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Results for “Vitrectomy”

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At least 649 records · Page 36Linked to original sources

PubMed1997

[The significance of preoperative visual electrophysiology for vitrectomy].

OBJECTIVE: To investigate the prognostic value of preoperative visual electrophysiology in patients with vitreoretinopathy (VRP) who underwent vitrectomy. METHODS: Electroretinogram (ERG) and visual evoked potential (VEP) were performed prior to vitrectomy in 82 patients with vitreous hemorrhage or opacity due to ocular trauma, retinal detachment or retinal vascular diseases (Eales' disease, diabetic retinopathy, etc.). A comparative analysis was made of the effectiveness and visual acuities 2 weeks postoperatively. RESULTS: Among the 82 eyes, the preoperative ERG was normal in 6 eyes, slightly or moderately reduced in 37 eyes and severely reduced or had no response in 39 eyes. Of these 39 eyes, no improvement or reduction in postoperative visual acuity was seen in 23 and 6 eyes respectively, a sharp contrast to the postoperative results of the 6 normal ERG eyes. The preoperative ERGs differed due to different causes. A further analysis regarding the VEP of the patients who had poor postoperative results was made. CONCLUSIONS: The data showed that the preoperative visual electrophysiology was significantly correlated with the effectiveness of the operation. It is helpful in prognostic assessment of the postoperative outcome and visual acuity changes in VRP patients treated mainly by vitrectomy.

Electroretinography↗

PubMed2000

[The Rayleigh color matches in idiopathic macular holes treated by vitrectomy].

PURPOSE: The Rayleigh color matches were measured to investigate the optical density in the cone photopigment of the central retina in patients with macular holes that had closed after vitrectomy. METHODS: The Rayleigh equation was measured with the IF-2 anomaloscope in 7 patients with macular holes in one eye, that had closed after vitrectomy and gained an improvement in visual acuity of 0.5 or better. Reductions in the pigment optical density of cone photoreceptors of the opposite eyes were estimated with Rayleigh equations obtained in this experiment. RESULT: The Rayleigh equations of the affected eyes were shifted toward protanomalous setting compared with that of the opposite eyes. The optical densities of cone photoreceptors of the affected eyes were lower than those in the opposite eyes, even in patients with visual acuity of 1.0 or better. CONCLUSION: These findings suggest that the recovery of the visual acuity may precede that of the optical density in cone photopigment of central retina. The Rayleigh equation is more sensitive than visual acuity for evaluating visual function after vitrectomy for macular holes.

Aged↗

PubMedDate not supplied

Optical coherence tomography findings in diabetic macular edema before and after vitrectomy.

BACKGROUND AND OBJECTIVE: To assess the role of optical coherence tomography (OCT) in the evaluation and follow-up after vitrectomy for diabetic macular edema. MATERIALS AND METHODS: The 18 eyes of 12 patients affected by presumed diabetic vitreous-induced macular edema underwent biomicroscopy with a Goldmann contact lens, fluorescein angiography, and OCT. RESULTS: OCT revealed two patterns of edema. The first group (15 eyes) was characterized by widespread thickening of the neurosensory retina with an increased nonhomogeneous reflectivity of the inner retinal layers; cystoid-like spaces of absent or reduced reflectivity in the neurosensory retina were also present. In the second group (3 eyes), a cystoid macular edema with a dome-shaped foveal profile because of a markedly increased retinal thickness in the foveal region was observed. The disappearance of the physiologic foveal profile was always seen. Biomicroscopy revealed an increased reflex of the inner limiting membrane in the first group and minimal alterations in the second one. Four patients (7 eyes) underwent vitrectomy with posterior hyaloid removal. In 5 eyes, the patients experienced a visual improvement greater than two Snellen lines. The restoration of the normal foveal profile and the reduction of the retinal thickness on the OCT were evident in all cases one month after surgery. CONCLUSION: OCT appears to be a useful tool in the diagnosis and management of diabetic macular edema and in the monitoring of the morphological changes after vitrectomy.

Aged↗

PubMed2000

Combined pars plana vitrectomy and sutured posterior chamber implant.

OBJECTIVE: To describe the surgical technique, visual acuity results, and complications of sutured posterior chamber intraocular lenses with complete pars plana vitrectomy. METHOD: A retrospective review of 63 eyes was combined with a telephone survey of the patients and their ophthalmologists. RESULTS: The preoperative diagnoses were trauma, 25 eyes; ectopia lentis, 24 eyes; aphakia following retinal detachment surgery, 7 eyes; cataract surgery, 6 eyes; and endophthalmitis, 1 eye. Mean follow-up was 20 months. Preoperative best-corrected visual acuity was 20/40 or better in 36% (23 of 63 eyes), 20/60 to 20/120 in 33% (21 of 63 eyes), and 20/200 or worse in 31% (19 of 63 eyes) improving to 20/40 or better in 76% (48 of 63 eyes), 20/60 to 20/120 in 18% (11 of 63 eyes), and 20/200 or worse in 6% (4 of 63 eyes) at final follow-up. Preoperative complications included iatrogenic retinal breaks in 3 cases, difficulty with a fixation suture in 1 case, and mild vitreous hemorrhage in 1 case. Postoperative complications included retinal detachment in 2 cases, choroidal hemorrhage in 1 case, intermittent pupil capture in 9 cases, self-limiting vitreous hemorrhage in 3 cases, and late intraocular lenses dislocation in 1 case. CONCLUSIONS: Suturing a posterior chamber implant concurrently, or following, a complete pars plana vitrectomy is a safe procedure. Complete vitrectomy may reduce the rate of long-term complications. Optimal visual rehabilitation can be achieved without the need for contact lens wear with an acceptable additional risk of surgical complications. Arch Ophthalmol. 2000;118:905-910

Adolescent↗

PubMed2000

[Refraction and anterior chamber depth change after vitrectomy for pseudophakia].

PURPOSE: To evaluate the association between the vitreous and the refractive error in pseudophakia. METHODS: Vitrectomy was performed in 67 eyes of 61 patients who underwent cataract surgery. Vitrectomy was needed for epiretinal membrane in 30 eyes, macular edema in 22 eyes, macular hole in 3 eyes, lamelar macular hole in 2 eyes, vitreous opacity in 6 eyes, and vitreous hemorrhage in 4 eyes. Refraction was measured before the operation, and 1 month, 3 months, 6 months, and 12 months after operation. Anterior chamber depth was measured in 10 eyes before the operation, and 1 month, 3 months, and 6 months after operation. We evaluated the refractive error after vitrectomy in 49 eyes that had predicted refraction. RESULTS: The mean value of refractive change was -0.3 D 1 month postoperatively, and then gradually became positive. The variation of refraction (6-month postoperative refraction minus preoperative refraction) was negatively correlated with preoperative refraction (p = 0.0052, R2 = 0.146). If preoperative refraction was more myopic than -1.5 D, then refraction became positive. If preoperative refraction was not more myopic than -1.5 D, then refraction became negative. CONCLUSION: About 15% of postoperative refractive error may be associated with the vitreous, but further investigation is required.

Aged↗

PubMed2000

Combined pars plana lensectomy-vitrectomy with open-loop flexible anterior chamber intraocular lens (AC IOL) implantation for subluxated lenses.

OBJECTIVES: To review our experience with combined pars plana lensectomy-vitrectomy and open-loop flexible anterior chamber intraocular lens (AC IOL) implantation for managing subluxated crystalline lenses. METHODS: Retrospective review of 36 consecutive eyes (28 patients), all of which had subluxated crystalline lenses, managed by pars plana lensectomy-vitrectomy with insertion of an open-loop flexible AC IOL. The study was performed at the Medical College of Wisconsin, Milwaukee, over an 8-year period. RESULTS: An average preoperative visual acuity of 20/163 (range, 20/25 to hand motions) improved to 20/36 (range, 20/20 to 4/200) with surgery after a mean follow-up of 14 months (range, 1 to 59 months) (P < .001, Student's paired t test). Final visual acuity of 20/40 or better was achieved in 75% of eyes (27/36). Complications included cystoid macular edema (8% [3/36]), pupillary block (6% [2/36]), retinal detachment (3% [1/36]), hyphema (3% [1/36]), wound leak (3% [1/36]), and transient vitreous hemorrhage (3% [1/36]). No persistent ocular hypertension was seen, nor did angle abnormalities or corneal decompensation develop. CONCLUSIONS: Pars plana lensectomy-vitrectomy with AC IOL implantation appears to be an excellent technique for managing subluxated crystalline lenses. It is associated with a significant improvement in visual acuity (P < .001) and avoids many of the complications seen with extraction of a subluxated lens through a limbal wound. Additionally, use of an AC IOL offers a simplified alternative to placement of a ciliary sulcus sutured posterior chamber intraocular lens (PC IOL).

Adolescent↗

PubMed2000

Perfluorodecalin condensation on posterior surface of lens capsule and corneal endothelium during vitrectomy.

BACKGROUND: High-density vitreous substitutes, including perfluorodecalin, are widely used in current vitreoretinal surgery. We report 4 cases of perfluorodecalin condensation on the posterior capsule of the lens or corneal endothelium during vitrectomy. To the best of our knowledge, no such phenomenon has ever been reported. METHODS: This study consisted of 4 patients with retinal detachment and large retinal tears. All patients were men. All of the patients underwent pars plana vitrectomy, perfluorodecalin injection, endolaser retinopexy and air-fluid exchange. Two patients received additional surgery for scleral buckling. RESULTS: Perfluorodecalin condensation was observed on the posterior surface of the lens capsule in one phakic patient and on the endothelium in three aphakic patients during vitrectomy. The condensation obscured the image of the fundus and made air-fluid exchange difficult. The condensation could be dissipated by first removing the perfluorodecalin as completely as possible, and then by lowering the intraocular pressure below the vapor pressure of perfluorodecalin. CONCLUSIONS: Perfluorodecalin condensation may occur when perfluorodecalin is not properly used. To avoid forming condensation, high-density vitreous substitutes should never be injected into eyes that are completely air-filled, prolonged air-fluid exchanges should be avoided, and the intraocular pressure should always be kept at a higher level during air-fluid exchange.

Adult↗

PubMed2001

[Long-term results of vitrectomy for complications of proliferative diabetic retinopathy].

PURPOSE: To evaluate the long-term results of vitrectomy for complications of proliferative diabetic retinopathy. METHODS: Five-year follow-up examinations were obtained on 33 eyes of 24 patients that underwent vitrectomy. The preoperative status of macula was no detachment(group 1, 9 eyes), macular detachment(group 2, 17 eyes), and traction macular fold (group 3, 7 eyes). RESULTS: The retina was successfully reattached in 17 eyes(100%). The final visual acuity obtained was as follows: 75% of the eyes had acuity of 0.1 or better in group 1, 65% in group 2, and 86% in group 3; 44% had acuity of 0.5 or better in group 1, 24% in group 2, and 14% in group 3; and 11% had acuity of 0.05 or worse in group 1, 18% in group 2, and 0% in group 3. 11% of the final visual acuity was worse than the postoperative best visual acuity(three lines or more) in group 1, 29% in group 2, and 14% in group 3. The causes of worsening in vision were optic or macular atrophy. CONCLUSIONS: Vitrectomy for complications of proliferative diabetic retinopathy is valuable in improving the patient's visual acuity.

Adult↗

PubMed2001

[Results in the treatment of acute endophthalmitis by vitrectomy using limbal incision].

PURPOSE: To describe the results obtained in the treatment of acute onset endophthalmitis after cataract surgery in our center using vitrectomy with corneal limbal incisions. METHODS: Study carried out in 12 patients with acute endophthalmitis after cataract surgery in whom a posterior vitrectomy by limbic incisions was performed followed by intravitreal injections of antibiotics (vancomycin + ceftazidime/amikacin) with systemic and topical antibiotic and corticosteroid treatment in the post-operative period. RESULTS: The incidence of endophthalmitis in our center was 0.92%. The most frequently isolated microorganism was Staphylococcus epidermidis (4 cases, 33.33%). Four cases were negative (33.33%). A visual acuity equal to or greater than 0.5 at three months was obtained in 6 patients (50%). Only one case required a second administration of intravitreal injections. One patient suffered vitreal hemorrhaging in the post-operative period, and no other complications were observed in the remaining patients. CONCLUSIONS: We consider that vitrectomy through limbal incisions is a valid alternative for acute onset endophthalmitis treatment.

Acute Disease↗

PubMed2001

[Histopathological examination of tissues removed from the retinal surface during vitrectomy in idiopathic macular holes].

PURPOSE: We examined electron microscopically the tissues removed from the retinal surface in cases with idiopathic macular holes. MATERIALS AND METHODS: We performed vitrectomy for idiopathic macular holes in 43 eyes from June 1994 to December 1998 at Fukuoka University Chikushi Hospital. The removed tissues were evaluated with transmission electron microscope in only 8 of the 43 eyes. All cases underwent 3 port vitrectomy. After occurrence of posterior vitreous detachment, epiretinal tissues were removed around the macular hole using a micro-hook needle. RESULTS: All tissues were transparent under an operating microscope, and they curled naturally. Histopathological examination showed that the removed tissues were from 2 to 6.5 microns thick. All tissues were composed mainly of extracellular matrix. There were type 2 collagen fibers in 6 eyes and basement membrane-like structures in 2 eyes. There were few cell components. All cases had the macular hole closed by the first surgery. Four eyes had improved visual acuities of more than 2 lines. The remaining 4 eyes had the same visual acuity as before the operation. CONCLUSION: Residual vitreous on the retinal surface was the main component of the transparent tissues removed from the retinal surface during vitrectomy.

Adult↗

PubMed2002

[Vitreous hemorrhage after vitrectomy in diabetic retinopathy and tissue plasminogen activator].

PURPOSE: To determine if intraocular recombinant tissue plasminogen activator (r-TPA) can be used to treat fibrin blood clots (hyphemas/vitreous) after vitrectomy surgery for diabetic retinopathy. MATERIAL AND METHOD: After a retrospective review of medical records, we found 52 patients who underwent vitrectomy for diabetic retinopathy and non-resolving vitreous hemorrhage and/or hyphema during the early postoperative (6 weeks). They were administered r-TPA in dose of 25 microgr/0.1 ml. Hyphemas and vitreous hemorrhages were classified in four grades. RESULTS: Tissue Plasminogen Activator was used after vitrectomy surgery in 52 fibrin clotted eyes (52 patients), within the first 3 days post surgery. Vitreous hemorrhages were categorized as grade 2 (21%), grade 3 (67.3%) and grade 4 (11.5%). Hyphemas observed in 18 eyes presented grade 3 (38.9%) and grade 4 (61%). We saw no evidence of intraocular reactions against the r-TPA solution at the dose used in this study. CONCLUSIONS: Fibrin blood clots can successfully and effectively be treated with intraocular r-TPA in doses of 25 microgr/0.1 ml (Arch Soc Esp Oftalmol 2002; 77: 7-12).

Adult↗

PubMed2001

The effect of vitrectomy with silicone oil tamponade on intraocular pressure and anterior chamber morphology.

We measured the tamponading effect of silicone oil, saline and air after vitrectomy, on intraocular pressure and aqueous humor outflow in 85 patients with highly proliferative retina and vitreous changes. Silicone oil as retinal tamponading agent after vitrectomy was used in 45 patients, and saline or air in 39 patients. The mean intraocular pressure measured at one month after treatment was greatly elevated in patients with silicone oil tamponade as compared to those with saline or air tamponade. At 6 and 12 months examinations, mean intraocular pressures were compared in these two groups of patients. Gonioscopy revealed silicone oil emulsification and presence of emulsified bubbles in the anterior chamber in 22.22% of patients, and narrowing of the chamber angle in several patients with silicone oil tamponade. Intraocular pressure elevation following vitrectomy with silicone oil tamponade was found to be of transient rather than permanent nature, since it regressed after silicone oil removal. This transient elevation was due to silicone oil tendency to emulsify. Silicone oil bubbles changed the morphology of the anterior chamber angle and fine trabecular structures by creating a barrier to aqueous humor outflow.

Air↗

PubMed1999

[Vitrectomy for vitreous hemorrhage caused by retinal vein occlusion].

OBJECTIVE: To evaluate the efficacy and complications of vitrectomy for vitreous hemorrhage after retinal vein occlusion. METHODS: We retrospectively studied 47 patients (47 eyes) having undergone vitrectomy during the period from April, 1992 to December, 1996. Follow-up was made on 30 patients. RESULTS: (1) Visual acuity was improved postoperatively in 80% of the eyes. The patients with branch vein occlusion achieved more favorable final vision than those with central retinal vein occlusion (P < 0.05). (2) The most common complications were lens opacity, recurrent vitreous hemorrhage, iatrogenic rhegmatogenous retinal detachment and glaucoma. (3) Patients treated with endophotocoagulation had a lower rate of recurrent vitreous hemorrhage (P < 0.05). CONCLUSIONS: (1) More than half of the patients can achieve ambulant vision after vitrectomy for vitrous hemorrhage induced by retinal vein occlusion. (2) Recurrent vitreous hemorrhage can be effectively prevented by endophotocoagulation during the operation.

Adult↗

PubMed1999

[Timing of vitrectomy for proliferative diabetic retinopathy in cases with type II diabetes mellitus].

OBJECTIVE: To determine the timing of vitrectomy for proliferative diabetic retinopathy with severe vitreous hemorrhage, retinal traction and even tractional detachment resulted from fibrovascular membranes in type II diabetes mellitus. METHODS: According to the preoperative duration of vitreous hemorrhage and severity of diabetic retinopathy, 78 eyes of 64 cases having undergone vitrectomy were divided into 2 groups for the comparison of postoperative visual acuity. RESULTS: After 9 months of follow-up, in the group with preoperative vitreous hemorrhage of or= 0.3, while in the group with preoperative vitreous hemorrhage of > 6 months' duration 5.3% of cases reached such a level (P < 0.01). After one year, in the group with preoperative vitreous hemorrhage of or= 0.5, while in the group with preoperative vitreous hemorrhages of > 6 months' duration, 7.1% (P < 0.05). In the group of vitreous hemorrhage with or without local tractional retinal detachment, 35.7% had visual acuity of >or= 0.5, while in the group with large area of tractional retinal detachment, 16.7% (P < 0.05). CONCLUSION: Earlier vitrectomy is preferable for type II diabetes mellitus with vitreous hemorrhage, and the operative treatment should not be abandoned for the patients with vitreous hemorrhage of longer duration and severe tractional retinal detachment.

Diabetes Mellitus, Type 2↗

PubMed2002

[Glaucoma valve devices for refractory glaucoma following vitrectomy].

OBJECTIVE: To evaluate the surgical effectiveness of glaucoma valve devices for refractory glaucoma following vitrectomy surgery. METHODS: Sixteen eyes of 15 patients suffering from secondary glaucoma following vitrectomy were treated with glaucoma valve implantation, all of the eyes were in critical condition, and the intraocular pressure failed to control after the silicone oil removal and/or with glaucoma medication. Among them, 13 eyes underwent Ahmed valve implantation and 3 eyes underwent Krupin disk implantation. RESULTS: The mean follow-up was 18.5 months. The total success rate was 76.9% at 3 months, 70.0% at 6 months and 66.7% at one year or longer. The postoperative complications included transient hyphema, early postoperative hypotony, choroidal detachment, shallow anterior chamber and obstruction of the tube tip. CONCLUSION: The glaucoma valve device is a safe and effective method for refractory glaucoma following vitrectomy, especially for the patients who have a certain level of visual acuity.

Adult↗

PubMed2002

[Vitrectomy for asteroid hyalosis].

PURPOSE: To evaluate the role of pars plana vitrectomy for asteroid hyalosis and synchisys scintillans with decrease of visual acuity. METHODS: Retrospective study of 15 patients on whom pars plana vitrectomy was performed. We studied the visual acuity before the surgery, the best and the final vision. Risk vascular factors, intraocular pressure, complications during the surgery or in the follow up were determined. RESULTS: We operated on 17 eyes of 15 patients (10 male, 5 female). In 2 cases we added peeling of macular pucker and in two cases a cataract surgery. Average age was 73.8 (standard deviation 8.6); risk vascular factors were found in 66.6%. There weren't any complications during the surgery. Later, 4 cataracts, 3 macular pucker and 1 macular hole (stage IV) developed. The average vision before the surgery was 20/60, the best 20/40 and the final vision 20/50. Average follow up time was 22.8 (s.d. 17.3) months. CONCLUSIONS: Asteroid hialosis was more frequent in elderly males (2/3) and in patients with risk vascular factors (66.6%). Cataract surgery was necessary in 50% of eyes during or after the pars plana vitrectomy. Seventeen percent of eyes presented macular pucker in the follow up. Recovery of vision was less than expected.

Aged↗

PubMed2002

[Can vitrectomy without use of microscissors improve results of surgery for proliferative diabetic retinopathy?].

In order to test the hypothesis that in proliferative diabetic retinopathy surgery the vitrectomy without the use of microscissors could improve the results and decrease the rate of complications as well as the operating time, two groups are compared in a consecutive series of 24 eyes, operated on with or without scissors, and with a minimum follow-up of 6 months. The study shows that the vitrectomy without scissors offers a higher percentage of eyes with a postoperative visual acuity at least two lines better than the preoperative visual acuity. It shows also a trend for a shorter surgery, with fewer complications in case of vitrectomy without scissors.

Diabetic Retinopathy↗

PubMed2002

[Therapeutic vitrectomy for severe uveitis and its complications].

OBJECTIVE: To investigate the therapeutic value of vitrectomy for uveitis and its complications. METHODS: Vitrectomy was performed on 14 patients (14 eyes) with uveitis. In these 14 eyes, there were 6 eyes with severe opacity of vitreous, 5 eyes with cataract, 5 eyes with retinal detachment, and 3 eyes with poor response to medication. Pars plana lenectomy, scleral cryopexy, buckling procedure, endolaser photocoagulation, gas-fluid exchange or silicone oil intraocular tamponade were added according to the different needs. The follow-up varied from 18 to 45 months. RESULTS: Twelve of the 14 eyes obtained better visual acuity, and in the other two light perception remained; less drugs were used after operation in all cases, and the uveitis was controlled. CONCLUSION: Vitrectomy is an effective method for severe uveitis and its complications both in the improvement or stabilization of visual acuity and in the reduction or cessation of systemic treatment.

Adolescent↗