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At least 1,315 records · Page 73Linked to original sources

PubMed1998

Visual field defect after pars plana vitrectomy.

OBJECTIVE: This study aimed to report the occurrence of visual field defects after pars plana vitrectomy (PPV) for the treatment of each of the following conditions: macular hole (MH), subretinal neovascular membrane (SRNVM), and epiretinal membrane proliferation (EMP). This study also aimed to speculate on the pathogenic mechanisms for the observed field defects. DESIGN: Noncomparative case series. PARTICIPANTS: The study included 48 subjects (50 eyes). Twenty-one of the 50 eyes had stage III MH, 13 eyes had SRNVM, and 16 eyes had EMP. TESTING: Goldmann kinetic perimetry was performed postoperatively. MAIN OUTCOME MEASURE: Visual field defects. RESULTS: Nine (18%) of the 50 eyes had visual field defects. Four (19%) of the 21 eyes with MH and 5 (38%) of the 13 eyes with SRNVM had visual field defects. Of the 16 patients who had epiretinal membrane peeling, none had a visual field defect. An air-fluid exchange had been performed in all patients found to have a postvitrectomy field defect. The difference in rate of visual field defects in eyes that had air-fluid exchange (EMP group) was statistically significant (P < 0.05, chi-square). No significant correlation was found between visual field defect and preoperative intraocular pressure, postoperative intraocular pressure, patient's age, and iatrogenic detachment of the vitreous cortex. The field defects identified were altitudinal (2 eyes), baring of the blind spot (1 eye), inferotemporal (3 eyes), inferonasal (2 eyes), and superonasal (1 eye). CONCLUSIONS: Central and peripheral visual field defects may occur after PPV for the treatment of MHs or SRNVMs. Air-fluid exchange procedure was the common denominator in all of the patients found to have visual field deficit. The etiology is likely to be trauma to the optic nerve region during the air-fluid exchange procedure.

Adult↗

PubMed1999

Glaucoma after pars plana vitrectomy and silicone oil injection for complicated retinal detachments.

OBJECTIVE: To determine the incidence and associations of glaucoma after pars plana vitrectomy (PPV) and silicone oil injection (SOI) for complicated retinal detachments and the response to treatment. DESIGN: Retrospective noncomparative case series. PARTICIPANTS: A total of 150 eyes of 150 patients who had completed a minimum of 6 months of follow-up were included in this study. Analysis included clinical records of all consecutive cases of complicated retinal detachment that underwent PPV with SOI between July 1991 and February 1996. INTERVENTION: Surgical intervention for vitreoretinal pathology included standard three-port PPV and additional procedures as appropriate for the retinal pathology, and SOI. Procedures for the control of glaucoma were silicone oil removal (SOR), trabeculectomy with mitomycin C, cyclocryotherapy, semiconductor diode laser contact transscleral cyclophotocoagulation (TSCPC) and anterior chamber tube shunt to encircling band (ACTSEB). MAIN OUTCOME MEASURES: Presence of glaucoma (predefined as intraocular pressure [IOP] > or = 24 mmHg, which also was > or = 10 mmHg over the preoperative level, sustained for > or = 6 weeks) and the result of medical and surgical management were the main outcome measures. Demographic, preoperative, intraoperative, and postoperative parameters including the age of the patient, etiology of retinal detachment, refractive status, pre-existing glaucoma, aphakia, diabetes mellitus, presence of silicone oil (SO) in the anterior chamber, emulsification of SO, rubeosis iridis, and anatomic success were evaluated by univariate and multivariate logistic regression analyses to assess their predictive value in the causation of glaucoma and to determine factors prognosticating response to treatment. RESULTS: The main indications for PPV+SOI were proliferative vitreoretinopathy (57%; 85 of 150), proliferative diabetic retinopathy (15%; 23 of 150), and trauma (14%, 21 of 150). Glaucoma occurred in 60 eyes (40%) at 14 days median (range, 1 day-18 months). Elevation of IOP could be attributed directly to SO in 42 (70%) eyes. Glaucoma was controlled in 43 (72%) of 60 eyes on treatment (with medicines alone in 30%; SOR and medicines in 25%; trabeculectomy with mitomycin C/ACTSEB/cyclocryotherapy or TSCPC in 17%); 28% (17 of 60) remained refractory. Independent predictive factors for glaucoma on multivariate analysis were rubeosis iridis (odds ratio, 10.76), aphakia (odds ratio, 9.83), diabetes (odds ratio, 6.03), SO in anterior chamber (odds ratio, 4.74), and anatomic failure (negative risk factor; odds ratio, 0.11). Poor prognostic factors for the control of glaucoma were SO emulsification (odds ratio, 15.34) and diabetes (odds ratio, 6.03). CONCLUSION: Glaucoma is a frequent and often a refractory complication of PPV with SOI and has a multifactorial etiology. Aggressive medical and surgical management with SOR, trabeculectomy with mitomycin C, glaucoma shunts, and cyclodestructive procedures shows modest success in controlling IOP.

Adolescent↗

PubMed1999

Suprachoroidal hemorrhage during pars plana vitrectomy. Risk factors and outcomes.

OBJECTIVE: Suprachoroidal hemorrhage (SCH) is an uncommon but serious complication of pars plana vitrectomy (PPV) that can be associated with a guarded visual prognosis. The purpose of this study is to document the risk factors and outcomes of this complication. DESIGN: Case-control study of consecutive cases of intraoperative SCH occurring during PPV (n = 36) and controls of PPV uncomplicated by SCH (n = 116). MAIN OUTCOME MEASURES: Baseline systemic and ocular characteristics, intraoperative findings, surgical procedures, and final anatomic and visual outcomes were measured. RESULTS: Significant risk factors for the development of SCH during PPV included high myopia (22% of cases vs. 5% of controls), history of retinal detachment (RD) surgery (61% vs. 22%), rhegmatogenous RD (97% vs. 60%), use of cryotherapy (75% vs. 33%), scleral buckling at the time of PPV (50% vs. 19%), external drainage of the subretinal fluid (22% vs. 2%), and intraoperative systemic hypertension. In the 34 SCH cases with 3 months' or more follow-up, the final visual acuity was 20/200 or greater in 11 (32%), count fingers in 5 (15%), hand movement in 7 (21%), light perception in 7 (21%), and no light perception in 4 (12%). In the 106 controls with 3 months' or more follow-up, the final visual acuity was 20/200 or greater in 79 (75%), count fingers in 20 (19%), hand movement in 5 (5%), light perception in 1 (1%), and no light perception in 1 (1%). In the eyes with SCH, 17 (50%) had persistent RD, 10 (33%) had secondary glaucoma develop, and 8 (24%) became hypotonic. The visual and anatomic outcomes of the SCH cases were significantly worse than those in the control group (P < 0.001). The visual outcome was more favorable if the SCH did not extend into the posterior pole (P = 0.002). Attempted intraoperative drainage of SCH was not associated with a better outcome. CONCLUSION: Risk factors for the development of intraoperative SCH during PPV are high myopia, previous RD surgery, rhegmatogenous RD, cryotherapy, scleral buckling, external drainage of subretinal fluid, and intraoperative systemic hypertension. Anatomic and visual outcomes are significantly worsened after this complication.

Case-Control Studies↗

PubMed1999

Pars plana vitrectomy without scleral buckle for pseudophakic retinal detachments.

OBJECTIVE: To report the anatomic and visual results of primary pars plana vitrectomy (PPV) without scleral buckling to repair primary rhegmatogenous retinal detachments in pseudophakic eyes. DESIGN: Nonrandomized, prospective, comparative clinical trial. PARTICIPANTS: Two hundred eighty-three consecutive patients (294 eyes) with pseudophakia, peripheral retinal tears, and new rhegmatogenous retinal detachments were treated according to the surgery protocol. INTERVENTION: Patients underwent PPV with fluid-gas exchange and endolaser to repair the retinal detachment. Two hundred sixty-four patients (275 eyes) were followed from 6 months to 6 years and 8 months with an average follow-up of 19 months. MAIN OUTCOME MEASURES: Reattachment of the retina and visual outcome were compared to previously published studies. RESULTS: Of 97 eyes with a macula-attached rhegmatogenous retinal detachment, 88 eyes (91%) were reattached with a single operation, and of the 178 eyes with a macula-detached retinal detachment, 153 (86%) eyes were reattached with a single operation. In 241 (88%) of 275 eyes, the retina was reattached with a single operation, and in 265 (96%) of 275 eyes, the retina was ultimately reattached with subsequent operations. The median initial visual acuity was 20/300, and the median final visual acuity was 20/40. The rate of reattachment with one operation was similar for eyes with an anterior chamber intraocular lens (91%) and for eyes with a posterior chamber intraocular lens (88%). Refractive error measurements obtained in 81 eyes were essentially unchanged. The mean change in refractive error was -0.15 diopter. Seventeen eyes (6%) developed macular puckers requiring surgery, 46 eyes (17%) developed cystoid macular edema, and 6 eyes (2%) developed full-thickness macular holes. CONCLUSION: Primary PPV with fluid-gas exchange and laser is a safe, effective method to repair primary pseudophakic retinal detachments. The anatomic reattachment rate and the visual acuity obtained with this technique appear to be at least as good as those reported in the literature for scleral buckling, PPV with scleral buckling, and pneumatic retinopexy.

Fluorocarbons↗

PubMed2005

[Results of treating rhegmatogenous retinal detachment with vitrectomy and silicone oil tamponade].

INTRODUCTION: Silicone oil is used in the treatment of rhegmatogenous retinal detachment when there is a high risk of postoperative proliferative vitreoretinopathy (PVR). This type of internal tamponade can be responsible for serious side effects. Removal of silicone oil is necessary to ensure a long-lasting functional result. The purpose of this study was to evaluate the results of using a transient internal tamponade with silicone oil. PATIENTS AND METHODS: A retrospective review of cases of rhegmatogenous retinal detachment treated with internal tamponade with silicone oil for the first time in a 1-year period (January 2001 to December 2001) was conducted. We studied the type of retinal detachment, treatment before vitrectomy and silicone oil tamponade, indication for silicone oil tamponade, surgical steps and their results, causes of recurrent retinal detachment, and final visual acuity. Anatomical success was defined as a reattached retina after silicone oil removal. RESULTS: Ninety-three patients were included. Anatomical success was achieved, after one or several procedures, in 71 patients (76.3%). The mean total number of surgical procedures was 2.6. After initial surgery, recurrence of retinal detachment after removal of silicone oil occurred in 17.0% of the cases. Recurrence of retinal detachment under silicone oil occurred in 45.1% of the cases; the cause of the recurrence was PVR in 97.6% of those patients. No serious complication of silicone oil tamponade occurred. The mean duration of the tamponade was 6.7 months. The best results were achieved among patients showing no recurrence with silicone oil: visual acuity above 4/200 in 84.6% of the patients, above 20/200 in 61.5% of the patients and above 80/200 in 20.5% of the patients. In case of recurrence with silicone oil treatment, visual acuity reached 4/200 in 70.4% of the patients and was above 20/200 in 25.9% of the patients. DISCUSSION AND CONCLUSION: The results of this study are equivalent to those of studies in which analysis was made after removal of silicone oil. Proliferative vitreoretinopathy remains the only risk factor of retinal detachment recurrence with silicone oil (p<0.01). The number of previous surgeries is not a risk factor for postoperative PVR. Retinectomy is a surgical procedure that seems to improve the results in cases of severe PVR.

Adult↗

PubMed2002

Floaterectomy: combined phacoemulsification and deep anterior vitrectomy.

We describe a 1-stage surgical technique to treat vitreous floaters. Phacoemulsification is combined with a deep anterior vitrectomy through a posterior curvilinear capsulorhexis followed by implantation of a posterior chamber intraocular lens. The technique was used in 10 eyes of 6 patients. Six months postoperatively, 8 eyes had a best corrected visual acuity (BCVA) of 6/6 with complete resolution of symptoms. Two eyes of 1 patient developed cystoid macular edema that reduced final BCVA to 6/18 bilaterally. In this case, the floaters may have been the result of previously undiagnosed intermediate uveitis.

Aged↗

PubMed2002

Combined surgery and sequential surgery comprising phacoemulsification, pars plana vitrectomy, and intraocular lens implantation: comparison of clinical outcomes.

PURPOSE: To evaluate the effectiveness and safety of combined phacoemulsification, pars plana vitrectomy (PPV), and intraocular lens (IOL) implantation in diabetic and nondiabetic patients and compare the clinical results with those of sequential surgery. SETTING: Seoul National University College of Medicine, Seoul, South Korea. METHODS: The results of combined phacoemulsification, PPV, and IOL implantation in 52 patients (52 eyes) were retrospectively analyzed. The main outcome measures were preoperative and postoperative best corrected visual acuity (BCVA), postoperative BCVA of 20/40 or better, and intraoperative and postoperative complications. Combined surgery and sequential surgery were also compared using the same outcome measures. RESULTS: Postoperatively, the BCVA was better in 44 eyes (84.6%); 12 eyes (23.1%) achieved a BCVA of 20/40 or better. Postoperative complications consisted of a transient intraocular pressure increase in 29 eyes (55.8%), hyphema in 10 (19.2%), neovascular glaucoma in 8 (15.4%), anterior chamber fibrin exudation in 7 (13.5%), vitreous hemorrhage in 7 (13.5%), retinal detachment in 3 (5.8%), and posterior capsule opacification in 1 (1.9%). In the diabetic patients, postoperative visual outcomes between the combined-surgery group and the sequential-surgery group were not significantly different; however, neovascular glaucoma occurred only in the combined-surgery group. Other complications were not different between the combined-surgery group and the sequential-surgery group. In the nondiabetic patients, the postoperative visual outcomes and complications between the 2 groups were not significantly different. CONCLUSIONS: Combined phacoemulsification, PPV, and IOL implantation was safe and effective in selected patients, with the clinical outcomes comparable to those of sequential surgery.

Adult↗

PubMed2003

Small-gauge, sutureless pars plana vitrectomy to manage vitreous loss during phacoemulsification.

This technique manages vitreous prolapse associated with posterior capsule rupture during phacoemulsification by performing small-gauge pars plana vitrectomy with a sutureless, self-sealing incision performed in a closed chamber, maintaining normal intraocular pressure. A high-speed cutter exerts minimal traction on the vitreous. Accessibility to the vitreous through the pars plana is better, ensuring more complete removal of the vitreous and restoration of normal anatomy.

Eye Diseases↗

PubMed2003

Role of posterior capsulotomy with vitrectomy and intraocular lens design and material in reducing posterior capsule opacification after pediatric cataract surgery.

PURPOSE: To study the effect of primary posterior capsulotomy with anterior vitrectomy (PPC + AV) and intraocular lens (IOL) design and material on the development of posterior capsule opacification (PCO) after pediatric cataract surgery. SETTING: Tertiary care institution in India. PATIENTS: Sixty-four eyes of 52 children ranging in age from 3 months to 12 years who had cataract extraction with IOL implantation were prospectively evaluated for a minimum postoperative period of 2 years. METHODS: Thirty-two eyes received a hydrophobic acrylic lens with a truncated, square edge and 32, a single-piece poly(methyl methacrylate) (PMMA) lens that was not heparin surface modified. Sixteen eyes in each IOL group had PPC + AV; in the remaining 16 eyes in each group, the posterior capsule was left intact. RESULTS: Postoperatively, 25 eyes in the intact capsule group and 5 in the PPC + AV group developed PCO; the difference between groups was significant (P<.05). Of eyes with an intact capsule, 12 with an acrylic IOL and 13 with a PMMA IOL developed PCO (P>.05). In the PPC + AV group, 2 eyes with an acrylic IOL and 3 with a PMMA IOL developed PCO (P>.05). Overall, 14 eyes with an acrylic lens and 16 eyes with a PMMA lens developed PCO (P>.05). After surgery, there was a significant short-term delay in the development of PCO in the acrylic group (14 eyes; mean 6.66 months +/- 1.57 [SD]) compared to the PMMA group (16 eyes; mean 3.16 +/- 0.83 months) (P<.05). CONCLUSIONS: It is the management of the posterior capsule rather than IOL design and material that influences the incidence of PCO after cataract surgery in children. Development of PCO in the postoperative period was delayed with a hydrophobic acrylic IOL with square edges compared with a PMMA lens without square edges.

Acrylic Resins↗

PubMed2003

Suture fixation of an intraocular lens combined with pars plana vitrectomy and gas tamponade.

We describe suturing an intraocular lens (IOL) after pars plana lensectomy and vitrectomy combined with gas tamponade in 4 patients with vitreoretinal disease and subluxated lenses that could not be managed with capsular tension rings. The IOL haptics were sutured before the fluid-gas exchange in a horizontal (case 1), oblique (cases 2 and 4), and vertical (case 3) manner. In a case of unavoidable horizontal fixation due to limited scleral space, the upper part of the IOL tilted anteriorly postoperatively because of the enhanced effect of the gas bubble. A peripheral anterior iris synechia also occurred. The IOL remained well positioned in cases with oblique and vertical fixations, and no other complications occurred. Careful preoperative planning of the surgical design can help avoid unnecessary horizontal fixation.

Adult↗

PubMed2004

Unsutured posterior chamber lens implantation in eyes requiring lens extraction at the time of pars plana vitrectomy with silicone oil tamponade.

PURPOSE: To describe a technique for the subsequent placement of an unsutured posterior chamber lens intraocular lens (PC IOL) in eyes requiring cataract or clear lens extraction at the time of pars plana vitrectomy (PPV) with silicone oil tamponade. SETTING: Department of Vitreoretinal Surgery, St. Thomas' Hospital, London, United Kingdom. METHODS: This retrospective review comprised 25 patients who had phacoemulsification to allow an adequate intraoperative retinal view or adequate access to anterior retinal pathology. Anterior and posterior capsulorhexes were combined with an inferior radial capsulectomy to fashion a keyhole-shaped capsule. RESULTS: The mean follow-up was 15.9 months +/- 8.0 (SD) (range 3 to 34 months). Silicone oil was removed and IOLs were implanted in 15 eyes (60.0%). Posterior chamber IOLs were implanted in 10 eyes (66.7% of those receiving an IOL), and anterior chamber AC IOLs were implanted in 5 eyes (33.3%). Nine of the 10 eyes receiving a PC IOL (60.0% of all IOLs) had uneventful surgery. In 1 eye, the PC IOL subluxated inferiorly. Two eyes developed pupil block that required further surgery. CONCLUSIONS: This technique allowed PC IOL implantation in 60% of eyes that received an IOL, showing that in selected patients who require simultaneous lens extraction and silicone oil tamponade, a keyhole-shaped capsulectomy provides for subsequent unsutured PC IOL insertion. The pupil block rate of 8% compares favorably with published rates. Refining the technique may allow it to be used in a greater proportion of eyes that would benefit from safe refractive correction.

Adult↗

PubMed2003

Black diaphragm intraocular lens implantation in aphakic eyes with traumatic aniridia and previous pars plana vitrectomy.

PURPOSE: To evaluate the efficacy of secondary black diaphragm intraocular lens (IOL) implantation in aphakic eyes with traumatic aniridia and previous pars plana vitrectomy (PPV). SETTING: Shandong Eye Institute and Hospital, Qingdao, China. METHODS: This retrospective study comprised 15 aphakic eyes with aniridia and no vitreous that had implantation of a secondary black diaphragm IOL 6 to 72 months after PPV. The PPV was performed as a result of trauma to the posterior segment. Before implantation of the IOL, all patients had reduced visual acuity from aphakia and intolerable glare from aniridia. Eyes were aphakic as a result of previous extracapsular cataract extraction (1 eye), lens extrusion during trauma (3 eyes), or simultaneous cataract lensectomy during PPV (11 eyes). Significant iris defects were present, with 9 eyes being aniridic after the injury. The mean follow-up was 17 months (range 3 to 34 months). The postoperative visual acuity, intra- ocular pressure (IOP), endothelial cell density, IOL centration, and intraocular inflammation were monitored. RESULTS: All 15 eyes had improved visual acuity and marked glare reduction after IOL implantation. No major IOL decentration was seen. Five patients had increased IOP 3 to 5 days after IOL implantation; 3 were known to have secondary glaucoma from trauma before surgery and their IOP was controlled preoperatively (< 21 mm Hg) with timolol 0.5% eyedrops. The other 2 patients had normal- appearing angles, and 1 was diagnosed with hemolytic glaucoma after IOL insertion. Postoperative elevated IOP was controlled by timolol eyedrops (4 eyes) or selective laser trabeculoplasty (1 eye). Hyphema was seen in 1 patient on the first day after IOL implantation, but no further bleeding was noted. Vitreous hemorrhage was seen the first day after IOL insertion in 2 patients. One resolved without sequelae; the other required vitreous washout. Retinal detachment and cystoid macular edema did not occur in any patient. CONCLUSIONS: Black diaphragm IOL implantation can be considered in eyes with coexisting aphakia and aniridia and without vitreous. Intraoperative IOP regulation is crucial in vitrectomized eyes to prevent complications such as expulsive hemorrhage. In general, visual function was better after IOL insertion as a result of better visual acuity and glare reduction. Although this IOL appears to be safe, long-term results must be assessed in studies with a longer follow-up and a larger study group.

Adolescent↗

PubMed1990

Management of subluxated and posteriorly dislocated intraocular lenses using pars plana vitrectomy instrumentation.

Thirty-four patients with subluxated and posteriorly dislocated intraocular lenses (IOLs) had repositioning, replacement, or removal of the IOL using pars plana instrumentation. Of the 25 cases posteriorly dislocated into the formed vitreous, ten posterior chamber IOLs were repositioned into the ciliary sulcus, one anterior chamber IOL was repositioned into the anterior chamber angle, and eight posterior chamber IOLs were exchanged for anterior chamber IOLs through a limbal incision. In the remaining six cases, the IOL was removed but was not replaced because of concurrent ocular pathology. In nine cases with subluxation of an anterior chamber IOL into a large basal iridectomy, a pars plana approach after vitrectomy was used for repositioning the IOL into the anterior chamber angle. Complications included each of the following: intraoperative retinal dialysis, postoperative extension of a pre-existing subclinical retinal detachment, recurrent subluxation of an anterior chamber IOL, breakdown of chronic cystoid macular edema to form a macular hole, and pseudophakic pupillary block requiring laser iridotomy.

Aged↗

PubMed1989

Results of secondary anterior chamber intraocular lens implants with iridoplasty and pars plana vitrectomy.

A combined three-part procedure to permit aphakic patients with full iridectomies to receive secondary anterior chamber intraocular lens implants is described. Pars plana vitrectomy leaves the anterior chamber free of vitreous, thus preparing the eye for the iridoplasty and implant. Iridoplasty is performed using a special micro needle that permits good visualization in the eye. The results of ten cases are discussed.

Aged↗

PubMedDate not supplied

Endophthalmitis: immediate management using posterior capsulorhexis and anterior vitrectomy through reopened cataract surgery incision.

An alternative tap/biopsy technique for early management of endophthalmitis is described. The technique uses the cataract surgery wound for anterior chamber washout and for a posterior continuous curvilinear capsulorhexis through which anterior vitrectomy, removal of part or all the vitreous abscess, and injection of antibiotics can be performed. The approach is safe, avoids pars plana incisions, and maintains capsule support for the intraocular lens or for removal and reimplantation of a posterior chamber lens in the bag.

Aged↗

PubMed1999

Treatment of traumatic cyclodialysis with vitrectomy, cryotherapy, and gas endotamponade.

An aphakic patient with severe chronic hypotony had an alternative treatment of a traumatic cyclodialysis cleft: a 3-port pars plana vitrectomy, cryotherapy of the cleft, and fluid-gas exchange with subsequent supine positioning. The therapeutic principle was mechanical apposition of the detached ciliary muscle to the scleral spur by the gas bubble and scar induction by cryotherapy. Intraocular pressure increased to within normal ranges, and visual acuity improved over a 15 month follow-up.

Air↗

PubMedDate not supplied

The adjunctive use of perfluoroperhydrophenanthrene (Vitreon) in diabetic vitrectomy.

OBJECTIVE: To evaluate the utility and efficacy of perfluoroperhydrophenanthrene in the management of retinal detachments secondary to severe proliferative diabetic retinopathy. PATIENTS AND METHODS: Forty consecutive patients with proliferative diabetic retinopathy and retinal detachments were entered into the study at nine participating clinical centers. Perfluoroperhydrophenanthrene (Vitreon) was used as an adjunct to pars plana vitrectomy and membranectomy. RESULTS: Preoperative diagnoses included combined traction and rhegmatogenous retinal detachments in 23 eyes (57.5%), traction retinal detachments in 13 eyes (32.5%), and recurrent rhegmatogenous retinal detachments in 4 eyes (10). Vitreous hemorrhage was present in 17 eyes (42.5%). Preoperative visual acuity ranged from light perception or hand motion in 28 eyes (70%) to 5/200 or greater in 12 eyes (30%). Vitreon was primarily used to flatten the retina following relaxing retinotomy in 12 eyes (30%), to displace subretinal fluid in a posterior-to-anterior direction without performing a drainage retinotomy in 15 eyes (37.5%), and to manage intraoperative complications such as iatrogenic tears in 8 (20%) and retinal dialysis in 5 eyes (12.5%). The retina flattened intraoperatively in all cases, facilitating administration of laser photocoagulation. Patients were followed for a minimum of six months (mean 13.2 months). At last follow up, the macula remained attached in 37 eyes (92.5%), including 31 (77.5%) in which the retina was totally attached. The retina remained detached in 3 eyes (7.5%). Visual acuity improved postoperatively in 20 patients (50%), was unchanged in 13 patients (32.5%), and worsened in 7 patients (17.5%). CONCLUSIONS: Perfluoroperhydrophenanthrene is a useful and effective intraoperative tool for the management of complex retinal detachments secondary to severe proliferative diabetic retinopathy.

Adolescent↗

PubMed1999

Pachometry before and after vitrectomy with silicone oil injection.

PURPOSE: To evaluate differences in central corneal thickness (CCT) before and after vitrectomy with injection of silicone oil as vitreous substitution material in order to determine whether silicone oil causes more frequent and/or pronounced corneal decompensation than other substitution materials. METHODS: CCT was measured by ultrasonic pachometry in 42 eyes. 25 eyes received injection of silicone oil and 17 eyes C3F8, atmospheric air or saline. Measurements were performed 24 hours pre operatively, during anaesthesia pre operatively and 24 hours, 48 hours and five months post operatively. RESULTS: A progressive central corneal thickening could be demonstrated in both groups. Eyes which received silicone oil showed maximum CCT increase of 0.083 mm (14.1%) 48 hours post operatively. At follow-up CCT had decreased to baseline value in both groups. Silicone oil did not induce CCT changes that were significantly different from those induced by other substitution materials. CONCLUSION: Silicone oil injection in detachment surgery induces reversible corneal decompensation to the same degree as other substitution materials within the first five months post operatively.

Adult↗