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At least 667 records · Page 37Linked to original sources

PubMed2003

[Diabetic cystoid macular edema and vitrectomy. Preliminary results: about 19 cases].

INTRODUCTION: Vitrectomy can be performed to release the anteroposterior and tangential vitreoretinal tractions that sometimes create diabetic macular edema. The present study evaluates the efficacy of this treatment. MATERIAL AND METHODS: We retrospectively studied 19 operated eyes in 15 patients with diabetes over 17 months. The group's mean age was 61.4 years. There were 11 men and 4 women, with 13 cases of noninsulinodependent and two cases of insulinodependent diabetes. A vitrectomy was done by the same surgeon to detach posterior hyaloidal and inner limiting membranes. Two groups were defined and compared, one including patients whose visual acuity had improved and the other, patients with no improvement. We used Student's t test and Leven's test from SPSS. RESULTS: Improvement in visual acuity was observed in 57.8% of the eyes studied, stabilization was achieved in 26.3%, and regression was noted in 15.7%. Cystoid macular edema resolved in 68.42% of eyes. Furthermore, inner limiting membrane colored by indocyanine green was removed. An angiographic improvement was noted in 68.42% of eyes. There was no significant difference between the two groups allowing a definition of success criteria. CONCLUSION: Vitrectomy for diabetic cystoid macular edema is currently under study and seems effective given its encouraging results.

Age Factors↗

PubMed2003

[Evaluation of the results of cataract extraction and lends implantation in eyes after vitrectomy].

PURPOSE: To evaluate the results of cataract surgery in previously vitrectomized eyes. MATERIAL AND METHODS: In 41 eyes, that had undergone prior vitrectomy, extracapsular cataract extraction was done and intraocular lens was implanted. The average time between operations was 14.5 months (range from 2 months to 6 years). The mean follow-up was 19 +/- 12.2 months (range from 4 months to 4 years). RESULTS: Statistically significant improvement was observed in visual acuity after cataract extraction and IOL implantation, compared to the results after vitrectomy. The most frequent complication was posterior capsule opacification, which occurred in 9 eyes (22%). CONCLUSIONS: The results show, that intraocular lens implantation in eyes after vitrectomy is safe and achieved visual acuity is similar or better, than before cataract formation.

Adult↗

PubMed2003

Vitrectomy and silicone oil in the treatment of acute endophthalmitis. Preliminary results.

PURPOSE: To evaluate the role of pars plana vitrectomy (PPV) and silicone oil injection in the treatment strategy of severe endophthalmitis. PATIENTS AND METHODS: This study analyses a retrospective case series of 34 patients with signs and symptoms of severe endophthalmitis with visual acuity limited to light perception. All underwent PPV with intraocular injection of antibiotics (IOAB), together with topical and oral antibiotics. In 10 patients (group 1), this treatment alone was sufficient to control infection. In 10 other patients (group 2) with the same initial treatment, a new vitrectomy was needed: 8 because of retinal detachment, 2 because of persistent infection. In 2 patients (group 3), initially treated with PPV and IOAB, a second vitrectomy with IOAB and silicone oil tamponade was needed to stop infection. In 12 patients (group 4), with the worse prognosis related to the severity of infection and/or to associated retinal necrosis, PPV, IOAB and silicone oil tamponade were conducted at first surgery. Final anatomic status and visual acuity were assessed to compare the effectiveness of these different treatments. RESULTS: In 22 patients (group 1, 2 and 3) treated initially without silicone oil, 12 patients (55%) needed further surgery, either for persistent infection or retinal detachment. Twelve patients (group 4) treated at first with silicone oil had a rapid control of the infectious process and better anatomical results with this procedure only. Final visual acuity was also better in the silicone oil groups (group 3 and 4) than in the non silicone groups (group 1 and 2). CONCLUSION: These results suggest that silicone oil tamponade might be beneficial in the treatment strategy of severe endophthalmitis.

Acute Disease↗

PubMed2003

[Iatrogenic retinal breaks during vitrectomy: retrospective study].

PURPOSE: To establish the incidence and characteristics of iatrogenic retinal breaks occurring during vitrectomy and to propose a protocol for their management. METHODS: Retrospective study of 195 consecutive vitrectomies performed in 2001. Minimum follow up was 3 months for all cases. RESULTS: 13 patients with iatrogenic retinal breaks (6.6%) have been detected. In 8 cases the breaks affected the peripheral retina, in 4 cases they were located in the posterior pole and there was one retinal dialysis. In 4 cases there were more than one retinal break. 9 patients (70%) were vitrectomized for diabetic retinal complications. In 12 cases, the breaks were detected during surgery and treated with endolaser and/or cryoretinopexy (3 cases located inferiorly). Nevertheless 7 cases (54%) developed a retinal detachment, 2 of which could be reattached. CONCLUSIONS: Among iatrogenic retinal breaks produced during vitrectomy, the peripheral ones are slightly more frequent than the breaks in the posterior pole. Iatrogenic breaks occur more frequently in diabetic patients, having a bad prognosis and often developing a retinal detachment despite endolaser or cryoretinopexy.

Adult↗

PubMed2003

Comparison of primary gas tamponade and a vitrectomy for repair of macular holes with retinal detachment in highly myopic eyes.

BACKGROUND: A preference for the primary use of standard gas tamponade or a vitrectomy combined with other adjuvant measures to treat myopic eyes with macular holes (MHs) and retinal detachment (RD) has not been established. This article evaluates postoperative outcomes of both surgeries, and recommends a surgical method based on the findings. METHODS: We reviewed the records of 61 patients (62 eyes) with high myopia (> -6.0 diopter, > 26 mm of axial length, or visible posterior staphyloma) and MHs with secondary RD (no peripheral retinal break) who were treated between April 1986 and September 2002 in southern Taiwan. Descriptive statistics of baseline examinations and results of the operations were retrospectively analyzed. RESULTS: Baseline clinical data of the primary gas tamponade and vitrectomy groups did not significantly differ, except for the mean preoperative log (minimum angle of resolution) visual acuity (VA) (p = 0.016) and extent of RD (p = 0.001, located in the posterior staphyloma only). None of the results (including success rate, cause of failure, number of operations until stability was achieved, and mean duration of postoperative follow-up) of the operations in the 2 groups significantly differed, except for the improved VA at the final status (p = 0.03). CONCLUSION: Among highly myopic eyes with MHs, we suggest a vitrectomy for those with poorer VA and a greater extent of RD. However, gas tamponade is strongly recommended for those with RD with posterior staphyloma (PS) only because this procedure is safer and requires no sophisticated instruments.

Adult↗

PubMed2003

[Application of endolaser in vitrectomy for retinal vascular disease].

PURPOSE: To discuss the usage and effectiveness of endolaser in vitrectomy for retinal vascular disease. METHODS: Twenty-four cases (28 eyes) of vitrectomy for retinal vascular disease were treated with endolaser. The methods of endolaser: 21 eyes were treated with panretinal scatter therapy; 2 eyes with endolaser ring-intercepting around retinal and sealing retinal breaks; 5 eye with focal therapy. RESULTS: After follow-up for 1-24 months (mean 9 months), retinal hemorrhage recurred in 3 eyes; the other 25 eyes, retinas were totally reattached, retinal breaks were sealed, and vision had considerable recovery, no hemorrhage. The ratio of recovery is up to 89.2%. CONCLUSIONS: Endolaser is an important adjuvant in vitreous operation nowadays and an effective procedure in vitrectomy for the cases of retinal hemorrhage.

Adolescent↗

PubMed2003

[Pars plana vitrectomy with corneal transplantation -- combined procedure].

The aim of our study is to present own observations with Eckardt temporary keratoprosthesis, during combined pars plana vitrectomy and corneal transplantation. We operated on two aphakic patients with unclear corneas and retinal detachment--I case, phthisis bulbi after recurrent uveitis--II case. Eckardt temporary keratoprosthesis was sutured to the corneal bed with 4 or 6 Ethilon 10.0 bites, pars plana vitrectomy was performed followed by corneal transplantation and silicone oil tamponade. We obtained good transplant clarity only in the I case, in the II case because of hipotony and persistent contract of silicone oil with cornea, transplant was cloudy and collapsed with small exception in the central area. After 3-rd month we noticed local retinal detachment in the periphery, which was suppressed with laser photocoagulations. We think, that Eckardt temporary keratoprosthesis gives possibility to do vitrectomy in patients with undear cornea, which was in the past impossible. However, combined procedure requires surgical skills in both: anterior and posterior segments of the eye.

Aged↗

PubMed2003

The role of patient age and intraocular gases in cataract progression following vitrectomy for macular holes and epiretinal membranes.

PURPOSE: To evaluate the rate of increase in nuclear sclerosis and posterior subcapsular cataracts in eyes as a function of patient age and use of intravitreal gas at the time of vitrectomy. METHODS: Nuclear sclerotic cataracts and posterior subcapsular cataracts were graded on a scale of 0 to 4.0 in 301 consecutive eyes prior and subsequent to vitrectomy for macular holes, epiretinal membranes, or vitreomacular traction syndrome. Linear regression analysis was performed to compare the rate of change in cataract score. RESULTS: Nuclear sclerotic cataracts showed minimal increase in patients younger than 50 years of age following vitrectomy (.13 grades per year). Nuclear sclerotic cataracts increased at a rate of .7 to .9 grades per year (mean, .812) in patients from age 50 to 60, 60 to 70, 70 to 80, and 80+ years, even though the baseline nuclear sclerosis scores were progressively greater for each decade. The increase in nuclear sclerotic cataracts in patients younger than 50 years was significantly less (P<.001) than in patients 50 years or older. The fellow nonsurgical eyes of patients 50 years or older also showed smaller increases in nuclear sclerotic cataracts over time (.091 to .342 grades per year; mean, .139). Eyes with intraocular gas use had a higher rate of nuclear sclerosis progression (.8 grades per year) compared to eyes without intraocular gas bubbles (.5 grades per year) (P<.001). Posterior subcapsular cataract scores showed minimal or no increases in all groups. CONCLUSIONS: Patients older than 50 years have a similar rate of increase in nuclear sclerotic cataracts independent of age. The rate is sixfold greater than in patients younger than 50 years and also sixfold greater than the progression of nuclear sclerosis in the fellow nonsurgical eyes. Intravitreal gas bubbles cause nuclear sclerosis to increase by 60%, compared to eyes without use of a gas bubble.

Aged↗

PubMedDate not supplied

A curved vitrectomy probe.

A curved vitrectomy probe for better accessibility of the peripheral retina in phakic eyes is described. The specially designed curved vitrectomy probe has a 20-gauge pneumatic cutter. The radius of curvature at the shaft is 19.4 mm and it is 25 mm long. The ora serrata is accessed through a 3.0- or 4.0-mm sclerotomy in phakic eyes without touching the crystalline lens. Use of this instrument avoids inadvertent trauma to the clear lens in phakic eyes requiring vitreous base excision. This curved vitrectomy instrument complements wide-angle viewing systems and endoscopes for safe surgical treatment of peripheral retinal pathology in phakic eyes.

Equipment Design↗

PubMed2004

[Vitrectomy for idiopathic and secondary preretinal macular membrane].

PURPOSE: To evaluate the results of pars plana vitrectomy and membrane stripping for idiopathic and secondary preretinal macular membrane (PMM). MATERIAL AND METHODS: Twenty one consecutive subjects (21 eyes) ranging in age from 40 to 78 (mean 66.9) with PMM underwent vitrectomy and membrane peeling. 17 cases had membranes that were considered idiopathic, and 4 cases were associated with other disorders: 3 occurred after successful retinal reattachment surgery, 1--after laserotherapy in the course of diabetic retinopathy. Visual acuity (VA), Amsler grid, and postoperative complications were assessed. The follow-up was 1 to 22 months, mean 5.7. RESULTS: Visual acuity improved postoperatively in 15 eyes (71.4%), at least two lines on the Snellen chart in 8 eyes (38.1%), entirely in patients with idiopathic PMM. It remained unchanged in 3 eyes (14.3%) and deteriorated in 3 eyes (14.3%). Eyes with transparent membrane showed greater visual improvement than opaque ones. The preoperative Amsler test was positive in 15 patients (71.4%), postoperatively--in 4 cases (19%). 2 idiopathic cases with VA of 0.7 showed postoperatively VA of 1.0. Complications included retinal detachment in 2 eyes (1 in idiopathic and 1 in secondary PMM), and development of nuclear sclerotic cataract in 2 eyes. At 6 months of follow-up, a residual membrane formation in 1 cases appeared. Macular pseudohole was observed in 1 eye with no impact on visual results. CONCLUSIONS: 1. Vitrectomy with membrane peeling for preretinal macular membrane provides improvement in visual acuity and reduces metamorphopsia 2. Thin, cellophane-like appearance of the membrane gives a better prognosis of visual function improvement.

Adult↗

PubMed2004

[Long-term effect of combined penetrating keratoplasty and pars plana vitrectomy with temporary keratoprosthesis].

OBJECTIVE: To evaluate the long-term effect of combined penetrating keratoplasty, pars plana vitrectomy and temporary keratoprosthesis for the treatment of complicated anterior and posterior segment diseases. METHODS: Combined penetrating keratoplasty and pars plana vitrectomy were performed in 107 eyes with temporary keratoprosthesis. The mean follow-up period was 13 months. Visual acuity, graft transparency, intraocular pressure and vitreoretinal anatomic status were examined during the follow-up. The criteria of success of the operation included a transparent graft, reattached retina and normal intraocular pressure with or without medication. RESULTS: Ninety-two eyes. 86.0%) could be preserved after the operation, including 78 eyes (72.9%) with clear graft, reattached retina and normal intraocular pressure. Graft rejection occurred in 34 eyes (31.8%), atrophy of the eye in 13 eyes (12.2%) and secondary glaucoma in 15 eyes (14.0%). The success rate for re-attachment of the retina was higher in eyes without pre-operative proliferative vitreoretinopathy. CONCLUSIONS: Combined penetrating keratoplasty and pars plana vitrectomy with temporary keratoprosthesis appear to be effective in the treatment of severe ocular injury. Decompensation of corneal endothelium function and proliferative vitreoretinopathy are the main causes for failure of the operation.

Adolescent↗

PubMed2004

Diagnostic ultrasound and pars plana vitrectomy in endophthalmitis.

PURPOSE: To compare the results by B-scan ultrasonography and findings in pars plana vitrectomy, and assess the diagnostic value of B-scan ultrasonography in endophthalmitis. METHODS: Thirty eyes of 30 subjects diagnosed as endophthalmitis were selected, who undergone preoperative B-scan ultrasonography. The result of pars plana vitrectomy was recorded. The above two results were compared. RESULTS: On the evaluation of vitreous and retinal states in the patients with endophthalmitis, the sensitivity of ultrasound was 90%-100%, and the specificity was 79%-100%. Poorer preoperative visual acuity was related with retinal detachment and retinal dissolution. The preoperative visual acuity in eyes with local vitreous opacity was better than with diffuse vitreous opacity. CONCLUSION: Comparison of the results of B-scan ultrasonography and the findings in pars plana vitrectomy showed B-scan ultrasonography is highly sensitive, specific, and is very helpful in the evaluation of endophthalmitis. B-scan ultrasonography can not only supply much information in the diagnosis of endophthalmitis but also inspect its trends and changes, which is helpful in the selection of treatment and planning the time of surgery.

Adolescent↗

PubMed2004

[Vitrectomy with daunorubicin].

PURPOSE: The vitreoretinal re-proliferations (PVR) are the most eminent cause of retinal surgery misfortunes. Daunorubicin has been widely discussed as the antimetabolic drug for PVR treatment for recent 20 years. The aim of the study was to evaluate the usefulness of daunorubicin, applied intravitreally during vitrectomy, as an antiproliferative factor stopping the vitreoretinal re-proliferations in eyes with rhegamatogenous retinal detachment complicated with PVR. MATERIAL AND METHODS: Vitrectomy, with daunorubicin infusion (1 microg/ml), was performed in 6 eyes with rhegamatogenous retinal detachment and PVR. In 6 other cases of retinal detachment, the gentamycine (20 mg/ml) solution was used as a vitrectomy infusion. During the 12 months follow-up, the risk of PVR relapse was evaluated. RESULTS: There was no signs of PVR relapse in the eyes treated with daunorubicin during the 12 months follow-up. As in the group of patients that had no daunorubicin infusion the PVR re-proliferation occurred in 2 of 6 operated eyes. CONCLUSIONS: 12 months follow-up showed that Daunorubicine could be a useful adjuvant drug reducing the rate of re-proliferations in the patients with rhegamatogenous retinal detachment.

Adult↗

PubMed2004

[Combined surgery, phacoemulsification, implantation of intraocular lens and pars plana vitrectomy].

PURPOSE: To evaluate the effectiveness, technical feasibility and incidence of complications after combining pars plana vitrectomy, phacoemulsification and intraocular lens implantation. MATERIAL AND METHODS: The results of combined vitreoretinal and cataract surgery in 100 eyes of 96 patients were retrospectively and prospectively analyzed. The mean follow-up period was 8.4 months. All patients had clinically significant lens opacities and vitreoretinal pathology requiring pars plana vitrectomy. Indications for vitreoretinal surgery included: persistent vitreous haemorrhage (28 eyes), vitreous hemorrhage combined with tractional retinal detachment (50 eyes), tractional retinal detachment without vitreous haemorrhage caused by proliferative diabetic retinopathy (7 eyes), rheumatogenous retinal detachment with proliferative vitreoretinopathy (10 eyes) and dislocated crystalline lens in the vitreous (5 eyes). RESULTS: Postoperatively, best corrected visual acuity improved in 81 eyes (81%)- by two lines or more in 31 eyes (31%) - by less than two lines in 50 eyes (50%). In 14 eyes (14%) visual acuity was unchanged and was worse in 5 cases (5%). Postoperative complications included fibrin reaction, posterior synechias of the iris, vitreous hemorrhage, neovascular glaucoma, posterior capsule opacification, redetachment of retina. CONCLUSIONS: Our cases confirm previous study, that performing phacoemulsification, IOL implantation and vitrectomy in one operation is safe and allows visual recovery with good technical results.

Adult↗

PubMed2004

Vitrectomy for epiretinal membranes with good visual acuity.

PURPOSE: To evaluate the visual results of vitrectomy for epiretinal membrane in eyes with a preoperative visual acuity of 20/50 or better. METHODS: The visual results and complications were analyzed following vitrectomy for idiopathic epiretinal membranes and epiretinal membranes secondary to retinal tears. This study was a retrospective, consecutive case series of 40 eyes of 40 patients treated by a single surgeon. RESULTS: The mean preoperative visual acuity was 20/50 +2 (range, 20/30 +1 to 20/50 -3). The mean visual acuity improved to 20/40 +2 (P = .02) by the final examination at a mean of 2.4 years following surgery. The status of the lens at the final examination was correlated with the visual results of surgery. Twenty-one eyes were phakic preoperatively, and 14 of these eyes had cataracts removed by the final examination. The mean preoperative visual acuity in seven eyes that were still phakic at the final examination was 20/50, and this decreased to 20/50 -2 (P = .82). The mean preoperative visual acuity was 20/50 +2 in 33 eyes that were pseudophakic by the final examination, and this improved to 20/32 -2 (P = .005). The visual acuity improved by 2 or more Snellen lines in only one in seven eyes (14%) that were still phakic on the final examination and in 14 of 33 eyes (42.4%) that were pseudophakic by the final examination. There were no serious surgical complications. CONCLUSIONS: Vitrectomy for epiretinal membranes is beneficial in eyes with relatively good preoperative visual acuities, but cataract surgery is necessary in phakic eyes to achieve long-term visual acuity improvement.

Aged↗

PubMed1992

[Aqueous protein concentration after vitrectomy for diabetic retinopathy].

The protein concentration in the aqueous humor in 46 eyes with proliferative diabetic retinopathy was quantitated before and after vitrectomy. Before surgery, the protein value as measured by a laser flare-cell meter was 5 times that in normal control eyes. The value was elevated on day 3 after surgery and gradually decreased to reach the preoperative value 1 month after surgery. The postoperative protein value significantly increased in accordance with the complexity of surgical maneuvers until day 17 when the 46 eyes were classified into 3 groups: simple-maneuver group (12 eyes), membrane delamination group (18 eyes) and silicone oil group (16 eyes). The time course of aqueous protein concentration in the simple-maneuver group was similar to that after vitrectomy for vitreous hemorrhage in 8 eyes with prior branch retinal vein occlusion. The observed increase in aqueous protein after vitrectomy seemed to be transferred from vitreous cavity to anterior chamber.

Adult↗

PubMed2005

[Vitrectomy for proliferative diabetic retinopathy].

PURPOSE: We reviewed the outcome of vitrectomy for proliferative diabetic retinopathy (DR) and evaluated factors affecting the final visual outcome. METHODS: We performed primary vitreous surgery for proliferative DR in 148 eyes of 118 cases in three years from July 1999 to August 2002. All cases were followed for at least 3 months. We excluded vitreous surgery for diabetic maculopathy. Ages ranged from 24 to 80 (mean 57) years. Average postoperative follow-up period was 15 months. We evaluated the stage of DR by the new Fukuda classification. RESULT: Preoperative classification consisted of BIV (54 eyes, 36%), BV (94 eyes, 64%), and BV + VI (36 eyes). Final visual acuity was improved by 2 lines or more in 102 eyes (69%), remained unchanged in 28 eyes (19%), and decreased by two lines or more in 18 eyes (12%). There was a statistical correlation between preoperative visual acuity and final visual acuity. Earlier stages of DR had better visual outcome. Compared to the surgical outcome in the 1990s, the percentage of worsened eyes decreased. CONCLUSION: Vitrectomy for proliferative DR may be beneficial if performed in the earlier stages of DR or if the patient has better visual acuity before vitrectomy.

Adult↗

PubMedDate not supplied

Long-term results of pars plana vitrectomy combined with filtering surgery for neovascular glaucoma.

BACKGROUND AND OBJECTIVE: To analyze the effectiveness of vitrectomy combined with filtering surgery for neovascular glaucoma. PATIENTS AND METHODS: Twenty-one eyes with neovascular glaucoma underwent pars plana vitrectomy combined with filtering surgery between January 1995 and December 2003. Thirteen eyes (10 cases) had neovascular glaucoma secondary to proliferative diabetic retinopathy and 8 eyes (8 cases) had neovascular glaucoma secondary to central retinal vein occlusion. The initial intraocular pressures ranged from 21 to 70 mm Hg with full medication. All cases were observed for more than 12 months after the last surgery and the ophthalmic records were retrospectively reviewed. RESULTS: During the follow-up period, 19 eyes (90.5%) had intraocular pressures of less than 21 mm Hg with or without antiglaucoma eye drops, whereas 18 eyes (85.7%) had a stable or improved visual acuity. CONCLUSION: Vitrectomy combined with filtering surgery is considered to be an effective treatment for neovascular glaucoma to maintain the visual function for a long period.

Aged↗