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PubMed1986

Sodium hyaluronate (Healon) in closed vitrectomy.

Healon was implanted into the vitreous cavity of 33 eyes at the conclusion of pars plana vitrectomy. In aphakic eyes, Healon diffused rapidly into the anterior chamber, reducing the length of effective tamponade posteriorly and causing marked elevations of intraocular pressure. In phakic diabetic eyes, Healon appeared to trap hemorrhage mechanically from bleeding fibrovascular stumps posteriorly. It may therefore reduce the risk of opacifying vitreous hemorrhage after vitrectomy in phakic eyes with active neovascularization.

Humans↗

PubMed1985

Clinical results of pars plana vitrectomy in posterior-segment disorders.

From June 1981 to August 1983, a total of 142 eyes with posterior-segment disorders were treated with a pars plana vitrectomy technique using the Ocutome II system. The patients were 45 years old on average, with an average follow-up of six months. Simple vitrectomy was performed in 108 eyes, and additional retinal reattachment surgery was performed in the remaining 34 eyes. The lens was removed in 56 eyes and untouched in 65 eyes; the remaining 21 eyes were either aphakic or pseudophakic. All of the cases were divided into six main groups: two diabetic groups, two nondiabetic groups, a penetrating trauma group, and an endophthalmitis group. The two diabetic groups included 16 eyes with vitreous opacity, six of them complicated by retinal detachment. The two nondiabetic groups included a total of 91 eyes, with 31 of them complicated by retinal detachment. The group with penetrating trauma included 24 eyes, seven of which had been injured by intraocular foreign bodies. The endophthalmitis group included 11 eyes, of which six were the result of penetrating trauma and five the result of cataract operation. In this series, vision was maintained or improved in 78.9% of cases and improved in 51.4%. Eyes with vitreous opacities in conjunction with retinal detachment were complicated by proliferative vitreoretinopathy of moderate or severe degree. The reattachment rate was 50.0% in the diabetic group and 51.6% in the nondiabetic group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1983

Management of infectious endophthalmitis by combined vitrectomy and intraocular injection.

Combined therapeutic vitrectomy and intraocular antibiotic injection were used as a primary treatment for infectious endophthalmitis after diagnostic vitreous tap on seven patients. Two patients also received penetrating keratoplasty in addition to vitrectomy. Postoperatively, two patients achieved visual acuity of 20/30 or better, and five patients achieved 20/100 or better. One eye was enucleated.

Aged↗

PubMed1984

[Treatment of retinal detachment by vitrectomy and injection of silicone oil. Long-term results and complications in 105 cases].

The present study is a two year-follow up of 105 eyes (including 27 aphakic eyes), operated on retinal detachment by silicone oil injection after pars plana vitrectomy. This procedure was chosen either as an initial treatment (37 eyes) or after a classical treatment by external indentation had failed (68 eyes). All cases of retinal detachment were of bad prognosis: macular hole, massive periretinal proliferation, isolated or associated with a tear. Cases of vitrectomy with silicone injection for proliferative retinopathy due to diabetes or hemoglobinopathy were excluded. Operations were performed under a surgical microscope with the help of a corneal contact lens (Goldmann, Kl oti or O' Malley ). Functional and anatomical results, as well as complications, were evaluated at least 2 years after treatment. In 24,7% of cases, vision was improved as compared to preoperative visual acuity. Cataract was a constant complication in all phakic eyes, as silicone oil had not been removed within the first 6 months. Intraocular hypertension developed frequently both in phakic and in aphakic eyes (29,5 and 33% of cases, respectively) and responded poorly to medical or surgical treatment. Other complications occurred less frequently. They were corneal edema, conjunctival hyperemia and uveitis. Pain imposed the evisceration of 2 eyes. These complications were the consequence of silicone oil toxicity and/or the mechanical effects of intraocular oil. Besides treatment-associated complications, early (36 during the first 6 months) as well as late (2 between the 12th and 18th months) recurrences of retinal detachment were observed. In contrast to these fair functional results, anatomical results were good in most cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1983

Lensectomy-vitrectomy in chronic uveitis.

Cataract extraction in patients with chronic uveitis may be hazardous, although recent studies have indicated an improvement in prognosis using lensectomy-vitrectomy techniques in selected cases of uveitic cataracts. The results of lensectomy-vitrectomy in 12 eyes with uveitic cataract are reported. All patients had improvement in vision. No significant "flare-up" of the underlying uveitis occurred. The importance of extensive preoperative evaluation is emphasized. The major cause of decreased acuity postoperatively was persistent cystoid macular edema, a complication of chronic inflammation.

Adolescent↗

PubMed1984

The use of an irrigating endo-illuminator for anterior vitrectomy.

Visualization of the vitreous during a closed anterior vitrectomy is difficult. We have recently begun to use an irrigating endo-illuminator in conjunction with the Ocutome to better visualize the clear vitreous during an anterior vitrectomy, and have used it in four different situations. We believe this technique is well suited to the general ophthalmologist and it is easy to learn.

Humans↗

PubMed1995

[Use of liquid perfluorocarbons in vitrectomy for difficult cases of proliferative diabetic retinopathy].

PURPOSE: Thanks to their physical properties, could perfluorocarbon liquids (PFCL) be useful during vitrectomy for severe cases of proliferative diabetic vitreo-retinopathy (PDVR)? METHODS: Among 120 vitrectomies for PDVR performed in a period of time from August 1992 to July 1993, we reviewed 24 cases with a minimal follow-up of six months for which we have used PFCL as intraoperative tool. Among these eyes, three (12%) were preoperatively attached, seven (29%) presented with a tractional retinal detachment sparing the macular area and 14 (59%) with a retinal detachment involving the macula. The indication for PFCL injection was either to flatten the retina in case of iatrogenic tear or retinotomy (15/24 eyes) or to stop a bleeding coming from the optic disc (9/24). The aim was to allow a good laser endophotocoagulation in all the cases and to inject an intraocular tamponade on a reattached retina if needed. As final tamponade, silicone oil was used in 10 eyes, gas in nine eyes and none in five eyes. RESULTS: At the end of the study, 20 (83%) eyes had a totally reattached retina and four (17%) a detached retina. The postoperative compared to the preoperative visual acuity was improved in 13 eyes (54%), unchanged in seven eyes (30%) and decreased in four eyes (16%). In one case (4%), some droplets of PFCL were noticed in the vitreous cavity, under the silicone oil bubble, with a good clinical tolerance. No specific complication of PFCL injection could be found in the 23 other eyes. CONCLUSION: In some selected cases of severe PDVR, the use of PFCL may help to flatten the retina, to stop bleeding from the optic disc and to perform a good endolaser photocoagulation. This allows to achieve good anatomical and visual results with few specific complications.

Adolescent↗

PubMed1995

[Anterior chamber inflammation after vitrectomy in posterior vitreous membrane syndrome and phacoemulsification and intraocular lens implantation].

We studied the anterior chamber inflammation with a laser flaremeter after transvitreal membrane peeling surgery for posterior vitreous membrane syndrome and cataract intraocular lens surgery, through separate surgery and combined surgery. In 16 eyes with vitrectomy and membrane peeling, mean flare count had one peak of 11 photons/msec at postoperative days 5 through 7. In 10 eyes with phacoemulsification and aspiration with posterior chamber lens implantation, the mean flare count had two peaks of 11 photons/msec at postoperative day 1 and in postoperative week 2. In 25 eyes with combined surgery of vitrectomy and cataract intraocular lens surgery, the mean flare count was similar to the summation of that of each simple surgery. In these 25 eyes, in 9 eyes with sutures, the mean flare count had two peaks of 37 photons/msec at postoperative day 1 and 27 photons/msec at postoperative week 2, and in 16 eyes with self sealing wounds, the mean flare count had one peak of 22 photons/msec at postoperative week two. In 14 vitrectomized eyes with cataract-intraocular lens surgery, the mean flare count was as high as in combined surgery. In eyes with self sealing wounds, the flare count at postoperative day one was significantly lower than that of sutured eyes.

Adult↗

PubMedDate not supplied

The visual outcome of vitrectomy for advanced diabetic retinopathy.

The indications for vitrectomy in the management of proliferative diabetic retinopathy are increasing. This is due to the improving results associated with earlier surgery, improving instrumentation and refinements in technique. The current indications for surgery include chronic or recurrent vitreous haemorrhage (of at least one months duration), progressive extramacular tractional retinal detachment, tractional macular detachment and elevated proliferative diabetic retinopathy. This paper reviews a series of 30 vitrectomies performed for severe complications of proliferative diabetic retinopathy. Most favourable visual outcome was associated with surgery for chronic or recurrent vitreous haemorrhage (in the absence of rubeosis iridis) and progressive extramacular tractional retinal detachment. Poor visual prognostic factors were, pre-operative rubeosis iridis and tractional retinal detachments involving the macula.

Adult↗

PubMed1994

[Treatment of ocular injury with lensectomy and closed vitrectomy].

The authors reviewed 104 consecutive cases of ocular injury treated with lensectomy and closed vitrectomy including anterior segment resection in 80 cases and posterior segment, in 24 cases. The curative rate was 80.8%. Post-operatively, 44 eyes (47.8%) gained visual acuities of 0.025-0.6 and 68 eyes (65.4%) obtained visual improvement. 29 eyes were followed up 1-38 months, averaging 22.5 months, to find long-term therapeutic effects in 23 eyes (79.3%). The authors believe that lensectomy with closed vitrectomy is a useful modality in treatment of ocular injury.

Adolescent↗

PubMed1994

[Vitrectomy under temporary keratoprosthesis].

In vitreoretinal disorders complicated by corneal opacity, a temporary keratoprosthesis device is placed into a trephined opening in the cornea to provide a clear stable view which permits the performance of pars plana vitrectomy and immediately following the vitrectomy, the keratoprosthesis is replaced by a corneal graft. Using this technique, we have saved blind eyes with corneal and vitreoretinal disorders in one surgical procedure, being a new approach for rehabilitation of eye sight. Since 1990, the operation has been performed on 10 patients of whom 9 obtained satisfactory results. They were the patients who had been impossible to be saved by other methods and had been abandoned. The patient with the best result had been followed for 15 months and his visual acuity achieved and maintained 0.3. In six cases, the operation was combined with multiple procedures in the vitreous, such as gas fluid exchange, internal drainage of subretinal fluid, injection of silicone oil, etc. to facilitate the reattachment of the complicated retinal detachment.

Cornea↗

PubMed1994

[Systematic search of the posterior vitreous cortex during vitrectomy. Technique, complications and results].

We present the results of a prospective study trying to answer the question: when a clinical or echographic premacular vitreous detachment occurs, is it still possible to find a preretinal membrane at the surface of retina? We looked for such a membrane in 50 consecutive vitrectomies for various indications. We found and removed such a membrane in 42 cases but were unable to obtain histological examinations. Our conclusions are: most of the time, the diagnosis of total vitreous detachment is very difficult and the finding of a premacular membrane during vitrectomy is a frequent event.

Adolescent↗

PubMed1993

[Vitrectomy in the treatment of ocular trauma].

74 cases of ocular trauma comprised traumatic cataract in 9 eyes, traumatic vitreous opacity in 23 eyes, traumatic retinal detachment in 29 eyes, intraocular foreign bodies in 11 eyes, and traumatic endophthalmitis in 2 eyes. Operations of closed vitrectomy, scleral buckling, lensectomy with vitrectomy and gas-fluid exchange effected vitreous clarity in 69 eyes (93.2%) and visual improvement in 52 eyes (70.3%). Surgical complications occurred in 8 eyes (10.8%).

Adolescent↗

PubMedDate not supplied

[Vitrectomy in treatment of retinal detachment with proliferative vitreoretinopathy].

The authors presented their experiences concerning the treatment of 26 eyes (in 25 patients) with retinal detachment complicated by PVR in which pars plana vitrectomy and silicone oil tamponade were applied. The patients have been previously operated with traditional methods however without success. Positive results, it is retinal attachment completely or in the superior and central part of the fundus with residual detachment inferiorly were achieved in 19 eyes (73%). An useful visual acuity (> 1/50) was achieved in 12 eyes and in 7 (27%) it was better than 5/50. Our results confirmed that this method (pars plana vitrectomy with silicone oil tamponade) is a method of choice in complicated retinal detachment, in which traditional methods failed.

Adult↗

PubMed1994

[Combined pars plana vitrectomy, lens removal and intraocular lens implantation for complications of diabetic retinopathy. Surgical results in 120 cases].

We performed combined vitrectomy, lens removal and posterior chamber intraocular lens implantation for proliferative diabetic retinopathy in 120 eyes of 101 patients. Follow-up periods ranged from 3 to 63 months, with a mean of 17 months. Three lens removal methods were used: extracapsular cataract extraction (14 eyes), phacoemulsification and aspiration (49 eyes), and pars plana phacoemulsification (57 eyes). Preoperative rubeosis iridis or neovascular glaucoma was found in 21 eyes. Gas or temporary silicone oil tamponade was employed in 32 eyes. Surgical results were good, and the postoperative vision was finger counts or below only in 13 eyes. Thus the combined surgery proved to have no serious problems. Our results indicate two important points. (1) It is best to chose either of the following two methods for the lens surgery: phacoemulsification with continuous circular capsulorhexis, self sealing sclerocorneal incision, and in-the-bag fixation of the posterior chamber lens, or pars plana phacoemulsification leaving the anterior capsule, rub off and aspirating the lens epithelial cells, continuous circular capsulorhexis, and posterior chamber lens implantation in front of the anterior capsule from a self-sealing sclerocorneal wound. (2) It is mandatory to do complete vitrectomy and cut out the vitreous gels incarcerated in the sclerotomy site.

Adult↗

PubMed1993

[Retinal whitening following vitrectomy for epiretinal macular membrane].

To investigate the clinical pictures of retinal whitening following epiretinal membrane dissection. I studied retrospectively the records of 18 eyes which had undergone vitrectomy. Two types of retinal whitening were observed: cotton wool-like spots within the superficial retinal layers and a linear or dendritic pattern within the deep retinal layers. The spots were mainly noted in idiopathic cases and resolved completely in a few weeks, and the pattern was observed in macular pucker cases after retinal detachment surgery and persisted for a long time after vitrectomy.

Adult↗

PubMed1993

[Results of pars plana vitrectomy in chronic uveitis in childhood].

During 1986-1991 vitreous surgery was performed in 5 girls and 8 boys (age range 2-15 years) with chronic uveitis. In 6 cases a combined lensectomy-vitrectomy was performed because cataract was present, so that the results generally refer to 19 eyes. We found a low rate of postoperative complications. During a follow-up period of 6 months to 5 years (average 2 years and 1 month), 12 of the 19 eyes showed a significant visual improvement. Preoperatively, 8 eyes were found to be affected by cystoid macular edema; in 7 of these cases remarkable regression of the edema was observed after surgery. In two-thirds of cases the intensity of the inflammation decreased, so that the dose of corticosteroids could be reduced postoperatively. Our results suggest that vitrectomy for chronic uveitis in children is a relatively safe and successful treatment. In order to prevent irreversible complications and amblyopia surgery should be performed in an early stage of the disease.

Adolescent↗

PubMed1993

[Observations on vitrectomy with silicone oil injection].

Silicone oils were injected in 37 eyes of 37 patients among 95 patients performed vitrectomy during 1988-1990. The indication was complicated retinal detachment except for 2 cases of diabetic proliferative retinopathy and vitreous hemorrhage. In 29 (78.4%) of the 37 eyes, the retina was totally reattached, and in 7 eyes partially reattached that did not regain ambulatory vision. In 22.7% of the eyes successfully operated, cataracts developed with silicone oil 1,000mPa.s while transient hypertension occurred in 27.3% with silicone oil 5,000mPa.s. Vitrectomy with silicone oil filling may help some retinal detachments that are refractory to conventional retinal and vitreous operations; however, due to possible complications, the use of silicone oil should be in limited cases and removed after retinal reattachment.

Adult↗