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PubMedDate not supplied

Vitrectomy and silicone oil tamponade for serous macular detachment associated with an optic disk pit.

PURPOSE: Description of the results of vitrectomy and silicone oil tamponade to repair serous macular detachment associated with optic disk pit. DESIGN: Interventional case report. METHODS: The authors report on a 17-year-old girl with serous macular detachment with a very thin layer near the fovea which clinically simulated a lamellar macular hole and macular schisis associated with an optic disk pit. The patient underwent pars plana vitrectomy with posterior hyaloid removal and silicone oil tamponade. RESULTS: Good anatomic and functional results were obtained after 1 year of follow-up. CONCLUSIONS: This surgical approach may be a valuable technique for the surgical management of serous macular detachment associated with an optic disk pit.

Adolescent↗

PubMed2005

Vitrectomy with complete posterior hyaloid removal for ischemic central retinal vein occlusion: series of cases.

BACKGROUND: Central retinal vein occlusion (CRVO) is a common retinal vascular disorder with potentially complications: (1) persistent macular edema and (2) neovascular glaucoma. No safe treatment exists that promotes the return of lost vision. Eyes with CRVO may be predisposed to vitreous degeneration. It has been suggested that if the vitreous remains attached to the macula owing to a firm vitreomacular adhesion, the resultant vitreous traction can cause inflammation with retinal capillary dilation, leakage and subsequent edema6. The roll of vitrectomy in ischemic CRVO surgical procedures has not been evaluated. CASE PRESENTATION: This is a non comparative, prospective, longitudinal, experimental and descriptive series of cases. Ten eyes with ischemic CRVO. Vitrectomy with complete posterior hyaloid removal was performed. VA, rubeosis, intraocular pressure (IOP), and macular edema were evaluated clinically. Multifocal ERG (m-ERG), fluorescein angiography (FAG) and optic coherence tomography (OCT) were performed. Follow-up was at least 6 months. Moderate improvement of visual acuity was observed in 60% eyes and stabilized in 40%. IOP changed from 15.7 +/- 3.05 mmHg to 14.9 +/- 2.69 mmHg post-operative and macular edema from 976 +/- 196 microm to 640 +/- 191 microm to six month. The P1 wave amplitude changed from 25.46 +/- 12.4 mV to 20.54 +/- 11.2 mV. CONCLUSION: A solo PPV with posterior hyaloid removal may help to improve anatomic and functional retina conditions in some cases. These results should be considered when analyzing other surgical maneuvers.

Aged↗

PubMed2001

Serum factors associated with neovascular glaucoma following vitrectomy for proliferative diabetic retinopathy.

We performed a retrospective study of serum factors associated with neovascular glaucoma that can occur following vitrectomy for proliferative diabetic retinopathy. The medical records of 183 patients (241 eyes) who received vitrectomy between August 1996 and August 2000 were studied retrospectively and subsequently analyzed by linear logistic regression analysis and multiple logistic regression tests. Neovascular glaucoma developed at an average of 2.7 months in 31 of 241 eyes (14.1%). The overall anatomical success rate of retinal attachment was 82.5% (199 eyes in 241 eyes), although it decreased to 45.1% (14 eyes in 31 eyes) in eyes with neovascular glaucoma. Serum cholesterol (P = 0.041) and fibrinogen levels (P = 0.020) were significantly associated with the development of neovascular glaucoma. However, no significant association could be found concerning hypertension, diabetic retinopathy or hypercholesterolemia (P > 0.05). We suggest that serum creatinine, cholesterol and fibrinogen levels can be used to predict the development of neovascular glaucoma in vitrectomized eyes with diabetic retinopathy and can further provide a more active approach to preventing the development of this condition.

Adult↗

PubMed2004

Vitreoretinal surgery using transconjunctival sutureless vitrectomy.

This report presents the effectiveness of 25-gauge Transconjunctival Sutureless Vitrectomy (TSV) for various vitreoretinal disorders. We performed vitreoretinal surgery on 6 patients using 25-gauge TSV. Minimal or no leakage of intraocular fluid or gas was observed at the entry site. No case required a suture to close the conjunctival or scleral opening site, and no complications resulted from the opening site. Median preoperative visual acuity was 0.04 and median postoperative best corrected visual acuity (BCVA) with a mean follow-up of 12 weeks, was 0.45. Median preoperative intraocular pressure was 12.67 mmHg, and median intraocular pressure on the first postoperative day was 15.67 mmHg. Because transconjunctival sutureless surgery is minimally invasive, it increases the efficiency of vitrectomy, hastens postoperative recovery, and improves outcomes due to the simplified surgical procedure. We feel that the adoption of the 25-gauge TSV would lead to improved patient comfort, care, and management.

Adult↗

PubMedDate not supplied

Retinal hemorrhage following lensectomy and anterior vitrectomy in children.

Lensectomy and anterior vitrectomy were performed on 13 eyes of 10 consecutive children, aged 10 years or less, with congenital or acquired nontraumatic cataracts or subluxed lenses. Operative eyes were examined prospectively to determine the incidence and natural course of hemorrhagic retinopathy following lens extraction. Flame-shaped retinal hemorrhages occurred in five eyes of four patients within 24 hours of surgery. In addition, a small vitreous hemorrhage was seen in one of these patients. All hemorrhages cleared within 3 weeks postoperatively. No statistically significant correlation was found between the occurrence of hemorrhage and patient age, race, sex, or duration of surgery. We conclude that retinal hemorrhage following lensectomy and anterior vitrectomy in children may occur more commonly than previously recognized.

Cataract↗

PubMedDate not supplied

Vitrectomy for dense vitreous hemorrhage in infancy.

PURPOSE: To report clinical data, including etiology and visual outcome, in newborns requiring vitrectomy for dense vitreous hemorrhage. METHODS: In this retrospective case series, we surveyed subscribers to the American Association for Pediatric Ophthalmology and Strabismus ListServe regarding patients under their care. RESULTS: A total of 28 eyes of 21 patients were included. Most common etiologies were thrombocytopenia, shaken baby syndrome, and birth trauma. In 9 cases (12 eyes), the vitreous hemorrhage was idiopathic. Mean time between diagnosis and surgery was 1.4 months. Complications included strabismus, cataract, glaucoma, high myopia, and retinal detachment. Recognition visual acuities were available for 8 eyes: 20/25 (2 eyes), 20/30, 20/40 (2 eyes), 20/60 (2 eyes), and 20/100. One eye had no light perception. CONCLUSIONS: The etiologies encountered in our patients were similar to those reported previously. Visual outcomes were much worse in cases with retinal complications. Other patients had better visual outcomes. Despite potential surgical and postoperative complications, this series demonstrates favorable visual outcomes can be achieved following early vitrectomy in this setting.

Birth Injuries↗

PubMedDate not supplied

Combined pars plana vitrectomy and phacoemulsification with intraocular lens implantation in severe proliferative diabetic retinopathy.

BACKGROUND AND OBJECTIVE: To evaluate the results of combined vitrectomies and intraocular lens implantations in cases of proliferative diabetic retinopathy. PATIENTS AND METHODS: Data from procedures on 117 eyes (91 patients) undergoing combined pars plana vitrectomy, phacoemulsification, and intraocular lens implantation for the complications of proliferative diabetic retinopathy were analyzed retrospectively. Follow-up ranged from 8 to 64 months (median = 25 months). RESULTS: Retinal tears were the most frequent intraoperative problems (19%). Limited postoperative fibrin formation occurred in 22% of eyes. Within 6 months, 7% developed glaucoma and 2% showed new anterior segment rubeosis. Overall, 10% underwent secondary surgical procedures as follows: lavage for hemorrhage (n = 3), silicone oil exchange after 7 days for focal rebleeding (n = 1), silicone oil surgery for retinal detachment after gas resorption (n = 1), and lavage for late vitreous hemorrhage (7 to 13 months) (n = 4). Half of the secondary procedures were necessitated within 3 months of the original surgery. CONCLUSIONS: Combined surgery in proliferative diabetic retinopathy is safe and effective. It should be considered when lens opacities are either present or likely to develop soon.

Adult↗

PubMed2004

[Sympathetic ophthalmia post-vitrectomy following trauma and perfluorocarbon liquid tamponade].

CASE REPORT: We report a case of sympathetic ophthalmia (SO) developed after blunt trauma and vitrectomy (complicated with a massive suprachoroidal hemorrhage) using perfluorocarbon liquid (PFCL) for tamponade. DISCUSSION: The presentation of SO in a vitrectomized patient after severe blunt trauma with extended intra-ocular tamponade with PFCL could support the hypothesis that chronic inflammation caused by PFCL could have contributed to the development of SO. Nevertheless, there are other possible causal factors such as the trauma, the vitrectomy itself or the choroidal detachment with possible uveal incarceration at wound sites.

Aged↗

PubMed1999

Combined central retinal artery and central retinal vein occlusion following pars plana vitrectomy.

Combined occlusion of the central retinal artery and central retinal vein is an infrequently encountered clinical entity. Although there are reports in the literature of a combined occlusion of the central retinal artery and vein, its occurrence following pars plana vitrectomy has not been described. We report the case of an elderly patient who developed this unusual occurrence following an uneventful pars plana vitrectomy for a posteriorly dislocated IOL.

Aged↗

PubMed1999

Combined cataract surgery, intraocular lens insertion, and vitrectomy in eyes with idiopathic epiretinal membrane.

To report the surgical outcomes of combined cataract surgery and pars plana vitrectomy in eyes with idiopathic epiretinal membrane. This is a retrospective review of 8 consecutive patients with concurrent cataract and idiopathic epiretinal membrane who underwent the combined procedure. At a mean follow-up of 22 months, the visual acuity improved by 2 or more Snellen lines in 7 patients (88%). Median preoperative and postoperative best-corrected visual acquities were 20/200 and 20/50 respectively. Simultaneous cataract surgery and vitrectomy for idiopathic epiretinal membrane removal resulted in visual improvement in the majority of patients.

Aged↗

PubMed1999

[Vitrectomy for proliferative diabetic retinopathy associated with iris rubeosis].

OBJECT: To compare the results of vitrectomy for phakic cases and those of aphakic cases with proliferative diabetic retinopathy (PDR) accompanied by rubeosis iridis. MATERIALS & METHODS: We reviewed 34 eyes of 24 cases that underwent vitrectomy for proliferative diabetic retinopathy with rubeosis iridis. RESULT: Phakic eyes needed significantly more reoperations (p < 0.001) than aphakic eyes. Aphakic eyes had significantly more successful visual results (p < 0.05) and better control of intraocular pressure (p < 0.005) than phakic eyes. CONCLUSION: This study showed the possibility that phakic eyes had more ischemic retina producing more angiogenic factors than aphakic eyes which had the same grade of rubeosis iridis. Phakic eyes with pre-operative rubeosis iridis need thorough clearance of ocular ischemia by panretinal photocoagulation.

Diabetic Retinopathy↗

PubMed1997

[Cataract extraction and intraocular lens implantation after vitrectomy].

OBJECTIVE: To study the characteristics of cataract extraction and surgical techniques in cases following vitrectomy. METHODS: Extra-capsular extraction/phacoemulsification of cataract and intra-ocular lens implantation were performed under vitreous irrigation. RESULTS: Of 37 cases (40 eyes), 31 eyes (77.5%) had obtained post-operative visual acuity > or = 0.1, 12 eyes (30.0%) > or = 0.3. The complications included nuclear dislocation into vitreous cavity (1 eye) and vitreous hemorrhage (1 eye) in the operation, and rubeosis iridis (1 eye) and pupillary capture (1 eye) after the operation. CONCLUSION: Anti-hypotony must be emphasized in the operation of cataract extraction after vitrectomy, and the vitreous irrigation is a good way against hypotony, extra-capsular extraction is more suitable than phacoemulsification in cases with hard nucleus.

Adolescent↗

PubMed1999

[Pars plana vitrectomy in the treatment of endophthalmitis].

The aim of the study was to present and assess the results obtained after performing vitrectomy in patients with endophthalmitis after cataract surgery and injuries of the eyeball. MATERIAL: The study material comprised 22 patients: 16 patients with endophthalmitis after cataract surgery, 4 after eyeball injuries and 2 after fistula operations. EFFECTS: After vitrectomy we obtained in most patients an improvement of visual acuity and reduction of inflammatory symptoms. 10 days after operation in half of the patients the visual acuity was from 2/50 to 5/50, in 27.2% from 5/30 to 5/10.

Adult↗

PubMed1999

Visual outcomes after anterior vitrectomy: comparison of ECCE and phacoemulsification.

PURPOSE: To determine whether vitrectomy instrumentation improved outcomes when vitreous loss occurred during either extracapsular cataract extraction (ECCE) or phacoemulsification (PE) with posterior chamber lens implantation (PCIOL). METHODS: A consecutive series of ECCE + PCIOL (group 1: 1985-1989) and PE + PCIOL (group 2: 1993-1997) surgeries by a single surgeon was reviewed retrospectively. RESULTS: In group 1, 14 of 647 patients (2.2%) and in group 2, 9 of 665 patients (1.4%) experienced vitreous loss. In group 1, final visual acuity averaged 20/83; in group 2, 20/25 (P = .005). Average follow-up was 5.7 years (group 1) and 3.2 years (group 2). Uveitis, glaucoma, corneal problems, and retinal problems were assessed. CONCLUSIONS: Anterior vitrectomy reduced complications from vitreous loss. Fewer vitreous losses occurred with PE than ECCE. Patients with vitreous loss after PE attained better vision.

Aged↗

PubMed2000

[Studies on vitrectomy cases associated with complicated branch retinal vein occlusion].

PURPOSE: To examine the factors affecting visual outcome in vitrectomized cases associated with complicated branch retinal vein occlusion (BRVO). MATERIALS AND METHODS: Of 114 eyes of 113 patients with BRVO, ages, general complications, distribution of occluding vessels, location of retinal breaks, classification of vitreoretinal pathology and number of cases, period from onset of BRVO to vitreous hemorrhage and from vitreous hemorrhage to vitrectomy, number of operations, relationship between posterior vitreous detachment (PVD) and number of operations, post and preoperative pholocoagulation status, pre and postoperative visual acuity, and cases with poor visual outcome were analyzed. RESULTS: The visual prognosis was much better in the cases with vitreous hemorrhages only than those with proliferative membrane and retinal detachment (p = 0.0029). Repeated operations were needed in the cases of incomplete PVD (p = 0.0023). CONCLUSIONS: Early vitrectomy, especially in the cases of incomplete PVD, seems to be essential for management and treatment for better visual acuity.

Adult↗

PubMedDate not supplied

Retina tomography after vitrectomy for macular edema of central retinal vein occlusion.

PURPOSE AND OBJECTIVE: To report retina tomography after vitrectomy for macular edema in central retinal vein occlusion (CRVO). PATIENTS AND METHODS: Five patients with macular edema caused by CRVO were examined using optical coherence tomography (OCT) through their clinical courses. RESULTS: The retinal thickness through the fixation was reduced in all 5 eyes. Preoperatively, the retina thickness at the foveola was more than 500 microm in three eyes and more than 1000 microm in 2 eyes. The retina thickness was reduced to 311+80 microm within two weeks on average. Visual acuity was improved by two or more lines in 3 of 5 eyes. CONCLUSION: Vitrectomy is worthy of consideration when macular edemas are prolonged in patients of CRVO. OCT is a useful instrument for management and treatment of macular edema.

Aged↗

PubMed1976

Intravitreal antibiotic injection and vitrectomy in acute bacterial endophthalmitis.

Two days after an unplanned extra-capsular cataract extraction with sector iridectomy, a patient showed typical signs of bacterial endophthalmitis. Vitreous and aqueous were aspirated for culture, and gentamicin and dexamethasone were injected. Twenty-four hours later, after isolation of Staphylococcus epidermidis, a vitrectomy to remove the central vitreous was done. Postoperatively, vision progressively improved; at the last review nine months after vitrectomy, visual acuity was 20/50.

Anterior Chamber↗

PubMed2000

[Vitrectomy for diabetic macular edema associated with hyaloid posterior traction].

The vitreomacular relationship has been demonstrated to play a role in the physiopathology of the diabetic macular edema. We review the functional and anatomic results of vitrectomy performed on four eyes of three patients with diabetic cystoid macular edema unresolved by photocoagulation. The preoperative visual acuity was "finger counting" at one meter to 1/20. After surgery, for three eyes, the visual acuity raised between 2/10 and 4/10. There was no change for one eye, which presented a subretinal fibrosis. The macular edema resolved in three eyes and improved in one eye. The mean postoperative follow-up is 13 months. The vitrectomy may be effective in cases of diabetic macular traction and edema without posterior vitreous detachment.

Aged↗