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At least 1,117 records · Page 62Linked to original sources
PubMedDate not supplied

Vitrectomy: a new challenge for the anesthesiologist.

A new surgical procedure, virtectomy, for alleviation of blindness caused by previously intractable vitreous disease, is described. Special demands of vitrectomy upon the anesthesiologist are enumerated. Problems presented by a patient population, 83 percent of whom suffered from severe diabetes mellitus and/or hypertension with a variety of complications, are discussed. Anesthetic technic used for 47 patients undergoing vitrectomy is described.

Adolescent↗
PubMed1975

Indications for vitrectomy via the pars plana.

Vitrectomy via the pars plana is a surgical technique with a wide range of applications, which should be understood by all ophthalmologists, for they allow the successful treatment of conditions for which there was previously no good therapy. On the other hand, the breadth of indications for this new surgical approach and the hopelessness of the prognosis with other treatments is a temptation for its misuse. Clear guidelines must be established as to when vitrectomy is indicated. Some such guidelines are proposed.

Cornea↗
PubMed1975

Vitrectomy with an alternative instrument system.

This is a description of an alternative type of vitrectomy instrument system which is characterized by specific advantages for mobilizing and removing sluggish intracapsular lens material, blood, debris, or plasmoid liquid pooled or sedimented at the posterior pole; and modular one-surgeon units adaptable to contemporary vitrectomy devices and techniques with a minimum of surgical or instrument modification. Electrovitreotomy for relaxing fixed folds due to taut opaque vasoproliferative bands inaccessible to or extremely hazardous with other cutting methods is a complementary procedure of value.

Cataract Extraction↗
PubMed1978

Anterior segment applications of vitrectomy techniques.

We have used vitrectomy instrumentation and techniques to treat a variety of conditions affecting the anterior segment, including: (1) Various conditions causing an occluded or inadequate pupillary space, (2) Complications of vitreous gel in the anterior chamber, (3) Growth of epithelium into the anterior chamber, (4) Selected indications for lens surgery, (5) Flat anterior chamber, (6) Total hyphaema. The vitrectomy methods provided improved capabilities, including controlled excision of intraocular tissues under optimum visualization using a closed-eye system with normal intraocular pressure and the ability to use accessory techniques such as intraocular diathermy. Although new difficulties are introduced by reliance on complex instrumentation and possible complications from excessive traction or use of large volumes of intraocular irrigating solution, our experience in using these techniques to treat selected anterior segment conditions has been, favourable.

Anterior Chamber↗
PubMed1979

[Pars plana vitrectomy--results and complication of 100 consecutive cases (author's transl)].

Indications, results and complications of 100 consecutive cases of pars plana vitrectomy are reported. In 83% of patients with anterior segment and/or vitreous opacities a clear view to the fundus could be obtained; visual acuity improved significantly in 73%. Complicated retinal detachments, not managable with conventional retinal surgery, could be reattached in 26% of the cases. In carefully selected patients vitrectomy was indicated to stabilize the anatomic situation and to prevent further visual deterioration.

Cataract Extraction↗
PubMedDate not supplied

[Hyalocytes transplantation after pars plana vitrectomy (author's transl)].

The transplantation of cultivated hyalocytes after vitrectomy gave favourable functional results in 64% of the cases and appears to be a method of preventing atrophy of the globe and ocular hypotony after vitrectomy. We have nevertheless still to demonstrate that the results are better than these after injections of physiological saline.

Animals↗
PubMed1979

An experimental model for the evaluation of vitrectomy instruments.

A scleral window was designed for implantation in human autopsy eyes. This model provides direct visualization of the pars plana, vitreous base and peripheral retina. Using this model, one can directly observe vitrectomy instruments entering the globe, and can evaluate the cutting ability of a variety of instruments. The model can also be used to provide practical experience, analogous to clinical vitrectomy, and is therefore useful as a training device.

Cadaver↗
PubMed1979

Anterior vitrectomy for complications of cataract extraction.

Our results of anterior vitrectomy in 12 patients with vitreo-corneal touch following cataract extraction, and in three patients with ghost-cell glaucoma due to vitreous hemorrhage were reported. The Machemer vitreous infusion suction cutter was used for pars plana and trans-corneal approaches. Anterior vitrectomy was effective in treating both disorders.

Cataract Extraction↗
PubMed1979

Vitrectomy techniques in treatment of macular pucker following retinal reattachment surgery.

Vitrectomy techniques to remove epiretinal membranes causing macular pucker and reduced vision were used to treat 11 consecutive eyes with macular pucker after otherwise-successful retinal reattachment surgery. A technically successful result with visual improvement was achieved in each case. An iatrogenic retinal tear occurred in eye, and recurrent retinal detachment requiring an additional operation occurred postoperatively in 2 eyes. Despite such risks, and the fact that the best postoperative acuity achieved was 20/40, the use of vitrectomy methods in removal of epiretinal membranes in selected cases of macular pucker can provide significant improvement in vision.

Adult↗
PubMed1979

Pars plana vitrectomy for diabetic retinopathy. A report of 8 years' experience.

Vitrectomies have been performed on 299 cases of dense diabetic vitreous hemorrhages and been followed for 6 months. A successful visual result was obtained in 61% of the cases. The vitreous remained clear in 71% of the cases, and the maculas were attached in 66% of the cases 6 months following surgery. 168 cases of traction macular detachments underwent vitrectomy, and had 6-month follow-up examinations. Significant visual improvement was obtained in 26% of the cases, with stabilization of the preoparative vision in an additional 37% of the cases. The vitreous cavity was clear in at least 64% of the cases, and the macula attached in at least 52% of the cases. 86 cases had both dense vitreous hemorrhages and traction macular detachments, and had 6-month postoperative examinations, with significant visual improvement having been obtained in 31% of the cases, and stabilization of the preoperative vision in an additional 33% of the cases. The postoperative vitreous cavities were clear in 59% of the cases, and the maculas attached in at least 45% of the cases.

Adult↗
PubMed1978

Vitrectomy in diabetics. A new procedure for prevention of blindness in diabetic retinopathy.

A report is presented of 46 diabetics submitted to pars plana vitrectomy on account of severe intravitreal haemorrhage. The follow-up period lasted up to 15 months. The visual acuity alone is not an adequate parameter for the evaluation of postoperative success in view of the central retinal lesions resulting from severe diabetic retinopathy. The vitreous cavity was found to be clear in 33 cases and in 27 cases visual acuity reached at least 6/60. In 11 cases new haemorrhages occurred postoperatively, 6 of which cleared spontaneously within 2 weeks. In the remaining cases irrigation of the vitreous chamber by means of the vitrectomy instrument was necessary. Retinal injury due to the tip of the instrument was avoided in every case. The patients were out of bed on the first postoperative day and discharged between the 8th and 10th postoperative day provided that no relapse haemorrhage occurred.

Diabetic Retinopathy↗
PubMed1983

Lensectomy-vitrectomy in chronic uveitis.

Cataract extraction in patients with chronic uveitis may be hazardous. 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 cases of uveitic cataract are reported. All patients had improvement in vision. No significant "flare-up" of the underlying uveitis was found and no patients deteriorated. The importance of extensive preoperative evaluation is emphasized. The major cause of decreased acuity after operation was persistent cystoid macular edema, a complication of chronic inflammation.

Adolescent↗
PubMed1980

Vitrectomy techniques in the management of complications in cataract surgery.

Considerable attention has been focused on the technique of closed vitrectomy in the management of vitreo-retinal problems involving the posterior segment of the eye. Less well known, but probably of greater relevance to the general ophthalmologist, is the role of this technique in the management of anterior segment problems, particularly those relating to cataract surgery. The role of the vitrectomy technique as an adjunct to conventional cataract surgery as in the management of capsule rupture, vitreous loss, and lens dislocation is outlined and the situations in which it might be of value in the management of complications such as pupil block glaucoma, vitreo-corneal touch, updrawn pupil, pupillary membranes, cystoid macular oedema, and endophthalmitis are indicated.

Cataract Extraction↗
PubMed1982

Management of infective endophthalmitis by pars plana vitrectomy.

Endophthalmitis is an ocular disaster that frequently leads to blindness. With the advent of vitrectomy and the opportunity for intraocular injection of antibiotics more of the eyes can be salvaged. In 11 patients the infection was controlled by vitrectomy. All had dramatic relief of pain, and eight showed an improvement in visual acuity. Pathogens were cultured from the aqueous or the vitreous, or both, of 64%, and from the conjunctival swabs of the remainder.

Adult↗
PubMed1980

Combined penetrating keratoplasty and mechanical anterior vitrectomy.

Forty patients with aphakic bullous keratopathy undergoing combined penetrating keratoplasty and anterior vitrectomy using mechanical vitreous instruments were studied for a mean length of 36 months. Seventy percent of the grafts remained clear and thirty percent failed during the follow-up period. Fifty-three percent of those with clear grafts (15/28) obtained a visual acuity of 20/70 or better. In comparison to older methods of anterior vitrectomy, we have found that removal of vitreous with mechanical vitreous instruments offers more effective removal of solid and liquid vitreous, decreased surgical time, and decreased retinal traction. Further, it is easy to learn to use and handle these instruments.

Corneal Diseases↗
PubMed1981

Current management of giant retinal breaks: results with vitrectomy and total air fluid exchange in 95 cases.

These results indicate that vitrectomy is a valuable adjunct in the management of giant retinal breaks with a partial or complete inversion of the posterior retinal flap. Removal of the vitreous gel makes possible the injection of a large bubble of air to more optimally unfold the posterior retinal flap. In addition, vitrectomy severs the equatorial membrane that can cause postoperative circumferential extension of the giant retinal break or the formation of new retinal tears. A 360 degree scleral buckle is mandatory in giant retinal breaks with a partial or complete inversion of the posterior retinal flap. Unless there are medical contraindications, the air fluid exchange should be carried out in the prone position.

Adolescent↗
PubMed1982

[Pars plana vitrectomy: causal affections, material employed, and approach in 1400 cases (author's transl)].

Isolated vitrectomy was employed in half of 1,400 cases operated upon, the other patients receiving an intra-ocular injection of silicone fluid. Emphasis is placed on the simplification undergone by the materials employed, the progress represented by the addition of an autonomous infusion for each instrument complementary to the vitrectomy, and the need for all ophthalmic surgeons, particularly those in training, to become familiar with the use of the vitreotome.

Ciliary Body↗