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Results for “Vitrectomy”

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At least 685 records · Page 38Linked to original sources

PubMed2005

Vitrectomy with peeling of the inner limiting membrane for treating diabetic macular edema.

PURPOSE: to evaluate the results of pars plana vitrectomy with peeling of the inner limiting membrane (ILM stained with infracyanine green (IfCG) in 26 patients with diabetic macular edema, and to identify which factors are associated with a better postoperative visual outcome. PATIENTS AND METHODS: 26 patients with diabetic macular edema were included in the study. A pars plana vitrectomy with ILM peeling stained with IfCG was performed, in some cases combined with cataract surgery. In 22 patients the ILM was retained, examined with electron microscopy and compared with normal ILM's. Visual acuity and fundus examination were recorded several months after surgery. To determine which factors lead to the best postoperative results, patients were divided into different groups and compared. RESULTS: during surgery, a taut posterior hyaloid was found in 26 patients, which was successfully detached in all cases. ILM peeling within the vessel arcade succeeded in all patients. Postoperative examination showed improved visual acuity and decreased macular edema in 19 patients, unaltered visual acuity in 3 patients and decreased visual acuity in 4 patients. Comparison between different groups of patients revealed that young patients with recent vision loss and without previous macular laser treatment, had better postoperative results. Electron microscopical examination showed a more condensed ILM in diabetic patients, consisting of a layer of fine curled fibers. CONCLUSION: pars plana vitrectomy with peeling of the ILM stained with IfCG leads to good postoperative results in young diabetic patients with recent vision loss due to macular edema and without previous macular laser treatment.

Adult↗

PubMed2005

Phacoemulsification, vitrectomy and the implantation of an intraocular lens in diabetic patients.

The purpose of this study was to evaluate results of combined phacoemulsification, intraocular lens implantation and pars plana vitrectomy in patients with advanced diabetic retinopathy. We retrospectively evaluated postoperative outcomes and complications in 102 eyes of 102 patients who underwent a combined procedure. All patients had a visually significant cataract. Forty two patients had vitreous hemorrhage and mild proliferative diabetic retinopathy. Sixty patients had a mild tractional retinal detachment. The median follow up was 14 months (range 6-36 months). 80% of patients had an increase of visual acuity of at least 2 Snellen lines. The most frequent early postoperative complication was elevated intraocular pressure, followed by mild fibrinous reaction. The most frequent late postoperative complication was the presence of posterior synechia, followed by glaucoma. Eleven patients required a repeated pars plana vitrectomy. Combined phacoemulsification, posterior chamber intraocular lens implantation and pars plana vitrectomy can be successfully performed in selected diabetic patients with favorable postoperative outcome.

Adult↗

PubMed2005

[Anterior segment fluorescein angiography for evaluating the effect of vitrectomy for neovascular glaucoma].

PURPOSE: Using anterior segment fluorescein angiography(AFA), we evaluated the relationship between the effect of vitrectomy combined with endophotocoagulation for neovascular glaucoma and the postoperative angiographic changes. SUBJECTS AND METHODS: Seven eyes of 7 patients (six eyes of 6 patients had proliferative diabetic retinopathy and 1 eye of 1 patient had central retinal vein occlusion) with neovascular glaucoma underwent both vitrectomy combined with endophotocoagulation and AFA before and after surgery. RESULTS: Of the 7 cases, the three eyes(42.9%), ther received one vitreous surgery alone had a reduction in intraocular pressure (IOP). The other 4 with uncontrollable IOP underwent trabeculectomy additionally, and three of them achieved good control of IOP. AFA showed less dye leakage in the iris after surgery in all cases. Three of 4 eyes with less dye leakage in the chamber angle showed good IOP control. Two of 3 eyes without the change in dye leakage were treated additionally by trabeculectomy. CONCLUSION: AFA is a sensitive technique in the assessment of neovascularization in the anterior segment, so that it is useful in evaluating the effect of vitrectomy combined with endophotocoagulation for neovascular glaucoma.

Adult↗

PubMedDate not supplied

Visual outcome of vitrectomy in seasonal hyperacute pan uveitis.

INTRODUCTION: Seasonal Hyper Acute Panuveitis (SHAPU) is a sight threatening condition often affecting children. Its management as yet is a challenge in ophthalmic practice. Most of the eyes even after treatment end up in pthisis bulbi. MATERIALS AND METHODS: A retrospective hospital based analysis of 18 patients with SHAPU managed with vitrectomy at Himalaya Eye Hospital (HEH) Pokhara over a period of two years was carried out. RESULTS: Out of 18 patients 10 were males. Majority of them were below the age of 15 years. Best corrected visual acuity (BCVA) at presentation was less then 3/60 in 72% of them. BCVA was better then 6/60 in 7 (50%) out of 14 patients, who underwent vitrectomy. CONCLUSION: Vitrectomy is a useful procedure in management of SHAPU.

Adolescent↗

PubMedDate not supplied

Combined pars plana vitrectomy and cataract surgery: outcome of phacoemulsification versus manual extracapsular cataract extraction through a sclerocorneal tunnel.

BACKGROUND AND OBJECTIVE: To compare the results of combined pars plana vitrectomy and cataract extraction with intraocular lens implantation by phacoemulsification versus manual extracapsular cataract extraction through a sclerocorneal tunnel. PATIENTS AND METHODS: Retrospective chart review of all patients who underwent combined pars plana vitrectomy with intraocular lens implantation and phacoemulsification or extracapsular cataract extraction through a sclerocorneal tunnel between March 1992 and July 2002. RESULTS: Fifty-four eyes of 51 patients were evaluated. Mean age was 69.68 +/- 9.11 years, and mean follow-up was 9 months. Phacoemulsification was performed in 35 cases (64%) and manual extraction in 19 cases (36%). Visual acuity improved from mean logarithm of the minimal angle of resolution 1.69 +/- 0.54 before surgery to 1.22 +/- 0.76 after surgery. There was a greater improvement of visual acuity in the phacoemulsification group (0.59 +/- 0.67) than in the extracapsular cataract extraction group (0.22 +/- 0.68) (P = .06). Final visual acuity was correlated to the vitreoretinal pathology. Ultrasound biomicroscopy showed well-positioned foldable or rigid intraocular lens in the bag or in the sulcus. CONCLUSION: Combined cataract extraction by phacoemulsification or extracapsular cataract extraction through sclerocorneal tunnel and pars plana vitrectomy are safe and effective procedures.

Adult↗

PubMed2006

Surgical outcomes of 25-gauge transconjunctival vitrectomy combined with cataract surgery for vitreoretinal diseases.

INTRODUCTION: To report surgical outcomes of 25-gauge transconjunctival vitrectomy combined with cataract surgery for the management of a variety of vitreoretinal diseases. MATERIALS AND METHODS: A retrospective, interventional case study was conducted. Chart review of a consecutive series of 150 eyes of 144 patients who underwent 25-gauge vitrectomy combined with phacoemulsification and intraocular lens implantation for epiretinal membrane (n = 62), refractory macular oedema associated with retinal vascular disorders (n = 29), idiopathic macular hole (n = 21), non-clearing vitreous haemorrhage (n = 18), rhegmatogenous retinal detachment (n = 11), tractional retinal detachment associated with proliferative diabetic retinopathy (n = 7), and subretinal haemorrhage (n = 2). Main outcome measures included preand postoperative visual acuity, operating time, intraocular pressure, intra- and postoperative complications. RESULTS: The mean follow-up period was 9.7 months (range, 6 to 26). The mean overall visual acuity improved from 20/100 preoperatively to 20/38 at final visit (P <0.001). Statistically significant improvement of visual acuity was also observed in each subgroup. Operative time was shortened in macular surgery. No intraoperative complications were noted attributable to small-gauge instruments and no cases required conversion to 20-gauge standard instrumentation. However, 12 eyes (8%) required suture placement to at least one sclerotomy site. Postoperative intraocular pressure remained stable in most cases except 18 eyes (13%) with transient hypotony during the first week after surgery. One case of retinal detachment but no case of endophthalmitis was observed throughout the follow-up period. CONCLUSIONS: 25-gauge vitrectomy combined with cataract surgery is a safe and effective system for the management of a variety of vitreoretinal diseases, especially cases requiring minimal intraocular manipulation. Further study is recommended to evaluate potential postoperative complications.

Aged↗

PubMed2006

[Vitrectomy with circumferential peripheral retinotomy for massive subretinal hemorrhage].

PURPOSE: To assess the effect of vitrectomy with circumferential peripheral retinotomy on massive subretinal hemorrhage. METHOD: Eight patients (8 eyes) with massive subretinal hemorrhage of more than 2 quadrants, underwent pars plana vitrectomy between May 2000 and February 2004. The average age was 73.5 years. Seven patients (7 eyes) were male, and one was female (1 eye). An average of 207.5 degree circumferential peripheral retinotomy was carried out for removal of subretinal hemorrhage. The amount of postoperative subretinal hemorrhage, the improvement of visual acuity, and postoperative complications were evaluated. RESULTS: Postoperatively, the volume of subretinal hemorrhage decreased in all cases. The visual acuity improved in 7 of the 8 eyes (87.5%). Postoperatively, none of the cases developed proliferative vitreoretinopathy, but subretinal hemorrhage recurred in 2 eyes. CONCLUSIONS: Vitrectomy with circumferential peripheral retinotomy may reduce massive subretinal hemorrhage and increase visual acuity.

Aged↗

PubMed2006

[Optic nerve atrophy after vitrectomy for diabetic retinopathy: its systemic and local risk factors].

PURPOSE: To evaluate the incidence and risk factors of optic nerve atrophy after vitrectomy for diabetic retinopathy. SUBJECTS AND METHODS: Clinical charts of 48 eyes of 40 patients who underwent vitrectomy for diabetic retinopathy were retrospectively reviewed. The relationship between postoperative optic nerve atrophy and patients' physical condition was statistically analyzed. RESULT: Postoperative optic nerve atrophy, distinct from glaucomatous optic nerve atrophy, occurred in 5 eyes (10.4%). Its incidence was correlated with higher plasma creatinine concentration (p=0.001), proliferative diabetic retinopathy (p= 0.046), and retinal white vessel formation (p= 0.007). Maintenance of the best postoperative visual acuity was difficult in the patients with optic nerve atrophy. CONCLUSION: Patients with proliferative diabetic retinopathy accompanied by renal dysfunction were at high risk of optic nerve atrophy after vitrectomy.

Adult↗

PubMed2006

[A case of Prader-Willi syndrome treated by vitrectomy].

BACKGROUND: We report a successful treatment by vitrectomy in an adult case of Prader-Willi syndrome. CASE REPORT: We encountered a case of Prader-Willi syndrome in a 29-year-old male patient with proliferative diabetic retinopathy and cataract. We performed a vitrectomy and a cataract extraction on the patient. Initial examination showed proliferative diabetic retinopathy in both eyes. Funduscopy revealed tractional retinal detachment with atrophic retina in the right eye and retinal detachment in the inferior half of the fundus with vitreous hemorrhage in the left eye. We performed a vitrectomy with a combination of phacoemulsification and intraocular lens implantation only on the left eye. Visual acuity in the left eye increased from counting fingers preoperatively to 0.6(n.c) postoperatively. The right eye was left untreated because the visual prognosis was not expected to improve even if the eye received surgical intervention. The final visual acuity in the right eye was no light perception at the end of the follow-up period. CONCLUSION: Careful follow-up and early treatment are necessary for patients with diabetic retinopathy accompanied by Prader-Willi syndrome as it could develop into blindness.

Adult↗

PubMed2006

[Efficiency of air tamponade in prevention of early recurrence of vitreal hemorrhage in diabetic patients with vitrectomy].

PURPOSE: To evaluate the efficacy and safety of air endo-tamponade in preventing early recurrence of vitreous hemorrhage in diabetic vitrectomy. MATERIALS AND METHODS: Prospective, consecutive, interventional, non-randomized study including 40 eyes (from 40 patients) with persistent or recurrent vitreous hemorrhage related to proliferative diabetic retinopathy. At the end of vitrectomy 20 cases (study group) were assigned to complete fluid--air exchange while the other 20 cases (control group) were left with BSS Plus. RESULTS: Early postoperative bleeding occurred in 9 out of 40 cases--22.5% (3 cases from the study group--15% and 6 cases from the control group--30%, p < 0.05). There was no statistically significant difference in visual acuity, intraocular pressure or incidence of late-onset hemorrhage recurrence between both groups during 6-month postoperative follow-up. In the study group there was a higher rate of lens opacities appearance. CONCLUSIONS: Air endo-tamponade seems a simple and efficient way of preventing early recurrence of vitreous hemorrhage in diabetic vitrectomy. Higher rate of lens opacities appearance may counteract this advantage thus this technique could be safely and electively used in pseudophakic patients.

Adult↗

PubMed2005

Vitrectomy for the treatment of submacular hemorrhages from macular degeneration: a comparison of submacular hemorrhage/membrane removal and submacular tissue plasminogen activator-assisted pneumatic displacement.

PURPOSE: To evaluate two techniques for treatment of large submacular hemorrhages resulting from choroidal neovascularization associated with age-related macular degeneration. METHODS: Retrospective consecutive case series of 42 eyes of 42 patients who presented with submacular hemorrhages of at least 12 disc areas associated with visual loss of 3 months or less duration. One of two treatments was performed: (1) vitrectomy with removal of the submacular hemorrhage/neovascular membrane complex using subretinal forceps (SRH group), or (2) vitrectomy with injection of subretinal tissue plasminogen activator (TPA) followed by air-fluid exchange to achieve pneumatic displacement of the hemorrhage (TPA group). RESULTS: The mean visual acuity in the SRH group improved from 20/1000 -1 to 20/640 -2 at 3 months and 20/640 at 1 year and at the final examination at a mean of 2.92 years (P = .048). The mean visual acuity in the TPA group remained stable initially with a visual acuity of 20/500 preoperatively and 20/640 +2 at 3 months. The visual acuity in the TPA group deteriorated to 20/1000 -2 at 1 year and 20/1000 +2 at the final examination at a mean of 2.3 years (P = .031). Visual acuity improved by at least .3 logMAR units (3 lines) in 44% of the SRH group at 3 months and in 48% at 1 year and at the final examination compared with 20% of the TPA group at 3 months and 13% at 1 year and at the final examination (P = .042 comparing SRH and TPA groups at 1 year and final examination). CONCLUSIONS: Vitrectomy with removal of the subretinal neovascular membrane/hemorrhage complex resulted in better visual results than displacement of the subretinal hemorrhage primarily due to continuing declines in the TPA group.

Aged↗

PubMed2006

Primary vitrectomy for rhegmatogenous retinal detachment associated with choroidal detachment.

PURPOSE: To evaluate the role and the anatomic and visual results of primary pars plana vitrectomy (PPV) in treating cases with rhegmatogenous retinal detachment associated with choroidal detachment. METHODS: All patients were divided into 2 groups. Each group included 23 consecutive eyes with rhegmatogenous retinal detachment and choroidal detachment with proliferative vitreoretinopathy less than grade C. In the study group, controlled removal of vitreous traction was achieved by primary vitrectomy and augmented by scleral buckling if needed. The breaks were treated by focused endolaser coagulation. Postoperative tamponade was done by SF6 or C3F8 gas. In the control group, all patients underwent regular scleral buckling procedure. The cases were followed up for 6 to 12 months. RESULTS: In the study group, retinal reattachment could be achieved in 21 cases (91.30%) after the first operation and in all cases after the second procedure. No occurrence of choroidal detachment occurred after the first procedure. Retinal reattachment rate and visual results tended to be better compared with conventional surgical techniques in the control group. CONCLUSION: Primary vitrectomy represents a safe, effective method in the management of rhegmatogenous retinal detachment associated with choroidal detachment.

Adult↗

PubMed2006

[Different outcome among eyes with proliferative diabetic retinopathy indicated for vitrectomy].

PURPOSE: The postoperative outcome was evaluated in each group of surgical indications of vitreous surgery for proliferative diabetic retinopathy (PDR), to investigate the factors responsible for postoperative visual prognosis. METHODS: Primary vitrectomy was performed in 119 eyes of 92 patients with PDR. Average postoperative follow-up period was 19 months. The indications for vitrectomy included vitrous hemorrhage in 58 eyes, macular tractional retinal detachment in 17 eyes, extramacular tractional retinal detachment in 10 eyes, macular heterotopia in 11 eyes, and progressive fibrovascular proliferation in the posterior fundus in 23 eyes. RESULTS: The visual acuity finally improved by 2 lines or more in 91 eyes (77%), remained unchanged in 10 eyes (8 %), and decreased by 2 lines or more in 18 eyes (15%). Final postoperative visual acuity was significantly better in cases of vitreous hemorrhage or progressive fibrovascular proliferation in the posterior fundus than in others. Preoperative rubeosis iridis and macular tractional retinal detachment were probably responsible for the final visual impairment, and intraocular tamponade affected the difference in visual prognosis between the groups of surgical indication. Multivariate analysis in all cases revealed that factors influencing visual outcome were preoperative rubeosis iridis and anemia. CONCLUSION: Rubeosis iridis and macular tractional retinal detachment were prognostic factors of the surgery. Vitrectomy for PDR may be effective in improving postoperative visual acuity if performed in the early stage of progressive fibrovascular proliferation in the posterior fundus after sufficient retinal photocoagulation.

Adult↗

PubMedDate not supplied

[Results of vitrectomy in children].

Presented are the results of vitrectomy in children operated in the Ophthalmological Department of Children Health Centre. The procedure was preformed in 110 eyes including 32 vitrectomies and 78 vitrectomies connected with lensectomy. Operated were eyes with chronical uveitis of various etiology, with posttraumatic changes, after vitreal haemorrhages in Eales' disease, in persistent vitreal artery cases. Improvement of the visual acuity was achieved in 68 cases (61.8 p.c.), deterioration was observed in 28 (25.5 p.c.); the visual acuity did not change in 14 cases (12.7 p.c.). Retinal detachment was the most frequent complication--38 cases (34.5 p.c.); from this number 10 cases (9 p.c.) improved after a repeated operation.

Child↗

PubMed1991

Effect of vitrectomy on the ocular distribution of gentamicin in the rabbit.

To determine whether vitrectomy affects the ocular distribution of intravitreally injected gentamicin sulfate, 25 pigmented rabbits received an intravitreal injection of gentamicin (control group), and 25 other pigmented rabbits underwent pars plana vitrectomy followed by an intravitreal injection of gentamicin (experimental group). The animals were killed in groups of five 1, 3, 6, 12 and 24 hours after the injection. The mean retinal gentamicin levels 1 and 3 hours after the injection were significantly higher in the experimental group than in the control group (p less than 0.01). The mean gentamicin level in the aqueous humour was significantly lower in the experimental group than in the control group 1 hour (p less than 0.01), 6 hours (p less than 0.01) and 24 hours (p less than 0.001) after the injection. The mean corneal gentamicin level 24 hours after the injection was significantly lower in the experimental group than in the control group (p less than 0.05). There was no significant difference in mean choroidal gentamicin level between the two groups. We conclude that vitrectomy significantly affects the ocular distribution of gentamicin in the rabbit.

Animals↗

PubMed1991

A simple method for practicing unimanual pars plana vitrectomy with the binocular indirect ophthalmoscope.

Bimanual vitrectomy has become the method of choice for performing closed vitrectomy. In certain situations, visualization is improved by using indirect ophthalmoscopy to see the vitrectomy instrument. A simple method using a +20.00-diopter condensing lens is described as a means of practicing the initially difficult unimanual technique, which requires working in an inverted operative field.

Fundus Oculi↗

PubMed1990

Re-operation following pars plana vitrectomy for the sequelae of proliferative diabetic retinopathy.

A review of 306 eyes undergoing pars plana vitrectomy for the complications of proliferative diabetic retinopathy revealed that 26 (8.5%) required a second vitrectomy operation. Among the eyes that required repeat vitrectomy, the eventual visual acuity ranged from 20/20 to 20/400 in 35% and was no light perception in 31%. Reasons for subsequent surgery included recurrent vitreous hemorrhage in 54% of eyes, retinal detachment in 42% and neovascular glaucoma in 4%. Twelve eyes (46%) remained with a permanent retinal detachment despite attempts at surgical repair, and eleven of these twelve eyes subsequently developed rubeosis iridis.

Adult↗

PubMed1990

Vitrectomy in asteroid hyalosis.

Asteroid hyalosis (AH), a condition in which calcium-lipid complexes form in the collagen meshwork of the vitreous, affects from 0.5% to 0.9% of the general population. In patients with dense AH and visual loss, obscuration of fundus detail on ophthalmoscopy and even on fluorescein angiography may complicate the diagnosis and treatment of underlying posterior segment disease. To evaluate the usefulness of vitrectomy in AH, we reviewed 7 cases of dense AH in 6 patients who underwent vitrectomy in the setting of decreased visual acuity of uncertain cause. Additional diagnoses made following surgery included age-related macular degeneration (ARMD) in 2 eyes, ARMD with associated epiretinal membrane in one eye, and the staging of diabetic retinopathy as proliferative in one eye. Although no major surgical complications occurred in this series, the potential for serious complications exists, and pars plana vitrectomy (PPV) should be considered only after less invasive diagnostic evaluations and therapeutic approaches have been exhausted.

Adult↗