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At least 1,459 records · Page 81Linked to original sources

PubMed2001

[Cataract surgery in eyes treated with vitrectomy for idiopathic macular holes].

The authors evaluated the final functional results in 30 eyes where on account of nuclear and cortical cataract an intraocular lens was implanted. The operation was preceded by pars plana vitrectomy (PPV) with internal gas tamponade on account of an idiopathic macular hole (IMD). The cataract the development of which was recorded in 57 eyes was the manifestation of a late postoperative complication from a total number of 84 phakic eyes (67.9%) which were operated on account of IMD between April 1996 and June 1999. After cataract surgery the corrected visual acuity improved in 23.3% eyes. The investigation confirmed improvement and stabilization of the final corrected visual acuity in 24 eyes (80%) and confirmed the importance of these surgical procedures.

Aged↗

PubMedDate not supplied

Traumatic lens abscess with chornic endophthalmitis successfully treated with pars plana lensectomy and vitrectomy.

Intralenticular abscess is a rare entity and has been infrequently reported after surgery, metastatic infection, or trauma. We report a case of post traumatic lens abscess with low-grade endophthalmitis following a penetrating eye injury with a splinter of wood. The patient was successfully treated with a pars plana lensectomy and vitrectomy. Despite thorough microbiological investigations, no causative organism could be isolated.

Abscess↗

PubMed2001

[Pars plana vitrectomy in treatment of tractional edema of the macula].

We analysed the causes and the consequences of traction macular edema with the possibility of solution of this stage by pars plana vitrectomy with removal of vitreomacular traction and epiretinal macular membranes. An analysis of preoperative and postoperative findings of 4 patients was made. There were found idiopathic epiretinal membranes in 3 cases and vitreomacular traction syndrome in 1 case. We reported postoperative improvement of visual acuity in 3 cases, stabilisation of postoperative state was reached in 1 patient.

Adult↗

PubMedDate not supplied

Combined cataract surgery and vitrectomy for breakthrough vitreous hemorrhage from age-related macular degeneration.

PURPOSE: To report combined cataract extraction (CE), posterior chamber intraocular lens (PCIOL) implantation, and pars plana vitrectomy (PPV) for concurrent cataract and breakthrough vitreous hemorrhage from age-related macular degeneration (AMD). METHODS: Retrospective case series. RESULTS: Six eyes were included in the study. The postoperative follow-up interval ranged from 3 to 22 months (mean 8 months). Preoperative visual acuity (VA) ranged from 20/400 to hand motion. Postoperatively, 5/6 eyes had 2 or more lines of visual improvement. Three eyes were better than 20/200. CONCLUSIONS: Combined CE, PCIOL insertion, and PPV in selected patients with cataract and breakthrough vitreous hemorrhage from AMD was successful in improving VA in the majority of patients.

Aged↗

PubMedDate not supplied

Clinically significant corneal astigmatism and pars plana vitrectomy.

PURPOSE: To report a rare and previously unappreciated potential wound-related complication of repeat pars plana vitrectomy (PPV) combined with anterior segment surgery. METHODS: From a total of 135 patients who had undergone PPV over a period of 15 months, 7 patients were identified on the basis of a visually disabling degree of astigmatism persisting at 3 to 4 months following their surgery. These patients were retrospectively studied from the standpoint of the numbers and combination of procedures they had experienced. Videokeratoscopy was employed as an objective method of documenting the astigmatism. RESULTS: The average astigmatism at the corneal plane in these 7 eyes was 4.5 diopters (D). In the 5 patients who required suture lysis for visual rehabilitation, the average corneal astigmatism was slightly greater than 5.0 D. In all cases, the astigmatism was a symmetric "bow-tie" pattern and was in the meridian corresponding to the superonasal and inferotemporal sclerotomies. All 5 of the patients requiring suture lysis had undergone repeat PPV through the same sclerotomies; all had their astigmatism reduced to an average of 1.5 D. CONCLUSION: Visually disabling astigmatism present months after surgery is almost certainly a rare, wound-related complication of PPV, but remains a previously unappreciated possibility in eyes undergoing repeat procedures through the same sclerotomies. Videokeratoscopy provides a reliable and rapid method of detection, while suture lysis in the steep axis represents a simple remedy.

Aged↗

PubMed2000

[Combined triple/multi-surgery of vitrectomy-lensectomy and posterior chamber intraocular lens implantation].

OBJECTIVE: To study the feasibility and safety of the combined triple/multi-surgery of vitrectomy-lensectomy and posterior chamber intraocular lens implantation. METHODS: Triple/multi-surgery was performed on 32 eyes of 32 cases, including 29 cases of serious eye injuries of traumatic cataract, lens luxation, vitreous hemorrhage (some cases with intraocular foreign body, iris damage or iridodialysis), 1 case with lens nucleus dislocated into the vitreous cavity during the senile cataract surgery and 2 cases with intraocular lens luxated into the vitreous cavity postoperatively. RESULTS: After follow up for 1 - 14 months (mean 5.6 months), 15 cases had the best corrected visual acuity (BCVA) >or= 0.5 (46.9%), 11 cases had BCVA of 0.1 - 0.4 (34.4%), and 6 cases had BCVA < 0.1 (18.8%). There was an average of 2.10 DC of astigmatism after surgery. Macular edema was found in 14 cases (43.8%). CONCLUSIONS: The results suggest that the triple/multi-surgery be safe and feasible. The major causes affecting the postoperative BCVA are astigmatism and macular edema. Proper selection of indication and skillful manipulation are the key points of the combined surgery.

Adolescent↗

PubMedDate not supplied

Topical anesthesia with sedation in phacoemulsification and intraocular lens implantation combined with 2-port pars plana vitrectomy in 105 consecutive cases.

BACKGROUND AND OBJECTIVE: To evaluate the efficacy of topical anesthesia as an alternative to peribulbar or retrobulbar anesthesia in phacoemulsification and intraocular lens implantation combined with our modified 2-port pars plana vitrectomy technique (phacovitrectomy). PATIENTS AND METHODS: Phacovitrectomy using topical anesthesia (4% lidocaine drops) was prospectively performed in 105 eyes with cataract and varied vitreoretinal pathology. In 75 eyes (71.4%), phacovitrectomy was combined with argon laser photocoagulation (endolaser). Preoperative and intraoperative sedation of varying degrees was necessary. Subjective pain and discomfort were graded from 1 (no pain or discomfort) to 4 (severe pain and discomfort). RESULTS: All patients had grade 1 pain and discomfort during most of the procedure. All patients had grade 2 (mild) pain and discomfort during pars plana sclerotomies, external bipolar cautery, and conjunctival closure. No patient required additional retrobulbar, peribulbar, or sub-Tenon's anesthesia. CONCLUSION: This technique avoids the risk of globe perforation, retrobulbar hemorrhage, and prolonged postoperative akinesia of the eye. With appropriate case selection, topical anesthesia is a safe and effective alternative to peribulbar or retrobulbar anesthesia in phacovitrectomy.

Aged↗

PubMed2002

[Results of vitrectomy in cystoid diabetic macular edema detected by optical coherence tomography].

PURPOSE: To evaluate the surgical results of the pars plana vitrectomy (PPV) with separation of the posterior hyaloid (PH) with the cystoid diabetic macular edema (DME) using optical coherence tomography (OCT). METHODS: PPV with removing of the PH was performed in 10 eyes of 10 patients with cystoid DME. The macular structure, the vitreoretinal interface and the foveal thickness before and after PPV was evaluated using OCT and was correlated with a slit lamp biomicroscope. All 10 eyes had undergone panretinal and macular photocoagulation. RESULTS: OCT demonstrated postoperatively in all 10 eyes the regression of cystoid DME and the presence of foveal depression. Visual acuity (VA) has improved by 2 and more Snellen lines in 6 eyes with preoperative decrease of VA not longer than 5 months. CONCLUSIONS: PPV with separation of PH is efficient method in treatment of cystoid DME. Duration of cystoid DME is a significant factor for determination of functional prognosis. OCT facilitates the follow-up of the dynamics of regression of the structure and thickness of the fovea.

Adult↗

PubMed2002

[Availability of TPD ophthalmic solution (mixture of Mydrin-P solution, Neosynesin Kowa solution, and Diclod solution) in regard to the corneal barrier function--clinical evaluation for vitrectomy in patients with diabetic retinopathy].

PURPOSE: We made TPD ophthalmic solution by combining Tropicamide solution(Mydrin-P: T), Phenylephrine Hydrochloride(Neosynesin Kowa solution: P) and Diclofenac Sodium(Diclod solution: D), and evaluated its efficiency in terms of corneal epithelial damage in patients with diabetic retinopathy. SUBJECTS AND METHODS: Five patients(10 eyes) who were to undergo vitrectomy were enrolled in this study. They each received T, P, and D 6 times and TPD solution in the same way. Before and after the instillation, superficial punctate keratopathy (SPK) was evaluated and corneal epithelial permeability was determined by anterior fluorophotometry. RESULTS: After the instillation of T, P, and D, corneal damage increased in all eyes. After the instillation of TPD, three eyes showed only one grade change up in AD(A: area, D: density) classification of SPK. The fluorescein uptake change between pre- and post-instillation was 457.5 +/- 468.8 (mean +/- standard deviation) ng/ml with T, P, and D and 100.5 +/- 235.6 ng/ml with TPD(p < 0.01). CONCLUSION: TPD solution decreases both corneal epithelium damage and barrier function change of corneal epithelium.

Adult↗

PubMed2003

[Endogenous mycotic endophthalmitis and pars plana vitrectomy (PPV)].

PURPOSE: To report clinical findings, diagnostic and treatment possibilities of patients with endogenous fungal endophthalmitis (EFE). METHODS: Retrospective study of 13 patients (19 eyes) with EFE diagnosed and treated in the Dept. of Ophthalmology, 1st Medical Faculty, Charles University in Prague. A detailed personal medical history was taken in all patients. Standard ophthalmic examinations were performed in all cases. RESULTS: All of our patients had one or more of known risk factors for ocular fungal infections. There were intravenous drug users, immunosuppressed patients, postoperative patients receiving broad-spectrum antibiotics in our investigated group. The mean age of the patients was 39 years (from 19 to 68 years), the interval between the first ocular symptoms and correct diagnosis was up to 7 months (mean 2.1 months). Pars plana vitrectomy (PPV) was performed in 15 eyes and Amphotericin B was instilled into vitreous cavity at the end of the procedure. Amphotericin B was injected into vitreous without PPV in two eyes. All patients were treated with systemic antifungal agents. Only Candida albicans was the cause of EFE in 10 patients. Microscopic examination and culture were positive in 9 patients, 1 patient had positive serum antibodies against Candida albicans in significant titres. Final visual acuity improved in 47% of the eyes, stabilized in 36% of the eyes, and decreased in 17% of the eyes. CONCLUSION: Endogenous fungal endophthalmitis was seen as an opportunistic disease in all patients. Candida albicans was the only evidenced cause of fungal endophthalmitis. If prompt antifungal treatment after clinical suspicion of EFE begins, successful visual outcome is possible.

Adult↗

PubMed2003

[Cataract surgery in eyes after vitrectomy filled with long-term silicone oil tamponade].

PURPOSE: Evaluation of the results of cataract extraction in eyes filled with silicone oil. MATERIAL AND METHODS: Twenty-nine eyes of 29 patients underwent cataract extraction without intraocular lens implantation, in eyes after vitrectomy filled with silicone oil. The average time of silicone oil tamponade was 3.5 years (range from 10 months to 6 years). The mean follow-up was 26.1 +/- 17.5 months. RESULTS: Useful visual acuity was achieved in 55% eyes. The main complication was the increased intraocular pressure, which appeared in 38% eyes. CONCLUSION: Cataract surgery in eyes with long-term silicone oil tamponade get benefit, because it enables restoring the useful visual acuity. More advanced retinal pathology and silicone oil tamponade increase the number of complications.

Adult↗

PubMedDate not supplied

Pars plana lensectomy, pars plana vitrectomy, and silicone oil tamponade as initial management of cataract and combined traction/rhegmatogenous retinal detachment involving the macula associated with severe proliferative diabetic retinopathy.

BACKGROUND AND OBJECTIVES: To evaluate visual acuity and anatomic outcomes, and complications, following pars plana lensectomy, pars plana vitrectomy, and silicone oil tamponade (PPL/PPV/SO) in the initial management of cataract and combined traction/rhegmatogenous retinal detachment involving the macula associated with severe proliferative diabetic retinopathy (PDR). PATIENTS AND METHODS: Retrospective, noncomparative, consecutive case series including all patients who underwent PPL/PPV/SO for the initial management of cataract and traction/rhegmatogenous retinal detachment involving the macula associated with severe PDR at Bascom Palmer Eye Institute between 1989 and 2000. Main outcome measures included visual acuity and rates of retinal reattachment and reoperation. RESULTS: The study included 22 eyes of 22 patients. The mean follow-up was 15.2 months. Preoperatively, 13 of 22 (59%) fellow (non-study) eyes had vision of light perception or worse, and 7 (32%) had vision of no light perception. The number of study eyes with a best-corrected vision of 20/400 or better increased from 5 (23%) preoperatively to 12 (55%) at 6 months (P < .05) and 15 (68%) at final follow-up (P < .05). The macula was attached at final follow-up in 20 (91%) eyes. In 14 (64%) eyes, silicone oil was removed at a mean of 8.4 months following retinal detachment repair; postoperative vision was 20/400 or better in 11 (79%) of these eyes at 6 months and 13 (93%) at final follow-up. In contrast, only 1 of 8 (13%) eyes with retained silicone oil achieved a postoperative vision of 20/400 or better (P < .05). CONCLUSIONS: Initial management with PPL/PPV/SO can achieve favorable anatomic and visual outcomes in selected patients with cataract and traction/rhegmatogenous retinal detachment involving the macula associated with severe PDR. This surgical approach should be especially considered in patients with traction/rhegmatogenous retinal detachment involving the macula in one eye and poor vision in the fellow eye.

Adult↗

PubMed2003

[Pars plana vitrectomy and primary implantation of silicone oil in the treatment of acute exogenous endophthalmitis in eyes without retinal detachment].

UNLABELLED: Acute exogenous endophthalmitis (AEE) is the most serious post-traumatic or postoperative complication which without immediate treatment leads to amaurosis or anatomical loss of the eye. If comprehensive antibiotic treatment fails immediate pars plana vitrectomy (PPV) is indicated. Empirically and later also by laboratory methods the antiinflammatory effect of silicone oil (SO) was revealed. The objective of the present retrospective study is to demonstrate anatomical and functional results of PPV with implantation of SO for AEE on eyes without detachment of the retina. In 1990-2000 the authors operated a total of 22 eyes of 22 patients with AEE. The mean age of the patients was 59.6 years, the mean observation period 35.5 months. In 17 eyes postoperative and in 5 eyes post-traumatic AEE was involved. The mean interval between the original operation and PPV was 20.8 days and between the injury and PPV 5.4 days. In all patients we took at the beginning of PPV specimens of the vitreous body for cultivatin which gave in 63.6% a positive result. The intraocular lens was explanted in 81.8% eyes. After subtotal resection of the vitreous body we implanted SO and in all aphakic eyes we performed iridectomy in no. 6. PPV was completed by administration of vancomycin and ceftazidime into the vitreous space. In 95.4% of the eyes we preserved anatomically the bulbus, in one instance we eviscerated the bulbus three days after failure of PPV (4.6%). In 86.4% the retina remained anatomically attached and in the remaining 9% eyes beneath the SO traction detachment of the retina developed. Visual acuity improved in 72.7% eyes, it remained unchanged in 9.1% eyes and deteriorated in 18.2% eyes. Silicone oil was explanted in 40.9% eyes after a mean interval of 4.6 months following PPV. In the remaining patients we did not indicate explantation of SO, in particular because of the patients' advanced age, CONCLUSION: We recommend PPV and implantation of SO in AEE on eyes without detachment of the retina as the method of choice.

Acute Disease↗

PubMed2003

[Primary pars plana vitrectomy in the treatment of penetrating eye injuries involving intraocular foreign bodies in the vitreous body ].

The method of choice in the treatment of penetrating eye injuries affecting the vitreous body with an intraocular foreign body is in the majority of patients primary pars plana vitrectomy with transvitreal extraction of the foreign body (FB). During the period from April 1999 till September 2000 the authors treated thus at the Ophthalmological Clinic of the General Faculty Hospital and 1st Medical Faculty Charles University Prague 26 eyes of 26 young men with an average age of 34 years. The mean interval between the injury and primary PPV was 8.5 days. The patients were followed up on average for 23.5 months. The entrance of the penetrating injury was in 17 eyes in the cornea or limbus, in 9 eyes in the sclera. In two eyes posttraumatic endophthalmitis developed. The intraocular FB was 6 mm2 in size in 16 eyes and 6-20 mm2 in 10 eyes. In primary PPV we indicated in 14 eyes internal tamponade with gas or silicone oil. On account of late retinal complications which developed as a result of proliferative vitreoretinopathy we indicated in eight eyes PPV reoperation. At the end of the investigation period in 3 eyes inoperable detachment of the retina developed. As the main negative prognostic factor for final visual acuity the authors evaluated a size of the FB greater than 6 mm2, other negative prognostic factors are the scleral entrance injury, complications of the entrance injury (prolapse of the iris, vitreous body, haemophthalmus) and the development of posttraumatic exogenous endophthalmitis.

Adult↗

PubMed1992

[Vitrectomy combined with intravitreal injection of drugs for the management of advanced suppurative endophthalmitis].

Sixty cases (60 eyes) of advanced suppurative endophthalmitis treated by a combination of vitrectomy and intravitreal injection of drugs (antibiotics or/and corticosteroids) were investigated perspectively. Of the 60 cases, 43 were infected after trauma, 12 were infected after surgical procedures, while the others were of unknown causes. During the follow-up period of 1/2-5 years, 57 cases (95%) retained functioning eyes, the postoperative visual acuity of 34 eyes (57%) being 0.05 or better and the postoperative visual acuity of 17 eyes (28%) 0.4 to 1.0. The advantages of the therapeutic regimen are analyzed. We believe that it is the most effective therapy for suppurative endophthalmitis. The timing of the operation and the factors influencing the results are discussed. This report also presents our clinical experiences in the management of advanced suppurative endophthalmitis.

Adolescent↗

PubMed1991

[Pars plana vitrectomy in proliferative diabetic retinopathy. Long-term results and prognostic parameters in diabetics with surgery 1983-1989].

The authors evaluated the long-term results and prognostic parameters of pars plana vitrectomy (PPV) in complications of proliferative diabetic retinopathy in 235 eyes of 187 diabetics operated between Jan. 1 1983 and June 30 1989. In 117 eyes PPV was combined with implantation of silicon oil. During an average observation period of 27 months PPV improved markedly the visual acuity of 125 eyes (53.2%), however a visual acuity of 0.1 or better acuity was recorded only in 53 eyes (22.6%). The number of successfully operated eyes declined with the length of the observation period from 67.7% after three months to 50% after 60 months. Active vascular proliferation, iatrogenic fissures of the retina, implantation of silicone oil and postoperative development of rubeosis were statistically significant adverse factors from the prognostic aspect. With the development of new surgical procedures the importance of different prognostic factors changes partly.

Adult↗

PubMed1992

[Persistent hyperplastic primary vitreous. Middle-term results of vitrectomy].

In this study, the authors present a homogeneous series of seven children suffering from persistent hyperplastic primary vitreous, in its complete anterior and posterior form. These children were operated by pars plana lensectomy and vitrectomy. The surgical operation was beneficial in every case: not only were there no complications, but the operation also prevented progression towards neovascular glaucoma, vitreous hemorrhages and phtisis bulbi. In addition, one of the benefits of this technique was esthetic, with the disappearance of leucocoria, the occasional correction of strabismus and the reduction in microphthalmos. Visual recovery can be surprisingly good, in the absence of any associated retinal malformation.

Eye Abnormalities↗

PubMed1992

[Long-term results of successful surgical treatment of retinal detachment by vitrectomy and silicone oil injection. Effect of removal of the tamponade on further complications].

We present, with a minimal follow up of six months, the results of 118 silicone oil removals following successful treatment of retinal detachment by pars plana vitrectomy and silicone oil injection. A recurrent retinal detachment occurred in 8.5% of cases, 13% of the 61 phakic eyes at the time of silicone oil removal maintained a clear lens, 29.6% of the eyes had a raised intraocular pressure and 6.8% had a keratopathy. The visual acuity improved in 72.8% of eyes after silicone oil removal. The main reasons for a late decrease in visual acuity were recurrence of the detachment, hypertonia, chronic hypotonia and keratopathy. All the eyes with late complications after silicone oil removal had a clinically significant droplet dispersion in the anterior chamber. Only complete and early silicone oil removal seems to decrease the complication rate.

Adolescent↗