scholarly journals Anatomical Outcome of Vitreoretinal Surgery Using Temporary Keratoprosthesis and Replacement of the Trephined Corneal Button for Severe Open Globe Injuries: One-Year Result

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Hui-Jin Chen ◽  
Chang-Guan Wang ◽  
Hong-Liang Dou ◽  
Xue-Feng Feng ◽  
Kang Feng ◽  
...  
Keyword(s):  
Silicone Oil ◽  
Case Series ◽  
Vitreoretinal Surgery ◽  
Corneal Transplant ◽  
Open Globe ◽  
Temporary Keratoprosthesis ◽  
Pars Plana ◽  
One Year ◽  
Anatomical Outcome ◽  
Corneal Button

In this case series of 74 patients with coexisting vitreoretinal injury and severe corneal opacification, after temporary keratoprosthesis (TKP) assisted pars plana vitrectomy (PPV), an allograft corneal transplant was not performed at the same time; instead, the patient’s trephined corneal button was sutured back. One year after the surgery, if intraocular pressure of the injured eyes was above 8 mmHg, removing silicone oil was attempted, and penetrating keratoplasty could be performed. Finally, 10 eyes (13.5%) were enucleated due to atrophia bulbi; 46 eyes (62.2%) were silicone-oil sustained; 15 eyes (20.3%) were anatomically restored; and 3 eyes (4.0%) experienced recurrent retinal detachment. These figures only demonstrate a small percentage of the injured eyes in our series, which have PKP indications. It is a practical option to suture back the patient’s trephined cornea following a TKP assisted PPV; keratoplasty was reserved for selected cases.

scholarly journals Surgical Management of Traumatic Retinal Detachment with Primary Vitrectomy in Adult Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Katarzyna Nowomiejska ◽  
Tomasz Choragiewicz ◽  
Dorota Borowicz ◽  
Agnieszka Brzozowska ◽  
Joanna Moneta-Wielgos ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Silicone Oil ◽  
Vitreoretinal Surgery ◽  
Eye Injuries ◽  
Primary Vitrectomy ◽  
Eye Trauma ◽  
Open Globe ◽  
Pars Plana ◽  
23 Gauge

Purpose.To evaluate functional and anatomical results of pars plana vitrectomy (PPV) in the retinal detachment (RD) followed by severe eye trauma.Methods.Retrospective analysis of medical records of forty-one consecutive patients treated with 23-gauge PPV due to traumatic RD. Age, gender, timing of PPV, visual acuity, and presence of intraocular foreign body (IOFB) and proliferative vitreoretinopathy (PVR) were included in the analysis.Results.Mean age of patients was 47 years; the majority of patients were men (88%). Closed globe injury was present in 21 eyes and open globe injury in 20 eyes (IOFB in 13 eyes, penetration injury in 4 eyes, and eye rupture in 3 eyes). Mean follow-up period was 14 months; mean timing of PPV was 67 days. Twenty-seven (66%) eyes had a functional success; 32 eyes (78%) had anatomical success. As a tamponade silicone oil was used in 33 cases and SF6 gas in 8 cases.Conclusions.Severe eye injuries are potentially devastating for vision, but vitreoretinal surgery can improve anatomical and functional outcomes. Among analysed pre- and intra- and postoperative factors, absence of PVR, postoperative retinal attachment, and silicone oil as a tamponade were related to significantly improved visual acuity.

scholarly journals Simultaneous Vitreoretinal Surgery and Penetrating Keratoplasty without a Keratoprosthesis or Endoscopy for Vitreoretinal Disease Associated with Corneal Opacity

2020 ◽  
Vol 11 (1) ◽  
pp. 127-136
Author(s):  
Takuya Yoshimoto ◽  
Naoyuki Yamada ◽  
Fumiaki Higashijima ◽  
Shinichiro Teranishi ◽  
Kazuhiro Kimura
Keyword(s):  
Penetrating Keratoplasty ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Vitreoretinal Surgery ◽  
Visual Outcome ◽  
Corneal Opacity ◽  
Additional Surgery ◽  
Vitreoretinal Disease ◽  
Temporary Keratoprosthesis ◽  
Pars Plana

We evaluated the visual outcome of combined penetrating keratoplasty (PKP) and 25G pars plana vitrectomy (PPV) performed without a temporary keratoprosthesis or endoscopy in a patient with vitreoretinal disease complicated by severe corneal opacity. The patient was a 68-year-old woman who had severe corneal opacity and silicone oil in her left eye after several previous intraocular surgeries for rhegmatogenous retinal detachment and proliferative vitreoretinopathy. We successfully performed a combined surgery of conventional PKP followed by 25G PPV without the use of a keratoprosthesis.At 6 months after surgery, visual acuity had not improved, and the density of corneal endothelial cells of the donor cornea had declined from 3,205 to 1,969 cells/mm2. However, corneal transparency remained good, and additional surgery for vitreoretinal disease was not necessary. The combined surgical procedure designed to minimize the number of open-sky steps and to limit vitreoretinal complications thus proved to be safe and achieved stable corneal clarity in a patient with vitreoretinal disease and severe corneal opacity.

Risk factors and prognosis of pediatric open globe injuries without initial light perception

2020 ◽  
Author(s):  
Xin Wen ◽  
Miner Yuan ◽  
Cheng Li ◽  
Chongde Long ◽  
Zhaohui Yuan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Silicone Oil ◽  
Vitreoretinal Surgery ◽  
Light Perception ◽  
Open Globe ◽  
Intraocular Hemorrhage ◽  
Control Study ◽  
Better Than ◽  
Open Globe Injuries

Purpose: To investigate the possible risk factors and prognosis of initial no light perception (NLP) in pediatric open globe injuries (POGI). Procedures: This retrospective, comparative, interventional case-control study included 865 eyes of POGI patients presenting to a tertiary referral ophthalmic center from 1 January 2011 to 31 December 2015. Eyes were divided into two groups: NLP group included eyes with initial NLP, and light perception(LP) group included eyes with initial LP or vision better than LP. Results: The following risk factors were significantly related to initial NLP: severe intraocular hemorrhage (OR=3.287, p=0.015), retinal detachment (RD) (OR=2.527, p=0.007), choroidal damage (OR=2.680, p=0.016) and endophthalmitis (OR=4.221, p＜0.001). Choroidal damage is related to remaining NLP after vitreoretinal surgery (OR=12.384, p=0.003). At the last visit, more eyes in the NLP group suffered from silicone oil–sustained status (OR=0.266, p=0.020) or ocular atrophy (OR=0.640, p=0.004), and less eyes benefitted from final LP (OR=41.061, p＜0.001) and anatomic success (OR=4.515, p＜0.001). Conclusion: Severe intraocular hemorrhage, RD, choroidal damage and endophthalmitis occurred more often in POGI with initial NLP. Choroidal damage was the major factor related to an NLP prognosis. Traumatized eyes with initial NLP could be anatomically and functionally preserved by vitreoretinal surgery.

Direct Transretinal Removal of Subfoveal Perfluorocarbon Liquid: The Role and Timing of Internal Limiting Membrane Peeling

2017 ◽  
Vol 27 (2) ◽  
pp. 249-252 ◽  
Author(s):  
Stefano De Cillà ◽  
Micol Alkabes ◽  
Paolo Radice ◽  
Elisa Carini ◽  
Carlos Mateo
Keyword(s):  
Retinal Detachment ◽  
Silicone Oil ◽  
Case Series ◽  
Vitreoretinal Surgery ◽  
Internal Limiting Membrane ◽  
Perfluorocarbon Liquid ◽  
Ilm Peeling ◽  
The Status ◽  
Anatomic Results ◽  
Silicone Oil Tamponade

Purpose To describe a case series including 4 patients undergoing direct transretinal aspiration of subfoveal perfluorocarbon liquid (PFCL) and internal limiting membrane (ILM) peeling after macula-off retinal detachment surgery. Methods Four patients who had undergone vitreoretinal surgery due to primary rhegmatogenous retinal detachment were further treated because of retained subfoveal PFCL. Direct transretinal aspiration of PFCL through a self-sealing foveal retinotomy was performed in all cases using a 41-G needle placed on the top of the bubble. The ILM was peeled off prior to and after PFCL removal in 2 cases, respectively. Optical coherence tomography (OCT) scans were obtained preoperatively and postoperatively to assess the status of the macula. Results Subfoveal PFCL was successfully removed in all cases. Two patients had silicone oil tamponade at the time of the second surgery, which was temporarily removed in both cases and then reapplied in one. Best-corrected visual acuity improved in all cases. No postoperative macular hole was observed by OCT. Conclusions Direct transretinal aspiration of subfoveal PFCL with a 41-G cannula combined with conventional ILM peeling is a safe and effective technique to avoid long-term damage to the retinal layers with good functional outcomes. Performing the ILM peeling immediately before or after the PFCL aspiration does not seem to influence anatomic results.

Pars plana Ex-Press mini shunt for management of persistent glaucoma in vitrectomized eyes: A novel technique

2020 ◽  
Vol 30 (5) ◽  
pp. 1179-1184 ◽  
Author(s):  
Abdussalam Abdullatif ◽  
Heba El-Saied
Keyword(s):  
Intraocular Pressure ◽  
Silicone Oil ◽  
Case Series ◽  
Ultrasound Biomicroscopy ◽  
Secondary Glaucoma ◽  
Antiglaucoma Medication ◽  
Novel Approach ◽  
Pars Plana ◽  
Secondary Refractory

Purpose: To evaluate the safety and efficacy of a novel approach to implant Ex-Press mini shunt via the pars plana under a scleral flap in pseudophakic or aphakic, vitrectomized patients with secondary refractory glaucoma. Methods: A prospective interventional case series of three patients with secondary glaucoma after pars plana vitrectomy. Intraocular pressure was not controlled by silicone oil removal, if the patient was siliconized, nor the maximum medical treatment. Ex-Press mini shunt via the pars plana was implanted. We evaluated the control of intraocular pressure and the development of intraoperative and postoperative complications. Results: During 1-year follow-up, control of intraocular pressure was achieved; 14, 15, and 15 mmHg at the 3 months, and 15, 15, and 16 mmHg at the 6 months in our three cases without antiglaucoma treatment and 16, 16, and 18 with single antiglaucoma medication at 1 year. Blebs were posterior and diffuse. No complications were encountered intraoperatively or postoperatively. Ultrasound biomicroscopy showed suprachoroidal posterior lake of fluid as an additional filtration route without any choroidal or retinal complication. Conclusion: Implantation of Ex-Press mini shunt via the pars plana in aphakic or pseudophakic, vitrectomized eyes is a promising, safe, and effective technique in patients with secondary glaucoma.

Full-Thickness Macular Hole Formation After Repair of Rhegmatogenous and Tractional Retinal Detachment

2019 ◽  
Vol 3 (5) ◽  
pp. 341-345
Author(s):  
Matthew A. Cunningham ◽  
Samantha Fink ◽  
Jaya B. Kumar ◽  
Elias C. Mavrofrides ◽  
S.K. Steven Houston ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Macular Hole ◽  
Case Series ◽  
Vitreoretinal Surgery ◽  
Visual Outcome ◽  
Full Thickness ◽  
Tractional Retinal Detachment ◽  
Full Thickness Macular Hole ◽  
Pars Plana

Purpose: This article reports the clinical features, associations, and outcomes of patients with full-thickness macular hole (MH) formation after pars plana vitrectomy for retinal detachment (RD). Methods: A retrospective, interventional case series is presented of consecutive patients undergoing surgical repair of MH following prior tractional or rhegmatogenous retinal detachment repair from September 2014 to October 2018 at a single vitreoretinal surgery practice. The size of the MH, presence of epiretinal membrane (ERM), rate of MH closure, and visual outcome following repair were evaluated. Results: A total of 996 cases of rhegmatogenous and tractional retinal detachment repair were identified. The average time from the RD surgery to MH diagnosis was 72 days. The incidence of subsequent MH formation in patients who underwent surgery was 0.8% (8/996). The presence of ERM prior to MH repair was noted in 50% of these cases (4/8). In cases with at least 3 months of postoperative follow-up, MH closure was achieved in 100% of eyes after a single surgery. The mean preoperative visual acuity (VA) was 2.06 logMAR (logarithm of the minimum angle of resolution) units (Snellen equivalent, 20/2296) and significantly improved to 0.72 logMAR units (Snellen, 20/104; P = .017) at the last follow-up after MH repair. All patients had improvement in VA at the final postoperative visit, with a VA of 20/200 or better achieved in 87.5% of cases. Conclusions: Although MH formation after successful RD repair is uncommon, favorable visual and anatomic results can be obtained.

Vitreoretinal Surgery in Diabetic Patients on Hemodialysis

1997 ◽  
Vol 7 (3) ◽  
pp. 283-287 ◽  
Author(s):  
J. Nawrocki ◽  
W. Chrzanowski ◽  
D. Koch ◽  
K. Dziegielewski
Keyword(s):  
Visual Acuity ◽  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Type I Diabetes ◽  
Vitreoretinal Surgery ◽  
Final Visual Acuity ◽  
Diabetic Patients ◽  
Type I ◽  
First Results ◽  
Pars Plana

The present paper reports our first results after pars plana vitrectomy in patients with diabetic retinopathy and hemodialysis with a follow-up of 6 to 24 months. Between January 1992 and October 1994 we performed vitreoretinal surgery with silicone oil tamponade in nine eyes of seven patients with diabetic nephropathy on hemodialysis. All patients had had type I diabetes for 19–32 years. Over the observation period the retina was completely attached in eight eyes. Final visual acuity of 0.1 - 0.7 was attained in four eyes, 0.06 two, hand movements in one eye. Two eyes had no useful final visual acuity because of redetachment of the retina or secondary glaucoma with rubeosis iridis. The small number of complications shows that pars plana vitrectomy can be done in diabetic patients with nephropathy on hemodialysis. This significantly improves their quality of life

scholarly journals Selective Laser Trabeculoplasty for Glaucoma Secondary to Emulsified Silicone Oil after Pars Plana Vitrectomy: A Pilot Study

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Zeynep Alkin ◽  
Banu Satana ◽  
Abdullah Ozkaya ◽  
Berna Basarir ◽  
Cigdem Altan ◽  
...  
Keyword(s):  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Open Angle Glaucoma ◽  
Case Series ◽  
Open Angle ◽  
Selective Laser Trabeculoplasty ◽  
Consecutive Case ◽  
Laser Trabeculoplasty ◽  
Pars Plana ◽  
The Mean

Background. To investigate the efficacy of selective laser trabeculoplasty (SLT) for lowering intraocular pressure (IOP) in patients with open angle glaucoma (OAG) secondary to emulsified silicone oil (SO).Methodology/Principal Findings. Prospective, interventional, consecutive case series of 11 eyes with sustained elevation of IOP after SO removal. The mean IOP at baseline, week 1, month 1, month 3, and month 6 was evaluated. The mean baseline IOP was significantly decreased from 25 ± 2.7 mmHg to 18.4 ± 5.5 mmHg at week 1(P=0.01), 17.9 ± 3.1 mmHg at month 1(P=0.008), 15.8 ± 3.9 mmHg at month 3(P=0.003), and 16.2 ± 4.7 mmHg at month 6(P=0.004). IOP < 21 mmHg was achieved in 91% of the eyes without a significant complication at month 6.Conclusion/Significance. SLT may be successful for lowering IOP in patients with OAG secondary to emulsified SO which was not controlled with maximum antiglaucomatous medical treatment.

scholarly journals Sympathetic Ophthalmia Two Weeks After 23-Gauge Vitrectomy

2020 ◽  
Author(s):  
Bahaeddin El Khatib ◽  
Alexander Hacopian ◽  
Menka S. Patel ◽  
Monica Dalal ◽  
H. Nida Sen ◽  
...  
Keyword(s):  
Rare Disease ◽  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Case Series ◽  
Sympathetic Ophthalmia ◽  
Ocular Injury ◽  
History Of ◽  
Pars Plana ◽  
23 Gauge ◽  
The Uk

Abstract Sympathetic Ophthalmia (SO) is a rare disease that presents as a bilateral, diffuse, granulomatous panuveitis. Sympathetic Ophthalmia is a clinical diagnosis with history of penetrating ocular injury in the inciting eye and presence of panuveitis in the sympathizing eye. Though early enucleation is believed to minimize the risk, there have been reports of SO even after enucleation of inciting eyes. The possible association between vitrectomy and SO has been initially proposed by Gass [9] and later studied extensively in a large cohort in the UK with an estimated SO risk of 1 in 799 vitrectomies [11]. There have been several case series and reports of SO following vitrectomy, however only three documented cases of SO following vitrectomy without use of silicone oil. These cases demonstrated an onset of SO ranging between 4 weeks to 2 months. We present a patient with SO in the sympathizing eye presenting 16 days after an uncomplicated 23-gauge (23G) sutureless pars plana vitrectomy (PPV) without the use of silicone oil.

scholarly journals A novel way of Subfoveal Perfluorocarbon liquid Removal using 26 gauge spinal anesthesia needle

2020 ◽  
Vol 12 (1) ◽  
pp. 119-124
Author(s):  
Abhishek Anand ◽  
Lalit Agarwal ◽  
Nisha Agrawal
Keyword(s):  
Spinal Anesthesia ◽  
Silicone Oil ◽  
Case Series ◽  
Cost Effective ◽  
Nerve Fibers ◽  
Complete Restoration ◽  
Pars Plana ◽  
Liquid Removal ◽  
Sd Oct

Introduction: Perfluorocarbon (PFCL) is an essential adjunct of retinal detachment surgery. Subfoveal migration of PFCL is a rare and vision threatening complication of its use. Various techniques have been described for its removal. However, no consensual technique of its removal has been established. We present a nova, relatively atraumatic and cost effective way of PFCL removal using a widely available 26G spinal anesthesia needle. Case: An 18 years old myopic patient who had undergone left eye pars plana vitrectomy (PPV) for myopic Rhegmatogenous Retinal Detatchment (RRD) in the past presented after 1 month with retained subfoveal PFCL. Its subretinal location was confirmed by Optical Coherence Tomography (OCT). He was taken up for early Silicone Oil Removal (SOR) along with removal of retained subfoveal PFCL under high magnification by using a surgical disposable contact macula lens. A 26G spinal anesthesia needle tip was used to dissect a small separation parallel to the nerve fibers at the temporal edge of tense cystic PFCL bleb. Silicone tipped flute cannula was used to passively aspirate the sub retinal PFCL under fluid with no additional intervention. No barrage LASER was done. Observation: Anatomical restoration of the retina was noted both intraoperatively and post-operatively. SD-OCT showed complete restoration of anatomical layers with no presence of intraretinal cystic cleft both at day 1 and 30 days postoperatively. Conclusion: Safe removal of subfoveal PFCL can be done with 26G spinal anesthesia needle which is atraumatic, inexpensive and readily available. However, long term validity of this process needs to be established in a case series.

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