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At least 1,351 records · Page 75Linked to original sources
PubMed1996

[Rhegmatogenous retinal detachment in atrophia gyrata: pars plana vitrectomy with silicone oil instillation].

BACKGROUND: Gyrate atrophy is a form of choroidal dystrophia characterized by a genetic defect of the mitochondrial matrix enzyme ornithine ketoacidoaminotransferase on chromosome 10. Apart from rare myopathic problems, cases of choroidal, iridal atrophy, complicated subcapsular cataract, optic atrophy, macular edema, reticular retinoschisis, vasculitis and perivasculitis could be observed so far. To our knowledge, rheumatogenous retinal detachment has been described before. We present a 34-year-old female subject with a retinal detachment of the right eye over 3 quadrants with 3 small round foramina in the area 10 to 11 o'clock. PATIENTS: Concentric defects of the visual field had been known since the age of 4; the patient was slightly myopic. At the age of 31, the patient had undergone cataract extraction with implantation of posterior chamber lenses in both eyes. The ophthalmological examination revealed large areas of choroidal atrophia in both eyes. A determination of visual acuity resulted in hand movements in the right eye and 0.1 in the left eye. The ERG was extinguished. RESULTS: The retina could be fully reattached by pars plana vitrectomy and instillation of silicone oil. At the same time, we performed an excision of secondary cataract. On demission, the visual acuity of the right eye was finger counting. Because a brother of the patient had also suffering from a progressive choroidal atrophy since his childhood, an autosomal recessive disease was suspected. The only abnormality detected was strongly elevated plasma levels of ornithin (7.5 to 14 mg/dl, compared to levels of 0.6 to 2.0 in controls). Urinary excretion of ornithin was also strongly increased. DISCUSSION: To our knowledge there was no previous description of a case of atrophia gyrata in association with rhegmatogenous retinal detachment after intraocular surgery. As the pigment epithelium is missing, intraoperative endolaser-coagulation would be useless. For this reason, and since a tendency for reattachment is lacking consistent with one of the characteristics of this disease, the only approach to this case is intraocular tamponade with silicone oil.

Adult↗
PubMed1992

[Pars plana vitrectomy in uveitis].

A vitrectomy was performed in 30 eyes suffering from different forms of uveitis. An improvement of visual acuity was obtained in 29 cases and was explained by removal of vitreous haze and/or of the cataract, but not by the improvement of the inflammatory process.

Adolescent↗
PubMed1990

[Pre-basal vitreous body after subtotal vitrectomy of aphakic eyes].

The anterior axial vitreous body of aphakic eyes is often severely liquefied. In a vitrectomy case, it was removed easily and completely. The behavior of the prebasal vitreous cortex after the procedure was not predictable. The postoperative biomicroscopic examination resulted in two different findings, are reported on here.

Cataract Extraction↗
PubMed1990

[Pars plana vitrectomy following accidental injection of depot steroids into the vitreous body].

The authors describe a case of accidental intraocular injection of depot steroids after treatment of a chalazion by an intralesional corticosteroid injection. The eye was treated by pars plana vitrectomy. Visual acuity improved postoperatively, ultimately attaining 1/16. As late complications, pathologic changes of the macula were observed, with macular pucker and optic nerve atrophy.

Humans↗
PubMed1988

[Pars plana vitrectomy in chronic uveitis].

Statistical analysis of 54 eyes with chronical endogenous uveitis, mostly juvenile, treated with simple or combined pars plana vitrectomy. Most striking is the high frequency of localized or combined cyclitis with good functional results, although complications of the disease (retinal detachment, vasculitis, PVR, macular damage) are extremely frequent in cyclitis, and this group also includes, three cases of postoperative phthisis. The best argument in favor of an chronic uveitis is the fact that an overwhelming majority of the patients were able to switch from rigorous systemic preoperative medication to simple eye drops or no treatment at all.

Adult↗
PubMed1988

[Early vitrectomy with primary silicone oil injection in very severely injured eyes].

Performing early vitrectomy with primary silicone oil filling in 11 severely injured eyes (large or multiple intraocular foreign bodies, double perforations, ruptures - all with vitreous hemorrhage and retinal detachment), the authors succeeded in treating the posterior segment trauma with adequate hemostasis in ten cases. During postoperative follow-up of between 12 and 39 months there were no recurrences of hemorrhage. Primary retinal reattachment was achieved in seven eyes. A traction detachment due to proliferative vitreoretinopathy developed in three eyes at a relatively late stage (6-19 months postoperatively): reoperation was successful in two cases. With regard to functional results, six eyes had a visual acuity of between 1/25 and 0.6, and in four it was in the range between perception of light projection and hand movements. There were three cases with keratopathy encouraged by aniridia or hypotonia. One eye with emulsification of the silicone oil developed a secondary glaucoma which responded to topical treatment. In three cases the silicone oil was removed without complications. In one eye there was an expulsive choroidal hemorrhage which could not be managed intraoperatively and which led to phthisis and amaurosis postoperatively.

Adolescent↗
PubMed1986

[Pars plana vitrectomy in proliferative diabetic retinopathy].

In this contribution the authors present the results of treatment by pars plana vitrectomy in a consecutive series of 200 patients with proliferative retinopathy. Anatomical success was achieved in 82% of the cases of simple vitreous hemorrhages, in 63% and 67% respectively of the cases of traction detachment with or without vitreous hemorrhage, and in 55% of the cases of combined rhegmatogenous and traction detachment. Postoperative visual success was generally dependent on preoperative macular findings. Visual success was achieved in 71% of cases where the macula was attached preoperatively, as opposed to only 38% of the patients in whom it was preoperatively detached. Intraoperative retinal complications were less than 1% in cases of simple vitreous hemorrhage, rose to 13%-15% in cases of traction detachment and were quite common (32%) in cases of combined rhegmatogenous and traction detachment. A major goal of this paper was to show that anatomical and visual success as well as intraoperative complications were highly dependent on the degree of surgical difficulty and the stage of the disease. The results support the concept that vitreous surgery should be considered early in the late stages of proliferative diabetic retinopathy.

Diabetic Retinopathy↗
PubMed1986

[Vitrectomy: measures for the prevention of intraoperative complications].

Problems during a pars plana vitrectomy, such as infusion terminal within a detached choroid or behind the retina, and opacities of the cornea and lens may be prevented by simple means. These include introduction of the infusion terminal using a trocar; using a scleral ring for miniature contact lenses, which is fixed by sutures to the four rectus muscles; and in incipient opacification of the corneal epithelium, irrigation of the cornea with a solution of 50% glucose may render removal of the corneal epithelium unnecessary. Opacification of the cornea and lens can also be prevented by using glucose (500 mg/100 ml) in the intraocular irrigation solution.

Contact Lenses↗
PubMed1986

[Temporary silicone oil implantation following vitrectomy in proliferative diabetic retinopathy].

Report on 23 patients with proliferative diabetic retinopathy who underwent silicone oil implantation due to recurrent intravitreal hemorrhages following pars plana vitrectomy. Postoperatively, it was possible to perform panretinal laser photocoagulation without difficulty or haste. After an average period of 4 months, silicone oil was removed from 10 eyes. Subsequent hemorrhages in 4 of these eyes are due to diabetic retinopathy, not to silicone oil. In 6 cases, silicone oil removal is planned for the near future; in a further 7 cases, silicone oil removal has been postponed because of the potential danger of further traction retinal detachment.

Diabetic Retinopathy↗
PubMed2002

Attenuation of ocular wall pulsation in eyes containing a gas bubble after vitrectomy.

PURPOSE: To evaluate the effect of an intraocular gas bubble on ocular wall pulsation. METHODS: Eight patients that underwent vitrectomy with intraocular gas injection for various reasons were studied. Ocular pulsation was evaluated in a semi-quantitative way by means of Goldman applanation tonometry in both eyes before and after the operation. Vitreous cavity gas fill in the operated eye was estimated by means of indirect ophthalmoscopy and was correlated with ocular pulsation. The follow up lasted until the gas totally disappeared. RESULTS: Ocular pulsation disappeared postoperatively in the operated eye and gradually reappeared when the gas fill diminished. Pulsation returned to preoperative level when the gas disappeared from the vitreous cavity. A negative statistical correlation between ocular pulsation and gas fill could be documented. CONCLUSION: The compressible nature of the intraocular gas bubble results in absorption of the vascular pulsation and prevents its transfer to the ocular wall. This leads to attenuation or even cancellation of ocular wall pulsation when a gas bubble exists within the eye.

Eye↗
PubMed2003

Use of viscodissection and silicone oil in vitrectomy for severe diabetic retinopathy.

Improvement in surgical techniques has led to improved anatomic and functional success rates following surgery for severe complications of proliferative diabetic retinopathy (PDR). We compared the anatomic and functional outcomes of surgery in a non-randomized, consecutive case series of patients with severe PDR. We found that viscodissection using Healon provides outcomes comparable to conventional pick and scissors dissection. We also found that adjunctive use of silicone oil can salvage selected cases with particularly severe manifestations of PDR (e.g., the fibrinoid syndrome). With proper selection of patients and techniques, the anatomic success rate can exceed 80% even in the most severe cases. The goal of this paper is to show the applicability of using viscodissection and silicone oil infusion during vitrectomy in eyes with severe PDR.

Diabetic Retinopathy↗
PubMedDate not supplied

Diode laser, vitrectomy and intravitreal triamcinolone. A comparative study for the treatment of diffuse non tractional diabetic macular edema.

PURPOSE: To determine the effectiveness and safety of diode laser, pars plana vitrectomy (PPV) with gas tamponade, and intravitreal triamcinolone (IVT) as possible treatments for diffuse diabetic macular edema (dDME). To determine whether the new macular edema Classification previously proposed by some of the authors may help as a guide in the choice of treatment. METHODS: A retrospective, comparative study of 169 eyes with dDME that underwent treatment. The eyes divided into 3 groups: in the PPV Group, 59 eyes received PPV with gas tamponade; in the DIODE Group, 53 eyes received a laser grid; in the IVT Group, 57 eyes received an intravitreal injection of 4 mg of triamcinolone acetonide. The follow up ranged from 6 to 24 months. The eyes were classified according to the new DME Classification based on OCT. MAIN OUTCOMES: Change in foveal thickness as determined by Optical Coherence Tomography (OCT); change in visual acuity; intra and postoperative complications. RESULTS: Mean visual acuity (VA) improved at 3 months with every treatment. At one year only eyes which underwent PPV still had better VA than the pre-op value, while eyes which underwent IVT and laser treatment showed regression. PPV show the greater percentage of eyes which gain 3 or more lines of VA at one year (17%). Mean foveal thickness improved at 3 months with every treatment. Only the eyes into the PPV Group showed relatively low foveal thickness at one year. Better final VA and foveal thickness were obtained if preop VA is > or = 0.3 and if earlier stages of DME were treated according to the new DME Classification. PPV was the treatment which offered the most stable results with at one year or longer. Similar results were observed into the PPV Groups as a whole and into a subgroup of eyes with preoperative PVD. No complications were encountered with laser diode treatment. Long term complications into the IVT Group were elevated IOP (8%), retinal detachment (3.5%) and posterior cataract (15%). Long term complications into the PPV Group were retinal detachment (3.4%) and cataract (90%). CONCLUSIONS: Diode laser, PPV with gas tamponade and IVT are effective alternative treatments to decrease foveal thickness and improve visual acuity in eyes with DME. However while the results of PPV are stable in the long term follow-up, diode laser and IVT do not offer stable results. Complications may be severe with PPV and IVT. It is necessary to carefully select cases which would benefit from these types of treatments. The authors think that the OCT Classification may serve as a guide for the choice of treatment.

Aged↗
PubMed2006

Bartonella henselae bacilli detected in vitrectomy aspirates in a patient with massive vitreous opacity with total retinal detachment.

PURPOSE: To present endophthalmitis-like massive vitreous opacity as a manifestation of cat-scratch disease. METHODS: Report of a case. RESULTS: A 47-year-old man developed massive vitreous opacity and total retinal detachment in his right eye after a four-month period of uveitis, which was controlled with oral prednisolone. During the diagnostic vitrectomy, a massive fluffy white opacity adhering to the detached retina was shaved using a vitreous cutter. Further surgical procedures to reattach the retina were not pursued because of the poor state of the infected retina. Pathological examination of the vitreous aspirates revealed pleomorphic bacilli. The serological testing done at referral revealed an IgG titer positive for Bartonella henselae and culture of the vitreous proved the infection a month later. With a mixture of oral sulfamethoxazole (1600 mg daily) and trimethoprim (320 mg daily), the intraocular inflammation subsided. CONCLUSION: Rapid progression of massive vitreous opacity with total retinal detachment, mimicking endophthalmitis, can occur in cat-scratch disease.

Anti-Infective Agents↗
PubMed1999

Diagnostic vitrectomy and uveitis.

When properly used, diagnostic vitrectomy can be an extremely helpful procedure for establishing the etiology of ocular inflammation. New instruments have enabled more expedient and safer surgery. Analytical assays continue to improve in quality and quantity as our understanding of ocular diseases grows. Though no single assay is completely sensitive, a combination of assays may improve the yield and accuracy of diagnostic vitreous biopsy (Table 5). Keeping abreast of these advances may aid ophthalmologists in obtaining earlier diagnosis and better outcomes for their patients.

Biomarkers↗
PubMedDate not supplied

Pars plana vitrectomy for aphakic cystoid macular edema.

The authors used a combined limbal and pars plana vitrectomy approach to treat 17 consecutive eyes (16 patients) with chronic aphakic cystoid macular edema associated with vitreous incarceration in the cataract wound. Criteria for surgery included: decreased visual acuity to 20/50 or worse; cystoid macular edema confirmed by fluorescein angiography; persistent edema of 6 months or longer; and visible vitreous incarceration in the limbal wound. The vitreous was successfully removed from the limbal wound in 16 of 17 eyes. Postoperatively, vision improved by two lines or more in 11 eyes (65%). The surgical technique is described.

Adult↗
PubMedDate not supplied

Electroretinographic changes after vitrectomy and intraocular tamponade.

Electrophysiologic responses were tested in a series of 20 patients undergoing vitrectomy for recent rhegmatogenous retinal detachment. Patients required intraocular tamponade using either liquid silicone (10 patients mostly with giant tears) or 20% SF6-air mixture (10 patients with posterior retinal breaks or associated vitreous haemorrhage). Similar responses were obtained in both the silicone and the gas-tamponaded eyes; these showed progressive recovery and electroretinogram throughout the 6-month follow-up period. The recovery was accelerated by either absorption of the gas bubble or by the removal of liquid silicone.

Cryosurgery↗
PubMedDate not supplied

Pathologic study following vitrectomy for proliferative diabetic retinopathy.

This article details the pathologic findings in eyes removed postmortem from a diabetic man with proliferative retinopathy, vitreous hemorrhage, and tractional retinal detachment. Several years before death, to control hemorrhage from extraretinal vasoproliferative lesions, one eye only was treated with argon laser panretinal photocoagulation. Eight months before death the treated eye also was operated for tractional retinal detachment with current vitrectomy methods: membranotomy, partial peeling, and segmentation of preretinal membranes. Despite their atropic clinical appearance, the extraretinal lesions on pathologic study were "active." In the operated and nonoperated eyes the vascular and nonvascular proliferative lesions were of equal severity. The sclerotomy wounds were complicated by intraocular granulation tissue, focal granulomatous inflammation related to suture fragments, and intraocular hemorrhage.

Aged↗