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Results for “Vitrectomy”

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At least 829 records · Page 46Linked to original sources

PubMed1996

Clinicopathologic correlation of an untreated macular hole and a macular hole treated by vitrectomy, transforming growth factor-beta 2, and gas tamponade.

PURPOSE: To study the clinicopathologic features of an untreated macular hole in the right eye and a macular hole in the left eye treated by vitrectomy, application of transforming growth factor-beta 2, and gas tamponade. METHODS: The patient, a 73-year-old man with bilateral macular holes, was studied clinically before and after surgical treatment of the macular hole in his left eye. The patient's eyes were obtained postmortem and serially step-sectioned through the macula and optic nerve head for electron microscopy. RESULTS: Examination of 1-micron thick plastic-embedded sections through the macula of the right eye disclosed a 0.6-mm macular hole with rounded gliotic margins, a thin epiretinal membrane, and parafoveal cystic changes. Examination of 1-micron thick plastic-embedded sections through the macula of the left eye disclosed a 0.25-mm defect in the fovea, which was bridged by glial cells. The glial cells were continuous with a thin hypocellular epiretinal membrane without contraction features on both sides of the defect. The ultrastructural features of the glial cells were consistent with Mueller cells. CONCLUSIONS: Treatment of a macular hole with vitrectomy, transforming growth factor-beta 2, and gas tamponade was followed by complete closure of the macular hole by Mueller cell proliferation.

Aged↗

PubMed1996

Vitrectomy for diabetic macular edema associated with a thickened and taut posterior hyaloid membrane.

PURPOSE: To evaluate the surgical results in a series of patients with diabetic macular edema associated with traction from a thickened and taut posterior hyaloid membrane and to identify features associated with better visual outcome. METHODS: We reviewed the clinical records of ten consecutive patients who underwent pars plana vitrectomy in one eye for diabetic macular edema that was preoperatively attributed to thickening and traction of the posterior hyaloid membrane. RESULTS: Best-corrected, preoperative visual acuity was 20/200 in seven eyes, 20/300 in one eye, and 20/400 in two eyes. Intraoperatively, seven patients were found to have an attached posterior hyaloid membrane which was thickened and taut. Among these seven patients, postoperative best-corrected visual acuity improved by six lines in two eyes, by five lines in one eye, by two lines in one eye, and remained within one line of preoperative visual acuity in three eyes. The other three patients had an epiretinal membrane simulating an attached and thickened posterior hyaloid membrane. CONCLUSIONS: Vitrectomy effectively improved visual acuity in some eyes with diabetic macular edema associated with traction from a thickened and taut posterior hyaloid membrane. Despite careful preoperative examination with a fundus contact lens, however, in some patients it may be difficult to assess how the posterior hyaloid membrane contributes to the macular edema. In selected patients, early surgical intervention may be associated with better visual outcome.

Aged↗

PubMed1997

Dehydration injury as a possible cause of visual field defect after pars plana vitrectomy for macular hole.

PURPOSE: To present the hypothesis that a visual field defect after pars plana vitrectomy for macular hole may be caused by dehydration injury to the nerve fiber layer during the fluid-air exchange. METHODS: In a consecutive nonrandomized series of 45 operations on 35 eyes of 34 patients with full-thickness macular hole, the surgical method was changed with postoperative visual field testing performed. RESULT: The incidence and location of the post-operative visual field defect was affected only by changing the location of the infusion cannula. CONCLUSION: Dehydration injury of the nerve fiber layer during the fluid-air exchange should be considered as a possible cause of visual field defect after pars plana vitrectomy for macular hole.

Desiccation↗

PubMed1995

Vitrectomy lens for examination of the optic disk in young children with glaucoma.

PURPOSE/METHODS: To examine the optic disk in infants and young children with glaucoma after the administration of anesthesia, a lens designed for vitrectomy surgery was used to obtain magnified stereoscopic images of the optic disk. RESULT/CONCLUSIONS: Excellent visualization of the optic disk was obtained with our method. Comparison of optic disk appearance is facilitated by using an inexpensive lens designed for vitrectomy surgery.

Anesthesia↗

PubMed1993

Aqueous tube-shunt implantation and pars plana vitrectomy in eyes with refractory glaucoma.

We reviewed the surgical outcome of 20 eyes of 20 consecutive patients who had undergone combined aqueous tube-shunt implantation and vitrectomy for complicated glaucoma associated with vitreoretinal disorders. After a mean follow-up of 10.39 +/- 5.43 months, visual acuity remained stable or improved in 13 patients (65%), and intraocular pressure was controlled (< 22 mm Hg) in 15 (75%). The most common complications were corneal edema (seven eyes) and choroidal effusion (three eyes). Combined tube-shunt implantation and pars plana vitrectomy may successfully control intraocular pressure and maintain preoperative visual acuity in refractory glaucoma associated with vitreoretinal disorders.

Adolescent↗

PubMed1992

Macular phototoxicity caused by fiberoptic endoillumination during pars plana vitrectomy.

Three cases of retinal phototoxicity were caused by light from the endoilluminator used in vitrectomy. Preoperative clinical examination, color photography, and fluorescein angiography in all three cases failed to disclose retinal pigment epithelial changes. Postoperative clinical findings, photographs, and fluorescein angiograms are highly suggestive of the presence of retinal phototoxicity. The characteristics of these lesions and surgical conditions implicate the endoilluminator as the source of photic injury. The macular lesions were noted within one week of the surgical procedure, measured between 2 and 5 disk diameters in size, involved the fovea in two eyes, and resulted in marked decrease in visual acuity in two of three eyes, with persistence in one eye. Initially, whitening of the outer retina was present, but was replaced by pigmentary mottling at the level of the retinal pigment epithelium within a few weeks. Preventive measures to avoid macular phototoxicity associated with vitrectomy are discussed.

Adult↗

PubMed1996

An infusion temporary keratoprosthesis for pars plana vitrectomy.

PURPOSE: To develop a temporary keratoprosthesis with integrated infusion cannula to minimize retinal complications during pars plana vitrectomy in eyes with an opaque cornea. METHODS: The wide-field temporary keratoprosthesis has been modified to include an integrated infusion cannula. The 20-gauge cannula runs from the periphery of the corneal flange, bends 90 degrees, and enters the eye after passing through the periphery of the corneal cylinder. RESULTS: The infusion wide-field temporary keratoprosthesis has been used successfully in three cases without the need to place a separate infusion, which risks iatrogenic retinal breaks or retinal dialyses. Droplet condensation on the posterior surface of the infusion temporary keratoprosthesis was reduced compared with the standard temporary keratoprosthesis. CONCLUSION: We have developed a wide-field temporary keratoprosthesis with an integrated infusion cannula for use during pars plana vitrectomy in eyes with severe corneal opacity. This device eliminates the risk of complications related to the pars plana infusion cannula.

Catheterization↗

PubMed1995

Visual field loss after pars plana vitrectomy with air/fluid exchange.

PURPOSE: To report the postoperative finding of a dense, permanent, peripheral temporal visual field defect in the treated eyes of three patients who underwent pars plana vitrectomy with air/fluid exchange. METHODS: The patient's charts were reviewed. RESULTS: Visual field loss after pars plana vitrectomy and air/fluid exchange occurs and may be caused by mechanical trauma to the optic nerve head. CONCLUSION: Great caution is advised when aspirating directly over the optic nerve with any extrusion instrument.

Adult↗

PubMed1994

Ultrasound biomicroscopy for examination of the sclerotomy site after pars plana vitrectomy.

PURPOSE/METHODS: The pars plana sclerotomy has been considered to be a potential site for complications. Ultrasound biomicroscopy was used for in vivo examination of the entry sites in 20 eyes of 19 patients after vitrectomy. RESULTS/CONCLUSIONS: In all patients the entry sites were identified by ultrasound biomicroscopy. Extensive membranes at the sclerotomy were found in eyes treated for complications after vitrectomy. Ultrasound biomicroscopy allows in vivo examination of the pars plana sclerotomy and gives further insight into postoperative complications.

Ciliary Body↗

PubMed1989

Posterior chamber intraocular lens insertion during pars plana lensectomy and vitrectomy for complications of proliferative diabetic retinopathy.

We inserted posterior chamber lenses into 21 eyes with complications of diabetic retinopathy upon completion of pars plana lensectomy and vitrectomy in a single session. After the original surgery, two eyes developed retinal detachments and underwent vitrectomy revisions with scleral buckling, one eye had a fluid-gas exchange for residual vitreous cavity blood, one eye had supplemental laser treatment, and one eye had intraocular antibiotics for endophthalmitis. Six months later, postoperative vision was better in 16 of the 21 eyes (76%), the same in four eyes (19%), and worse in one eye (5%). In 16 eyes visual acuity was 20/200 or better, and in six eyes it was 20/40 or better postoperatively. Decreased vision was caused by preexisting macular disease; two eyes had corneal edema with iris neovascularization associated with residual retinal detachment. The procedure and lenses were well tolerated and provided good pseudophakic vision.

Adult↗

PubMed1989

Vitrectomy for complicated retinal detachments secondary to branch retinal vein occlusions.

Combined rhegmatogenous and traction retinal detachments associated with branch vein occlusions occurred in five eyes of five patients between Jan. 1, 1986 and Dec. 31, 1987. Four patients underwent surgery with pars plana vitrectomy and intravitreal gas, with or without scleral buckling. One patient refused treatment. All operated on eyes had attached retinas at a mean follow-up of seven months. Because posterior traction plays an important role in these unusual detachments, consideration should be given to pars plana vitrectomy and air-fluid exchange rather than scleral buckling alone.

Adult↗

PubMed1989

Histopathology of tissue removed during vitrectomy for impending idiopathic macular holes.

Vitrectomy may prevent the progression of an impending macular hole by removing the layer of cortical vitreous from the posterior retina. To determine the nature of the cortical vitreous tissue, we identified and removed from the surface of the posterior retina a thin sheet of what appeared to be posterior cortical vitreous in 29 patients undergoing vitrectomy for an impending macular hole. In seven patients, the tissue was isolated for transmission electron microscopic study. Millipore filter specimens of the vitreous aspirates from all of the patients were studied by light microscopy. Vitreous condensates were present in all 29 specimens, fibrocellular membrane fragments were present in three, and fragments of internal limiting membrane were present in four. A collagen matrix was present in each of the seven specimens studied by electron microscopy, and in every specimen, the collagen's diameter was consistent with indigenous vitreous collagen. These findings confirm the presence of an acellular tissue layer on the posterior retina in eyes with an impending macular hole and indicate that it is usually indigenous vitreous collagen.

Collagen↗

PubMed1987

Intraoperative argon endophotocoagulation for recurrent vitreous hemorrhage after vitrectomy for diabetic retinopathy.

We reviewed the medical records of 103 consecutive cases of vitrectomy performed for complications of diabetic retinopathy to determine if the introduction of argon laser endophotocoagulation had reduced the incidence of recurrent vitreous hemorrhage. Twenty-six eyes (48%) treated with endophotocoagulation and 35 (71%) eyes not receiving laser treatment had a recurrent hemorrhage. Follow-up was shorter for the eyes treated with endophotocoagulation, but a log-rank analysis to allow for this variable confirmed the benefit of laser photocoagulation (P less than .05). The proportion of eyes requiring surgical removal of the hemorrhage was also significantly lower in the group receiving endophotocoagulation (P less than .05). The beneficial effect of intraoperative laser treatment was independent of the amount of preoperative laser treatment, aphakia, and indications for the original vitrectomy surgery.

Argon↗

PubMed1996

Condensation of silicone oil on the posterior surface of a silicone intraocular lens during vitrectomy.

PURPOSE: We experienced a complication caused by the condensation of silicone oil on the surface of a silicone intraocular lens during pars plana vitrectomy. METHODS: A 74-year-old woman with proliferative vitreoretinopathy underwent a pars plana vitrectomy in her left eye, which contained silicone oil and a silicone intraocular lens. RESULTS: Intraoperatively, condensation of silicone oil on the posterior surface of a silicone intraocular lens caused a loss of visibility during fluid/gas exchange. The silicone oil droplets could not be removed. CONCLUSION: Surgeons should avoid direct contact of silicone oil with silicone intraocular lens.

Aged↗

PubMed1983

Vitrectomy for nondiabetic vitreous hemorrhage.

In a group of 94 eyes with nondiabetic vitreous hemorrhage that underwent pars plana vitrectomy between March 1974 and September 1982, the causes of the hemorrhages were retinal branch vein obstruction (36 eyes), blunt trauma (11 eyes), cataract extraction (ten eyes), subretinal neovascularization (nine eyes), Eales' disease (eight eyes), Terson's syndrome (four eyes), and idiopathic (five eyes) and miscellaneous (11 eyes) conditions. Vision was improved postoperatively in 88 of the 94 eyes, including all of those that underwent blunt trauma or cataract extraction, those with Eales' disease and Terson's syndrome, and those in the idiopathic and miscellaneous groups. Final visual acuities, which depended primarily on the underlying condition and its effect on the macula, were 20/20 or better in ten eyes, 20/25 to 20/40 in 37 eyes, 20/50 to 20/200 in 26 eyes, 20/300 to 20/400 in 11 eyes, 9/200 to 5/200 in three eyes, and hand movements or light perception in seven eyes. Retinal tears, the most common surgical complication, occurred in 18 eyes. The incidence of anterior retinal tears was reduced from 11% (11 of 38 eyes) to 4% (two of 56 eyes) after we began using a vitrectomy probe with a smaller diameter. Some postoperative lens opacification occurred in 16 of 50 phakic eyes, and the incidence of later lens opacification increased as the follow-up lengthened.

Adolescent↗

PubMedDate not supplied

Vitrectomy for diabetic cystoid macular edema.

PURPOSE: We evaluated visual outcomes following vitrectomy for diabetic cystoid macular edema. METHODS: Visual outcomes and factors possibly influencing final visual acuity were assessed and documented retrospectively in 45 eyes of 40 patients, all of whom were followed up for at least 6 months postoperatively. RESULTS: Compared with the preoperative logarithm of the minimum angle of resolution (logMAR) visual acuity, final logMAR visual acuity improved 0.2 or more in 51% of the eyes, was unchanged in 47%, and decreased 0.2 or more in 2%. A final postoperative visual acuity of 0.5 or better was achieved in 38%. Preoperative visual acuity and the extent of the cystoid space on fluorescein angiography were significantly related to final visual acuity. A final postoperative visual acuity of 0.5 or better was noted in 8% of eyes with a preoperative visual acuity below 0.1, in 50% of eyes with a preoperative visual acuity of 0.1 or better, in 71% of eyes with a cystoid space smaller than 5 disc areas, and in 20% of eyes with a cystoid space of 5 disc areas or more. The state of the posterior vitreous membrane did not influence final visual acuity. There were no complications that decreased visual acuity. CONCLUSIONS: We conclude that diabetic cystoid macular edema is a good indication for vitrectomy, regardless of the state of the posterior vitreous membrane. A preoperative visual acuity of 0.1 or better and/or a cystoid space smaller than 5 disc areas may be indications for surgery aimed at achieving a final postoperative visual acuity of 0.5 or better.

Adult↗

PubMedDate not supplied

The management of retinal detachments associated with choroidal colobomas by vitrectomy with cyanoacrylate retinopexy.

The techniques used and the outcome in eyes treated for retinal detachment associated with choroidal coloboma are described. We reviewed the medical reports on five eyes of five patients with retinal detachment associated with choroidal coloboma who underwent vitrectomy. Retinal breaks were identified at the margin of or within the coloboma and the retina was successfully reattached by vitrectomy and cyanoacrylate retinopexy in four of the five eyes. The remaining one eye, with no visible retinal break both before and during surgery, also underwent cyanoacrylate retinopexy at regions suspected of retinal break, and was successfully reattached. In four eyes (80%) the vision showed improvement and had a visual acuity of 20/100 or better after surgery. None of the eyes required silicone oil tamponade or endophotocoagulation around the disc or at the papillomacular bundle. For the management of retinal detachment associated with choroidal coloboma, cyanoacrylate retinopexy is the method of choice, providing adequate chorioretinal adhesion and satisfactory visual outcome.

Adolescent↗

PubMed2001

Surgical management of secondary glaucoma after pars plana vitrectomy and silicone oil injection for complex retinal detachment.

OBJECTIVE: To evaluate the outcomes of surgical intervention for secondary glaucoma after pars plana vitrectomy and silicone oil injection for repair of complex retinal detachment. DESIGN: Retrospective noncomparative interventional case series. PARTICIPANTS: Forty-three eyes of 43 patients who underwent incisional surgery for secondary glaucoma after pars plana vitrectomy and silicone oil injection for repair of complex retinal detachment over a 9-year period. MAIN OUTCOME MEASURES: Intraocular pressure (IOP), intraoperative and postoperative complications, visual acuity, and the need for further surgical intervention for glaucoma. Success was defined as IOP < or =21 mmHg and > or =5 mmHg with or without medication but without surgical reoperation for glaucoma. RESULTS: Findings associated with elevated IOP included emulsified oil in the anterior chamber (n = 14), pupillary block from silicone oil (n = 13), open-angle glaucoma without silicone oil in the anterior chamber (n = 9), and angle-closure glaucoma without pupillary block (n = 7). The mean (+/- standard deviation) IOP was 41.4 +/- 15.1 mmHg before surgery for glaucoma and 17.2 +/- 10.2 mmHg after an average follow-up of 19.6 months (P < 0.001). Cumulative success was 69%, 60%, 56%, and 48% at 6, 12, 24, and 36-months respectively. In patients who underwent silicone oil removal alone for surgical management of glaucoma (n = 32), 11 of 12 IOP failures (92%) were due to uncontrolled IOP, whereas most IOP failures in the group who underwent silicone oil removal plus glaucoma surgery (n = 8) failed because of hypotony (3 of 4, 75%, P = 0.027). Of three patients who underwent glaucoma surgery alone to control IOP, one failed because of hypotony. There was no significant change in visual function at last follow-up (logarithm of the minimum angle of resolution [logMAR] 2.01) compared with preoperative visual function (logMAR 2.07, P = 0.74). CONCLUSION: Surgical management of secondary glaucoma after silicone oil injection for complex retinal detachment may achieve good IOP control and stabilization of visual function in most patients. Patients who undergo silicone oil removal alone to control IOP are more likely to have persistent elevation of IOP and possibly undergo reoperation for glaucoma, whereas patients who undergo concurrent silicone oil removal and glaucoma surgery are more likely to have hypotony.

Female↗