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At least 739 records · Page 41Linked to original sources

PubMed1978

Results of pars plana vitrectomy in penetrating ocular trauma.

Thirty-four severely injured eyes were operated with pars plana vitrectomy. The nine cases with involvement exclusively of the anterior segment alone were operated with success in all cases. However, the injuries of the posterior segment still reflect significant problems in that only 50 percent obtained successful visual results. This reflects, in great part, the degree of severity of the initial damage. The theoretical rationale for pars plana vitrectomy in penetrating ocular trauma is discussed. Because of the many variables from patient to patient and injury to injury, conflicting clinical impressions as to appropriate management prevail. In the abscence of a definitive clinical trial or suitable experimental model, our guidelines for the role and proper timing of pars plana vitrectomy for penetrating ocular trauma are presented.

Eye Diseases↗

PubMed1981

Effects of vitrectomy and phakectomy on the drainage of the vitreous compartment.

Plastic microspheres (7-10 micrometers in diameter), 51Cr-labeled autologous red blood cells (RBC), and 125I-tagged homologous albumin were injected into the vitreous space of vitrectomized phakic and aphakic rabbits. The drainage into the aqueous compartments and blood circulation was assessed. In phakic eyes, there was practically no movement of microspheres and RBC into the anterior chamber over a period of 19 days. In aphakia, vitreous clearance improved but only 1%-3% of labeled RBC appeared in the blood circulation during the first 3-4 days. About 40%-70% of the 125I-albumin injected left the eye within 24 h, as compared to 15%-25% in phakic rabbits. Thus, a vitrectomy in phakic eyes does not lead to anterior drainage of intact RBC and even after combined vitrectomy and phakectomy, the drainage of RBC is not complete; the elimination of albumin is greatly enhanced after vitrectomy.

Animals↗

PubMed1982

Anterior bulbus perforation and vitrectomy in the 'minipig'.

Wound healing after experimental anterior eye perforation, including lens, ciliary, body and vitreous, was studied in 12 miniature pigs (minipigs). In half of the eyes, perforation was followed by removal of the damaged lens and suturing of the wound. In the other half, a primary subtotal vitrectomy was performed after removal of the lens. The behaviour of the connective tissue in the wound-healing process was not fundamentally changed by subtotal vitrectomy. In both groups very little fibrous ingrowth into he vitreous structure was observed, suggesting that the pig vitreous has marked antifibroplastic properties. The anatomical and technical features of vitrectomy in the minipig, and the advantages and disadvantages of this animal model are discussed. It appears that the eye of the minipig is ideal for the study of biochemical factors preventing fibrous ingrowth into the vitreous.

Animals↗

PubMed1980

An integrated approach to vitrectomy instrumentation.

I devised a vitrectomy instrument integrating tray for a variety of vitrectomy systems. The tray controls the infusion and suction instrumentation through pinch valves, provides pathways for fiberoptic, diathermy and electrical cords, and provides silicone moldings for holding the various instruments used in vitrectomy surgery.

Electrosurgery↗

PubMed1981

Sympathetic ophthalmia after pars plana vitrectomy-lensectomy for endogenous bacterial endophthalmitis.

A 71-year-old woman developed an endogenous bacterial endophthalmitis in her right eye. Because of the rapid progression she was treated by para plana vitrectomy-lensectomy and with antibiotics and corticosteroids. The patient improved after the antibiotic therapy. One month later she had a recurrence of the inflammatory signs in the same eye. Examination disclosed lens remnants in the vitreous. Because of the possibility of phacoallergic uveitis, she underwent a second vitrectomy. The corticosteroid dosage was increased. She did well until three months later when, while still taking corticosteroids, she noted loss of visual acuity in the left eye, accompanied by bilateral inflammatory signs. Sympathetic ophthalmia was suspected and the blind right eye was enucleated. The choroid was grossly unremarkable; the routine sections disclosed many inconspicuous foci of mononuclear infiltration. Tangential sections of flat-embedded choroid, however, showed ill-defined nests of epithelioid cells containing phagocytosed melanin, supporting the diagnosis of sympathetic ophthalmia. To our knowledge, this is the first published report of this complication after pars plana vitrectomy-lensectomy in the absence of nonsurgical trauma or other surgical procedures.

Aged↗

PubMed1982

Vitrectomy in uveitis associated with ankylosing spondylitis.

Chronic recurrent iridocyclitis in three eyes of two patients with ankylosing spondylitis was associated with posterior spillover of inflammatory cells into the vitreous cavity. Continued inflammation resulted in significant vitreous opacification in all three eyes. After pars plana vitrectomy (two eyes) and cataract extraction with subtotal vitrectomy (one eye), visual acuity improved and stabilized in all three instances. Ocular inflammation was not appreciably exacerbated by surgical intervention. Vitreous opacification did not recur after vitrectomy, but visual improvement was limited because of chronic cystoid macular edema.

Adult↗

PubMed1982

Epiretinal membrane formation after vitrectomy.

Our experimental model of epiretinal membrane formation in the rabbit eye after lensectomy and vitrectomy provides a way of studying pharmacologic and surgical approaches to inhibiting epiretinal cellular proliferation and contraction in the eye that has undergone vitrectomy. We injected 400,000 tissue-cultured retinal pigment epithelial cells onto the retinal surface of rabbit eyes that had undergone lensectomy, vitrectomy, and fluid-gas exchange. By one week, a funnel-shaped detachment of the medullary rays had occurred in 100% of the injected eyes. Histologically, the cells formed an epiretinal membrane by six hours after injection and caused major wrinkling of the inner retina after 24 to 48 hours. The percentage of tritiated-thymidine-labeled epiretinal cells increased dramatically 24 hours after injection and then declined. Cellular membranes bridging the optic nerve, followed by growth and contraction of the epiretinal cells on the detached internal limiting membrane, were responsible for the closed funnel appearance of the medullary rays.

Animals↗

PubMed2000

A Case of Proliferative Sarcoid Retinopathy with Sarcoid Nodules in Tissue Obtained During Vitrectomy.

Background: In previous studies, intraocular proliferative tissues obtained from proliferative sarcoid retinopathy cases during vitrectomy have been examined histopathologically. However, there is no report of identification of sarcoid nodules in examined tissues. We performed vitrectomy for a case of proliferative sarcoid retinopathy with extensive proliferative changes. Histopathologically, sarcoid nodules were identified in the fibrovascular membranes.Case: A 25-year-old man was treated for sarcoid uveitis in the right eye by his local ophthalmologist. Lens aspiration was performed for complicated cataract. He was referred to our hospital with vitreous opacity and traction retinal detachment which occurred after the surgery.Findings: The vitreous opacity was so severe that details of the fundus were not visible. Traction retinal detachment was suspected from findings of B-mode echography. Vitrectomy was performed, and total retinal detachment due to contraction of the fibrovascular membrane around the optic disc and posterior pole was observed. Sarcoid nodules were identified histopathologically in fibrovascular membranes obtained during vitrectomy.Conclusion: In proliferative sarcoid retinopathy cases, sarcoid lesions may be one of the causes of fibrovascular membrane formation.

Journal Article↗

PubMed2001

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, 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 =.0052, R(2) = 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.

Journal Article↗

PubMed1980

Combined phacoemulsification and closed pars plana vitrectomy capability in a single computerized instrument.

The Heslin/Mackool Ocusystem allows either phacoemulsification or pars plana vitrectomy in a maximally controlled closed system. A unique flow control system maintains a constant balance between infusion and evacuation. Low flow rates and high suction levels are therefore possible without surging of intraocular contents or ocular collapse. The ultrasonic handpiece has reusable tips and is air-cooled, self-tuning, lightweight and autoclavable. The vitrectomy handpieces have a guillotine cutting mechanism or a self-sharpening rotational cutting mechanism and are as small as 0.79 mm in diameter (21 gauge). One and two-handed techniques for phacoemulsification and vitrectomy are possible through limbal or pars plana approaches.

Cataract Extraction↗

PubMed1978

Vitrectomy techniques in the management of selected penetrating ocular injuries.

Closed vitrectomy techniques provide new capabilities to treat severe penetrating ocular injuries involving posterior segment structures. With these methods damaged iris tissue, lens, and vitreous can be removed and intraocular opacities can be cleared to identify and treat any retinal damage. Removal of damaged vitreous also prevents later cyclitic membrane formation and traction on the retina. The vitrectomy technique can be combined with additional methods to treat other conditions including nonmagnetic intraocular foreign bodies. We present the rationale and technique of vitrectomy together with the results of treatment in 51 consecutive cases of penetrating ocular trauma. Guidelines are offered for management of severe penetrating injuries.

Adolescent↗

PubMed1981

Closed vitrectomy and the intraocular implant.

Closed vitrectomy was successfully performed on eyes containing intraocular lenses (IOLs) in order to remove retropseudophakic membranes, remove vitreous strands surrounding IOLs or adherent to the corneoscleral incision and iris in cases of persistent cystoid macular edema (CME), assist in the relocation of IOLs which had dislocated into the vitreous, and to relieve pseudophakic pupillary block. Closed vitrectomy was also performed to remove vitreous present in the anterior segment prior to secondary IOL implantation. Techniques and results of 33 closed vitrectomies in such instances are presented.

Aged↗

PubMed1981

Subtotal open-sky vitrectomy for severe retinal detachment occurring as a late complication of ocular trauma.

Subtotal open-sky vitrectomy was performed on 50 eyes with severe retinal detachment that developed as a late complication of ocular trauma. The retina was reattached in 32% of the eyes and vision was improved in 50% of the reattached cases. Two cases of giant retinal tear with massive preretinal retraction were successfully treated by suturing the retinal flap of the tear to the choroid. Subtotal open-sky vitrectomy may be helpful in cases in which closed vitrectomy has failed or would be likely to fail.

Adult↗

PubMed1983

[Vitrectomy in endophthalmitis].

The authors report on 14 cases of fulminant and delayed forms of endophthalmitis, in which a diagnostic and therapeutic vitrectomy, were performed. By diagnostic processing of the excised vitreous the chances of obtaining positive findings were increased, especially with a combination of bacteriological and histopathological methods. As advantages of a diagnostic and therapeutic vitrectomy versus purely antibiotic treatment in endophthalmitis the authors discuss the following factors: (1) improved diagnostic possibilities in combination with vitrectomy; (2) a reduction in the quantities of infective organisms and toxins; and (3) improved penetration of antibiotic into and out of the vitreous body cavity.

Aged↗

PubMed1981

[Vitrectomy general considerations (author's transl)].

On the basis of approximately 700 pars plana vitrectomies performed by the author during the past nine years, some general aspects of this new surgical technique are discussed. Since we remove the vitreous in some cases today, whereas ten years ago we took the utmost care to preserve it, some speculations on the function of the vitreous are discussed. The importance of the clinical examination for the indication for vitrectomy is pointed out. Finally, some general results are given and the further development of vitrectomy is outlined.

Eye Diseases↗

PubMed1979

One hundred consecutive cases of pars plana vitrectomy with the vitreous stripper.

The results of 100 consecutive cases of pars plana vitrectomy are reported. Vitrectomy was performed on accunt of complications of diabetic retinopathy (37 eyes), complicated retinal detachment (28 eyes), vitreous haemorrhage of various causes (17 eyes), vitreous haemorrhage and complications secondary to injuries (13 eyes) and secondary cataract or vitreous in the anterior chamber creating corneal dystrophy (5 eyes). With an average follow-up time of 14.2 months, vitrectomy resulted in visual improvement in 55 eyes, unchanged visual acuity in 24 eyes and reduced visual acuity in 21 eyes. The operative and postoperative complications were: secondary vitreous haemorrhage (11 eyes), retinal detachment (8 eyes), haemorrhagic glaucoma (7 eyes), retinal tears (5 eyes), lens injury (4 eyes), corneal dystrophy (2 eyes) and endophthalmitis (1 eye).

Adolescent↗

PubMed1981

Pars plana vitrectomy in the management of intraocular inflammation.

To evaluate the role of pars plana vitrectomy in the management of intraocular inflammation with dense vitreous opacification, vitrectomy was performed in 14 patients with chronic uveitis, 6 eyes with retinal periphlebitis, and in 8 cases of endophthalmitis. Visual acuity improved in 21 eyes, remained unchanged in 3, and deteriorated in 4 cases (follow-up period 2 months to 3 years). Pre-existing retinal damage such as cystoid macular oedema or degeneration restricted final visual acuity. In most eyes inflammation (aqueous flare and cells) diminished, except in hypotonic eyes with chronic iridocyclitis, which also gained little in vision. The results indicate that vitrectomy is valuable in the treatment of chronic uveitis with vitreous opacification due to cellular invasion and membrane formation, in periphlebitis with vitreous hemorrhages, and in endophthalmitis.

Adult↗

PubMed1982

Anterior vitrectomy for shallow anterior chamber after cataract extraction.

Pars plana anterior vitrectomy was performed in 9 patients with shallow anterior chamber after cataract extraction. Five patients had choroidal and/or ciliary body effusion (CCBE), and 4 had aphakic pupillary block (APB). Vitrectomy was performed only after medical treatment failed to restore a normal anterior chamber depth. In all patients the anterior chamber restored during surgery and remained so thereafter, although in patients with CCBE, the fundal pathology subsided days or even months later. The only surgical complication was a longstanding cystoid macular oedema in one patient. Pars plana vitrectomy would appear to have advantages over other surgical techniques, in similar circumstances.

Aged↗