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At least 19 recordsLinked to original sources
PubMed1988

Early vitrectomy for severe proliferative diabetic retinopathy in eyes with useful vision. Clinical application of results of a randomized trial--Diabetic Retinopathy Vitrectomy Study Report 4. The Diabetic Retinopathy Vitrectomy Study Research Group.

Six patients are described, each of whom underwent early vitrectomy for advanced, active, proliferative diabetic retinopathy (PDR) in an eye with useful vision. These cases were selected to illustrate the spectrum of retinopathy severity for which early vitrectomy should be considered and the favorable outcome that can follow this procedure. None of the eyes that had an unfavorable result after early vitrectomy is presented. The eyes most suitable for early vitrectomy are those in which both fibrous proliferations and at least moderately severe new vessels are present, and in which extensive scatter photocoagulation has already been carried out or is precluded by vitreous hemorrhage.

Adult↗
PubMed1988

Early vitrectomy for severe proliferative diabetic retinopathy in eyes with useful vision. Results of a randomized trial--Diabetic Retinopathy Vitrectomy Study Report 3. The Diabetic Retinopathy Vitrectomy Study Research Group.

Three hundred seventy eyes with advanced, active, proliferative diabetic retinopathy (PDR) and visual acuity of 10/200 or better were randomly assigned to either early vitrectomy or conventional management. After 4 years of follow-up, the percentage of eyes with a visual acuity of 10/20 or better was 44% in the early vitrectomy group and 28% in the conventional management group. The proportion with very poor visual outcome was similar in the two groups. The advantage of early vitrectomy tended to increase with increasing severity of new vessels. In the group with the least severe new vessels, no advantage of early vitrectomy was apparent.

Adult↗
PubMed1976

Vitrectomy in endophthalmitis. Results of study using vitrectomy, intraocular antibiotics, or a combination of both.

A rabbit model of endophthalmitis was produced by inoculating Staphylococcus epidermidis and S aureus into the vitreous cavity. Elimination of microorganisms was compared using intravitreal administration of 0.1 mg of gentamicin alone, vitrectomy alone, and a combination of gentamicin and vitrectomy. In the case of S. epidermidis treated 24 hours after inoculation, all untreated eyes were culture-positive at one week, eyes treated with gentamicin alone or intravitreal gentamicin in combination with vitrectomy were all culture-negative, and vitrectomy alone rendered half of the eyes culture-negative. In the case of S aureus, eyes not treated by vitrectomy alone were all culture-positive at one week. Eyes treated with intravitreal gentamicin 25 to 31 hours after infection were culture-negative for S aireus in 33% at one week, while eyes treated with combined vitrectomy plus intraocular gentamicin were culture-negative in 83% of cases. When treatment was delayed 40 to 49 hours after inoculation of S aureus, intravitreal rendered 50% culture-negative at one week, while vitrectomy combined with intravitreal gentamicin eliminated the infection in 100% of eyes.

Animals↗
PubMed1990

Early vitrectomy for severe vitreous hemorrhage in diabetic retinopathy. Four-year results of a randomized trial: Diabetic Retinopathy Vitrectomy Study Report 5.

Six hundred sixteen eyes with recent severe diabetic vitreous hemorrhage reducing visual acuity to 5/200 or less for at least 1 month were randomly assigned to either early vitrectomy or deferral of vitrectomy for 1 year. The proportion of eyes with visual acuity of 10/20 or better was higher in the early vitrectomy group than in the deferral group throughout the 4-year follow-up period. Up to the 18-month visit, the early group had a higher proportion of eyes with visual acuity of no light perception. An increased chance of obtaining good vision with early vitrectomy was clearly present in the type I diabetes group, particularly in patients who developed severe vitreous hemorrhage after less than 20 years of diabetes, a patient group tending to have more severe proliferative retinopathy. This advantage was not found in the type II diabetes group, in which patients were older and tended to have less severe retinopathy. The findings of this and previous Diabetic Retinopathy Vitrectomy Study reports support early vitrectomy in eyes known or suspected to have very severe proliferative diabetic retinopathy as a means of increasing the chance of restoring or maintaining good vision.

Adult↗
PubMed1975

Vitrectomy from the anterior approach. Vitrectomy for the anterior segment surgeon.

There are three basic needs for a vitrector or vitreophage. One is for the anterior segment surgeon so that he may have a machine available when vitreous is lost during anterior segment surgery and may spare himself the hazards and potential complications of doing vitrectomy solely with cellulose sponges. The simplified vitrector which is disposable, sterile, and rapidly made ready ideally serves this need in a way which is not served by any other technique. Two, the removal of normal vitreous may be necessary in patients with vitreous contact, and any type of vitreous removing machine may be useful for this. The vitrector we have worked with is simple and satisfactory, and has the potential advantage of having blades which are always sharp and always pushed firmly against the cutting edge of the hole since they are disposable and inexpensive. An infusor as well as simple cutting tips are available. Three, vitrectomy for serious vitreous pathology can be done with the simple vitrector through the anterior segment approach if the lens is absent or will be removed, and if heavy pre-retinal and vitreous bands are not present. For the handling of diabetic retinopathy and sheets of vitreous membranes which appear organized, other equipment may be superior.

Cellulose↗
PubMedDate not supplied

Pars plana vitrectomy. Vitrectomy in diabetic retinopathy.

In spite of the rather high rate of complications, it is clear that in selected cases of proliferative diabetic retinopathy with massive long-standing vitreous hemorrhage, significant improvement can be accomplished by pars plana vitrectomy. However, the number of eyes recovering 20/40 vision or better remains small (7% in our series at 9 to 15 months postvitrectomy), and consideration needs to be given to means to improve these figures. Whether vitrectomy at an earlier stage of the retinopathy can accomplish this is the subject of an upcoming cooperative study under the sponsorship of the National Eye Institute.

Cataract Extraction↗
PubMedDate not supplied

Pars plana vitrectomy. The role of vitrectomy in traumatic vitreopathy.

Debridement of the vitreous from perforating injuries can be more effectively and expeditiously accomplished with the aid of vitreous suction and cutting instruments than with conventional sponge-forceps technique. This technique is of great value as part of primary closure of perforating ocular injuries. In addition, trauma which results in (1) lens rupture with expulsion of the lens material into the vitreous; (2) massive vitreous hemorrhage with ciliary body laceration or posterior globe laceration; (3) retinal detachment with vitreous hemorrhage; or (4) retained reactive intraocular foreign body, requires vitrectomy. Because of inflammatory and fibroplastic changes, the earliest possible surgical intervention is recommended in these situations. Removal of lens material, reactive foreign body, or traction membranes, and early repair of retinal detachment may all be facilitated by new vitrectomy instrumentation.

Adult↗
PubMedDate not supplied

Pars plana vitrectomy. Vitrectomy treatment of vitreous opacities.

Twenty-one patients suffering from vitreous opacities caused by central- and branch-vein occlusion, sickle cell retinopathy, retinal vasculitis, endophthalmitis, hypertensive retinopathy, and uveitis underwent pars plana vitrectomy with the vitrophage. Intraoperative complications included retinal tears in two eyes with sickle cell retinopathy and tractional retinal detachment. Both were successfully treated. Postoperative complications were recurrent vitreous hemorrhage, hemolytic glaucoma, and corneal blood staining in a patient suffering from sickle cell retinopathy. Long-standing corneal edema was observed in patients suffering from endophthalmitis. Visual acuity improved in 95% of our patients and was worse in 5% of the patients.

Aged↗
PubMedDate not supplied

Pars plana vitrectomy. The role of vitrectomy in penetrating ocular injuries.

Pars plana vitrectomy and related procedures occupy an important role in the management of perforating injuries. Vitreous surgery is particularly important in rendering retinal detachments observable and operable. The frequent postvitrectomy complication of delayed retinal detachment appears to be reduced with prophylactic encircling scleral buckle procedures. Although certain categories of injuries continue to carry a poor prognosis, earlier surgical intervention promises improved results.

Eye Injuries↗
PubMedDate not supplied

Pars plana vitrectomy. Vitrectomy technique in anterior segment surgery.

Instrumentation and techniques developed primarily for vitreoretinal surgery were used to treat 20 eyes with an occluded or inadequate pupillary space and 5 aphakic eyes with complications caused by formed vitreous in the anterior chamber. A pars plana approach was used in 19 eyes and a limbus approach was used in 6 eyes. In every eye an adequate pupillary space was provided and all formed vitreous was removed from the anterior segment. No intraoperative complications occurred. This new approach to selected cases of anterior segment surgery offers several advantages over conventional techniques. A larger number of cases and longer period of follow-up are necessary to further define the specific indications and limitations of this technique.

Cataract Extraction↗
PubMed1992

Pars plana vitrectomy in the Early Treatment Diabetic Retinopathy Study. ETDRS report number 17. The Early Treatment Diabetic Retinopathy Study Research Group.

BACKGROUND: The Early Treatment Diabetic Retinopathy Study (ETDRS) enrolled 3711 patients with mild-to-severe nonproliferative or early proliferative diabetic retinopathy in both eyes. Patients were randomly assigned to aspirin 650 mg/day or placebo. One eye of each patient was assigned randomly to early photocoagulation and the other to deferral of photocoagulation. Follow-up examinations were scheduled at least every 4 months, and photocoagulation was initiated in eyes assigned to deferral as soon as high-risk proliferative retinopathy was detected. Aspirin was not found to have an effect on retinopathy progression or rates of vitreous hemorrhage. The risk of a combined end point, severe visual loss or vitrectomy, was low in eyes assigned to deferral (6% at 5 years) and was reduced by early photocoagulation (4% at 5 years). Vitrectomy was carried out in 208 patients during the 9 years of the study. This report presents baseline and previtrectomy characteristics and visual outcome in these patients. METHODS: Information collected at baseline and during follow-up as part of the ETDRS protocol was supplemented by review of clinic charts for visual acuity and ocular status immediately before vitrectomy. RESULTS: Vitrectomy was performed in 208 (5.6%) of the 3711 patients (243 eyes) enrolled in the ETDRS. The 5-year vitrectomy rates for eyes grouped by their initial photocoagulation assignment were as follows: 2.1% in the early full scatter photocoagulation group, 2.5% in the early mild scatter group, and 4.0% in the deferral group. The 5-year rates of vitrectomy (in one or both eyes) were 5.4% in patients assigned to aspirin and 5.2% in patients assigned to a placebo. The indications for vitrectomy were either vitreous hemorrhage (53.9%) or retinal detachment with or without vitreous hemorrhage (46.1%). Before vitrectomy, visual acuity was 5/200 or worse in 66.7% of eyes and better than 20/100 in 6.2%. One year after vitrectomy, the visual acuity was 20/100 or better in 47.6% of eyes, including 24.0% with visual acuity of 20/40 or better. CONCLUSIONS: With frequent follow-up examinations and timely scatter (panretinal) photocoagulation, the 5-year cumulative rate of pars plana vitrectomy in ETDRS patients was 5.3%. Aspirin use did not influence the rate of vitrectomy.

Adult↗
PubMed1991

[Extracapsular cataract extraction and implantation in the capsular sac during vitrectomy in diabetics].

Removal of the lens is often performed during pars plana vitrectomy for complications of proliferative diabetic retinopathy, but correction of aphakia often remains unsatisfactory. Some authors have reported posterior chamber intraocular lens implantation during pars plana vitrectomy in diabetic patients who presented with coexisting cataract and vitreoretinal complications from proliferative diabetic retinopathy. Some patients were operated by pars plana lensectomy and vitrectomy followed by posterior chamber intraocular lens implantation in the ciliary sulcus, others by extracapsular extraction, posterior chamber intraocular lens implantation in the ciliary sulcus, and pars plana vitrectomy. Other authors have described phacoemulsification through the limbus, pars plana vitrectomy and implantation in the capsular bag in one operation in various indications, including complications of proliferative diabetic retinopathy. We inserted a posterior chamber intraocular lens into the capsular bag in 18 eyes of 16 patients with complications of proliferative diabetic retinopathy after extracapsular cataract extraction and pars plana vitrectomy in a single session. A standard extracapsular cataract extraction was performed before pars plana vitrectomy. Sufficient anterior capsule was left in place in order to facilitate implantation in the capsular bag after pars plana vitrectomy. The anterior chamber was filled with sodium hyaluronate in order to maintain anterior chamber depth, corneal clarity, and good mydriasis during the continuation of the procedure. A standard three port pars plana vitrectomy was performed in all cases. After closure of superior sclerotomies, superior corneal incision was partially reopened, an intraocular lens specifically designed for the capsular bag with an optic size of 7 mm was inserted, and the corneal incision was closed with interrupted 10/0 sutures.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1976

Vitrectomy in sickling retinopathy: report of five cases.

The unique problems encountered in sickle patients include the need to remove peripheral vitreous if perfusing sea fans-which can bleed after vitrectomy-are present at the time of surgery. However, peripheral vitrectomy is riskier than central vitrectomy alone. If visualization of the sea fans is sufficient, it is safer to close the sea fans prior to vitrectomy in order to obviate the need for peripheral vitrectomy; then, only central vitrectomy is performed. When sea fans cannot be closed prior to vitrectomy, peripheral vitreous is removed to allow early photocoagulation of the sea fans before they bleed again. Four case presentations illustrate these principles. Vitrectomy relieved severe vitreous traction that complicated retinal detachment in the fifth patient, thereby eliminating the need for a tight encircling structure, which can be poorly tolerated in patients with SC hemoglobin.

Adult↗
PubMed1979

Vitrectomy in penetrating ocular trauma: an experimental study using rabbits.

To study the value and the proper timing of vitrectomy in cases of ocular trauma involving the posterior segment, 24 rabbit eyes were traumatized by introducing a steel foreign body and autogenous blood into the vitreous. Twelve eyes underwent vitrectomy, 6 in the first week after trauma ("early") and 6 in the fourth week ("late"). The other 12 eyes, which underwent removal of the foreign body but not vitrectomy, served as controls. Traction retinal detachment did not develop in the 6 early-vitrectomy eyes, but it did occur before vitrectomy in 4 of the 6 eyes of the late-vitrectomy group and in 6 of the 12 control eyes. Iatrogenic cataract and retinal breaks were twice as frequent in the late as in the early group. The data seem to favor early vitrectomy in eyes with posterior-segment trauma. However, in routine clinical practice we advise prompt primary repair and exploration to evaluate the extent of posterior-segment damage, and vitrectomy within 14 days after injury.

Animals↗
PubMedDate not supplied

[Value of vitrectomy in intermediate uveitis and Behçet's disease with hyalitis. A study of 400 cases].

Can vitrectomy help to understand the vitreous role in intermediate uveitis and Behçet's disease with vitritis without retinal detachment? 400 vitrectomies were decided because of vitreous changes but, over all, if macular changes were seen clinically or on the angiogram in 58 Behçet's disease and 342 intermediate uveitis including 59 children cases. Visual acuity, clinical, angiographical and visual field controls, recurrences, reduction of the medical treatment and growth were followed during 1 to 9 years. The vitrectomy products were compared to those of other inflammatory origin vitreous, the both representing 149 cases. Vitrectomy at the early stage of only posterior interface changes prevent the macular edema but this one is irreversible. The preexisting angiographical lesions have not regressed but they are generally quiet. The RD incidence is lower even if it is possible after vitrectomy, in 1.2% of the cases (1% in late vitrectomies). Recurrences and further medical treatment are reduced. This psychological point of view is important. Thus, vitrectomy at alone posterior interface change stage avoid ocular complications. Its pathogenic role in intermediate uveitis is not demonstrated; it seems more a secondary than a primary process.

Adult↗
PubMed1990

Pars plana vitrectomy for acute retinal detachment in penetrating ocular injuries.

We studied 41 eyes with acute retinal detachment after penetrating ocular trauma in a retrospective cohort analysis. Pars plana vitrectomy was performed in 28 eyes, while the remaining 13 eyes had only primary repair and closure of the wound. The two groups differed in the type of trauma (more gunshot wounds in the vitrectomy group and more blunt injuries in the nonvitrectomized group). Visual success (visual acuity of 5/200 or better) was observed in 10 (37%) of the eyes treated by vitrectomy compared with one (8%) of the eyes in the nonvitrectomy group. Anatomic success was achieved in 21 (75%) of the eyes in the vitrectomy group but in only one (8%) of those in the nonvitrectomy group. Enucleation or phthisis was observed in seven (54%) of the eyes in the nonvitrectomy group compared with only five (18%) in the vitrectomy group. Significant prognostic factors for anatomic outcome in the vitrectomy group were the location of the laceration and the presence of the lens.

Acute Disease↗
PubMed1991

Quantitative analysis of lens changes after vitrectomy by fluorophotometry.

We measured the amount of autofluorescence in the lens to evaluate quantitatively lens changes after vitrectomy. Thirteen phakic patients, ranging in age from 12 to 75 years, were studied after unilateral vitrectomy, with a follow-up period of more than two years (range, 26 to 55 months). Autofluorescence in the lens was measured at the center along the ocular axis by fluorophotometry. Lens autofluorescence in the eyes that underwent vitrectomy was significantly higher than in the contralateral eyes that were not operated on (P = .0003). The increase of autofluorescence was correlated significantly with the age at time of vitrectomy (P = .0008). There was no correlation between the increase in autofluorescence and the length of postoperative follow-up or the use of air during vitrectomy. Based on these results, we believe that oxidation of lens proteins intraoperatively may be one of the causes of development of nuclear cataract after vitrectomy.

Adolescent↗