Timing of Pars Plana Vitrectomy in Management of Gunshot Perforating Eye Injury: Observational Study

The aim of this study is to report the difference in either anatomical or functional outcome of vitreoretinal intervention in cases of gunshot perforating eye injury if done 2–4 weeks or after the 4th week after the original trauma. Patients were treated with pars plana vitrectomy and silicon oil. Surgeries were performed in the period from February 2011 until the end of December 2014. 253 eyes of 237 patients were reviewed. 46 eyes were excluded. 207 eyes of 197 patients were analyzed. The included eyes were classified based on the timing of vitrectomy in relation to the initial trauma into two groups: 149 eyes (the first group) operated on between the 3rd and the 4th week and 58 eyes (the second group) operated on after the 4th week after the trauma. Following one surgical intervention, in the first group, attached retina was achieved in 93.28% of patients. In the second group, attached retina was achieved in 96.55% of patients. All RD cases could be attached by a second surgery. Visual acuity improved in 81.21% of patients, did not change in 15.43% of patients, and declined in 3.35% of patients. In the second group, visual acuity improved in 81.03% of patients, did not change in 12.06% of patients, and worsened in 6.89% of patients. There was no statistically significant difference between the two groups in either anatomical or functional results. We recommend interfering before the 5th week after the trauma as retinal detachment is encountered more in cases operated on after the 4th week. The visual outcome depends on the site of entry and exit (the route of gunshot).

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Clinico-microbiological Profile and Visual outcome in Traumatic Endophthalmitis following Pars Plana Vitrectomy at a Tertiary Eye Care Centre of Nepal

Journal of Nepal Medical Association ◽

10.31729/jnma.2709 ◽

1970 ◽

Vol 52 (195) ◽

pp. 886-891

Author(s):

Raba Thapa ◽

Govinda Paudyal

Keyword(s):

Foreign Body ◽

Pars Plana Vitrectomy ◽

Visual Outcome ◽

Eye Injury ◽

Visual Recovery ◽

Care Centre ◽

Eye Care ◽

Female Ratio ◽

Pars Plana ◽

Perforating Eye Injury

Introduction: Endophthalmitis is a potentially devastating ocular complication of perforating eye injury where prompt intervention can save some vision. This study aims to explore the clinico-microbiologic profile and visual outcome following pars plana vitrectomy (PPV) in traumatic endophthalmitis. Methods: This is a retrospective interventional case series study conducted at a tertiary eye care centre of Nepal. A total of 49 consecutive cases (49 eyes) of endophthalmitis following PEI, who underwent PPV from January 2007 to June 2010 were included in the study. Results: Mean age was 14.7 years (S.D. 14.27). Twenty seven patients (55%) were of age group below 10 years. Male to female ratio was 2.75:1. Mean duration of presentation was 8.9 days. Nineteen eyes (36.73%) had injuries with wooden sticks, followed by injury with metallic objects in 16 patients (32.56%). PEI involving zone I was found in 31 eyes (63.25%). The retained intraocular foreign body was found in seven patients (14.2%). The post operative vision improved in almost 24 cases (49%) with visual recovery of 20/200 and better in six cases (12.24%). The vitreous culture was positive in five cases (12.8%) with predominant streptococcus pneumonia in four cases (10.25%). Conclusions: Children were the mostly affected group with males outnumbering females. Wooden sticks and metallic objects were the commonest insulting agents. Despite the late presentation and predominant zone I injury, eye could be salvaged in majority with visual recovery of 20/200 and better in six cases (12.24%).Keywords: endophthalmitis; intra-ocular foreign body; perforating eye injury; vitrectomy .

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PARS PLANA VITRECTOMY IN POST-CATARACT SURGERY ENDOPHTHALMITIS IN CIPTO MANGUNKUSOMO HOSPITAL

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i10.1448 ◽

2020 ◽

Vol 4 (10) ◽

Author(s):

Andi Arus Victor ◽

Fitria Romadiana ◽

Ari Djatikusumo ◽

Elvioza ◽

Gitalisa Andayani Adriono ◽

...

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Effective Treatment ◽

Pars Plana Vitrectomy ◽

Demographic Data ◽

Visual Outcome ◽

Descriptive Study ◽

Common Cause ◽

Causative Microorganism ◽

Pars Plana

Background: Endophthalmitis is one of the emergencies in ophthalmology and can cause blindness. The most common cause of endophthalmitis in intraocular surgery is cataract surgery. Immediate diagnosis and treatment can provide optimal final vision. This research aimed to describe the demographic data, and causative microorganisms, as well as the success rate of visual outcome after pars plana vitrectomy (PPV) in post-cataract surgery endophthalmitis in Cipto Mangunkusumo Hospital. Methods: A retrospective descriptive study of post-cataract surgery endophthalmitis underwent vitrectomy in Cipto Mangunkusumo Hospital, Indonesia, from January 2017 - June 2017. Results: There were twenty one cases of post-cataract surgery endophthalmitis undergoes PPV within the period of January 2017-June 2017. The most frequently identified causative microorganism was Staphylococcus (23%). There was an improvement of visual acuity after PPV procedure in 47,6% post-cataract surgery endophthalmitis. Conclusion: Immediate PPV is an effective treatment and leads to vision improvement in post-cataract surgery endophthalmitis. Keywords: pars plana vitrectomy, endophthalmitis, cataract surgery

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An Atypical Presentation of Propionibacterium Acnes Endophthalmitis Following Cataract Surgery

Journal of VitreoRetinal Diseases ◽

10.1177/2474126419895873 ◽

2020 ◽

Vol 4 (4) ◽

pp. 332-336

Author(s):

Itamar Livnat ◽

Jay Daniels ◽

Leanne T. Labriola ◽

Michael S. Tsipursky

Keyword(s):

Visual Acuity ◽

Pars Plana Vitrectomy ◽

Complete Resolution ◽

Propionibacterium Acnes ◽

Visual Outcome ◽

Unusual Presentation ◽

Atypical Presentation ◽

Good Visual Outcome ◽

Pars Plana

Purpose: To describe a case with an unusual presentation of Propionibacterium acnes ( P acnes) with ultimately a good visual outcome. Methods: A case report with review of approaches to P acnes endophthalmitis. Results: We describe a patient with an unusual presentation of P acnes of panuveitis with white, circular preretinal lesions without intracapsular deposits. Diagnosis was made from cultures from pars plana vitrectomy. Eventually, she was definitively managed with capsulectomy, repositioning of her intraocular lens via sutureless intrascleral fixation, and intravitreal vancomycin injection. Conclusion: This is a report of P acnes endophthalmitis presenting with discrete preretinal lesions where surgical and medical management lead to a complete resolution of uveitis and symptoms after a 3-year follow up where the patient’s final visual acuity was Snellen 20/20 OU.

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COMPARISON BETWEEN PARS PLANA VITRECTOMY WITH VERSUS WITHOUT A 360° EPISCLERAL BAND IN THE MANAGEMENT OF GUNSHOT PERFORATING EYE INJURY

Retina ◽

10.1097/iae.0000000000000739 ◽

2016 ◽

Vol 36 (3) ◽

pp. 596-602 ◽

Cited By ~ 2

Author(s):

Hammouda Hamdy Ghoraba ◽

Hosam Osman Mansour ◽

Mohamed Amin Heikal ◽

Hitham Mammon Abdelfattah ◽

Emad Mohamed Elgemai

Keyword(s):

Pars Plana Vitrectomy ◽

Eye Injury ◽

Pars Plana ◽

Perforating Eye Injury

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Posterior Segment Retained Intraocular Foreign Body: A Study from Western Nepal

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v13i1.28981 ◽

2021 ◽

Vol 13 (1) ◽

pp. 22-30

Author(s):

Bikram Bahadur Thapa ◽

Sweta Singh ◽

Gyanendra Lamichhane ◽

Shanti Gurung ◽

Saurav Piya

Keyword(s):

Visual Acuity ◽

Foreign Body ◽

Retinal Detachment ◽

Pars Plana Vitrectomy ◽

Large Diameter ◽

Visual Outcome ◽

Posterior Segment ◽

Intraocular Foreign Body ◽

Pars Plana ◽

The Mean

Introduction: Posterior segment retained Intraocular foreign body (IOFB) management is challenging. Facility of pars plana vitrectomy (PPV) and availability of well trained vitreo retina surgeons are the basic need to accomplish this work. Encircling band provide permanent 360° support to close the anterior retinal break and prevent traction on the retina. The objective of this study is to analyse the clinical characteristics and predictors of the final visual outcome and survival of the globe in cases of retained IOFB in the posterior eye segment. Materials and methods: A hospital based retrospective observational study was conducted. All the patients of retained IOFB in the posterior segment presented from January 2016 to June 2019 were enrolled. Patients presented with visual acuity of NPL were excluded. Statistical analysis was performed using a variety of tests using SPSS version 21. Results: Forty eyes of 40 patients were included. The mean age was 27.08±10.68 years (range 5-66). 95% of our patients were male. Most of them (52.5%) worked on the farm. 26(65%) of 40 eyes had Zone I injury. The median time spent before presentation was 13.5 day. Retinal detachment, vitreous hemorrhage, and endophthalmitis were present in 15, 23 and 5 eyes, respectively, before IOFB removal. The mean LogMAR visual acuity was improved significantly from 2.50±0.87 to 1.33± 1.01 (p=0.003). Poor presenting visual acuity, retinal detachment and large diameter of IOFB were found as the predictor of poor final visual acuity. Conclusion: Pars plana vitrectomy by a vitreo retinal surgeon can give encouraging results in the cases of retained posterior segment IOFB. Poor presenting visual acuity, large diameter of IOFB and RD before IOFB removal are predictors of poor visual outcome.

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Outcomes of Silicone Oil Removal in Complex Retinal Detachment

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v10i2.23012 ◽

2018 ◽

Vol 10 (2) ◽

pp. 124-129

Author(s):

Ritesh Shah ◽

Raghunandan Byanju ◽

Sangita Pradhan

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Ocular Hypertension ◽

Pars Plana Vitrectomy ◽

Silicone Oil ◽

Visual Outcome ◽

Complication Rates ◽

Oil Removal ◽

Silicone Oil Removal ◽

Pars Plana

Introduction: Pars plana vitrectomy in combination with intraocular tamponade with silicone oil is a standard technique in the treatment of complex retinal detachment. Although the use of silicone oil has improved the results of retinal detachment surgery, its removal is recommended due to the ocular complications related to its long term use. However, retinal redetachment can occur after silicone oil removal. Objective: To evaluate the anatomical and visual outcome after silicone oil removal (SOR) in eyes with complicated retinal detachment. Material and Methods: We retrospectively analyzed 64 eyes of 64 consecutive patients of silicone oil removal over a period of 12 months. All eyes had undergone standard 3 ports pars plana vitrectomy with silicone oil placement for complicated retinal detachment. Cases that completed at least 1 month follow up duration after SOR were included in the study. Anatomical success after SOR was achieved in 56 of 64 eyes (87.5%). Seven of 8 redetachments (87.5%) were seen in eyes with silicone oil tamponade duration of less than 6 months. Visual acuity improved or was stabilized in 49 of 64 eyes (76.6%). Using paired T-test, it was found that there was no significant difference in pre and post SOR visual acuity. Postoperative ocular hypertension, corneal decompensation, band shaped keratopathy and hypotony was observed in 9.4%, 4.7%, 6.4% and 21.9% respectively. Conclusion: Although there was no significant improvement in visual acuity, redetachment and complication rates were comparable to other studies. The duration of endotamponade was not significantly associated with the redetachment rate. Key words: Silicone oil removal, Redetachment, Visual outcome, Keratopathy, ocular hypertension.

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Long-term results of pars plana vitrectomy as an anti-inflammatory therapy of pediatric intermediate uveitis resistant to standard medical treatment

European Journal of Ophthalmology ◽

10.5301/ejo.5001020 ◽

2018 ◽

Vol 28 (1) ◽

pp. 98-102 ◽

Cited By ~ 3

Author(s):

Denisa Darsová ◽

Pavel Pochop ◽

Jana Štěpánková ◽

Dagmar Dotřelová

Keyword(s):

Visual Acuity ◽

Pars Plana Vitrectomy ◽

Immunosuppressive Treatment ◽

Functional Results ◽

Long Term Results ◽

Intermediate Uveitis ◽

Pars Plana ◽

Anti Inflammatory ◽

Standard Medical Treatment

Purpose: To evaluate the efficacy of pars plana vitrectomy (PPV) as an anti-inflammatory therapy in pediatric recurrent intermediate uveitis. Methods: A retrospective study evaluated the long-term results of PPV indicated for intermediate uveitis with a mean observation period of 10.3 years (range 7-15.6 years) in 6 children (mean age 8 years, range 6-12 years). Pars plana vitrectomy was performed on 10 eyes in the standard manner and was initiated by vitreous sampling for laboratory examination. Data recorded were perioperative or postoperative vitrectomy complications, anatomic and functional results of PPV, and preoperative and postoperative best-corrected Snellen visual acuity. Results: No perioperative or postoperative complications were observed. Bacteriologic, virologic, mycotic, and cytologic analysis of the vitreous was negative in all tested children. Five eyes were subsequently operated on for posterior subcapsular cataracts. An average preoperative visual acuity of 0.32 improved to an average postoperative visual acuity of 0.8. Conclusions: In the case of systemic immunosuppressive treatment failure in pediatric uveitis, particularly in eyes with cystoid macular edema, we recommend PPV relatively early.

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Management of Vasoproliferative Tumors of the Retina with Macular Complications by Pars Plana Vitrectomy Combined with Episcleral Cryotherapy

Journal of Ophthalmology ◽

10.1155/2021/6667755 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Wenhua Zhang ◽

Zeyuan Qiang ◽

Hao Song ◽

Xiaoli Li ◽

Handong Dan ◽

...

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Pars Plana Vitrectomy ◽

Tumor Regression ◽

Case Series ◽

Morphological Structure ◽

Mean Values ◽

Pars Plana ◽

The Mean ◽

The Difference

Objective. To evaluate the efficacy of pars plana vitrectomy (PPV) combined with episcleral cryotherapy in treating vasoproliferative tumors of the retina (VPTR) with macular complications. Methods. In this retrospective noncomparative interventional case-series analysis, we included 11 eyes of ten patients diagnosed with VPTR. All patients underwent comprehensive ophthalmic examinations and were treated with PPV combined with episcleral cryotherapy. Best-corrected visual acuity (BCVA), tumor activity, retinal morphological structure, and postoperative complications were evaluated. Results. Macular complications included epimacular membrane (n = 10), macular hole (n = 3), and macular edema (n = 1). Tumors were treated with triple freeze-thaw episcleral cryotherapy during PPV. The mean logarithm of minimal angle of resolution (logMAR) BCVA dropped from 0.62 ± 0.58 to 0.39 ± 0.46. The difference between the mean values of logMAR BCVA before and after treatment was statistically significant (t = 2.48, P = 0.033 ). The tumor activity was controlled effectively in nine cases. Compared with preoperative tumor activity, tumor activity after treatment was significantly lower ( P < 0.01 ). The increase of central retinal thickness and the disruption of retinal layers were associated with macular holes, macular edema, and retinal proliferative membrane. After the treatment, visual acuity improved in 91% of the cases, and 73% had no long-term complications. Conclusion. PPV combined with episcleral cryotherapy promoted tumor regression, preserved retinal integrity, and improved visual acuity. Thus, the combination of PPV with episcleral cryotherapy can be considered effective and safe for the management of VPTR with macular complications.

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Visual Outcome in Pars Plana Vitrectomy for Acute Postoperative Endophthalmitis after Cataract Surgery

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v36i3.991 ◽

2020 ◽

Vol 36 (3) ◽

Author(s):

Abdul Rafio Soomro ◽

Fayaz Ahmed Soomro ◽

Munawar Hussain ◽

Abdul Qadeem Soomro ◽

Nazia Qidwai ◽

...

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Pars Plana Vitrectomy ◽

Visual Outcome ◽

Final Visit ◽

P Value ◽

Postoperative Endophthalmitis ◽

Chi Square ◽

Finger Counting ◽

Pars Plana

Purpose: To determine the visual outcomes in patients undergoing pars plana-vitrectomy (PPV) for acute postoperative endophthalmitis after cataract surgery.Study Design: Quasi experimental study.Place and Duration of Study: Al- Ibrahim Eye Hospital, Malir, Karachi for a period of 2 years.Material and Methods: Thirty-three patients were selected using non-probability convenient sampling technique.Patients with acute postoperative endophthalmitis after cataract surgery diagnosed clinically and on B-scan, withvisual acuity of only perception of light were included while patients with better visual acuity and any other typesof endophthalmitis were excluded. PPV was performed in all cases and the patients were examined postoperativelyon 1st day, 3rd day, 1, 2 and 3 weeks after surgery. During these follow ups, visual acuity wasrecorded, detailed slit lamp and fundus examination was performed. Using SPSS version 20.0, chi-square testwas applied to test for significance keeping p-value of < 0.05 as significant.Results: Out of 33 patients 19 (57.6%) were males and 14 (42.4%) were females. Mean age of the patients was54.50 ± 14.14 years. On 1st post-operative day 8 patients (24.2%) showed improvement of visual acuity fromperception of light to finger counting while 02 (6.1%) patients reported visual acuity of 6/60. On final visit at 3rdweek postoperatively, 19 patients (57.6%) had visual acuity of finger counting, 08 patients (24.2%) had handmovement and 06 (18.2%) patients reported a visual acuity of 6/60.Conclusion: PPV for acute post-cataract endophthalmitis results in favourable outcomes in terms of visual acuity.

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Short-Term Results of Ocriplasmin versus Prompt Vitrectomy for Macular Hole. Which Performs Better?

Journal of Clinical Medicine ◽

10.3390/jcm9123972 ◽

2020 ◽

Vol 9 (12) ◽

pp. 3972

Author(s):

Andrea Cacciamani ◽

Pamela Cosimi ◽

Marta Di Nicola ◽

Guido Ripandelli ◽

Fabio Scarinci

Keyword(s):

Pars Plana Vitrectomy ◽

Group Versus ◽

Functional Results ◽

Retinal Sensitivity ◽

Vitreomacular Adhesion ◽

Functional Changes ◽

Primary Surgery ◽

Macular Holes ◽

Significant Difference ◽

Pars Plana

In this retrospective study, we compared the anatomical and functional changes in patients with vitreomacular traction associated with macular holes between the following groups: (1) Patients who were treated with a single intravitreal injection of ocriplasmin (the OCRIALONE group); (2) those who failed the ocriplasmin treatment and underwent vitrectomy one month later (the OCRIVIT group); and (3) patients who directly underwent par plana vitrectomy (VITREALONE group). A total of 38 patients, 19 in the OCRIALONE group + OCRIVIT group (seven and 12 patients, respectively) and 19 in the VITREALONE group with focal vitreomacular adhesion associated with macular holes were evaluated with spectral domain optical coherence tomography. Functional examinations included best-corrected visual acuity (BCVA) and microperimetry analysis. Visual function changes were compared between the OCRIALONE group + OCRIVIT group and VITREALONE group up to three months. Furthermore, a subgroup analysis compared the OCRIVIT group and the VITREALONE group. BCVA values and the mean retinal sensitivity showed statistically significant improvement in all groups (p < 0.001). Specifically, the retinal sensitivity values at the end of the follow-up were significantly higher in the OCRIALONE group + OCRIVIT group than in the VITREALONE group. These functional findings were also confirmed when the statistical analysis was conducted between the OCRIVIT group and the VITREALONE group. Although the OCRIALONE group + OCRIVIT group exhibited faster retinal thinning than the VITREALONE group (p = 0.006), the analysis of the OCRIVIT group versus the VITREALONE group did not show any statistically significant difference. The better functional results and similar anatomical findings suggest that ocriplasmin can be used as a first-line treatment, and that prompt pars plana vitrectomy as primary surgery does not provide better outcomes in comparison with pars plana vitrectomy after ocriplasmin injection.

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