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At least 757 records · Page 42Linked to original sources

PubMed1982

Use of portable vitrectomy instrumentation (VISC X) in the rural Guatemalan highlands.

In a rural mountain setting 20 patients with blinding ocular opacities were treated surgically with modern vitrectomy techniques. There were no intraoperative or postoperative complications unique to the isolated environment. Because of its compact portability, the VISC X proved to be an ideal vitrectomy instrument. In addition to plastic lid procedures, cataract extraction, and strabismus surgery, repair of retinal detachment and vitrectomy in selected cases has been added to the armamentarium of surgeons who are seriously involved in exporting ophthalmology to remote places.

Adult↗

PubMed1975

Microsurgical roto-extractor instrument for vitrectomy.

A double-edged cutting blade oscillates between a clockwise and a counter-clockwise high speed rotation without completing a full revolution. This imparts a great mechanicaldvantage and safety to the instrument's cutting efficiency. The cutter may also be used with a continuous high speed clockwise rotation. Multiple interchangeable probe tips are used that are of either double- or triple-walled construction. A fiber-optic light pipe surrounds the probe tip used for deep vitrectomy in conjunction with an irrigated fundus lens. A film will illustrate the use of the roto-extractor in two diabetic patients with old unabsorbed vitreous hemorrhage and membranes. In the first case, a pars plana incision was used for vitrectomy in conjunction with a cataract extraction. In the second case, the para plana vitrectomy was combined with an optical iridectomy necessitated by the presence of an updrawn pupil following previous cataract extraction complicated by vitreous loss. To date, 12 roto-extractors have been distributed to 12 various teaching institutions throughout the United States.

Cataract Extraction↗

PubMed1979

Vitrectomy methods in anterior segment surgery.

We have used vitrectomy instrumentation and techniques to treat a variety of conditions affecting the anterior segment, including: 1) an occluded or inadequate pupillary space, 2) complications of vitreous in the anterior chamber, 3) epithelial ingrowth, 4) complicated lens surgery, and 5) total hyphema. The vitrectomy methods provided controlled excision of intraocular tissues under optimum visualization using a closed-eye system with normal intraocular pressure and the ability to use techniques such as intraocular diathermy. Our experience has been favorable in this series of 117 cases. Of these, 104 cases (89%) were anatomically successful, 70 eyes (60%) had a significant postoperative improvement in vision. The detailed results of vitrectomy surgery for anterior segment disorders are presented for each indication.

Adolescent↗

PubMed1979

Vitrectomy in experimental endophthalmitis: Part II--Bacterial endophthalmitis.

Three methods of treatment for Staphylococcus aureus endophthalmitis were compared: subconjunctival injection with intramuscular gentamicin, intravitreal injection with intramuscular gentamicin, and vitrectomy using infusion solution containing gentamicin along with intramuscular gentamicin. Subconjunctival injection with intramuscular gentamicin was not successful in treating infection. Intravitreal injection with intramuscular gentamicin and vitrectomy with intramuscular gentamicin were equally effective in eradicating infection; however, the combination of vitrectomy and intramuscular gentamicin provided clearer vitreous with greater fundus detail.

Animals↗

PubMed1982

Lensectomy-vitrectomy for stage V cicatricial retrolental fibroplasia.

Ten infants (18 eyes) blind from stage V cicatricial retrolental fibroplasia were examined from January 1978 to January 1981 at North Carolina Memorial Hospital. The early perinatal factors which may have predisposed to the binding end-stage cicatrix are identified. To increase their visual potential and to prevent secondary angle closure glaucoma, 12 lensectomy-vitrectomies were performed on 12 eyes (eight infants). One eye (one infant) had a pars plana vitrectomy without lensectomy. Seven eyes (seven infants) were not operated. Five of these eyes (five infants) had stage VRLF while two eyes (two infants) remained stable at stage II RLF. All retinas remained detached immediately after surgery. Secondary vitrectomies with air injections (three eyes, two infants) similarly failed to attach any retinas. Adherence of ciliary epithelium to clear lens and retrolental membrane as visualized within the dilated pupil (Eifrig-Merritt sign) was an intra-operative indicator of imminent surgical failure. Two eyes (two infants) developed early vitreous hemorrhages, hyphemas, secondary glaucoma, and phthisis bulbi within 12 months. Follow-up data were unavailable on two infants. Blindness secondary to cicatricial retrolental fibroplasia is increasing due to increased survival of low birthweight premature infants. Since surgical visual rehabilitation is not possible after the retrolental cicatrix has formed, the risk factors common to this high risk population should prompt preventive therapies.

Cicatrix↗

PubMed1980

Pars plasma vitrectomy in the management of the Irvine-Gass syndrome.

Twelve eyes of 10 patients with type I Irvine-Gass syndrome underwent pars plana vitrectomy after cystoid macular edema had been present a mean of 13 months and showed no evidence of resolving spontaneously or, in some cases, of responding to laser photocoagulation or steroid therapy. The disorder appears to resolve spontaneously in an average of 16 months. Following vitrectomy the edema resolved clinically in 10 of the 12 eyes, in an average of 3.7 months, and the visual acuity improved significantly in 8 of the 12 eyes--in five instances from legal blindness to 20/50 or better. The results suggest that pars plana vitrectomy is of value in the treatment of this disorder.

Adult↗

PubMed1981

Postoperative endophthalmitis secondary to Candida parapsilosis. A case treated by vitrectomy and intravitreous therapy.

A 79-year-old woman developed Candida parapsilosis endophthalmitis nine weeks after an uneventful cataract extraction. The diagnosis was suspected on clinical examination and documented by culture of the vitreous biopsy obtained during vitrectomy. The endophthalmitis was treated by pars plana vitrectomy and intravitreous injection of amphotericin B and dexamethasone. The patient was also treated with systemic flucytosine, to which the operative isolate proved resistant. This was therefore immediately discontinued; however, the intraocular infection cleared rapidly after the initial vitrectomy and intravitreous injection. The patient's visual acuity ultimately returned to 20/20. The combination of these two newer methods of treatment for fungal endophthalmitis achieved a favorable outcome in a disease process that has often previously wrought disaster.

Aged↗

PubMed1977

Is the procedure of vitreous suction out of date since introduction of vitrectomy?

Vitreous suction is still a useful procedure in cases of severe vitreous opacification. In spite of the technical perfection and good results of vitrectomy, the chances of a vitreous suction should be taken into consideration before a definite decision is made. The surgical technique of vitreous suction is very simple, lensectomy is never required, and the possibility of a subsequent vitrectomy is not impaired of the suction manoeuvre has failed. The frequency of complications, namely retinal detachment and bacterial intraocular infection, is reasonable if the almost hopeless condition of the affected eyes, and the severe general diabetic angiopathy and poor resistance are considered, which in individuals with postoperative endophthalmitis usually are found. Vitreous suction is still acceptable as a minor sort of vitrectomy.

Animals↗

PubMed1977

[Indications, technique and results of anterior vitrectomy (author's transl)].

The indications for anterior vitrectomy are presented and the surgical technique is described. An analysis is made of the results of anterior vitrectomy in 93 eyes followed for 4 years and compared with the results of a previous study in which vitreous loss was treated more conservatively. The results of anterior vitrectomy are significantly better particularly in regard to prevention of complications in the anterior chamber and the final visual result.

Eye Diseases↗

PubMed2000

Argatroban inhibits intraocular fibrin formation after vitrectomy in rabbits.

OBJECTIVES: To examine whether the specific thrombin inhibitor argatroban can prevent anterior chamber, pupillary area, and anterior vitreous fibrin formation after vitrectomy and lensectomy in rabbits. METHODS: Argatroban was infused into the vitreous cavities of Japanese albino rabbits for 5 minutes after pars plana vitrectomy and lensectomy. Slitlamp microscopy and indirect ophthalmoscopy were performed at postoperative hours 0.5, 1, 2, 3, and 6, and at postoperative days 1, 2, 3, and 7, and the amounts of fibrin formation in the anterior chamber, pupillary area, and anterior vitreous were scored from grade 0 to 4. RESULTS: Argatroban prevented fibrin formation from 0.5 hours postoperatively in a dose-dependent manner. In the eyes treated with 0.01% argatroban, the median score for postoperative fibrin formation was significantly less than that in control eyes between hours 1 and 3 (hour 1, P =.02; hour 2, P =.005; and hour 3, P =.003); the eyes treated with 0.003% argatroban also had significantly less fibrin than control eyes between 1 and 2 hours (hour 1, P =.005; hour 2, P =.03). CONCLUSION: These results indicate that argatroban inhibits intraocular fibrin formation in an experimental rabbit model. CLINICAL RELEVANCE: Argatroban may be useful clinically in cases that often produce fibrin postoperatively, such as proliferative vitreoretinopathy and proliferative diabetic retinopathy.

Animals↗

PubMed2006

Visual outcomes after 3-port lens-sparing vitrectomy in stage 4 retinopathy of prematurity.

OBJECTIVE: To assess the visual acuity of eyes successfully treated with 3-port lens-sparing vitrectomy for stage 4 retinopathy of prematurity. METHODS: Of 102 consecutive eyes achieving at least posterior pole reattachment, 30 eyes of 26 patients were tested by Teller or Allen acuity measurements and were subsequently converted to logarithm of the minimum angle of resolution (logMAR). Visual outcomes were also examined as either favorable or unfavorable (Snellen equivalent >20/200). RESULTS: Seventy-two eyes were not tested because of either inability to perform testing (age or neurologic sequelae related to prematurity) or loss of follow-up. Of those tested, mean +/- SD logMAR visual acuity for the stage 4A and stage 4B groups was 0.51 +/- 0.09 (Snellen approximate 20/62) and 1.03 +/- 0.19 (Snellen approximate 20/200), respectively (odds ratio, 0.39; 95% confidence interval, 0.24-0.64; P = .001). Of those eyes assessed by Teller measurements, 10 of 10 stage 4A eyes and 3 (37.5%) of 8 stage 4B eyes had favorable outcomes; among eyes assessed with Allen measurements, 4 of 4 stage 4A eyes and 0 of 8 stage 4B eyes had favorable outcomes. CONCLUSIONS: The majority of eyes were not tested. Among eyes tested after successful 3-port lens-sparing vitrectomy, some eyes treated prior to macular detachment may be associated with a more favorable outcome and improved maintenance of functional visual acuity.

Female↗

PubMed1984

Vitrectomy and Whipple's disease.

We diagnosed Whipple's disease from the vitreous aspirate of two patients who underwent vitrectomies . In one case, the vitrectomy specimen would have indicated the diagnosis three years before the jejunal biopsy was performed had the appropriate PAS stain been used. In the second case, the PAS-positive macrophages were identified at the time of surgery.

Biopsy↗

PubMed1985

Experimental vitrectomy. A lens-sparing technique in the rabbit eye.

We describe a technique for experimental vitrectomy in the rabbit eye, in which the lens remains intact and the postoperative intraocular inflammatory response is minimized. In comparison with combined vitrectomy and lensectomy, our technique allows the fundus to remain visible for follow-up from the very first postoperative day; traction retinal detachment does not develop as a late complication. We also describe a simple method for gross identification and estimation of the amount of residual vitreous gel on the retinal surface.

Animals↗

PubMed1986

Macular infarction after endophthalmitis treated with vitrectomy and intravitreal gentamicin.

We encountered two cases of macular infarction that occurred after vitrectomy performed for mild endophthalmitis, which, on culture, yielded Staphylococcus epidermidis. At the end of each vitrectomy, 0.4 mg of gentamicin, 1.0 mg of cefazolin, and 0.32 mg of dexamethasone were injected into the vitreous cavity. We are concerned that the macular lesion was a retinal toxic effect of gentamicin because of the recent description of similar lesions occurring after the inadvertent intraocular injection of massive doses of this drug.

Adult↗

PubMed1987

Vitrectomy for progressive proliferative diabetic retinopathy.

We analyzed the results of 105 diabetic vitrectomy cases. The vitrectomies were performed for progressive fibrovascular proliferation that caused epiretinal membranes, vitreopapillary traction, florid neovascularization, or subhyaloid hemorrhage, with or without substantial preoperative visual loss. Eyes with inactive retinal neovascularization, dense vitreous hemorrhage, traction retinal detachment involving the macula, or combined traction and rhegmatogenous retinal detachment were excluded. Seventy-four eyes (70%) had improved final vision. The final vision was unchanged in eight eyes (8%) and was worse in 23 eyes (22%). Factors associated with a favorable visual prognosis included the following: age of 40 years or less, preoperative visual acuity of 5/200 or better, absence of preoperative iris neovascularization, preoperative panretinal photocoagulation, and absence of an iatrogenic retinal break.

Adult↗

PubMed1989

Kinetics of intraocular gases. Disappearance of air, sulfur hexafluoride, and perfluoropropane after pars plana vitrectomy.

Intraocular gas bubbles are an important source of internal tamponade for the treatment of retinal breaks in eyes requiring vitrectomy. The kinetics of disappearance of air, 20% sulfur hexafluoride, and 10% perfluoropropane were prospectively evaluated in 76 eyes undergoing pars plana vitrectomy. The absorption of each gas approximated a first-order kinetic equation with respect to bubble volume. The half-life of air was 1.6 days in phakic and 0.9 days in aphakic eyes. The half-life of 20% sulfur hexafluoride was 2.8 days in phakic and 2.4 days in aphakic eyes. The half-life of 10% perfluoropropane was 5.7 days in phakic, 4.5 days in aphakic, and 4.3 days in pseudophakic eyes. The difference in half-life among the three gases was significant. Intraocular gases had a shorter half-life in aphakic than in phakic eyes.

Absorption↗

PubMed1991

The endophthalmitis vitrectomy study.

Endophthalmitis after cataract surgery can be a disastrous complication that may result in functional loss of an eye. All patients with this problem should receive direct injection of intravitreal antibiotics. The roles of initial vitrectomy and of intravenous antibiotics in treating this condition are controversial. Through a prospective, randomized, clinical trial, these issues can be assessed. We encourage ophthalmologists close to each clinical center to refer patients with postoperative endophthalmitis to these clinics. Questions concerning the Endophthalmitis Vitrectomy Study can be addressed to the principal investigator at the nearest clinical trial center.

Anti-Bacterial Agents↗

PubMed1991

Effect of temperature on electroretinograph readings during closed vitrectomy in humans.

To determine whether intraocular cooling using room-temperature irrigating solution can cause abnormal electroretinograph readings, we operated on six patients with premacular fibrosis and minimal retinal detachment, measuring the temperature in the vitreous cavity and using an electroretinographic monitor. The temperature in the vitreous cavity dropped to 27 degrees C to 28 degrees C after vitrectomies during which room-temperature solutions were used. This resulted in abnormal electroretinograph readings (markedly delayed peak times and reduced amplitudes). These results suggest that the routinely used room-temperature solution affects retinal function during vitrectomy; however, this functional change was reversible in patients having only minimal retinal abnormality.

Body Temperature↗