa endophthalmitis after vitrectomy using ceftazidime in the irrigating solution.

PURPOSE: To test the efficacy of ceftazidime in irrigating solution during vitrectomy to prevent experimental Pseudomonas aeruginosa endophthalmitis. METHODS: Thirty-two rabbit eyes were divided into 6 groups. Vitrectomy using one of two different irrigating solutions was followed by intravitreal injection of P. aeruginosa: Group 1, balanced salt solution (BSS) followed by 100 colony-forming units (CFU) P. aeruginosa; Group 2, BSS fortified with ceftazidime 175 microg/mL (CBSS) followed by intravitreal injection of 100 CFU P. aeruginosa; Group 3, BSS followed by 500 CFU P. aeruginosa; Group 4, CBSS followed by 500 CFU P. aeruginosa; Group 5, BSS followed by 5000 CFU P. aeruginosa; and Group 6, CBSS followed by 5000 CFU P. aeruginosa. The eyes were examined clinically. Vitreous samples were cultured and histology was performed. RESULTS: Group 1: Three of 5 eyes showed mild to moderate vitreous opacities. Group 2: No vitreous opacities developed. Group 3: All eyes demonstrated endophthalmitis. Group 4: All 6 eyes had clear vitreous with visible fundus. Group 5: Severe endophthalmitis occurred in all 6 eyes. Group 6: Four eyes had clearly visible fundus, 2 eyes had hazy vitreous with red reflex of the fundus. Bacterial growth in groups 3, 4, 5, and 6 was seen in 4/4, 1/6, 6/6, and 0/6 eyes, respectively. CONCLUSION: When 100-5000 CFU P. aeruginosa were injected after vitrectomy, ceftazidime in the irrigating solution inhibited the signs of intraocular inflammation, and the rate of positive bacterial culture.

Administration, Topical↗

PubMed1999

Visual recovery in unilateral traumatic pediatric cataracts treated with posterior chamber intraocular lens and anterior vitrectomy in Pakistan.

PURPOSE: To evaluate visual recovery in unilateral traumatic cataracts in children treated with posterior chamber intraocular lens implantation and anterior vitrectomy. METHODS: Sixteen children with unilateral traumatic cataract between ages 3-10 years (mean, 5 years 8 months) were treated with posterior chamber intraocular lens implantation and anterior vitrectomy. Surgery was performed between 2 weeks and 7 months (mean, 7.75 weeks) after injury. Follow up was between 9 and 29 months (mean, 17.9 months). RESULTS: The most common postoperative complication was fibrinous uveitis, which developed in 4 children (25%). All eyes had a clear visual axis postoperatively; none required capsulotomy. The mean postoperative refraction was +0.9 diopters (range, +3.50 to -2.75 diopters). Three eyes (18.75%) had visual acuity of 6/9, 8 eyes (50%) had visual acuity of 6/12 or better, and 11 eyes (68.75%) had visual acuity of 6/18 or better. The cause of poor visual acuity was cystoid macular edema in one eye, macular scars in two eyes, and amblyopia in one eye. CONCLUSIONS: Unilateral traumatic cataracts in children in whom aphakia is corrected with posterior chamber lens implantation combined with anterior vitrectomy result in good visual outcome, and we recommend this treatment modality in traumatic cataract in children.

Capsulorhexis↗

PubMed2000

Pars plana vitrectomy for regression of choroidal neovascularization with age-related macular degeneration.

OBJECTIVE: In age-related macular degeneration, the posterior vitreous surface often remains attached to a higher degree than expected for the patient's age, suggesting the involvement of the posterior vitreous membrane in the pathophysiology of choroidal neovascularization. Thus, we performed simple pars plana vitrectomy and artificial posterior vitreous detachment in order to induce regression of choroidal neovascularization. METHODS: Vitrectomy was performed in 12 eyes of 11 patients with age-related macular degeneration in whom the posterior vitreous surface remained attached, and in whom there was evidence of highly active choroidal neovascularization. The posterior vitreous membrane was artificially detached during surgery, but photocoagulation and/or a subretinal procedure for choroidal neovascularization was not performed. Patients underwent fluorescein and indocyanine green angiography both pre- and postoperatively to assess the status of choroidal neovascularization. RESULTS: Six months after surgery, 6 of the 12 eyes showed regression of choroidal neovascularization, and in 2 eyes it had disappeared completely. Subretinal exudative changes in 8 eyes had improved. Visual acuity testing showed improved vision in 4 eyes, unchanged vision in 4 eyes, and worsening of vision in 4 eyes. The final best corrected visual acuity was 10/20 or better in one eye, 10/ 20 to 20/200 in 7 eyes, and 20/200 or worse in 4 eyes. CONCLUSION: The results of the present study suggest the involvement of the posterior vitreous membrane in the pathophysiology of age-related macular degeneration. Furthermore, the minimally invasive pars plana vitrectomy may represent a new treatment for age-related macular degeneration.

Aged↗

PubMed2000

Phaco-vitrectomy for full-thickness macular holes.

PURPOSE: To investigate the role of combined phaco-vitrectomy surgery in the management of full-thickness macular holes. METHODS: Thirteen eyes with full-thickness macular holes had combined phacoemulsification cataract removal and vitrectomy surgery with instillation of 20% C2F6 gas. RESULTS: The mean duration of macular holes prior to surgery was 6.5 months. Eleven holes closed, 2 remained opened. All patients except one had an improvement in visual acuity. Laser treatment was performed to treat retinal breaks noted intraoperatively in 4 patients. CONCLUSION: Combined cataract and vitrectomy surgery for full-thickness macular holes enables good visibility during surgery. A large gas bubble can be obtained with excellent tamponade of the hole. Combined surgery prevents the patients having to return for cataract surgery.

Aged↗

PubMed2001

Hemostatic effects of SF6 after diabetic vitrectomy for vitreous hemorrhage.

PURPOSE: To investigate the hemostatic effects of SF6 gas in preventing postoperative vitreous hemorrhage in diabetic vitrectomy. METHODS: A prospective, randomized study of 33 diabetic eyes with vitreous hemorrhage, treated by vitrectomy. In 17 of our cases SF6 20% was injected into the eye at the end of the operation, while in 16 cases BSS remained in the vitreous cavity. RESULTS: The incidence of vitreous hemorrhage recurrence was 17.6% for the SF6 group and 12.5% for the BSS group (statistically not significant). Progression of lens opacities was observed in 23.5% of the SF6 group, and in 18.8% of the BSS group (statistically not significant, with a higher incidence in the SF6 group). CONCLUSIONS: SF6 gas did not show hemostatic effects in the cases studied. Furthermore, it may have contributed to cataract progression. Therefore we suggest that the use of SF6 is not recommended as a treatment modality in preventing new vitreous hemorrhage after diabetic vitrectomy.

Adult↗

PubMed1999

Combined phacoemulsification--vitrectomy surgery: technique, indications and outcomes.

PURPOSE AND METHODS: Cataract extraction may be combined with vitrectomy to improve the operative view and/or enhance post-operative rehabilitation. A retrospective review of the records of all patients undergoing combined phacoemulsification and vitrectomy procedures since 1993 was performed. Surgical technique is discussed. RESULTS: Fifty operations on 49 patients are described. Visual acuity improved overall (mean LogMAR acuity 1.58 +/- 0.74 pre-operatively and 1.17 +/- 0.76 LogMAR post-operatively), with 57% of patients having improved acuity post-operatively. Operative complications were few and post-operative complications were acceptable given the severity of the posterior segment disease. CONCLUSIONS: Combined phacoemulsification-vitrectomy surgery is a viable option in the management of posterior segment disease in the presence of cataract. It has a number of advantages over other approaches, and can be combined with intraocular lens insertion into the capsular bag in most cases.

Adult↗

PubMed2001

Pars plana vitrectomy with silicone oil in the management of combined rhegmatogenous retinal and choroidal detachment.

PURPOSE: Rhegmatogenous retinal detachment combined with spontaneous pre-operative choroidal detachment (RDCD) represents a rare but specific entity, which has in the past been associated with a poor prognosis. This study was designed to determine the efficacy of pars plana vitrectomy with silicone oil injection in the management of this very difficult vitreoretinal problem. METHODS: A retrospective analysis was carried out of 13 eyes of 13 consecutive patients who underwent vitrectomy and silicone oil exchange. RESULTS: In a total of 10 eyes (77%) the first procedure produced anatomical success. Two eyes required a further procedure to achieve retinal reattachment, producing a final anatomical success rate of 92%. CONCLUSION: Pars plana vitrectomy with silicone oil exchange is an effective technique for managing RDCD.

Adult↗