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At least 1,405 records · Page 78Linked to original sources
PubMed1993

Visual outcome after vitrectomy for diabetic retinopathy. A five-year follow-up.

For 5 years after surgery we measured visual acuity in 56 eyes that had undergone pars plana vitrectomy for proliferative diabetic retinopathy. A total of 44.7% eyes maintained improved visual outcome, 19.6% had unchanged visual acuity, and 35.7% were considered failures, as compared to preoperative measurements. Visual results obtained from each patient's visual acuity measured at 3 months, 6 months, 1 year, and 3 years after surgery were statistically compared with that obtained from the visual acuity at 5 years using the chi 2 test. Results showed that visual results recorded at 3 months and 6 months were significantly different from that recorded at the 5-year follow-up (p < 0.02, respectively). We found a tendency for the visual acuity to change during the initial 6 months after surgery and to stabilize by 1 year. Further analysis showed that the initial instability was due to the presence of preoperative retinal detachment. Postoperative visual functions also worsened with complications such as postoperative retinal detachment, glaucoma, and cataract formation.

Adult↗
PubMed2005

Vitrectomy with short term postoperative tamponade using perfluorocarbon liquid for giant retinal tears.

AIM: To determine the efficacy and safety of perfluorocarbon liquid as a short term postoperative tamponade in patients with retinal detachment from giant retinal tears. METHOD: A retrospective consecutive case series of patients with retinal detachment from giant retinal tears who underwent vitrectomy using perfluorocarbon liquid as a short term postoperative internal tamponade. The perfluorocarbon liquid was removed 5-14 days (mean 7.5 days) later and replaced by gas or silicone oil. Scleral buckling was performed in some cases with proliferative vitreoretinopathy. The crystalline lens was removed if there was interference with the surgical view or if it was subluxated. The success rate of retinal reattachment, visual outcome, and postoperative complications were assessed. RESULTS: A total of 62 eyes of 61 patients with a follow up of 8-69 months (mean 24.5 months) were included. All retinas were attached intraoperatively. 14 eyes (22.6%) developed re-detachment and additional operations were performed in 13 eyes. At final visit, 58 eyes (93.5%) had retinas that remained attached with visual acuity 6/12 or better in 27 eyes (46.5%). The visual acuity improved in 34 eyes (54.8%) with 28 eyes (45.2%) improving at least two Snellen lines, it was unchanged in 20 eyes (32.3%), and was worse in eight eyes (12.9%). Three patients developed glaucoma that was controlled medically. There was no retained perfluorocarbon liquid in any eyes. CONCLUSION: Perfluorocarbon liquid appears safe and effective to use as a short term postoperative tamponade in management of retinal detachment from giant retinal tears.

Adolescent↗
PubMed2006

Pars plana vitrectomy with peripheral retinotomy after injection of preoperative intravitreal tissue plasminogen activator: a modified procedure to drain massive subretinal haemorrhage.

AIMS: To report outcome of a modified procedure for draining massive subretinal haemorrhages (SRHs). METHODS: The charts of eight consecutive eyes from eight patients with massive SRHs extending to the periphery and involving two or more quadrants with haemorrhagic and bullous retinal detachment were reviewed. Tissue plasminogen activator (tPA) was injected intravitreally 12-24 h preoperatively; vitrectomy was carried out with peripheral retinotomy, drainage of the SRH from the retinotomy using perfluorocarbon liquid and gas tamponade with prone positioning postoperatively. RESULTS: The preoperative visual acuities ranged from light perception to 20/200. Most of the subretinal haematomas moved postoperatively to the vitreous cavity through the peripheral retinotomy using perfluorocarbon liquid. Residual SRHs were drained from the anterior chamber at the bedside after prone positioning overnight. SRH recurred in one eye 14 months postoperatively and was successfully retreated. No other serious complications developed. The final visual acuity improved in seven eyes (range 20/1000-20/60). Polypoidal lesions in choroidal vasculatures were present in three of seven patients. CONCLUSIONS: The technique seems safe and effective for treating massive SRH. However, visual recovery is limited by the underlying macular pathology. Polypoidal choroidal vasculopathy, other than age-related macular degeneration, may be another cause of massive SRHs.

Aged↗
PubMed2006

Pars plana vitrectomy with intravitreal triamcinolone: effect on uveitic cystoid macular oedema and treatment limitations.

OBJECTIVE: To investigate the effect of pars plana vitrectomy (PPV) in combination with intraoperative intravitreal triamcinolone acetonide injection on the course of cystoid macular oedema (CME) in patients with uveitis. METHODS: Patients with uveitis with CME (n = 19) not responding to systemic corticosteroids and/or immunosuppression combined with acetazolamide were retrospectively studied after PPV with additional intravitreal injection of 4 mg triamcinolone acetonide. Patients had chronic anterior uveitis (n = 4), intermediate uveitis (n = 9), posterior uveitis (n = 3) or panuveitis (n = 3). Visual acuity tests, tonometry, fluorescein angiographic appearance and postoperative complications were analysed. Mean follow-up was 14 months (SD 4.6). RESULTS: CME improved in 58% of the patients within the first 6 weeks postoperatively. After 12 months, CME was further improved in 44% and worsened in another 12%. Improvement of visual acuity was noted in 42% after 3 months and in 28% after 12 months. Cataract progressed in 85% of the phacic patients postoperatively. Increased intraocular pressure was detected in 27% at 2 weeks and in 11% at 12 months after surgery. CONCLUSION: Uveitic CME that is unresponsive to systemic immunosuppression and acetazolamide may improve after PPV with additional intravitreal triamcinolone application. The effect seems to be transient in many of the patients. Frequent complications were cataract formation and ocular hypertension.

Adolescent↗
PubMed1984

Vitrectomy and fluid/silicone-oil exchange for giant retinal tears: results at six months.

The results of vitrectomy combined with fluid/silicone-oil exchange in 73 eyes with giant retinal tears are reported at six months after surgery. Initial anatomical success was achieved in 71 out of 73 eyes (97%) and, prior to removal of silicone-oil, in 66 out of 73 eyes (90%). In 63 eyes (86%) the retina remained attached six months after surgery. Of these visual acuity was 6/60 or better in 44 (70%). The high proportion of eyes with macular detachment before surgery and the frequency of macular abnormalities are thought to account for reduced vision in many of the anatomically successful cases.

Adolescent↗
PubMed1985

Electroretinographic studies following vitrectomy and intraocular silicone oil injection.

Vitrectomy was performed bilaterally in pigmented rabbits and followed by silicone oil injection in one eye only. Electroretinographic studies were performed preoperatively and at selected postoperative intervals. In the early postoperative period both eyes showed an initial reduction in a and b wave amplitudes, followed by a return to baseline values. The amplitudes were symmetrically and equally affected. Sequential studies over a 20-month period showed no deterioration in electroretinographic response in eyes with and without silicone oil injection.

Animals↗
PubMed1985

Indications for vitrectomy in congenital retinoschisis.

Two patients with congenital retinoschisis developed rhegmatogenous retinal detachments with either a tractional component or associated vitreous haemorrhage. The second patient also had a large, raised schisis cavity under vitreous traction, which obscured visualisation of the macula. Vitrectomy is indicated for some patients with congenital retinoschisis.

Child↗
PubMed1985

Retinal detachment with proliferative vitreoretinopathy: surgical results with scleral buckling, closed vitrectomy, and intravitreous air injection.

Seventy-five cases of total retinal detachment complicated by the more advanced grades (grades C and D) of proliferative vitreoretinopathy were treated with scleral buckling, vitrectomy, and air-fluid exchange. The overall reattachment rate was 56%, ranging from 100% in grade C-1 to 26% in grade D-3. The postoperative visual acuity was 6/120 or better in 48% of the 42 eyes in which the retina was reattached. The major causes of surgical failure were redetachment from persistent vitreoretinal traction (32%) and intraoperative complications (12%).

Adolescent↗
PubMed1987

Acute glaucoma following vitrectomy and silicone oil injection.

Three cases are described of acute glaucoma following vitrectomy and silicone oil injection in proliferative vitreous retinopathy. The first case developed silicone-induced pupillary block in a phakic eye. Cases 2 and 3 developed elevated pressure in aphakic eyes with deep anterior chambers. Cases 1 and 3 were treated by laser iridectomy. Case 2 was treated by removal of silicone. The pathogenesis and treatment of these problems are discussed.

Aged↗
PubMed1988

Long-term visual results after pars plicata lensectomy-vitrectomy for congenital cataracts.

We performed a pars plicata lensectomy-vitrectomy on 32 patients (47 eyes) with congenital cataracts. Ocular abnormalities, mainly nystagmus, strabismus, and microphthalmia, were present in 29 patients. No complications occurred intraoperatively or postoperatively in 39 eyes with up to 8 1/2 years' follow-up (average 2.2 years). The pars plicata approach is a good surgical technique for the management of congenital cataracts.

Adolescent↗
PubMed1991

Nitrous oxide and internal tamponade during vitrectomy.

We analysed the nitrous oxide composition of the intraocular gas bubble following vitrectomy and fluid-air exchange in 12 patients. Samples were taken under standardised conditions at 20 minutes after completion of the fluid-air exchange. Analysis was conducted by a Medishield MS2 mass spectrometer. The percentage composition of nitrous oxide in the samples varied between 4 and 21% (mean 9%). This influx of nitrous oxide was associated with an increase of intraocular pressure. Pressure rises of greater than 20 mm Hg were not seen owing to venting of gas through the sclerostomies. An inverse relationship was noted between the extent of retinal detachment preoperatively and the amount of nitrous oxide entering the eye. A possible explanation for this relationship is proposed. The importance of nitrous oxide movement is stressed.

Adolescent↗
PubMed1991

Vitrectomy, argon laser, and gas tamponade for serous retinal detachment associated with an optic disc pit: a case report.

We report the case of a 9-year-old boy with a right optic disc pit and associated serous retinal detachment of the macula. This was treated by vitrectomy, endolaser, and gas tamponade as a primary procedure, which resulted in complete resolution. We review the literature and conclude that further reports of the management of this uncommon condition are required so that firmer guidelines on treatment can be established.

Child↗
PubMed1993

Removal of silicone oil following diabetic vitrectomy.

The outcome of the removal of silicone oil from previously vitrectomised diabetic eyes was studied in a series of 25 eyes in 24 patients. Originally the patients presented with complex retinal detachments associated with proliferative diabetic retinopathy and all had reattached retinas after the initial operation. During the silicone tamponade, a number of complications had occurred. Cataract had developed in 14 eyes, glaucoma in eight, and reproliferation of fibrous membranes in 12. After the removal of silicone the retina redetached in three eyes (in all cases associated with severe postoperative haemorrhage), hypotony occurred in five eyes (transiently in four) and the seven eyes remaining phakic developed a cataract. In spite of these problems the eventual visual acuities returned to the immediate post-vitrectomy levels in almost all the eyes.

Adolescent↗
PubMed2000

Risk factors for proliferative vitreoretinopathy after primary vitrectomy: a prospective study.

AIM: To assess clinical variables and vitreous protein as risk factors for the development of postoperative proliferative vitreoretinopathy (PVR). METHODS: A prospective study was conducted on 140 patients with a rhegmatogenous retinal detachment in whom a primary vitrectomy was performed. 12 clinical variables were recorded and vitreous samples obtained for measurement of protein concentration. Univariate and multivariate logistic regression analysis was used to determine the risk factors for PVR. RESULTS: Complete data were available for 136 of 140 patients. 40 of the 136 patients (29.4%) developed postoperative PVR. Univariate regression revealed that significant (p<0.05) risk factors included aphakia, presence of preoperative PVR, size of detachment, the use of silicone oil, and high vitreous protein level. Multivariate regression analysis revealed only aphakia (odds ratio 2.72), the presence of preoperative PVR (odds ratio 3.01), and high vitreous protein concentration (odds ratio 1.11) to be significant (p<0.05) independent, predictive risk factors for the development of PVR. CONCLUSIONS: This study has shown that the significant risk factors for PVR are preoperative PVR, aphakia, and high vitreous protein levels. Two models (clinical factors only and clinical factors and vitreous protein) were constructed to predict the probability of developing postoperative PVR and may be used to identify those at risk for possible intravitreal pharmacological treatment.

Adolescent↗
PubMed2001

Management of inferior retinal breaks during pars plana vitrectomy for retinal detachment.

AIMS: To determine whether it is necessary to support inferior retinal breaks with a scleral explant during pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RD). METHODS: A prospective study was carried out on nine eyes of nine consecutive patients undergoing PPV for primary RD with associated inferior retinal breaks and no significant proliferative vitreoretinopathy. RESULTS: Eight eyes were successfully reattached with a single operation. No cases presented with redetachment because of failed closure of the original inferior breaks. CONCLUSIONS: It is not necessary to support inferior retinal breaks with a scleral explant during PPV for primary RD repair in selected cases.

Adult↗
PubMed2003

Pars plana vitrectomy assisted by triamcinolone acetonide for refractory uveitis: a case series study.

AIM: To examine the outcome of a triamcinolone acetonide (TA) assisted pars plana vitrectomy (PPV) for refractory uveitis. METHODS: Six patients suffering from proliferative vitreoretinopathy (PVR) with refractory uveitis underwent a TA assisted PPV. The patients consisted of one with Vogt-Koyanagi-Harada disease, one with acute retinal necrosis, one with Behçet's disease, and three with sarcoidosis. TA was inoculated into the vitreous cavity to visualise the vitreous. In four of six patients, 4 mg of TA were intentionally left in the vitreous cavity to reduce the degree of postoperative inflammation. RESULTS: The vitreous body was clearly seen using TA during surgery, which greatly helped us to perform a posterior hyaloid resection safely and thoroughly. As we previously observed in other disease, TA allowed us to visualise the transparent vitreous and thus was helpful in removing the vitreous cortex from the retina completely in uveitis. One patient (Behçet's disease, in whom TA was intentionally left) showed an elevated intraocular pressure (IOP) transiently after surgery which was controllable by topical eye drops. The remaining TA diminished day by day and had almost completely disappeared within a month from operation. CONCLUSION: TA improved the visibility of the hyaloid and the safety of the surgical procedures and no serious complications were observed after TA assisted PPV in uveitis. Although the long term effects are still unknown, this method appears to be potentially useful as an improved treatment for PVR associated with refractory uveitis.

Adult↗