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At least 919 records · Page 51Linked to original sources

PubMed2004

Comparison of retinal outcomes after scleral buckle or lens-sparing vitrectomy for stage 4 retinopathy of prematurity.

PURPOSE: To compare anatomic outcomes after lens-sparing vitrectomy (LSV) or scleral buckle (SB) for stage 4 retinopathy of prematurity (ROP). METHODS: Nonrandomized, retrospective study of infants consecutively treated for stage 4 ROP by LSV or SB. Outcomes were retinal attachment at 1 month of initial surgery and at the end of follow-up (6 months) and number of procedures to achieve retinal attachment. Exact chi2 methods determined significance, and student's t-test compared mean postmenstrual age and birthweight between the groups. RESULTS: After one procedure, LSV (72%) was associated with retinal attachment more often than was SB (31%). At the end of follow-up, after one or more procedures, there was no difference in retinal reattachment rate between LSV or SB as the first procedure. There were no differences between the surgical groups by mean postmenstrual age and birthweight or severity of ROP determined by zone, clock hours of ridge elevation, or quadrants of plus disease. CONCLUSION: This study supports the hypothesis that vitrectomy by LSV stops progressive stage 4 ROP. As an initial procedure, LSV was associated with retinal attachment more often than SB. Future prospective studies can determine the effects of LSV and SB on visual development in progressive stage 4 ROP.

Birth Weight↗

PubMed2005

Vitreomacular adhesion and the defect in posterior vitreous cortex visualized by triamcinolone-assisted vitrectomy.

PURPOSE: To study the vitreomacular adhesion and the contractile force of posterior hyaloid, which are shown in triamcinolone acetonide (TA)-assisted pars plana vitrectomy (PPV). DESIGN: Interventional case series. METHODS: Twenty-eight eyes with diabetic macular edema (DME) without posterior vitreous detachment (PVD) received TA-assisted PPV. Surgical PVD was performed by an aspiration of vitrectomy probe, and the dynamic changes of posterior vitreous cortex and residual vitreous cortex were evaluated. RESULTS: A premacular defect was formed in the detached posterior vitreous cortex during surgical PVD in 27 of 28 eyes. Immediately thereafter, the small defect expanded into a large hole in the detached posterior vitreous cortex in all cases. A residual vitreous cortex was left on the macula in 22 eyes. CONCLUSIONS: These observations demonstrate a firm vitreoretinal adhesion in the central macula and suggest that the enlargement of the defect of posterior vitreous cortex may be extrusion of vitreous out through the premacular dehiscence into the preretinal space, or a tangentially contractile force may exist in the posterior vitreous cortex. Both macular adhesion and the traction of vitreous cortex might contribute to the pathogenesis of DME and other vitreomacular disease.

Diabetic Retinopathy↗

PubMed2006

Pars plana vitrectomy with and without peeling of the inner limiting membrane for diabetic macular edema.

PURPOSE: A prospective, comparative, nonrandomized study to evaluate the efficacy of pars plana vitrectomy (PPV) with and without inner limiting membrane (ILM) peeling for persistent diffuse clinically significant macular edema. METHODS: Eighteen patients with persistent diffuse clinically significant macular edema despite laser photocoagulation were recruited for the study. Clinical assessment included determination of best-corrected visual acuity, fundus fluorescein angiography, optical coherence tomography, and perifoveal cone function testing. Eight patients underwent PPV with elevation and removal of the posterior hyaloid alone, and 10 patients underwent vitrectomy and ILM peeling. The follow-up was 12 months. RESULTS: Patients with ILM peeling had improvement in foveal thickness (P = 0.07) and significant improvement in the macular volume (P = 0.039) 12 months after surgery but did not have significant improvement in Early Treatment Diabetic Retinopathy Study vision or perifoveal cone function. There was no significant difference in outcome parameters between the no peeling group and the ILM peeling group. CONCLUSIONS: In this prospective, comparative study of PPV with and without ILM peeling for diffuse clinically significant macular edema, structural improvement was seen but with limited visual improvement after ILM peeling.

Adult↗

PubMed1994

Diabetic vitrectomy.

Proliferative diabetic retinopathy is one of the leading causes of permanent vision loss. Vitrectomy for the complications of proliferative changes has resulted in preservation of vision. Recent studies have focused on the cellular and structural changes in patients with proliferative changes. Data obtained from the early Treatment of Diabetic Retinopathy Study show that the rate of vitrectomy is reduced in eyes that have early-scatter photocoagulation in comparison with those that have deferral of treatment. The efficacy and complications of silicone oil tamponade have been more carefully evaluated with respect to complex detachments associated with proliferative diabetic retinopathy.

Diabetic Retinopathy↗

PubMed2003

Cataract surgery results after pars plana vitrectomy.

Continuous refinements in vitreoretinal surgical techniques and an increasing number of posterior segment disorders are being successfully managed with pars plana vitrectomy (PPV). This has resulted in an increase in the number of vitrectomized eyes seen by cataract surgeons. Cataract surgery in previously vitrectomized eyes has been reported to be more challenging than in eyes without previous vitrectomy. Special considerations and precautions are often required before, during, and after the surgery to successfully address these challenges. Several studies have reported that phacoemulsification with intraocular lens implantation after PPV is a relatively safe procedure that can improve visual acuity and quality of life. The extent of visual improvement may be limited only by retinal comorbidity.

Humans↗

PubMed2006

Lensectomy and vitrectomy with and without intravitreal triamcinolone acetonide for vascularly active stage 5 retinal detachments in retinopathy of prematurity.

PURPOSE: To determine the anatomical success rate of lensectomy and vitrectomy with and without intravitreal triamcinolone acetonide (TA) for vascularly active stage 5 tractional retinal detachments due to retinopathy of prematurity (ROP). METHODS: In a retrospective, interventional, single-surgeon, consecutive case series, the records of 21 eyes of 21 patients presenting with stage 5 retinal detachment secondary to ROP who underwent primary pars plicata vitrectomy with lensectomy from February 1998 to January 2004 were evaluated. All eyes were vascularly active at the time of surgery. Eleven eyes underwent the surgical procedure without TA (group 1), and 10 eyes received TA at the end of the procedure (group 2). The main outcome measure, retinal reattachment, was reviewed at the final follow-up visit, which ranged from 6 months to 42 months (mean, 28 months) after surgery. RESULTS: None (0/11) of the eyes in group 1 maintained attachment, while 6 (60%) of 10 eyes in group 2 maintained at least posterior pole reattachment at the final visit. None of the group 2 eyes exhibited plus disease during follow-up. None of the eyes in either group exhibited signs of increased intraocular pressure after surgery. All six eyes that maintained posterior pole reattachment were able to fix and follow light at the last follow-up visit. CONCLUSIONS: Vascularly active stage 5 ROP detachments portend a poor progress. The use of TA as a postoperative adjunct may improve the likelihood of retinal reattachment in select cases.

Birth Weight↗

PubMed2006

Correlation of optical coherence tomography pattern and visual recovery after vitrectomy with silicone oil for retinal detachment.

PURPOSE: To assess prospectively the features of the macular surface in silicone oil-filled eyes after surgery by analyzing whether silicone oil affects optical coherence tomography (OCT) measurements and their reproducibility and whether a statistical correlation exists between postoperative best-corrected visual acuity (BCVA) and foveal thickness measured by OCT. METHODS: Twenty eyes of 20 patients underwent vitrectomy with silicone oil tamponade for retinal detachment. After vitrectomy, complete ophthalmic examination including determination of BCVA and OCT was performed to quantify the visual recovery and the foveal thickness. RESULTS: Ophthalmoscopy revealed that the retina appeared to be reattached in all 20 eyes at 3 months after surgery. BCVA ranged from 0.4 logMAR to 1.7 logMAR, and foveal thickness ranged from 80 microm to 500 microm. Postoperative foveal thickness and BCVA had a strong correlation (r = 0.93; P = 0.003). CONCLUSION: The presence of silicone oil in the vitreous chamber does not change the reproducibility of OCT measurements of foveal thickness (coefficient of reproducibility, 1.48%). This study showed high statistical correlation between BCVA and foveal thickness. Therefore, postoperative BCVA is affected by postoperative foveal thickness, and visual improvement is limited in eyes with increased or decreased foveal thickness.

Adult↗

PubMed2007

Eccentric macular holes after vitrectomy with peeling of epimacular proliferation.

PURPOSE: To describe six patients (six eyes) who developed an eccentric macular hole after surgery for idiopathic epimacular proliferation. METHODS: In a retrospective review of 631 consecutive patients who underwent vitrectomy with peeling of the epimacular proliferation and in most cases the internal limiting membrane (ILM) from May 2001 to May 2005, 6 patients were found to have developed an eccentric macular hole postoperatively. RESULTS: Eccentric macular holes developed 9 days to 8 months (mean, 3.1 months) after epimacular proliferation peeling. The ILM was peeled in addition to the epimacular proliferation in five of the six cases. Of the six eccentric macular holes, four were located temporal to the fovea, one was located superior to the fovea, and one was located nasal to the fovea. Final visual acuities after a mean follow-up period of 17.3 months were 20/20 in 2 eyes, 20/25 in 1 eye, 20/40 in 2 eyes, and 5/200 in 1 eye. The eye with the eccentric macular hole nasal to the fovea had the poorest final visual acuity of 5/200. CONCLUSION: Eccentric macular hole occurring after vitrectomy to remove epimacular proliferation is an uncommon postoperative finding. To our knowledge, this is the largest case series of such patients reported. Various explanations have been suggested for the etiology of these holes, but there remains no consensus.

Adult↗

PubMed2007

Conjunctival epithelium in pars plana vitrectomy specimens.

PURPOSE: To review histopathology of vitrectomy specimens obtained during routine pars plana vitrectomy (PPV) for evidence of inadvertent introduction of conjunctival epithelium into the vitreous cavity during PPV. METHODS: Retrospective review of all vitreous specimens obtained from PPV over a 3-year period during which vitreous samples were routinely submitted from routine and diagnostic PPV. Patient charts and operative reports were reviewed, with particular attention to history of postoperative endophthalmitis, and the use of transconjunctival PPV. RESULTS: A total of 650 specimens were obtained over a 3-year period. Three specimens with conjunctival epithelium were identified. None of these cases resulted in endophthalmitis. Two of these three cases used transconjunctival techniques. In one case all three sclerotomies were made using transconjunctival techniques. CONCLUSIONS: The presence of conjunctiva in the vitreous aspirate from completely transconjunctival PPV indicates that conjunctival epithelium can be inadvertently introduced into the vitreous cavity during PPV. Although none of these cases resulted in endophthalmitis, special care to sterilize the conjunctiva before the creation of transconjunctival sclerotomies is warranted.

Aged↗

PubMed2007

Effect of oxygenated intraocular irrigation solutions on the electroretinogram after vitrectomy.

PURPOSE: To investigate the effect of oxygenated intraocular irrigating solutions on electroretinograms (ERGs) for postvitrectomy rabbits. METHODS: Eight groups of five rabbits each underwent pars plana vitrectomy on the right eye; the left eye of each rabbit served as control. The intraocular irrigating solutions were balanced salt solution (BSS), BSS-plus, BSS + oxygen (BSS + O2), BSS-plus + O2, and combinations of each with the addition of endoillumination (L). All animals were evaluated by single-flash scotopic electroretinography on the operated and nonoperated eyes before surgery and at 1 hour, 1 day, 1 week, and 1 month after surgery by an unmasked observer. The main outcome measures were dark-adapted b-wave amplitudes of operated eye/nonoperated eye ratios. The results for the different groups were compared by analysis of variance. RESULTS: Mean dark-adapted b-wave amplitudes of operated eye/nonoperated eye ratios +/- SD for BSS-plus and BSS-plus + O2 before surgery and 1 hour, 1 day, 1 week, and 1 month after surgery were 1.01 +/- 0.09, 0.50 +/- 0.11, 0.95 +/- 0.11, 0.97 +/- 0.11, and 0.99 +/- 0.08 and 0.98 +/- 0.08, 0.59 +/- 0.10, 0.92 +/- 0.06, 0.97 +/- 0.08, and 0.97 +/- 0.10, respectively. At both 1 hour and 1 day after surgery, rabbits treated with BSS-plus + O2 had an earlier b-wave return to baseline findings, but the differences were not statistically significant (P > 0.05). Mean dark-adapted b-wave amplitudes of operated eye/nonoperated eye ratios +/- SD for BSS and BSS + O2 before surgery and 1 hour, 1 day, 1 week, and 1 month after surgery were 1.02 +/- 0.10, 0.47 +/- 0.09, 0.77 +/- 0.07, 0.89 +/- 0.07, and 0.89 +/- 0.07 and 1.02 +/- 0.06, 0.62 +/- 0.16, 0.94 +/- 0.09, 0.97 +/- 0.08, and 0.96 +/- 0.06, respectively. One hour and 1 day after surgery, ERG readings for rabbits treated with BSS + O2 exhibited a statistically significantly earlier return of ERG voltage to baseline values compared with both BSS and BSS + L (P = 0.05 and P = 0.02, respectively). One day after surgery, rabbits treated with BSS alone had the lowest ERG ratios. One week and 1 month after surgery, for all solutions tested other than BSS, ERG values were within normal limits. CONCLUSION: The use of oxygenated solutions appears to affect ERG readings after pars plana vitrectomy. Further studies to evaluate the role of oxygenated solutions in different vitreoretinal surgical procedures are warranted.

Acetates↗

PubMed1986

Results of vitrectomy in children.

Though vitrectomy results in the general population are being well established, the results in children particularly of amblyopic age are still largely unknown. This paper details the results in 44 children aged one month to 13 years, of whom 28 were seven years of age or less. The most frequent indication for vitrectomy was penetrating ocular trauma (61%). Of the total 44 cases, 28 (63%) were rendered unilaterally aphakic, 18 of these being less than 7 years old. Improvement in vision occurred in 34 (77%) of the 44 patients, and 10 (23%) remained unchanged. In the 18 children aged one month to seven years who became unilaterally aphakic, 11 (61%) improved and seven (39%) remained unchanged. The management of amblyopia and contact lenses in children is stressed. These results indicate that vitreous surgery plays a significant role in the restoration of vision in children.

Adolescent↗

PubMed2005

Visual outcomes following vitrectomy and peeling of epiretinal membrane.

BACKGROUND: Visual outcomes of patients following vitrectomy and peeling of visually significant epiretinal membranes were assessed to determine the influence of specific perioperative factors and surgical complications on final visual acuity and functional vision. METHODS: In an unmatched, consecutive surgical series, vitrectomy and membrane peeling were performed on 125 eyes of 123 patients with visually significant macular epiretinal membranes. Patients were followed for 6-36 months. Visual outcome measures included postoperative logMAR visual acuity, change in visual acuity and functional vision tasks evaluated by questionnaire. Perioperative factors including duration of symptoms, preoperative visual acuity, aetiology, membrane type and leakage on fundal fluorescein angiogram were correlated with final visual outcomes. RESULTS: Visual acuity improved by a mean of 0.31 A+/- 0.21 units (three lines of vision). In 104 cases (83%), visual acuity improved in patients by two lines or more, with 20 cases (16%) having unchanged acuity and one case (1%) having worse acuity. Ninety-three per cent of interviewed cases reported improvement in functional vision, especially reduction of distortion. Cataract was observed in 52 cases (52% of phakic eyes) postoperatively compared with 19 cases (19%) preoperatively. Postoperative visual acuity correlated with preoperative visual acuity. Patients with worse preoperative vision recorded greater visual improvement following surgery. No other perioperative factors were found to have a prognostic value in this study. CONCLUSION: Epiretinal membrane peeling improves vision in the majority of patients with significant symptoms, even if preoperative visual acuity is not substantially reduced. Surgery improves functional vision including metamorphopsia not measurable by visual acuity, and thus assessment of functional vision should be included in surgical case planning.

Adult↗

PubMedDate not supplied

Pars plana vitrectomy for the treatment of ophthalmomyiasis interna posterior in a dog.

Unilateral chorioretinitis caused by ophthalmomyiasis interna posterior in a 5-month-old, female spayed Dachshund is reported. Larva removal by pars plana vitrectomy was performed after an unsuccessful photocoagulation of the organism. The larva was intact after surgical removal and was identified as a first stage instar Cuterebra spp. larva. The eye remains visual and comfortable with no signs of residual or recurrent inflammation postoperatively. This report describes, for the first time, the successful surgical retrieval of an intravitreal fly larva in a dog using vitrectomy techniques without sacrificing either the globe or vision, and taxonomic identification of the parasite.

Animals↗

PubMed1995

A comparative study of intraocular irrigating solutions: effects on electroretinography readings during closed vitrectomy in humans.

The effects of intraocular irrigating solutions on electroretinography have been extensively studied in animal models, but effects on human electroretinography have not been reported. This study examined the effects of two commercially available irrigating solutions, S-MA2 (Opeguard MA) and DE-057 (BBS-Plus) on 30-Hz flicker electroretinography during closed vitrectomy in humans. Eight eyes of 8 patients were examined. All patients underwent a simple vitrectomy without treatment of proliferative membrane. For 30-Hz flicker electroretinography recording, a contact lens with a built-in light-emitting diode was sterilized and used as both a stimulus source and a recording electrode. Replacing S-MA2 with DE-057 decreased the electroretinography amplitude from 55.8 +/- 15.2 to 45.5 +/- 13.2 microV (mean +/- SEM). Changing the irrigation solution from DE-057 back to S-MA2 increased the amplitude from 45.5 +/- 13.2 to 59.9 +/- 17.3 microV. However, these changes were not statistically significant. Replacing S-MA2 with DE-057 significantly increased the peak time from 50.1 +/- 1.5 to 57.6 +/- 1.3 msec (p < 0.001). This change was reversible; after changing from DE-057 back to S-MA2, the peak time of flicker electroretinography significantly decreased from 57.6 +/- 1.3 to 49.0 +/- 2.1 msec (p < 0.01). Thus intraoperative 30-Hz electroretinography showed delayed peak time during irrigation with DE-057, as compared with S-MA2. The lower potassium concentration and higher glucose concentration of S-MA2, as compared with DE-057, may be the cause of such electroretinography changes.

Aged↗

PubMed1985

Light perception in diabetic vitreous haemorrhage and its prognostic value in pars plana vitrectomy.

Ninety-two years with a pre-operative visual function of light perception 6 m or less, were treated with vitrectomy because of diabetic vitreous haemorrhage. The post-operative visual function after 6 months was improved to 5/50-5/5 in 37 eyes and counting fingers from 1 to 5 m in 32 eyes. In 23 eyes the postoperative visual function was unchanged or decreased, and among these were all 7 eyes with pre-operative light perception at 1.5 m or less. No eye with pre-operative light perception at 1.5 or less benefitted from vitrectomy due to extensive retinal damage.

Adult↗

PubMed1985

Vitrectomy in double perforating eye injuries.

The results of 41 consecutive cases of double perforating eye injuries, operated with vitrectomy between December 1975 and December 1982, are reported. Fourteen eyes (34%) obtained a visual acuity of 5/10 or better, and 23 eyes (56%) obtained 5/200 or better. Twenty-eight (68%) developed retinal detachment, and 12 of these were attached by surgery. In this series the pre-operative visual function and the type of injury had a significant effect on the final result. No beneficial effect from early (within 14 days) vitrectomy could be shown.

Adolescent↗

PubMed1987

Early vitrectomy in the treatment of post-operative purulent endophthalmitis.

In 1979-85, 12 cases of purulent postoperative endophthalmitis (PPE) were treated with broad-spectrum antibiotics, corticosteroids and vitreous surgery. In 11 eyes endophthalmitis developed after cataract surgery, in 6 of them after an intraocular lens (IOL) implantation, in one eye after trabeculectomy. Signs related to an intraocular infection appeared 2 to 32 days after surgery, earlier in eyes with an IOL or post-operative complications than in those without. All 5 eyes where vitrectomy was performed within 24 h from the beginning of symptoms retained useful vision (0.1-0.6), whereas 2 of the 7 eyes where vitrectomy was performed later were lost. In the latter two the causative agent was streptococcus. No IOL implants were removed.

Aged↗

PubMed1988

Neovascular glaucoma following vitrectomy for diabetic eye disease.

Between September 1979 and December 1985, 124 eyes of 105 patients underwent vitrectomy for diabetic eye disease. Until May 1987 (mean follow-up of 3.2 +/- 0.3 years) neovascular glaucoma (NVG) occurred in 21 eyes (17%); in 18 of them within the first post-operative year. Post-operative total retinal detachment (P = 0.0003) and pre- and/or per-operative aphakia (P = 0.0047) proved to be significant independent risk factors for post-operative NVG (odds ratio 9.9 and 4.6, respectively). The rate of NVG decreased from 22% in the second half of the study period (NS). This decrease may be related to smaller proportion of aphakic vitrectomies in the latter half (50% vs 18%, P less than 0.0004). Lack of previous panretinal photocoagulation did not increase the risk of NVG significantly. Of the 84 non-vitrectomized fellow-eyes NVG occurred in 17. In 4 of the 21 eyes the intraocular pressure (IOP) was satisfactorily controlled by antiglaucomatous medication after retinal panphotocoagulation, direct photocoagulation of the iris new vessels and/or cyclocryocoagulation. Four eyes remained hypertonic, but were comfortable with symptomatic medication, 12 eyes became hypotonic. One eye was enucleated. Useful vision was preserved in 3 eyes, light perception (LP) in 2 eyes, the remaining 16 lost LP. In 13 of the 16 eyes vision was lost within the first post-operative year.

Adolescent↗