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At least 991 records · Page 55Linked to original sources
PubMed2002

[Treatment of dislocated lenses in patients with Marfan's syndrome using vitrectomy and intraocular lenses].

PURPOSE: To evaluate results of surgical complex treatment of lens dislocation in Marfan syndrome cases. MATERIAL AND METHODS: Nineteen eyes of 13 patients were operatively treated for lens dislocation. Pars plana vitrectomy was done in all eyes. Dislocated lenses were removed by lensectomy in 5 eyes and with an intracapsular method in 14 eyes. The scleral fixation technique was used for primary posterior chamber intraocular lens implantation in 18 eyes, and one eye remained aphakic. Time of observation ranged between 6 and 71 months (mean 3.5 years). RESULTS: All eyes achieved improvement in visual acuity or good preoperative visual acuity was maintained. The vision between 6/6 and 6/8 was achieved in 14 patients. There were no serious intraoperative or early postoperative complications. Retinal detachment appeared in two eyes in a long observation time and it was successfully operatively treated. The not good visual results were due to amblyopia (n = 2), complications of retinal detachment surgery (n = 2) and glaucomatous optic disc atrophy coexisting with macular degeneration (n = 1). CONCLUSIONS: Pars plana vitrectomy and primary scleral-fixated IOL implantation gives quick and good visual rehabilitation in adult patients with Marfan's syndrome. The described surgical method is complex and need a prolonged operative time, but gives very good functional results and very few complications.

Adult↗
PubMedDate not supplied

Pars plana vitrectomy and transscleral fixation of black diaphragm intraocular lens for the management of traumatic aniridia.

BACKGROUND AND OBJECTIVES: Partial or complete aniridia occurring after severe ocular trauma is a difficult therapeutic problem. Diaphragm intraocular lenses were developed for the correction of aniridia, but the safety and efficacy of implanting such lenses are not well established in traumatic cases because of very few reports, and the small number of cases studied. PATIENTS AND METHODS: Six patients, 4 men and 2 women with a mean age of 44 years, were treated for traumatic aniridia using pars plana vitrectomy and transscleral fixation of a black diaphragm intraocular lens. Total aniridia was observed in 3 eyes and partial aniridia in 3 eyes. Four eyes were aphakic and severe lens subluxation was seen in 2 eyes. Vitreous hemorrhage coexisted in 2 patients and bacterial endophthalmitis was present in 1 patient. Follow-up time ranged between 4 and 39 months (mean, 23 months). RESULTS: Best-corrected visual acuity improved in 5 patients and 1 remained unchanged. Good visual acuity (20/20 - 20/40) was achieved in all cases and all lenses were well-centered. No severe complications were noted. Three of 6 patients required glaucoma topical medications pre- and postoperatively achieving good intraocular pressure control. CONCLUSION: The management of traumatic aniridia using pars plana vitrectomy and implantation of scleral fixation black diaphragm intraocular lenses seem to be safe. Very good functional results and lack of severe complications are encouraging. Additional cases with a longer follow-up study are necessary to support our opinion.

Adult↗
PubMed2003

[Should associated intraoperative and/or postoperative photocoagulation be systematic during or after vitrectomy for proliferative diabetic vitreoretinopathy?].

PURPOSE: To analyze the results of vitrectomy in proliferative diabetic vitreoretinopathy and to check whether systematic intra- and/or postoperative photocoagulation is necessary in most cases. PATIENTS AND METHODS: We retrospectively reviewed 108 patient records (137 eyes) of vitrectomy performed for complications of proliferative diabetic vitreoretinopathy between 1982 and 2000. Fifty-eight percent of the patients were women. The average age was 44 years. Sixty percent of the patients presented with diabetes type 1. Only 39% of the eyes had complete preoperative panretinal photocoagulation. Preoperative visual acuity was lower than 2/200 in 81% of eyes, 27% presenting initially with traction retinal detachment involving the macula. The surgical technique used was segmentation-delamination. Endodiathermy was necessary in 45% of the eyes and intraoperative photocoagulation was not performed. Postoperative complementary photocoagulation was carried out in only 9% of the eyes. RESULTS: Results were analyzed with an average follow-up of 66 months. Anatomical success was obtained in 69% of the eyes, with 55% visual improvement. These results were unchanging at long-term follow-up in 95% of the eyes studied. Iatrogenic retinal breaks were observed in 8% of the eyes. Postoperative complications were dominated by single (8%) or recurrent vitreous hemorrhage (8%). The rate of postoperative neovascular glaucoma was approximately 5%. These results are similar to the rates reported by other authors using intraoperative endophotocoagulation. CONCLUSION: Intra- and/or postoperative photocoagulation should not be systematic but reserved for management of iatrogenic retinal breaks and also for extensive panretinal photocoagulation in recurrent vitreous hemorrhage.

Adult↗
PubMed2002

[Refraction changes after cataract extraction with IOL implantation in the eyes with previous performed vitrectomy].

PURPOSE: To determine differences between the predicted and postoperative refraction after cataract extraction with intraocular lens implantation in the eyes, which previous underwent vitrectomy. MATERIAL AND METHODS: Fifty three eyes of 52 patients underwent the analysis: twenty five in group I, nineteen in group II and nine eyes with previous scleral buckling in group III. All the eyes had ECCE and IOL with PMMA implantation after vitrectomy. In groups II and. III silicone oil tamponade was used and removed before cataract extraction. Thirty eyes of the control group K underwent cataract surgery and IOL implantation alone. The IOL power calculation was performed with SRK II formula. The predicted and postoperative refractions were compared. The follow-up was minimum 4 months (on average 15 +/- 12.71 months). RESULTS: The postoperative refractions were significantly shifted toward myopia than it was predicted--1.41 +/- 1.21 D in group I, -0.81 +/- 2.11 D in group II and -3.03 +/- 1.49 D in group III. In the control group K the difference was--0.07 +/- 0.91. CONCLUSIONS: Myopic shift of postoperative refraction after cataract surgery should be considered, when calculating the IOL power in the eye after vitreoretinal procedures.

Adult↗
PubMed1992

Acute onset of rubeosis iridis after diabetic vitrectomy can indicate peripheral traction retinal detachment.

Acute onset or exacerbation of rubeosis iridis associated with peripheral retinal detachment after vitrectomy represents a rare but serious complication of advanced diabetic retinopathy that indicates a poor prognosis. The clinical features, surgical procedures, and anatomical and functional results for a series of 13 eyes presenting with this complication are reported. In addition to rubeosis iridis and peripheral retinal detachment, anterior hyaloidal fibrovascular proliferation (APH) was also present in 10 eyes. All eyes had undergone one or more previous vitrectomies for diabetic complications such as nonclearing vitreous hemorrhage and traction retinal detachment. Treatment modalities for iris neovascularization and peripheral retinal detachment included reattachment procedures with an encircling band, peripheral membrane peeling, and, if necessary, peripheral retinectomy. Peripheral coagulation therapy was performed in all eyes. Eight eyes received an intraocular silicone-oil tamponade. Early results (4 weeks post-surgery) showed regression or stabilization of rubeosis iridis in all eyes. Later results (mean, 9 months post-surgery) revealed nine eyes with stabilized anterior ocular neovascularization and reattachment of the retina. Four eyes were anatomic failures due to recurrent rubeosis iridis/AHP or traction retinal detachment, and three of them also developed ocular hypotony. None of the eyes has thus far been lost as a result of neovascular glaucoma or painful phthisis. Ambulatory vision was retained in ten eyes, but function was limited to a low level as a result of the underlying ischemic disease. Immediate reattachment surgery in combination with anterior/peripheral coagulation therapy was shown to be an effective measure for controlling iris neovascular activity in eyes afflicted with acute anterior ocular neovascularization.

Acute Disease↗
PubMed2003

[Primary vitrectomy in eyes with posterior scleral rupture].

PURPOSE: To evaluate the therapeutic effects of primary vitrectomy in eyes with posterior scleral rupture. METHODS: Twenty-two cases(23 eyes) which were cured by primary vitrectomy in eyes with posterior scleral rupture and vitreum haemorrhage were studied retrospectively for 3-9 months (mean 6 months) after the operation. RESULTS: After operation, most of the eyes' (16 eyes, 69.5%) visual acuity was improved in different degree. The reason for visual acuity not improved was eyeball atrophy. CONCLUSION: The operation was safe and effective. It can improve visual acuity rapidly and lessen complication.

Adolescent↗
PubMedDate not supplied

[Evaluation of the usefulness of vitrectomy in the treatment of proliferative diabetic retinopathy].

The authors analyse the results of 146 operations of vitrectomy through the pars plana executed in cases of complications of diabetic retinopathy. In 50 eyes with prognostically very severe conditions (tractional retinal detachment, presence of central retinal holes, recurrent intraocular haemorrhages) vitrectomy was connected with an intra-bulbar injection of silicone oil. In the period of 6 months to 3 years after surgery the improvement of the visual acuity was attained in 96 eyes (66 p.c.). Intravitreal injection of the silicone oil increased the chance of reattachment of the retina and reduced the incidence of a postsurgical recurrent intraocular haemorrhage.

Adolescent↗
PubMed1992

Ouabain-sensitive Na-K ATPase response in the rabbit iris-ciliary body after lensectomy-vitrectomy.

We studied ouabain-sensitive Na-K adenosine triphosphatase (ATPase) activities in the iris-ciliary body of rabbit eyes after lensectomy-vitrectomy. Changes in enzyme activities were quantitatively investigated in the plasma membrane of iris-ciliary body at 0 or 7 hours and at days 1, 3, 7, and 14. The specific activity of Na-K ATPase rose to significantly higher levels than the control value at 7 hours following surgery, but returned to the baseline value after 7 days. In addition, we evaluated enzyme activities after lensectomy-vitrectomy during which SF6 or silicone oil was injected. The specific activity of Na-K ATPase following the injection of SF6 or silicone oil was significantly higher than the control value at 7 hours and did not return to the normal value even after 14 days. Consensual reaction, demonstrated by increased Na-K ATPase activity, also was found in the contralateral unoperated eyes of SF6- and silicone oil-injected rabbits. The increased Na-K ATPase activity in the iris-ciliary body after experimental surgery may play an important role in restoring swollen tissues.

Animals↗
PubMed1992

[Vitrectomy plus air tamponade for treatment of retinal detachment with proliferative vitreoretinopathy].

Closed vitrectomy, membrane peeling, intraocular air tamponade and scleral encircling were performed for 35 consecutive cases of retinal detachment with proliferative vitreoretinopathy (PVR), comprising 2 cases of grade C2, 4 cases of grade C3, 6 cases of grade D1, 17 cases of grade D2, and 6 cases of grade D3. 21 eyes (60%) attained anatomic retinal reattachment with improved visual acuity in 20 eyes. The authors believed that vitrectomy combined with membrane peeling was a logical approach to the treatment of retinal detachment with PVR. The surgical success was related to the extent of membrane peeling, and intraocular air tamponade was a simple and effective adjunctive measure.

Adolescent↗
PubMed2003

Intraocular irrigating solutions. A clinical study of BSS Plus and dextrose bicarbonate fortified BSS as an infusate during pars plana vitrectomy.

PURPOSE: To compare the effect of Balanced Salt Solution Plus (BSS Plus, Alcon Laboratories, Fort Worth, Texas, USA) and fortified regular BSS on the cornea and lens, when used for continuous irrigation in pars plana vitrectomy (PPV) surgery. METHODS: Prospective, investigator masked, randomised study. Forty patients were randomly assigned to undergo PPV using BSS Plus (n=20) or fortified BSS (n=20) [regular BSS, fortified with 10.5 cc. of dextrose in water (D5W) and 13.1 cc. of 8.4% sodium bicarbonate]. Intraoperative features of the corneal epithelium, postoperative changes in the corneal endothelial cell denstiy (ECD) at 3 months, and clarity of the lens during surgery and postoperatively were evaluated. RESULTS: Intraoperative epithelial changes were similar in both groups with 7 (35%) of the cases having the epithelium removed in the BSS Plus group and 8 (40%) in the BSS fortified group (P=0.23). The mean differences in ECD (3 months versus preoperative) in the operated eyes when adjusted for changes in the control eye showed no difference with the type of BSS (P=0.98). Intraoperative lens changes were more significant (P=0.018) in the BSS fortified group. Postoperative lens status at 3 months was similar for both groups. Though there was a trend towards worse postoperative nuclear sclerosis change in the BSS fortified group, it was not significant (P=0.160). CONCLUSION: Standard BSS fortified with dextrose and bicarbonate is an efficacious infusion fluid during pars plana vitrectomy. Both solutions showed comparable effects on postoperative corneal endothelial cell density and corneal epithelial changes intraoperatively. BSS fortified has more lenticular changes intraoperatively than BSS Plus although no lens had to be removed in either group. The study implications are important since BSS fortified is significantly less expensive than BSS Plus.

Acetates↗
PubMed2003

[Importance of diagnostic and therapeutic pars plana vitrectomy in endogenous uveitis].

OBJECTIVE: To evaluate the importance of diagnostic-therapeutic pars plana vitrectomy in patients with clinical manifestations of endogenous uveitis. PATIENTS AND METHODS: The diagnostic-therapeutic pars plana vitrectomy (DT PPV) has been performed at the Eye Clinic of General Faculty Hospital and 1st Medical Faculty on Prague on 62 eyes in 49 patients at the mean age of 45 years. The DT PPV was indicated in patients with uveitis of unusual clinical picture or poorly reacting to treatment, suspected infection or tumor etiology. In the beginning of PPV, 0.5 to 1.5 ml of undiluted vitreous body was samples and subsequently examined by microbiology, immunology and molecular genetic methods. PPV was performed on both eyes in 10 patients, on one eye twice in each of three patients. The authors evaluated 62 samples of vitreous body on the whole. The patients were observed for up to 96 months. RESULTS: Laboratory examination of the samples of vitreous body from 22 eyes (35.4%) supported our notion on infection etiology of intraocular inflammation, manifestations of intraocular tumor were in 12 eyes (19.3%), vascular or vitreoretinal pathology was present in 6 eyes (9.6%). Nonspecific inflammatory changes were detected in 22 eyes (35.4%). Drugs were administered into the vitreous body in 16 eyes. In the observation period the authors detected marked late complications in connection with DD PPV in 18 eyes (29%). Visual acuity improved by two or more lines of the Snellen optotypes in 43 eyes (69.3%), remained unchanged in 11 (17.7%) eyes. The vision deteriorated in 8 eyes (12.9%). CONCLUSION: Based on this experience the authors are of the opinion that DT PPV is indicated in patients with uveitis for giving more precision to the diagnosis of intraocular inflammation or a masking syndrome. DT PPV also represents a therapeutic procedure to cure complications connected with a severe form of inflammation and makes it possible to save central visual acuity.

Adolescent↗
PubMedDate not supplied

Pars plana vitrectomy foreign body extraction assisted with a 24-gauge needle tunnel.

A 54-year-old man presented with corneal laceration, traumatized iris, small vitreous hemorrhage, lens opacity, and a 13-mm intraocular foreign body embedded in the retina. Pars plana vitrectomy and argon laser photocoagulation were performed. Using intraocular forceps, the object was forced into a 24-gauge needle that was inserted through the sclerotomy. The foreign body and the needle were removed from the eye. Phacoemulsification with foldable intraocular lens implantation in the ciliary sulcus was performed. Seven days after the surgery, the patient's visual acuity was 20/20 with spectacle correction of -3.5 diopters. The use of a needle tunnel during pars plana vitrectomy should be considered in similar cases of large, irregular intraocular foreign bodies to avoid severe and irreversible damage to the adjoining tissues.

Cornea↗
PubMed2003

[The effect of vitrectomy combined with full endocular panretinal photocoagulation in late proliferative diabetic retinopathy].

OBJECTIVE: To investigate the effect of vitrectomy combined with full endocular panretinal photocoagulation in patients with late stage of proliferative diabetic retinopathy (PDR). METHODS: Pars plana vitrectomy combined with full panretinal photocoagulation were undergone in 56 eyes (56 cases) with late stage of PDR, including 32 eyes with tractive retinal detachment. Preoperative and postoperative visual acuity, anterior segment by slit lamp and fundus examination by indirect ophthalmoscopy, as well as fluorescein angiography (FFA) were analyzed. RESULTS: Retina were reattached in 52 eyes. Vitreous hemorrhage, retinal bleeding, exudation and neovascular changes were not observed in these eyes. Non-irrigated areas were not found in 28/32 eyes in which FFA examination has been performed. Final visual acuity was improved in 52 eyes. CONCLUSION: Full endocular panretinal photocoagulation with low energy is an effective and safe procedure with low rate of complications for the late stage of PDR.

Adult↗
PubMed1992

Secondary cataract in infants after extracapsular cataract extraction and anterior vitrectomy.

Two infants developed secondary cataract after undergoing extracapsular cataract extraction (ECCE), posterior chamber intraocular lens (IOL) implantation, posterior capsulectomy, and anterior vitrectomy. A similar complication developed in a third child, who had undergone ECCE and posterior capsulotomy. The secondary cataracts developed in these patients from 3 to 12 weeks after the primary operation. In infants, unlike adults, posterior capsulectomy and anterior vitrectomy after ECCE do not seem always to prevent secondary cataracts. In infants, the complication may be related to IOL implantation.

Anterior Eye Segment↗
PubMed1992

Intraocular lens insertion during vitrectomy.

Vitrectomy was performed in 10 patients in combination with posterior chamber intraocular lens (IOL) insertion. Indications for vitrectomy included traumatically dislocated cataract, choroidal hemorrhage, epiretinal membrane, lens involving intraocular foreign body, vitreous hemorrhage, and extruded anterior chamber IOL. Postoperative visual acuity improved in each case. The main advantages of simultaneous IOL insertion, in selected cases, are reduced cost and inconvenience, and more rapid visual rehabilitation.

Adult↗
PubMed2004

[The surgical outcome of vitrectomy for idiopathic epiretinal membranes and foveal thickness before and after surgery].

PURPOSE: To evaluate the surgical outcome of vitrectomy and foveal thickness before and after vitrectomy for idiopathic epiretinal membranes. SUBJECTS AND METHODS: Twenty-three eyes of 21 patients with idiopathic epiretinal membranes were analyzed. The mean follow-up period was 17.8 months. In 16 eyes of 14 patients, foveal thickness was measured by optical coherence tomography (OCT). RESULTS: Preoperative visual acuity ranged from 0.1 to 0.7. Postoperatively, 17 eyes achieved a final visual acuity of 1.0 or better, and 21 eyes achieved 0.5 or better. Preoperative foveal thickness ranged from 205 to 575 microns (mean +/- standard deviation, 409.9 +/- 103.3 microns). Postoperatively, mean foveal thickness was 347.7 +/- 106.0 microns (1 week follow up), 338.6 +/- 103.7 microns (2 months), 304.6 +/- 97.0 microns (6 months), and 274.3 +/- 78.7 microns (1 year). There was a weak negative correlation between visual acuity and foveal thickness. CONCLUSION: Visual acuity improves significantly after surgery. OCT is useful for idiopathic epiretinal membrane surgery.

Adult↗
PubMedDate not supplied

Pars plana vitrectomy and lamina cribrosa puncture in absolute glaucoma.

Two patients with refractory end-stage glaucoma who had no light perception underwent pars plana vitrectomy and lamina cribrosa puncture to relieve pain and decrease intraocular pressure. The patients presented with blind, painful eyes and high intraocular pressure (> 40 mm Hg). After the procedure, the pain was relieved and the intraocular pressure was lowered in both cases. The patients remained asymptomatic. Pars plana vitrectomy and lamina cribrosa puncture might be related to the decrease of intraocular pressure, probably by facilitating drainage of aqueous humor through the optic nerve.

Adult↗