Longterm follow-up of pars plana vitrectomy for vitreous floaters: complications, outcomes and patient satisfaction

Pars plana vitrectomy (PPV) surgery in vitreous opacities is an effective treatment method that increases patient satisfaction. However, due to the risks associated with PPV surgery, its application in vitreous floaters is controversial. Instead, performing sutureless, minimally invasive PPV surgery with 25 gauge trocars on floaters may reduce the risks. For surgical treatment, it is important to select appropriate patients, evaluation of the risk and benefit balance of PPV, and application the treatment.

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Pars plana vitrectomy for disturbing primary vitreous floaters: clinical outcome and patient satisfaction

Graefe s Archive for Clinical and Experimental Ophthalmology ◽

10.1007/s00417-012-2205-3 ◽

2012 ◽

Vol 251 (5) ◽

pp. 1373-1382 ◽

Cited By ~ 47

Author(s):

Karlijn F. de Nie ◽

N. Crama ◽

Maurits A. D. Tilanus ◽

B. Jeroen Klevering ◽

Camiel J. F. Boon

Keyword(s):

Patient Satisfaction ◽

Clinical Outcome ◽

Pars Plana Vitrectomy ◽

Vitreous Floaters ◽

Pars Plana

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27-Gauge Vitrectomy for Symptomatic Vitreous Floaters with Topical Anesthesia

Case Reports in Ophthalmology ◽

10.1159/000453332 ◽

2017 ◽

Vol 8 (1) ◽

pp. 35-39 ◽

Cited By ~ 1

Author(s):

Zhong Lin ◽

Nived Moonasar ◽

Rong Han Wu ◽

Robin R. Seemongal-Dass

Keyword(s):

Postoperative Complications ◽

Minimally Invasive ◽

Pars Plana Vitrectomy ◽

Topical Anesthesia ◽

Retrobulbar Anesthesia ◽

Vitreous Floaters ◽

Pars Plana ◽

Vitrectomy Surgery ◽

Surgery Duration

Purpose: Traditionally acceptable methods of anesthesia for vitrectomy surgery are quite varied. However, each of these methods has its own potential for complications that can range from minor to severe. The surgery procedure of vitrectomy for symptomatic vitreous floaters is much simpler, mainly reflecting in the nonuse of sclera indentation, photocoagulation, and the apparently short surgery duration. The use of 27-gauge cannulae makes the puncture of the sclera minimally invasive. Hence, retrobulbar anesthesia, due to its rare but severe complications, seemed excessive for this kind of surgery. Method: Three cases of 27-gauge, sutureless pars plana vitrectomy for symptomatic vitreous floaters with topical anesthesia are reported. Results: The vitrectomy surgeries were successfully performed with topical anesthesia (proparacaine, 0.5%) without operative or postoperative complications. Furthermore, none of the patients experienced apparent pain during or after the surgery. Conclusion: Topical anesthesia can be considered for 27-guage vitrectomy in patients with symptomatic vitreous floaters.

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Recurrent Intraocular Lens Dislocation in a Patient with Familial Ectopia Lentis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094545 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4545

Author(s):

Tomasz K. Wilczyński ◽

Alfred Niewiem ◽

Rafał Leszczyński ◽

Katarzyna Michalska-Małecka

Keyword(s):

Intraocular Lens ◽

Pars Plana Vitrectomy ◽

Vision Loss ◽

Silicone Oil ◽

Single Case ◽

Recurrent Dislocation ◽

Ectopia Lentis ◽

Pars Plana ◽

The Right

A 36-year-old patient presented to the hospital with recurrent dislocation of the intraocular lens (IOL). The patient with the diagnosis of familial ectopia lentis was first operated on for crystalline lens subluxation in the left eye in 2007 and in the right eye in 2009. In both eyes, lens extraction with anterior vitrectomy and transscleral fixation of a rigid IOL was performed. In 2011, the IOL in the right eye luxated into the vitreous cavity due to ocular trauma. The patient underwent a pars plana vitrectomy with the IOL resuturation to the sclera. Seven years later, a spontaneous vision loss in the right eye was caused by a retinal detachment. The pars plana vitrectomy with silicone oil tamponade and a consequential oil removal three months later were performed in 2018. The follow-up examination revealed recurrent IOL dislocation in the same eye. Due to a history of previous suture-related complications a decision was made to remove the subluxated rigid polymethyl-methacrylate (PMMA) IOL and fixate to sclera a sutureless SOLEKO FIL SSF Carlevale lens. The purpose of this report is to present a single case of a 36-year-old patient who was presented to the hospital with recurrent dislocation of the intraocular lens. In a three-month follow-up period, a good anatomical and functional outcome was finally obtained with transscleral sutureless intraocular lens. This lens is an option worth considering especially in a young patient with a long life expectancy and physically active.

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Combined pars plana glaucoma drainage device placement and vitrectomy using a vitrectomy sclerotomy site for tube placement: a case series

BMC Ophthalmology ◽

10.1186/s12886-021-01872-z ◽

2021 ◽

Vol 21 (1) ◽

Cited By ~ 1

Author(s):

Enchi Kristina Chang ◽

Sanchay Gupta ◽

Marika Chachanidze ◽

John B. Miller ◽

Ta Chen Chang ◽

...

Keyword(s):

Visual Acuity ◽

Pars Plana Vitrectomy ◽

Case Series ◽

Tube Placement ◽

Glaucoma Drainage Device ◽

Drainage Device ◽

Glaucoma Drainage Devices ◽

Pars Plana ◽

Sclerotomy Site

Abstract Purpose The purpose of this study is to report the safety and efficacy of pars plana glaucoma drainage devices with pars plana vitrectomy using one of the vitrectomy sclerotomy sites for tube placement in patients with refractory glaucoma. Methods Retrospective case series of 28 eyes of 28 patients who underwent combined pars plana glaucoma drainage device and pars plana vitrectomy between November 2016 and September 2019 at Massachusetts Eye and Ear. Main outcome measures were intraocular pressure (IOP), glaucoma medication burden, best corrected visual acuity, and complications. Statistical tests were performed with R and included Kaplan-Meier analyses, Wilcoxon paired signed-rank tests, and Fisher tests. Results Mean IOP decreased from 22.8 mmHg to 11.8 mmHg at 1.5 years (p = 0.002), and mean medication burden decreased from 4.3 to 2.1 at 1.5 years (p = 0.004). Both IOP and medication burden were significantly lower at all follow-up time points. The probability of achieving 5 < IOP ≤ 18 mmHg with at least 20% IOP reduction from preoperative levels was 86.4% at 1 year and 59.8% at 1.5 years. At their last visit, three eyes (10.7%) achieved complete success with IOP reduction as above without medications, and 14 eyes (50.0%) achieved qualified success with medications. Hypotony was observed in 1 eye (3.6%) prior to 3 months postoperatively and 0 eyes after 3 months. Visual acuity was unchanged or improved in 23 eyes (82.1%) at their last follow-up. Two patients had a visual acuity decrease of > 2 lines. Two eyes required subsequent pars plana vitrectomies for tube obstruction, and one eye had transient hypotony. Conclusions The results of pars plana glaucoma drainage device and pars plana vitrectomy using one of the vitrectomy sclerotomy sites for tube placement are promising, resulting in significant IOP and medication-burden reductions through postoperative year 1.5 without additional risk of postoperative complications. Inserting glaucoma drainage devices into an existing vitrectomy sclerotomy site may potentially save surgical time by obviating the need to create another sclerotomy for tube placement and suture one of the vitrectomy ports.

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Endophthalmitis following pars plana vitrectomy for vitreous floaters

Clinical Ophthalmology ◽

10.2147/opth.s67855 ◽

2014 ◽

pp. 1649 ◽

Cited By ~ 7

Author(s):

Christopher R. Henry ◽

Stephen Schwartz ◽

Harry Flynn Jr.

Keyword(s):

Pars Plana Vitrectomy ◽

Vitreous Floaters ◽

Pars Plana

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Rupture of the Globe: What to Do, What not to Do

Klinische Monatsblätter für Augenheilkunde ◽

10.1055/a-1233-8997 ◽

2020 ◽

Vol 237 (09) ◽

pp. 1070-1078

Author(s):

Antonia M. Joussen ◽

Bert Müller ◽

Bernd Kirchhof ◽

Theodor Stappler ◽

Oliver Zeitz

Keyword(s):

Pars Plana Vitrectomy ◽

Peak Pressure ◽

Eye Injury ◽

Retinal Tear ◽

Giant Retinal Tear ◽

Macular Holes ◽

Pars Plana ◽

The One

AbstractDue to their complexity, globe ruptures are highly compromising traumas for the patient. This is due on the one hand to the eye injury itself with the accompanying loss of vision and on the other hand due to the need for extended treatment with uncertain prognosis and the resulting psychological stress. Globe ruptures are among the prognostically most unfavorable injuries due to the force and peak pressure impacting the eye. Furthermore, contusional retinal necrosis may be of significance prognostically. In the present review, we discuss treatment of globe ruptures involving retinal surgery. We discuss the primary sugery, its chronological planning and extent as well as the necessity for follow-up interventions. We also discuss the origin of traumatic retinal detachment with differential diagnosis of giant retinal tear versus oradialysis as well as secondary sequelae of traumas such as formation of macular holes and their treatment. On this basis, the use of buckling surgery versus pars-plana vitrectomy is discussed. Further focus is set on the role of the iris lens diaphragm in surgery of globe ruptures.

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Lack of Toxicity During Long-Term Follow-Up of Intraocular Metallic Fragments After Pars Plana Vitrectomy

Ophthalmic Surgery Lasers and Imaging ◽

10.3928/15428877-20080701-08 ◽

2008 ◽

Vol 39 (4) ◽

pp. 319-322 ◽

Cited By ~ 2

Author(s):

Tom W. Harper ◽

Harry W. Flynn ◽

Audina Berrocal ◽

John T. Thompson ◽

Jean-Marie Parel

Keyword(s):

Pars Plana Vitrectomy ◽

Long Term Follow Up ◽

Pars Plana

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A Female Case of X-Linked Retinoschisis with Macular Hole Bilaterally

Case Reports in Ophthalmological Medicine ◽

10.1155/2020/8824995 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

A. Altun

Keyword(s):

Visual Acuity ◽

Macular Hole ◽

Pars Plana Vitrectomy ◽

Silicone Oil ◽

Surgical Experience ◽

Flap Technique ◽

Macular Holes ◽

Female Case ◽

Pars Plana

Purpose. We aimed at reminding that X-linked retinoschisis may also be seen in female patients and share our vitreoretinal surgical experience. Methods. The patient underwent pars plana vitrectomy including the closure of the macular holes with inverted ILM flap technique bilaterally. Lens extractions were performed by phacoemulsification during the removal of silicone oil endotamponade. Patient. An 18-year-old girl with X-linked retinoschisis and large macular holes in both eyes presented to the clinic of ophthalmology. It was confirmed that the patient had RS1 mutation Results. Nine-month-follow-up was uneventful for retinal findings. Significant improvement in visual acuity was achieved, and macular holes were remained closed. Conclusion. In cases with large macular holes due to XLR, an inverted ILM flap technique might be safe and effective. Four-month-silicone-endotamponade might be sufficient.

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Proposal for the management of myopic traction maculopathy based on the new MTM staging system

European Journal of Ophthalmology ◽

10.1177/1120672120980943 ◽

2020 ◽

pp. 112067212098094

Author(s):

Barbara Parolini ◽

Michele Palmieri ◽

Alessandro Finzi ◽

Rino Frisina

Keyword(s):

Retrospective Review ◽

Surgical Complications ◽

Pars Plana Vitrectomy ◽

Staging System ◽

Combined Surgery ◽

Primary Surgery ◽

Myopic Traction Maculopathy ◽

Pars Plana ◽

Phakic Eyes

Purpose: To propose the Myopic Traction Maculopathy (MTM) management Table, based on the MTM Staging System (MSS). Methods: A retrospective review of 157 eyes affected by MTM, operated with pars plana vitrectomy (PPV), or macular buckle (MB) or combined surgery (MB + PPV). Each case was classified according to the MSS. Anatomical results were evaluated with OCT at an intermediate follow-up (3–6 months) and at a final follow-up (2–8 years), considering changes both in the foveal and in the retinal pattern. The number and type of operations needed were noted. The surgical complications were reported. Results: Primary surgery was MB for 83 eyes (52%), PPV for 36 (23%) and MB + PPV for 38 (24%). At intermediate follow-up, the retinal pattern was restored in 55.41% and foveal in 42.68%. Further surgery was indicated as PPV in 25.48%, MB in 14.65%. At the final follow-up, the retinal pattern was restored in 96.16% and the foveal pattern in 87.90%. BCVA improved at the final follow-up ( p < 0.05). The complications of MB were not sight-threatening. The complications of PPV were FTMH in 67% cases in stages 2, 3, and 4. Cataract developed in 60% of phakic eyes. The complications of combined MB+PPV were cataract (56%) and PVR (5%). Conclusions: Both PPV and MB may be used to treat MTM. PPV addresses the changes in the foveal pattern while MB addresses the changes in the retinal pattern. The MTM management table offers a proposal for the choice of type and timing of treatment customized per each stage of MTM.

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