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At least 109 records · Page 6Linked to original sources

PubMed1997

An investigation of the hospital charges related to the treatment of endophthalmitis in the Endophthalmitis Vitrectomy Study.

PURPOSE: The purpose of the study is to assess the hospital charges associated with the treatment of endophthalmitis using a sample of patients from the Endophthalmitis Vitrectomy Study (EVS). METHODS: The Endophthalmitis Vitrectomy Study was a multicenter, randomized clinical trial with a two-by-two factorial design to compare immediate pars plana vitrectomy to tap-biopsy and to compare the use of systemic antibiotics (intravenous) to no intravenous antibiotics in the management of postoperative endophthalmitis. Hospital charge data were collected retrospectively from 129 patients from the 4 clinical centers participating in this ancillary study. This represents 31% of the total Endophthalmitis Vitrectomy Study population. An analysis of variance was used to compare hospital charges across center and treatment. A charge-effectiveness analysis compared measures the effectiveness across treatment groups. The annual savings of hospital charges in the United States was estimated for a range of annual incidence rates of endophthalmitis. RESULTS: The use of intravenous antibiotics significantly increased hospital charges. Patients undergoing vitrectomy had significantly higher hospital charges than did patients undergoing tap-biopsy. The most charge-effective treatment for patients presenting with light perception only vision was immediate vitrectomy, whereas the most charge-effective treatment for patients presenting with better vision was tap-biopsy. Factors other than treatment independently associated with hospital charges were female sex, history of diabetes, symptom of red eye, and baseline vision of light perception only. CONCLUSIONS: Assuming the results of the Endophthalmitis Vitrectomy Study were used as a guide for the treatment of endophthalmitis, the estimated annual nationwide reduction of hospital charges would be between $7.6 million and $40.0 million.

Aged↗

PubMed2006

[Combined surgery for lens extraction, vitrectomy, and implantation in the diabetic patient using phacoemulsification versus phacofragmentation].

INTRODUCTION: In diabetic patients, we often need to perform cataract and pars plana vitrectomy. Two different techniques are currently valid: 1) phacoemulsification and pars plana vitrectomy and 2)pars plana lensectomy and posterior vitrectomy. METHODS: Retrospective study of two different groups of type 2 diabetic patients: those receiving 1) phacoemulsification and pars plana vitrectomy or 2) pars plana lensectomy and posterior vitrectomy. RESULTS: On statistical analysis there were no differences in complications between the two groups. The effect on visual acuity was similar in both groups. DISCUSSION: The association of cataract surgery and posterior vitrectomy is a valid technique for treating diabetic retinopathy complications. In the present study, the complications of the two techniques were similar, the most important concerning only anterior chamber opening in the first group. CONCLUSION: The two techniques of cataract extraction and pars plana vitrectomy at the same time have no differences in their results and are valid for treatment of diabetic patients.

Aged↗

PubMed2006

[Triamcinolone-assisted vitrectomy in the treatment of recurrent retinal detachment due to myopic macular hole].

PURPOSE: To report the use of triamcinolone-assisted vitrectomy to assess the cause of vitrectomy failure in the treatment of retinal detachment due to myopic macular hole. OBSERVATIONS: We report the cases of three myopic patients presenting with recurrent retinal detachment due to macular hole after initial vitrectomy treatment with posterior vitreous detachment, a systematic attempt at membrane peeling, and gas injection (SF6). No retinal traction or tear other than the macular hole was observed. The recurrence of retinal detachment was treated with vitrectomy and intraoperative use of triamcinolone, which demonstrated persistent posterior hyaloid and thin and strongly adherent membrane remnants in each case. Anatomic success was obtained after peeling these structures. CONCLUSION: Intraoperative use of triamcinolone reduces the risk of overlooking hyaloid or membrane remnants during vitrectomy for the treatment of myopic retinal detachment. Transparent remnants of posterior hyaloid and membranes were visualized by triamcinolone-assisted vitrectomy. They could lead to traction on the retina and explain the failure of the initial vitrectomy. Anatomic success was obtained after peeling these structures.

Aged↗

PubMed2000

[Combined pars-plana-vitrectomy and tectonic keratoplasty; indications for and results from 15 patients].

BACKGROUND: Acute endophthalmitis requires a vitrectomy. Vitrectomy and autokeratoplasty has been reported, if the infection originates from a stromal keratitis in an aphakic eye. This retrospective non-randomized cohort study points out the requirements, indications and results of combined keratoplasty and vitrectomy in keratitis and endophthalmitis compared with noninfectious corneal and vitreoretinal problems. PATIENTS AND SURGERY: In 1995-1999, a vitrectomy and keratoplasty was performed on 15 patients (16 eyes), 10 of these with an endophthalmitis (median 71 years) and a follow-up of 2-60 months (median 19.3 months). 14 of 15 patients had had multiple prior surgery. Stromal keratitis as a sequela of keratoplasty was seen in 5 eyes (3x ruptured suture), 5x diffuse infiltration in compromised corneas (1x with a perforation, 2x with Fuchs' corneal dystrophy, 3x postoperative). In the patients without endophthalmitis 6 eyes were aphakic with corneal scars and no fundus visualization. Five eyes had a retinal detachment, one had an intraocular foreign body. An allogeneic keratoplasty was done in 14, and an allogeneic sclerokeratoplasty and an autologous sclerokeratoplasty in one eye each. RESULTS: Keratoplasty without keratoprosthesis allowed for fundus visualization, and a pars plana vitrectomy was done with a wide angle contact lens, 8x with C2F6-, 1x with silicone oil 5000 cs instillation, and gentamicin and 15 micrograms r-tPA added. In 5 vitrectomy specimens (50%) pathogenic bacteria were found. No recurrences of infection were seen. Conservation of the eyes and postoperative fundus visualization was possible in each case. The postoperative increase in visual acuity of 0.1 or better was significant in both patient groups. 2 eyes remained at preoperative levels, 14 ameliorated by > 1 lines. Complications were 1x directly postoperative graft decompensation, 1x rejection after 40 months, 6x persisting secondary glaucomas, 2x hypotony syndromes, 1x with phthisis and enucleation, 1x epiretinal gliosis. CONCLUSIONS: Curative surgery of acute keratitis and endophthalmitis by vitrectomy and keratoplasty may result in similarly successful outcomes as in noninfectious corneal scars and vitreoretinal pathology, if some requirements (e.g. adequate antibiotic treatment, graft material, skilled anterior and posterior segment surgeon) are fulfilled.

Adult↗

PubMed1998

[Experimental results of erbium:YAG laser vitrectomy].

BACKGROUND: Vitrectomy performed by conventional guillotine devices includes the risk of mechanical damage to retina as well as other ocular structures. The present study aims to investigate the efficacy of the Er:YAG laser for vitreous liquefaction. MATERIALS AND METHODS: Vitreous liquefaction by means of Er:YAG laser pulses was performed using a special handpiece. The output of an Er:YAG laser operating at 2.94 microns was coupled into a ZrF optical fibre (length 2 m) which ended inside a cavity located at the quartz tip (diameter 320 microns) of the handpiece where tissue ablation took place. The viscosity of the liquefied vitreous was determined by rotation viscosimetry and compared to liquefied vitreous obtained by mechanical vitrectomy. In addition, the aspiration flow (ml/min) was correlated to the repetition/cutting rate of the laser and the cutter. The temperature rise at the handpiece was recorded with a micro thermocouple. RESULTS: The cutting threshold was determined to 5 mJ +/- 3 mJ at a pulse duration of 200 microseconds. The viscosity of the vitreous liquefied with the Er:YAG laser was 31 +/- 10 mPa s which is similar to the results of mechanical vitrectomy (42 +/- 19 mPa s) but significant less than that of normal vitreous (880 +/- 280 mPa s). The aspiration of the laser handpiece in dependence to the repetition rate increases linear up to 2.6 ml/min at 30 Hz. The temperature increase at the handpiece was < 1 K under vitrectomy conditions (aspiration and irrigation) with an averaged laser power of 0.3 W (10 mJ at 30 Hz). CONCLUSIONS: The decreased vacuum forces used by the laser vitrectomy system may result in less mechanical stress to the retina as well as intravitreal structures which may be attached to it. An Er:YAG laser vitrectomy system may offer the potential of fewer complications during vitrectomy.

Animals↗

PubMed1997

[Vitrectomy in treatment of eyes with complicated uveitis].

BACKGROUND: Vitrectomy serves as an important treatment modality in uveitis, removing inflamed vitreous body and eliminating secondary complications. The aim of our retrospective study was to evaluate the value of vitrectomy in the treatment of complications in uveitis. PATIENTS AND METHOD: We included 50 eyes of 50 patients suffering from chronic uveitis, which underwent vitrectomy surgery during the period of 1990 to 1993. The study only included patients who had vitrectomy for uveitis for the first time. Indications leading to surgery were density of optic media, retinal detachment, cyclitic or preretinal membranes. The mean follow-up was 455 (range 48-1420) days. RESULTS: Vitrectomy was performed at a mean delay of 452 days after initial presentation. The mean visual acuity at the time of surgery was 0.05. The best visual acuity postoperatively was measured at a mean time of 118 days after vitrectomy. Overall, at the last control, eyes with preoperative retinal detachment presented a much worse final functional result (visual acuity of 0.02) than eyes without detachment (visual acuity of 0.5). Ten eyes resulted in hypotonia after surgery (7 eyes with persisting hypotonia). Most frequent complications in the postoperative course were macular pucker (11 eyes), secondary glaucoma (10 eyes), macular edema (6 eyes) and retinal detachment (6 eyes). Fifty percent of all complications occurred within the first 3 months following surgery. CONCLUSION: Vitrectomy leads to a permanent increase in visual acuity through the treatment of complications, on the condition that a stable retinal situation was present preoperatively.

Adult↗

PubMed1998

Candida albicans endophthalmitis in brown heroin addicts: response to early vitrectomy preceded and followed by antifungal therapy.

The management of Candida albicans endophthalmitis in intravenous drug abusers (IVDAs) has yet to be established. Early vitrectomy was previously reported as a promising treatment for C. albicans endophthalmitis. In our series, C. albicans endophthalmitis was diagnosed for 15 IVDAs. Funduscopic examinations confirmed severe vitritis in 12 patients and chorioretinitis in three. Blood and vitreal cultures were positive for C. albicans for seven and eight patients, respectively. Patients with vitritis received antifungal therapy before and after vitrectomy. Amphotericin B or fluconazole therapy was given according to the physician's preference. Vitrectomy was defined as early if it was performed within 1 week after the diagnosis of vitritis. All seven patients who underwent early vitrectomy had a favorable response without complications. Two of three patients who underwent late vitrectomy developed blindness or scotoma. Blindness was also described in two patients with vitritis who did not undergo vitrectomy. Early vitrectomy preceded and followed by antifungal therapy seems to be appropriate management of vitritis in IVDAs.

Adult↗

PubMed2004

Incidence of cataract extraction after diabetic vitrectomy.

PURPOSE: To determine the frequency of visually significant cataracts after vitrectomy for complications of diabetic retinopathy. METHODS: We studied 40 patients and 56 concurrent control patients in a retrospective, consecutive, comparative case series in an institutional setting. Entry criteria included phakic patients with a clear lens or mild lens opacity undergoing anatomically successful diabetic vitrectomy, without lens removal at the time of vitrectomy, without intraocular gas or silicone oil use, and with at least 1 year of postoperative follow-up examination information. Two comparative phakic control groups with the diagnosis of macular hole or epiretinal membrane were selected, also with follow-up examination information of at least 1 year postoperatively. The occurrence of cataract extraction was the principal outcome measure. Its validity as a measure of cataract formation was evaluated by ascertainment of improved visual acuity after cataract extraction. A secondary endpoint analysis included eyes that needed cataract extraction at the final follow-up examination. RESULTS: For the primary analyses (clear lens preoperatively), there were 26 patients in the study group, 38 in the macular hole control group, and 18 in the epiretinal membrane control group. The cumulative cataract extraction rates at 2 years were 15%, 66%, and 53% respectively. By using multivariate survival analysis, the patient age was an important factor, with a younger age associated with a lower rate of progression to nuclear sclerosis. After controlling for age, the difference in these three groups was still statistically significant. In the four patients with diabetes undergoing cataract surgery, the visual acuity improved at least two lines in only one of the eyes and did not change in three eyes. After expanding the outcome measures to include study patients with mild lens opacities at baseline or those judged to be in need of cataract surgery at the final follow-up examination, there was still a strongly statistically significant difference between the three groups. CONCLUSION: The rate of cataract extraction after vitrectomy in patients with diabetes is lower than in patients without diabetes undergoing vitrectomy and suggests a lower rate of cataract formation. This inference should be considered when attributing subnormal vision in a patient who has had a diabetic vitrectomy to a cataract. This is especially significant because the risk ratio in patients with diabetes in general and in patients with a previous vitrectomy is likely less favorable compared with the general population.

Adult↗

PubMed1996

Vitrectomy in diabetic patients with a blind fellow eye.

Results of pars plana vitrectomy for complications of proliferative diabetic retinopathy were analysed in 32 consecutive patients with a blind fellow eye due to diabetic eye disease. The mean follow-up period was 22.3 months. Only 16% of all eyes examined had received full scatter photocoagulation prior to referral for vitrectomy. Out of 9 eyes with vitreous haemorrhage, 8 improved to a visual acuity of > or = 0.2 postoperatively. Amid 23 eyes which were vitrectomized for advanced traction retinal detachment, only 4 eyes improved to a postoperative visual acuity of > or = 0.02. In this group 12 eyes deteriorated after vitrectomy, 3 eyes progressing to no light perception. The postoperative visual outcome after vitrectomy for traction retinal detachment in this group of diabetics with a blind fellow eye (mean postoperative visual acuity 0.03 +/- 0.05) was significantly worse (p < 0.000) compared to a group of 196 patients with a seeing fellow eye who were vitrectomized for traction retinal detachment at our clinic (mean postoperative visual acuity 0.09 +/- 0.11). Therefore we conclude that traction retinal detachment in this subgroup of patients is a particularly severe presentation of diabetic retinopathy with a guarded functional prognosis after vitrectomy. Our results demonstrate the importance of timely full scatter photocoagulation and early vitrectomy in eyes with progressive fibrovascular proliferation not responding to panretinal photocoagulation. We conclude that especially diabetic patients with a blind fellow eye must be followed closely and assigned to vitrectomy at an earlier stage of their disease in order to improve functional prognosis.

Adult↗

PubMedDate not supplied

Therapeutic effects of laser photocoagulation and/or vitrectomy in Eales' disease.

PURPOSE: To determine visual outcomes and regression of retinal neovascularization following laser photocoagulation and/or vitrectomy in eyes with Eales' disease. METHODS: In a retrospective noncomparative study, the authors reviewed the existing data of 67 eyes of 54 patients with a diagnosis of Eales' disease who had undergone laser photocoagulation and/or vitrectomy based on their clinical presentations. Main outcome measures were visual acuity changes and regression of retinal neovascularization of the eyes following treatment. RESULTS: Both laser therapy and vitrectomy improved visual acuity and induced regression of retinal neovascularization. Forty-three eyes had undergone laser therapy; their rate of visual acuity 320/30 improved from 53% before treatment to 60% after treatment. Twenty-four eyes had undergone vitrectomy; rate of visual acuity 320/30 improved from 13% before surgery to 38% after surgery. In eyes that had undergone laser therapy, additional laser therapy controlled recurrent neovascularization in 47% of the eyes, but ultimately, 12% of them required vitrectomy. In the primary vitrectomized group, additional required treatment was repeat vitrectomy in 21%, and/or laser therapy in 29% of the eyes. CONCLUSIONS: Although laser photocoagulation should be the first line of treatment in Eales' disease, it cannot always induce regression of retinal neovascularization. In such cases vitrectomy may further enhance therapeutic success.

Adult↗

PubMed2004

Post-cataract surgery endophthalmitis treated with core vitrectomy: a case report.

Postoperative endophthalmitis is one of the most serious complications after cataract surgery though its frequency may be low. We report a case with post-cataract extraction bacterial endophthalmitis treated favorably by core vitrectomy through pars plana with anterior vitrectomy cutter (A-vit). The patient, a 72-year-old woman, presented with blurred vision 7 days after phacoemulsification and aspiration (PEA) and intraocular lens (IOL) implantation. Her initial visual acuity was counting fingers. As hypopyon and corneal edema progressed in a few hours, we decided to perform vitectomy. Firstly, we performed IOL explantation and anterior vitrectomy through the corneal stab incision with A-vit attached to the phaco machine. The inflammation, however, appeared to be severe. Secondly we performed core vitrectomy with the same cutter as we used in the first operation through pars plana as well as intravitreal injection of vancomycin on the following day. The inflammation was gradually subsided and her corrected visual acuity was recovered to 30/20 at 7 months after the vitrectomy. The results is suggest that for cataract surgeons in the facilities that are not equipped with 3-port vitrectomy machine, post-cataract extraction bacterial endophthalmitis of the emergency stage can be successfully treated by core vitrectomy through pars plana as well as intravitreal injection of antibiotics with neither vitreous shaving at the vitreous base nor artificial posterior vitreous detachment.

Aged↗

PubMed2000

[Vitrectomy for pseudophakic retinal detachment].

OBJECTIVE: To study the method of vitrectomy for treatment of pseudophakic retinal detachment. METHODS: 32 pseudophakic retinal detachment eyes were treated with vitrectomy, primary vitrectomy in 11 eyes (34.4%), vitrectomy after conventional buckling failure in 21 eyes (65.6%), combined with silicone oil 10 eyes (31.3%), removal of intraocular lens 12 eyes (37.5%). All eyes had passed the 6 months to 5 years of follow-up examination. RESULTS: Intra-operative new retinal breaks were identified in 7 eyes (21.9%). The retinal total reattachment was in 25 eyes (78.1%); part reattachment was in 4 eyes (12.5%), and their visual acuity was improved than that before the operation. Due to severe proliferative vitreoretinopathy (PVR), failure occurred in 3 eyes. CONCLUSIONS: The main advantage of vitrectomy is the better intra-operative sight to the peripheral retinal breaks, removal of retinal traction and the low rate of PVR after vitrectomy. Vitrectomy for complicated type of pseudophakic retinal detachment can improve the success rate of the retinal detachment surgery and the visual acuity outcome.

Adult↗

PubMed2003

[Relationship between vitrectomy and the morphology and function of the retina].

Pathological processes in the vitreous will be reflected in the morphology and function of the retina, and these processes can originate from sources outside the vitreous. The purpose of vitreous surgery is to remove the qualitatively and/or morphologically diseased vitreous. Successful vitrectomy will be manifested by an improvement in the structure and/or function of the retina. We have evaluated the morphology of the vitreoretinal interface, and the function of the retina before and after vitreous surgery. Plasmin-assisted vitrectomy was used in some cases to remove the diseased vitreous more efficiently and less invasively. The effect of this procedure was assessed by examining the morphology and function of the retina. First, the relationship between the qualitative and structural abnormality of the vitreous in macular diseases was studied. In aphakic/pseudophakic eyes with cystoid macular edema, there was a depression of retinal function over the entire retina which may have been caused by chemical mediators released into the vitreous. These mediators may have been produced by inflammation in the anterior segment of the eye. In eyes with an idiopathic macular hole, optical coherence tomographic (OCT) images suggested that the progression of the macular hole might depend on a balance between foveal adhesion and the posterior vitreous. Second, the efficacy, surgical damage, and limitations of vitreous surgery were investigated. The recovery of macular function was assessed by focal macular electroretinograms (FMERGs) after vitrectomy for epiretinal membrane, choroidal neovascularization, and diabetic macular edema. The concurrent examination by optical coherence tomography (OCT) suggested that a decrease in retinal thickness contributed to the functional recovery. Macular functional recovery was delayed and limited after macular translocation, diabetic macular edema, and internal limiting membrane peeling. Third, we studied the effect of plasmin-assisted vitrectomy on the retina. The plasmin was used to remove the vitreous more completely and less invasively. In rabbits, ERG, OCT, and histological examinations demonstrated that the use of commercially-available plasmin at a concentration used on human patients resulted in temporary adverse effects on the retina. For human patients, we purified the plasmin from the patients' serum at the Nagoya University Hospital and the activity was about the same as in previous reports. The purified plasmin was approved by our hospital's institutional review board, and written informed consent was obtained from each patient. Patients with macular edema, idiopathic macular hole, and epiretinal membrane without posterior detachment underwent plasmin-assisted vitrectomy and were evaluated morphologically and electrophysiologically. The efficacy of the plasmin in separating the vitreo-retinal interface was demonstrated by an occasional spontaneous posterior vitreous detachment with or without core vitrectomy, and the presence of less vitreous cortex attached to the internal limiting membrane that was removed during vitrectomy. This was the first histological demonstration of the effectiveness of plasmin in the living eye. Full-field ERGs before and after surgery demonstrated clear evidence that no alteration of retinal functional had occurred, although we did detect a possible osmotic effect by an increase in OCT-determined retinal thickness by the high-molecular weight autologous plasmin. In future studies, the proper concentration and reaction time for each condition of the vitreous should be determined. In conclusion, the pathophysiology of the vitreous should reflect the retinal function. The recovery of the structure of the retina is important for the recovery of retinal function. This should always be the primary goal of surgeons who perform quality surgery.

Animals↗

PubMedDate not supplied

[Value of vitrectomy in intermediate uveitis and Behçet's disease with hyalitis. A study of 400 cases].

Can vitrectomy help to understand the vitreous role in intermediate uveitis and Behçet's disease with vitritis without retinal detachment? 400 vitrectomies were decided because of vitreous changes but, over all, if macular changes were seen clinically or on the angiogram in 58 Behçet's disease and 342 intermediate uveitis including 59 children cases. Visual acuity, clinical, angiographical and visual field controls, recurrences, reduction of the medical treatment and growth were followed during 1 to 9 years. The vitrectomy products were compared to those of other inflammatory origin vitreous, the both representing 149 cases. Vitrectomy at the early stage of only posterior interface changes prevent the macular edema but this one is irreversible. The preexisting angiographical lesions have not regressed but they are generally quiet. The RD incidence is lower even if it is possible after vitrectomy, in 1.2% of the cases (1% in late vitrectomies). Recurrences and further medical treatment are reduced. This psychological point of view is important. Thus, vitrectomy at alone posterior interface change stage avoid ocular complications. Its pathogenic role in intermediate uveitis is not demonstrated; it seems more a secondary than a primary process.

Adult↗

PubMed1995

[Vitrectomy in the treatment of simple retinal detachment].

PURPOSE: To report the indications and results of vitrectomy in the treatment of uncomplicated retinal detachment. METHODS: This retrospective study covered 103 vitrectomies that were carried out during an 8-year period for the treatment of rhegmatogenous retinal detachment without severe proliferative vitreoretinopathy, macular hole, or giant tear. Mean follow-up time was 20.3 months. RESULTS: The indications for vitrectomy were vitreal opacities in 32 cases, unseen or uncertain retinal breaks despite a good retinal view in 9 cases, a difficult arrangement of breaks in 34 cases, severe vitreal traction in 15 cases, and iatrogenic intraocular bleeding in 13 cases, 6 of them referred. In all, retinal breaks were uncertain or invisible in 49 cases. A buckle was used in 83 cases and an internal tamponade in 93. After vitrectomy, the retina was reattached in 76 cases, and after further surgery in 88 (85.4%). With vitrectomy, we were able to confirm or to detect all breaks in 36 cases. Of the 13 intraoperatively unseen breaks, 10 were responsible for vitrectomy failure. Late recurrence after more than 6 months was observed in 5 cases (4.9%). Secondary cataract was observed in 22 (66.6%) of the 33 phakic cases that had been operated on successfully and without complication. CONCLUSION: Our results indicate that vitrectomy is a useful procedure in the management of certain cases of uncomplicated rhegmatogenous retinal detachment. However, secondary cataract is a problem, and the risk of late recurrence needs further evaluation.

Adolescent↗

PubMed1994

[Results of pars plana vitrectomy with intraocular SF-6 gas tamponade in complicated retinal detachment].

Vitrectomy following complicated retinal detachment (PVR, giant tears, persistent retinal detachments or redetachments) has become standard in ophthalmic surgery. Intraocular tamponade is performed with gas (e.g. SF-6) or silicone oil. We retrospectively analyzed our functional and anatomical results after vitrectomy with SF-6 gas tamponade in complicated cases of retinal detachment. Ninety-four severe retinal detachments in 85 patients were treated by vitrectomy using SF-6 gas tamponade in the period from July 1990 to June 1991. In 68% of eyes complete retinal reattachment was achieved with the use of SF-6 gas. Thirty-two per cent of the operated eyes developed retinal redetachment an average of 3.4 weeks after initial surgery; 27% of those eyes were treated again with the use of silicone oil. The success rate using vitrectomy with SF-6 gas ranged between 46% and 74%, depending on pathogenetic factors. The best results were obtained in patients receiving primary vitrectomy for complicated retinal detachment. It is concluded that SF-6 gas is a successful tool in the treatment of severe retinal detachment with primary vitrectomy. In cases of persistent or recurrent detachment of the retina the results are not equally good and these cases merit consideration of silicone oil tamponade, depending on the severity of the disease process. However, no definite preoperative criteria for the success of vitrectomy and gas tamponade were identified.

Follow-Up Studies↗

PubMed1997

[Vitrectomy and proliferative diabetic retinopathy. Apropos of 66 eyes].

PURPOSE: We report a retrospective study about vitrectomy in diabetic patients and the analysis of anatomical and functional results after surgery. METHODS: We studied 66 eyes of 52 diabetic patients who underwent pars plana vitrectomy. Vitrectomy was performed for nonclearing intravitreous hemorrhage in 75% of eyes and for tractional macular retinal detachment in 14% of eyes. RESULTS: After vitrectomy for intravitreous hemorrhage, visual acuity increased in 84% of eyes with more than 5/10 in half the cases. After vitrectomy for tractional retinal detachment, visual acuity increased or became stable in only 55% of eyes. The major complication of surgery was recurrence of intravitreous hemorrhage. A new surgery was not necessary in most cases. Neovascular glaucoma, phtysis, retinal detachment and cataract were the other complications of surgery. CONCLUSION: Visual prognosis after vitrectomy performed in complicated diabetic retinopathy depends on the final macular function. Surgery for intravitreous hemorrhage without macular detachment produced in most of cases a good visual acuity. On the other hand, vitrectomy for tractional macular retinal detachment was followed by poor visual prognosis. After recurrent intravitreous hemorrhage, a new surgical procedure is possible with good visual results in most cases, even if several procedures are necessary.

Adult↗

PubMed1990

Pars plana vitrectomy for acute retinal detachment in penetrating ocular injuries.

We studied 41 eyes with acute retinal detachment after penetrating ocular trauma in a retrospective cohort analysis. Pars plana vitrectomy was performed in 28 eyes, while the remaining 13 eyes had only primary repair and closure of the wound. The two groups differed in the type of trauma (more gunshot wounds in the vitrectomy group and more blunt injuries in the nonvitrectomized group). Visual success (visual acuity of 5/200 or better) was observed in 10 (37%) of the eyes treated by vitrectomy compared with one (8%) of the eyes in the nonvitrectomy group. Anatomic success was achieved in 21 (75%) of the eyes in the vitrectomy group but in only one (8%) of those in the nonvitrectomy group. Enucleation or phthisis was observed in seven (54%) of the eyes in the nonvitrectomy group compared with only five (18%) in the vitrectomy group. Significant prognostic factors for anatomic outcome in the vitrectomy group were the location of the laceration and the presence of the lens.

Acute Disease↗