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At least 1,621 records · Page 90Linked to original sources

PubMed1978

Pathogenesis of proliferative neovascular retinopathies and the role of vitrectomy. A hypothesis.

Proliferative neovascular retinopathies may be caused by the release of a hypothetical vasoproliferative factor, but mechanical factors seem to self-perpetuate the disease as well. Contraction of proliferative tissue causes vitreous detachment and traction on the retina. Congestion of vascular fronds by traction further stimulates vascularization. Traction on vessels results in hemorrhages. Surgical removal of all intravitreal scaffolds by vitrectomy seems to eliminate the development of this vicious cycle. Results of vitreous surgery seem to indicate that the hypothesis of scaffold removal is valid.

Diabetic Retinopathy↗

PubMed1983

The intraocular foreign body. Principles and problems in the management of complicated cases by pars plana vitrectomy.

In a retrospective study, the results of pars plana vitrectomy in treatment of injuries with intraocular foreign bodies were described. The patient material was subdivided into five different groups. In 41.6% of the cases, practical blinding could not be prevented. A visual acuity of 0.2 and better was present in 26.6% of the cases. The preoperative (45%) and postoperative (30%) traumatic retinal detachment have an extremely unfavorable prognosis with a reattachment rate of 40 or 21% respectively. The results in the treatment of injuries with magnetic splitters and their sequelae are very much better than those with nonmagnetic foreign bodies. The gunshot and air rifle pellet injuries were the most unfavorable group.

Eye Foreign Bodies↗

PubMed1981

[Quantitative chemical analyses on the material gained by vitrectomy (author's transl)].

The material gained by vitrectomy from 13 eyes suffering from different pathological changes of the vitreous body was analysed in relation to the concentrations of protein, lactic acid and glycogen, and standardized by means of a special method. The concentration of protein was found to have increased in cases of intravitreal haemorrhage, shrinkage of the vitreous body after complete spontaneous resorption of intravitreal haemorrhage, and in a case of intravitreal membranes following endophthalmitis; in cases of subvitreal haemorrhage the protein content was approximately normal. The concentrations of lactic acid and glycogen were examined to find out if anaerobic glycolysis could be proved in cases of ischaemic retinopathy. Only one case showed an increased concentration of lactic acid while in three cases there was a reduced content of glycogen. In these three cases the possibility of anaerobic glycolysis could not be excluded, because in rabbits a rapid excretion rate of increased lactic acid concentrations via retinal vessels has been reported.

Adult↗

PubMed1978

Iris fluorescein angiography in diabetic vitrectomy patients.

Preoperative iris fluorescein angiograms (IFA) and ophthalmic records of 34 diabetic patients who underwent vitrectomy were reviewed. Of 2 patients without clinically apparent rubeosis, 23 showed evidence of iris microvascular abnormalities or rubeosis on IFA. Patients with rubeosis (Grades III and IV) on IFA had a 63% incidence of postoperative neovascular glaucoma, thus isolating them as a high risk group. The visual outcome of patients developing neovascular glaucoma was poor.

Diabetic Retinopathy↗

PubMed1975

Histopathology after vitrectomy with the vitrophage.

A 72-year-old adult-onset diabetic woman underwent vitrectomy with the vitrophage because of persistent vitreous hemorrhage. Postoperatively a hyphema developed and elevation of intraocular pressure was refractory to medical management. Intraocular pressure was controllable within normal limits after vitreous lavage. Eleven days after vitreous lavage the patient died from pulmonary embolization. Histologic sections demonstrated a flat pars plana over the sclerotomy site with vitreous condensation along the internal aspect of the wound. Rubeosis iridis was postulated as the source of the hyphema. A hemolytic mechanism may have caused the elevated intraocular pressure.

Aged↗

PubMed1979

Ultrasonic vitrectomy - an alternative technique to presently used mechanical procedures. Experimental results.

The liquification of the corpus vitreum by ultrasound is a promising new alternative to presently used mechanical methods of vitrectomy. With regard to the duration time of insonation, as well as to the ultrasonic intensity, there exist thresholds, the exceeding of which causes a discontinuous breakdown of the vitreous frame in a spherical zone around the transducer tip which can be verified by ultrasonic pulse echo methods. Viscosity measurements showed that the vitreous isonified in this area has almost the same viscosity as water whereas its optical transparency remains unchanged. The dependence of the diameter of the liquified zone on insonation time was measured.

Animals↗

PubMed1975

Vitrectomy in exogenous Candida endophthalmitis.

A case of Candida endophthalmitis was clinically diagnosed three weeks after perforating injury. It was successfully treated with vitrectomy and intravitreal injection of 5 mcg of amphotericin B. A Candida speices was cultured from the vitreous aspirations.

Amphotericin B↗

PubMed1980

Anterior pars plana vitrectomy in ciliary and iris block glaucoma.

Ciliary and iris block glaucoma in aphakic and phakic eyes is characterized by the accumulation of aqueous humor in the vitreous cavity causing an increase in vitreous volume, a flattening of the anterior chamber, and an elevation of intraocular pressure. As vitreous blocks the space between the ciliary body and the iris or lens, respectively, an anterior vitrectomy via the pars plana is the logical surgical approach. This operation was performed in one phakic and 15 aphakic eyes with so-called pupillary block. The anterior chamber retained a normal depth in each case. Post-operatively the vitreous was found to be completely removed from the posterior chamber and the epiciliary space, rendering a free communication between the ciliary body and the posterior and anterior chamber. Early surgery in aphakic eyes with a flat anterior chamber resulted in a prompt normalization of intraocular pressure, whereas eyes with a block duration of over 4 weeks were at high risk of developing a secondary outflow resistance probably due to chronic angle closure.

Adult↗

PubMed1986

The treatment of difficult retinal detachments with an expanding gas bubble without vitrectomy.

In a prospective study on the use of perfluorocarbon gases (CF4, C2F6, C3F8) without prior mechanical vitrectomy, 51 retinal detachments that were not suitable for scleral buckling were treated by injection of a small bubble of gas into the vitreous to form a tamponade. There were 23 patients with giant tears, 16 with posterior holes, 9 with breaks at different latitudes, and 3 in whom the gas was used for diagnostic purposes. The gases were sustained at therapeutic volumes for 10-70 days. The tears were sealed with argon or krypton laser. The overall reattachment rate was 71%. Postoperative visual acuity improved or remained the same in all patients with reattached retina. In a follow-up of 1 year-38 months there were no late complications, such as cataract, glaucoma, keratopathy, or subsequent visual deterioration.

Adolescent↗

PubMed1987

The treatment of giant tear detachments using retrohyaloidal perfluorocarbon gases without drainage or vitrectomy.

In a pilot study, an expanding perflurocarbon gas was injected into the retrohyaloidal space for treating giant tear detachments. Using the balloon-gas procedure with a single gas injection, a bubble was obtained that was large enough to tamponade a giant tear without prior drainage of subretinal fluid or vitrectomy. The procedure was performed under subconjunctival anesthesia in order to preserve the patient's light perception, the fading of which served as a safeguard against excessive gas injection. The posterior hyaloidal membrane was only attached to the anterior flap of the tear and to the circumference of the retina anterior to the equator. The retrohyaloidal gas injection was not followed by star-fold formation or other evidence of preretinal proliferation. During the follow-up, the detached posterior hyaloidal membrane appeared to have collapsed on the anterior retina in concertina-like folds. Reattachment occurred in four of the five cases; no retina redetached during an average follow-up of 2 years.

Adult↗

PubMed1976

Resorption of intravitreal blood following vitrectomy.

Eight rhesus monkeys underwent unilateral vitrectomy and subsequent injection of blood into both vitreous cavities. There was no significant inflammation, cataract, delayed corneal healing, or elevated intraocular pressure. Blood in the operated eyes dispersed immediately while blood in the control eyes did not disperse until seven to 14 days after injection. All operated eyes showed more rapid clearing of blood than control eyes containing formed vitreous. This result occurred in the presence or absence of the crystalline lens.

Animals↗

PubMed1976

Pars plana vitrectomy for the management of sever diabetic retinopathy.

In 100 severely diseased diabetic eyes we performed pars plana vitrectomy. After a median follow-up time of seven months, major visual improvement was achieved in 49% of the eyes. An additional four eyes maintained a preoperatively good visual acuity resulting in an overall success rate of 53%. Eyes with only vitreous hemorrhages did better (71%) than eyes with posterior retinal detachments (31%). We did not observe new tissue proliferation in any of the operated eyes.

Cataract Extraction↗

PubMed1976

One hundred consecutive pars plana vitrectomies using the vitrophage.

One hundred consecutive eyes underwent vitrectomy with the disposable vitrophage via a pars plana approach. Eyes were divided into two main categories based on opacity location-in the anterior or posterior segment. Patients with posterior segment opacities had diabetic retinopathy, nondiabetic vitreous hemorrhages, retinal detachments associated with vitreous hemorrhage, bands, or membranes, and intraocular foreign bodies or silicone oil. Patients with anterior segment opacities were treated for pupillary membranes resulting from surgical trauma or perforating injuries, and for complications following cataract extraction, such as capsule breakage and vitreous loss. Postoperatively, visual acuity improved in 68% of eyes with posterior segment opacities and in 85% of eyes with anterior segment opacities. Overall, visual acuity was 20/300 or better in 45% of eyes. There were only two intraoperative retinal tears and one postoperative rhegmatogenous retinal detachment.

Anemia, Sickle Cell↗

PubMed1976

Corneal endothelial degeneration and fibrous proliferation after plana vitrectomy.

A 45-year-old woman with juvenile-onset diabetes had persistent corneal edema after a pars plana vitrectomy and lensectomy procedure. Phase contrast and electron microscopic observation of the patient's cornea revealed extreme attenuation of the endothelial cell layer and abnormal collagenous and basement membrane material interposed between Descemet's membrane and the endothelium. Endothelial fibrous proliferations in this case were consistent with the development of ultrastructurally identical fibrous proliferations in many other situations involving dysfunction of the corneal endothelium.

Basement Membrane↗

PubMed1976

Endophthalmitis after vitrectomy.

A 29-year-old white man with growth-onset diabetes developed fulminant endophthalmitis after vitreous lavage. The only significant symptom was severe pain 36 hours after surgery. The endophthalmitis rapidly became more severe. Despite systemic antibiotics, therapeutic vitrectomy and lensectomy, followed by the intraocular injection of antibiotics 48 hours postoperatively, the eye was lost.

Adult↗

PubMed1976

Severe perforating injuries treated with pars plana vitrectomy.

Forty-one patients underwent vitrectomy through the pars plana for sequelae of severe penetrating injuries. Almost all were inoperable by conventional techniques. After a minimum follow-up time of six months, 13 eyes (32%) had visual improvement and six (15%) were technical successes. The main cause for failure was intravitreal proliferation of fibrous tissue.

Adult↗

PubMed1976

Vitrectomy in the treatment of ocular perforating injuries.

Using pars plana (closed) vitrectomy with related procedures we achieved improved vision in certain catagories of perforating ocular injuries. These procedures were particularly useful in removing retained nonmagnetic foreign bodies and correcting retinal detachments associated with traction bands and opaque vitreous. Limited success was obtained with longstanding injuries, double perforations from shotgun injuries, and large corneoscleral lacerations. Early vitreous surgery produced the best results.

Adolescent↗

PubMed1977

Endophthalmitis after pars plana vitrectomy.

In three cases of bacterial endophthalmitis following pars plana vitrectomy the important diagnostic findings included increased orbital pain, decreased visual acuity, and the presence of a hypopyon. Despite agressive antibiotic therapy, all three eyes became blind, and two progressed rapidly to phthisis.

Adult↗