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.

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 Sympathetic ophthalmia after vitreoretinal surgery: a report of two cases

2021 ◽  
Vol 49 (8) ◽  
pp. 030006052110327
Author(s):  
Junhui Shen ◽  
Zheng Zhang ◽  
Dian Ye ◽  
Zuohui Wen ◽  
Xupeng Shu ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Vitreoretinal Surgery ◽  
Sympathetic Ophthalmia ◽  
Positive Outcomes ◽  
Dexamethasone Intravitreal Implant ◽  
Intravitreal Implant ◽  
Pars Plana ◽  
23 Gauge

Sympathetic ophthalmia (SO) is a panuveitis that usually occurs after trauma to one eye. We describe two cases of SO occurring after 23-gauge vitrectomy. Case 1 involved a 66-year-old woman who underwent pars plana vitrectomy (PPV) for a rhegmatogenous retinal detachment. Two months later, she presented with decreased visual acuity (VA) and bilateral uveitis. Case 2 involved a 43-year-old woman who underwent a second PPV for recurrent retinal detachment. Two months later, she presented with bilateral panuveitis. Both patients were diagnosed with SO and were treated with methylprednisolone and cyclosporine. The first patient was further treated with a dexamethasone intravitreal implant (Ozurdex®) owing to the side effects of methylprednisolone. The VA and symptoms improved significantly after treatment in both patients. Bilateral granulomatous panuveitis following PPV should alert surgeons to consider SO. Appropriate interventions for SO can produce positive outcomes.

scholarly journals Effects of the Pars Plana Vitrectomy on the Chronic Total Rhegmatogenous Retinal Detachment in the Young Adults

2021 ◽  
Vol 8 ◽  
Author(s):  
Jinguo Yu ◽  
Xingxing Hu ◽  
Jiangkai Zhang ◽  
Han Han ◽  
Bo Huang ◽  
...  
Keyword(s):  
Young Adults ◽  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Retrospective Chart Review ◽  
Related Factors ◽  
Pars Plana ◽  
23 Gauge ◽  
Second Procedure

Objective: To observe the characteristics and evaluate the efficacy and safety of the chronic total rhegmatogenous retinal detachment (RRD) treatment by the 23-gauge pars plana vitrectomy (PPV) in young adults and to analyze the related factors.Methods: A retrospective chart review was performed for the young adults who underwent the 23-gauge PPV for the chronic total RRD at the Tianjin Medical University General Hospital from 2011 to 2018. A total of 54 eyes of 48 patients were included in this study. The preoperative vision ranged from 2.00 to 1.00. The mean duration of RRD was 9 ± 0.6 months with a range from 4 to 18 months. The proliferative vitreoretinopathy (PVR) grade D1 and grade D2 was diagnosed in 48 eyes and 6 eyes, respectively. About 37 eyes were filled with C3F8 and 17 eyes were filled with silicone oil tamponade. The follow-up ranged from 9 to 78 months with a mean of 23 ± 2.2 months.Results: The postoperative visual acuity increased in all the eyes at the final observation. The retinal attachment was achieved in 49 eyes (90.7%) in the primary PPV. Five eyes (9.3%) with the failed retinal attachment finally achieved the attachment after the second procedure. The postoperative complications mainly included temporary intraocular pressure (IOP) elevation, hyphema, and retinal redetachment.Conclusion: Chronic total RRD can be treated via the 23-gauge PPV with a great anatomical and visual prognosis in the young adult. The successful treatment of the chronic total RRD in young adults is mainly associated with the complete dissection of the severe vitreoretinopathy, especially for the epiretinal membrane at the retinal breaks and degenerations and the subretinal proliferation during surgery.

Hybrid 20/23-G pars plana vitrectomy in endophthalmitis and trauma: a strategic approach

2017 ◽  
Vol 28 (1) ◽  
pp. 94-97
Author(s):  
Daraius Shroff ◽  
Priyanka Gupta ◽  
Charu Gupta ◽  
Neelam Atri ◽  
Ranjan Dutta ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Silicone Oil ◽  
Vitreous Surgery ◽  
Safety And Efficacy ◽  
Suprachoroidal Space ◽  
Strategic Approach ◽  
Pars Plana ◽  
Silicone Oil Tamponade ◽  
Difficult Cases

Purpose: To assess the safety and efficacy of hybrid vitreous surgery combining active 23-G ports with a sutured 20-G 6-mm infusion cannula for performing vitrectomy in endophthalmitis and trauma. Methods: This is a retrospective analysis of 10 eyes with endophthalmitis and 10 eyes with trauma requiring vitreous surgery, having corneal clarity suitable for vitrectomy and best-corrected visual acuity (BCVA) greater than or equal to light perception. All patients underwent hybrid 20/23-G vitrectomy. Intraoperative notes were analyzed for peroperative complications. The BCVA and retinal status at 3 months were analyzed. Results: In the endophthalmitis group, patients ranged from 5 to 85 years of age and showed varied etiologies. Retinal detachment was present in 5 eyes, which received silicone oil tamponade. Mean preoperative logMAR visual acuity (VA) was 2.29 ± 0.45, which improved to 1.10 ± 0.72 at 3 months postoperatively (p<0.001). Trauma cases ranged from 21 to 75 years of age. Retinal detachment was present in 9 out of 10 eyes, all of which received silicone oil tamponade. Preoperative logMAR VA was 2.26 ± 0.71, which improved to 1.33 ± 0.50 postoperatively (p<0.001). At 3 months postsurgery, the retina was attached in all eyes in both groups. Conclusions: The longer sutured 20-G cannula was easier to visualize through fibrin, exudates, and hemorrhage and did not slip out or enter the suprachoroidal space in any of our cases. The 23-G active ports and vitrectomy cutter enhanced safety and efficacy. Hybrid vitrectomy enabled safe surgery in these difficult cases.

Primary Combined Pars Plana Vitrectomy and Phacoemulsification With Anterior Segment Removal of Posterior Segment Intraocular Foreign Bodies: A 30-Month Longitudinal Study

2018 ◽  
Vol 2 (2) ◽  
pp. 79-86
Author(s):  
Razek Georges Coussa ◽  
Fares Antaki ◽  
Ali Dirani ◽  
Thomas Cordahi ◽  
Radwan Ajlan ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Foreign Bodies ◽  
Anterior Segment ◽  
Posterior Segment ◽  
Long Term Results ◽  
Open Globe ◽  
Pars Plana

Purpose: To describe a surgical technique and report visual and anatomical outcomes after primary combined pars plana vitrectomy (PPV) and phacoemulsification in patients with posterior segment intraocular foreign bodies (IOFBs) removed via the anterior chamber without enlarging preexisting sclerotomies. Posterior IOFBs are generally managed in a stepwise surgery consisting of phacoemulsification/lensectomy for traumatic cataract removal then PPV and removal of IOFB through enlarged sclerotomies. Enlarged sclerotomies may carry a significant risk of hypotony, vitreous hemorrhage, vitreous and retinal incarceration, and rhegmatogenous retinal detachment with proliferative vitreoretinopathy. Limited studies exist on long-term results of primary anterior segment removal of posterior IOFB combined with primary phacoemulsification. Methods: Medical records of consecutive patients who had ocular lacerations and posterior segment IOFB between October 2003 and June 2017 in a university hospital were reviewed. Patients who received a combined primary IOFB removal and phacoemulsification were included in the study. The postoperative evolution including visual acuity and complications were all recorded. Results: Thirteen patients (13 eyes) were included in the study. All patients were men, and the average age at presentation was 38 years. All IOFB were metallic, and their size ranged from 2 to 7 mm. All patients were operated within 24 hours of presentation. Six (46%) of the 13 lacerations were corneal, and 7 (54%) were scleral. Overall, 9 of 13 (69%) had a final postoperative best-corrected visual acuity equal to or better than 20 of 25. There were 3 (23%) postoperative complications of recurrent rhegmatogenous retinal detachment that occurred within the first postoperative year. Conclusion: Primary combined PPV and phacoemulsification with the removal of IOFB via the anterior segment is a safe and promising approach for repairing open globe injuries. Our results demonstrate the favorable prognostic benefit of this technique, which is recommended in cases with small corneal laceration and posterior segment pathology resulting from IOFB.

scholarly journals Outcomes of Silicone Oil Removal in Complex Retinal Detachment

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.

Postoperative Complication Rates in 23- vs 25-Gauge Pars Plana Vitrectomy

2018 ◽  
Vol 2 (5) ◽  
pp. 272-275 ◽  
Author(s):  
Austin D. Igelman ◽  
John A. Johnson ◽  
Stanford C. Taylor ◽  
Brock J. Alonzo ◽  
Steven T. Bailey ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Postoperative Complication ◽  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Vitreoretinal Surgery ◽  
Complication Rates ◽  
Pars Plana ◽  
23 Gauge ◽  
Clinically Significant

Purpose: The purpose of this study was to compare rates of clinically significant complications between 23- and 25-gauge pars plana vitrectomy (PPV) in vitreoretinal surgery. Methods: Demographics, PPV indication, and surgical complications were reviewed. Patients with prior PPV or other retina surgery; cases requiring silicone oil removal, keratoplasty, or glaucoma valve implant; patients <18 years old; or patients with <4 months of follow-up were excluded. Comparative and descriptive statistics were used to evaluate the data. Results: A total of 579 eyes met inclusion criteria, and their charts were reviewed. Demographics, PPV indication, follow-up time, and lens status were similar ( P > .05). A 23-gauge PPV was performed more frequently than a 25-gauge PPV (328 vs 251 eyes, respectively). Although rates of eyes with a clinically significant postoperative complication requiring surgical intervention were higher in 23-gauge PPV (112/325, 34.4%) than in 25-gauge PPV (54/250, 21.6%), PPVs indicated by rhegmatogenous retinal detachment were more common with 23-gauge PPVs (155/325, 47.7%) than with 25-gauge PPVs (37/250, 14.8%; P <.001) and were more likely to have postoperative complications; however, rates of recurrent retinal detachments were not different in the 2 cohorts ( P = .862). When controlling for differences in indication, there was a moderately higher rate of postoperative complications following 23-gauge PPV ( P = .063). Conclusions: This retrospective review suggests that clinically significant complications are moderately more likely following 23-gauge PPV compared with 25-gauge PPV, even when the differences in surgical indication are considered.

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 Hemorrhagic Retinal Macrocyst with Retinal Detachment

2021 ◽  
Vol 62 (9) ◽  
pp. 1300-1304
Author(s):  
Ye Eun Han ◽  
Hyun-Ah Kim ◽  
June-Gone Kim
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Visual Disturbance ◽  
The Face ◽  
History Of ◽  
Pars Plana ◽  
23 Gauge ◽  
One Year ◽  
Oil Injection

Purpose: To report a satisfactory clinical outcome of hemorrhagic retinal macrocyst with retinal detachment after pars plana vitrectomy and silicone oil injection. Case summary: A 33-year-old man visited our clinic with a 1-week history of visual disturbance in his left eye. His ocular and medical history were unremarkable, and best-corrected visual acuity (BCVA) in the left eye was 20/40. Fundoscopic examination of the left eye showed a hemorrhagic retinal macrocyst that was well-demarcated, semi-transparent, dome-shaped, and larger than 8 disc diameters at the superonasal location, with macular-off retinal detachment. B-scan ultrasonography also confirmed the presence of an intra-retinal cystic lesion with internal mobile echogenic signals representing blood. The patient underwent 23-gauge pars plana vitrectomy, barrier laser photocoagulation around the retinal tear and boundary of the cyst, and silicone oil injection, without any other additional procedures for the hemorrhagic retinal macrocyst. After the surgery, the patient stayed in the face down position for two weeks. Three months postoperatively, a completely collapsed hemorrhagic retinal macrocyst with successful retinal reattachment was observed. Six months later, the BCVA in the left eye had improved to 20/30. One year later, even after silicon oil removal, the collapsed hemorrhagic retinal macrocyst and reattached retina remained stable.Conclusions: A hemorrhagic retinal macrocyst with retinal detachment was successfully treated with pars plana vitrectomy and silicone oil tamponade.

Our Experience with Perfluorohexyloctane (F6H8) as a Temporary Endotamponade in Vitreoretinal Surgery

2002 ◽  
Vol 12 (6) ◽  
pp. 518-522 ◽  
Author(s):  
M.I. Stefaniotou ◽  
M.V. Aspiotis ◽  
G.D. Kitsos ◽  
CHR.D. Kalogeropoulos ◽  
I.C. Asproudis ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Vitreoretinal Surgery ◽  
Additional Surgery ◽  
Special Cases ◽  
Perfluorocarbon Liquids ◽  
Pars Plana ◽  
Oil Injection ◽  
Anatomical Success

Purpose To evaluate the use of F6H8 as a temporary endotamponade for complicated and special cases of retinal detachment instead of silicone oil. Methods We have used F6H8 with 14 patients since February 1999. Eight suffered from rhegmatogenous retinal detachment (RRD) with multiple tears located inferiorly. Three presented inferior traction retinal detachment (TRD) under silicone oil, two suffered from ocular trauma with inferior TRD, and one had idiopathic macular hole. The substance was introduced into the eye after pars plana vitrectomy and membrane peeling if needed, and we tried to introduce as much as possible. Results With F6H8 the retina was easily reattached in all cases, like with perfluorocarbon liquids. The postoperative view was very good. F6H8 was removed in all cases after 3–8 weeks. Anatomical success was achieved in 12 out of 14 eyes. Two eyes presented severe PVR. F6H8 entered the anterior chamber in 4 cases, but no corneal complications occurred. In one case there was a marked IOP rise due to an anterior block, treated with superior iridotomy. In two cases retinal detachment (RD) occurred in the upper part and was treated with additional surgery, F6H8 removal and silicone oil injection. Conclusions F6H8 seems to be a promising tamponade agent for special cases of RD.

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