scholarly journals Long-Term Effect of Silicone Oil Tamponade for Postoperative and Posttraumatic Bacterial Endophthalmitis

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Yong Koo Kang ◽  
Jae Pil Shin ◽  
Han Sang Park
Keyword(s):  
Visual Acuity ◽  
Silicone Oil ◽  
Streptococcus Group ◽  
Hand Motion ◽  
Time To Surgery ◽  
Bacterial Endophthalmitis ◽  
Additional Surgery ◽  
Positive Rate ◽  
The Mean ◽  
Mean Time

Purpose. To compare clinical features and microbial profiles, treatment outcomes, and prognostic factors of the eyes between postoperative and posttraumatic bacterial endophthalmitis after pars plana vitrectomy (PPV) with silicone oil (SO) tamponade. Methods. Overall, 57 eyes of 57 patients who diagnosed exogenous bacterial endophthalmitis and underwent PPV with SO tamponade between 2000 and 2019 were reviewed. Causative microorganisms, culture positivity, change of mean best-corrected visual acuity (BCVA), and course of treatment were investigated between postoperative and posttraumatic groups, and relevant factors were analyzed according to the final BCVA. Results. The mean BCVA change was not significantly different between groups. The positive rate of microorganisms was significantly higher in the postoperative group. The mean time to surgery over 48 hours, initial BCVA worse than hand motion, and additional surgery after initial vitrectomy were correlated with poor final BCVA worse than 20/200. There was significantly achieved final BCVA 20/200 or better in the Staphylococcus and Streptococcus group than the Enterococcus and Pseudomonas group. Conclusion. PPV with SO tamponade may be an effective surgical treatment strategy for exogenous bacterial endophthalmitis. Final visual outcomes were not significantly different between postoperative and posttraumatic groups, and the mean time to surgery, initial visual acuity, additional surgery, and type of microorganism are significantly related to visual prognosis.

scholarly journals Intraocular lipopolysaccharide examination for early diagnosis of Stenotrophomonas maltophilia endophthalmitis: a case report

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052092986
Author(s):  
Li Chen ◽  
Zhuo Zai Xu ◽  
Yong Tao
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Early Diagnosis ◽  
Stenotrophomonas Maltophilia ◽  
Gram Negative ◽  
Hand Motion ◽  
Bacterial Endophthalmitis ◽  
Negative Bacillus ◽  
Gram Negative Bacillus ◽  
Intraocular Fluid

This report describes the presence of Stenotrophomonas maltophilia endophthalmitis after phacoemulsification in a 66-year-old woman. The patient presented with ocular redness and pain, as well as hypopyon in the anterior chamber and reduction of visual acuity to hand motion. Intraocular fluid examination revealed a lipopolysaccharide level of >2.5, which suggested bacterial endophthalmitis. The patient was promptly treated with intravitreal ceftazidime 2 mg and vancomycin 1 mg, as well as intravenous infusion of cefuroxime 750 mg, all administered simultaneously at 12-hour intervals. She also received topical levofloxacin eyedrops, once per hour. Subsequently, pathology culture confirmed the presence of the Gram-negative bacillus, S. maltophilia. The presence of lipopolysaccharide in intraocular fluid is an important early indicator of bacterial endophthalmitis, which can provide guidance for clinical treatment.

Outcomes After the Use of Silicone Oil in Complex Retinal Detachment Repair

2020 ◽  
Vol 4 (2) ◽  
pp. 96-102
Author(s):  
Omar A. Saleh ◽  
Efrat Fleissig ◽  
Charles C. Barr
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Chart Review ◽  
Silicone Oil ◽  
Retrospective Chart Review ◽  
Final Visit ◽  
Complication Rates ◽  
Minimum Angle ◽  
The Mean ◽  
Better Than

Purpose: This study compares visual acuity (VA), anatomic outcomes, and complications in eyes that underwent complex retinal detachment (RD) repair in which silicone oil (SO) was retained vs removed. Methods: A retrospective chart review of patients undergoing vitrectomy with SO tamponade. The eyes were divided into 2 groups based upon SO removal or retention. Main outcome measures were corrected VA, anatomic outcomes, and the presence of SO-related complications. Results: Fifty-seven eyes with removed SO and 53 eyes with retained SO were identified. In both groups, the mean best-corrected VA (BCVA) at the final visit was significantly better than at baseline. In the retained-SO group, vision improved from 1.79 ± 0.6 to 1.2 ± 0.7 logarithm of the minimum angle of resolution (logMAR) (Snellen, 20/1200 to 20/350) at the final visit ( P < .001). In the removed-SO group, mean BCVA improved from 1.84 ± 0.5 at baseline to 1.55 ± 0.6 logMAR units (Snellen, 20/1400 to 20/700) at the visit preceding SO removal ( P < .002) and to 1.43 ± 0.6 logMAR units (Snellen, 20/500) at the final visit ( P < .001). Complication rates were similar in both groups, apart from RD, which occurred more frequently in the removed-SO group ( P = .03). Conclusions: There was similarity in VA and complications among patients with removed or retained SO. Removal of SO may benefit eyes with SO-related complications, but SO retention may decrease the chance of RD and may be indicated in selected cases.

scholarly journals Passive Removal of Silicone Oil with Temporal Head Position through Two 23-Gauge Cannulas

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Zhong Lin ◽  
Zhi Sheng Ke ◽  
Qian Zheng ◽  
Zhen Quan Zhao ◽  
Zong Ming Song
Keyword(s):  
Silicone Oil ◽  
Fast Method ◽  
Oil Removal ◽  
Slit Lamp ◽  
New Approach ◽  
The Mean ◽  
23 Gauge ◽  
Mean Time ◽  
Vitrectomy System ◽  
Air Exchange

Purpose. To report a new approach for removal of silicone oil. Methods. All surgeries were performed using 23-gauge vitrectomy system with two transconjunctival sutureless cannulas. At the beginning, most of the silicone oil was removed by traditional microinvasive vitrectomy system through inferior-temporal cannula. Then, the blood transfusion tube is removed from the inferior-temporal cannula, and the fluid-air exchange is performed. A passive fluid-air exchange was performed to aspirate the residual silicone oil after gradually turning the patient’s head temporally by approximately 90° gradually. Results. After the surgery, all patients had a clear anterior chamber and vitreous cavity on slit lamp and B scan examination, respectively. The mean time taken for silicone oil removal and total surgery was 8.0±1.4 minutes and 12.4±2.5 minutes, respectively. The mean intraocular pressure 1 day, 3 days, 1 week, 1 month, and 3 months after surgery was 9.0±5.8 mmHg, 11.3±7.6 mmHg, 16.1±6.9 mmHg, 17.7±4.8 mmHg, and 17.1±3.5 mmHg, respectively. Conclusion. This new approach may provide a safe and fast method to remove the silicone oil.

scholarly journals Clinical outcomes following intravitreal methotrexate for primary vitreoretinal lymphoma

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Casey L. Anthony ◽  
J. Clay Bavinger ◽  
Jessica G. Shantha ◽  
Ghazala D. O’Keefe ◽  
William A. Pearce ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Clinical Outcomes ◽  
Systemic Chemotherapy ◽  
Cns Lymphoma ◽  
Primary Vitreoretinal Lymphoma ◽  
Vitreoretinal Lymphoma ◽  
Intravitreal Treatment ◽  
The Mean ◽  
Mean Time

Abstract Purpose To describe the visual acuity and anatomic outcomes of intravitreal methotrexate (MTX) for the treatment of primary vitreoretinal lymphoma (PVRL). Methods Single-center retrospective case series of patients with a diagnosis of PVRL treated with intravitreal MTX. Patient records were reviewed for demographic information, ocular exam findings, and treatment regimens including number of MTX injections. Clinical outcomes recorded included visual acuity (VA), time to partial (PR) or complete response (CR), disease-free survival, time to relapse, and any CNS progression. Results Ten eyes of 7 patients (4 male, 6 female) were reviewed. The mean age ± standard deviation (SD) was 70 ± 12 years. Five patients had prior or concomitant diagnosis of primary CNS lymphoma with a history of systemic chemotherapy including MTX. Three eyes (30%) exhibited isolated vitreous involvement, four (40%) had subretinal lesions, and three (30%) presented with both vitreous and subretinal disease. Mean initial logMAR VA was 0.38 ± 0.52 (Snellen visual equivalent 20/50), while mean final logMAR VA ± SD was 0.34 ± 0.27 (Snellen visual equivalent 20/40) with a mean follow-up time of 26 months (Range, 3–49 months). Patients received an average of 6 intravitreal MTX injections (Range 1–10) over the course of treatment. Two patients received concomitant systemic chemotherapy. Mean time to either PR or CR was 57 days, and 6 eyes (60%) exhibited regression with no relapse after local treatment. For the 4 eyes that eventually relapsed, the mean time ± SD to first relapse was 193 days ± 155 days, and one eye experienced a second relapse. Two of 3 patients with subretinal disease showed complete regression with extended follow-up of 1 and 4 years following treatment with less than 3 doses of intravitreal MTX. One patient with PVRL developed CNS lymphoma during the study period. VA remained stable overall between the initial treatment visit, 3, 6, and 12-months (P > 0.05 for paired comparisons of VA over time). Conclusions Intravitreal methotrexate was well-tolerated and led to local disease response in the majority of patients at approximately 2 months after initiation of treatment of intraocular lymphoma. Further studies on the efficacy of intravitreal treatment alone versus combined systemic and intravitreal treatment are warranted.

scholarly journals Predictors of Visual Acuity and Usefulness of a Treatment Algorithm in Rhinogenous Optic Neuritis

2019 ◽  
pp. 014556131986549
Author(s):  
Yu Hosokawa ◽  
Kazuhiro Omura ◽  
Satoshi Aoki ◽  
Keisuke Miyashita ◽  
Makoto Akutsu ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Optic Neuritis ◽  
Early Treatment ◽  
Treatment Algorithm ◽  
Sinus Surgery ◽  
Initial Examination ◽  
Visual Outcomes ◽  
Postoperative Visual Acuity ◽  
The Mean ◽  
Mean Time

Rhinogenous optic neuritis, which causes neuropathy associated with visual dysfunction, greatly reduces patient quality of life and requires suitable early treatment. This study aimed to analyze visual outcome predictors in patients with rhinogenous optic neuritis and to develop and investigate the usefulness of an algorithm to facilitate early treatment. Prospective and retrospective investigations were conducted at the Department of Otorhinolaryngology. The visual outcomes after sinus surgery of 24 of 53 patients suspected of having rhinogenous optic neuritis were analyzed. Furthermore, the usefulness of the treatment algorithm was evaluated in 27 of these 53 patients. Data from 24 patients who underwent surgery were included in a multiple regression analysis to investigate the associations between visual outcomes and concomitant symptoms and the time from symptom onset to surgery. The mean time from the initial examination to a request for otorhinolaryngological examination to assess the usefulness of the treatment algorithm was compared in 27 patients who did not undergo an initial otorhinolaryngological examination. Visual acuity improved in 23 participants who underwent surgery. Multivariate analysis identified the time from onset to surgery and headache as significant predictors of postoperative visual acuity. The mean time from the initial examination to a request for otorhinolaryngological examination was significantly shorter after the algorithm was introduced (1.13 days, 8 patients; P = .008). Early surgical treatment is essential to avoid further postoperative visual acuity decreases in patients with rhinogenous optic neuritis. Patients who experience headache may have poorer postoperative outcomes.

scholarly journals Phacovitrectomy without preoperative steroids for rhegmatogenous retinal detachment with associated choroidal detachment

2018 ◽  
Author(s):  
Junmin Gui ◽  
Ling Ai ◽  
Ting Huang
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Silicone Oil ◽  
Final Visit ◽  
Choroidal Detachment ◽  
Postoperative Visual Acuity ◽  
Single Operation ◽  
Preoperative Administration ◽  
Surgical History ◽  
The Mean

Abstract Background: To report the anatomical and visual outcomes of combined phacoemulsification and micro-invasive pars plana vitrectomy (phacovitrectomy) without preoperative administration of steroids in the treatment of combined retinal detachments associated choroidal detachment(RRD/CD). Methods: Medical records of patients who were diagnosed as RRD/CD without past ocular trauma and surgical history were retrieved and analyzed. All the patients were treated with phacovitrectomy plus silicone oil (SO) tamponade without preoperative steroids. Patients were followed up at least 3 months postoperatively. The mean follow-up time were 10.3±10.1 months. Results: Seventeen patients (17 eyes), 8 women and 9 men, met the including criteria with mean age of 60.4±8.4 years. None of these eyes had intraocular lens implanted and none had combined scleral procedures in the primary surgical intervention. Preoperative B ultrasound showed that choroidal detachment was severe in 10 eyes (58.8%), moderate in 2 eyes (11.8%) and mild in 5 eyes(29.4%). Fifteen eyes(82.4%) had retina reattached after single operation. Of these 15 eyes, 14 eyes had SO removed, 8 of them had intraocular lens implanted, 2 eye had epimacular membrane peeling at the time of SO removing and one eye was refilled with SO. Two patients had retinal redetached within a month after primary surgical repair due to proliferation and would not willing to take re-operation. Fifteen eyes had postoperative visual acuity improved, 10 eyes had postoperative visual acuity equal or great than 0.1(20/200). The mean IOP at final visit was 15.7±4.2 mmHg, ranging from 10 to 28 mmHg. Conclusions: Phacovitrectomy without preorerative steroids can achieve a satisfied single-operation anatomic and functional outcome. Free of preoperative steroid intervention will not only reduce the time waiting for surgery but also avoid the complications associated with systemic or local administration of steroids.

scholarly journals Endophthalmitis: 5 Years Experience in a Tertiary Eye Care Center Mohammed V Military Medical Training Hospital

2019 ◽  
pp. 1-7
Author(s):  
Rachid Zerrouk ◽  
Yassine Malek ◽  
Adil Elkhoyaali ◽  
Yassine Mouzari ◽  
Karim Reda ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Medical Training ◽  
Care Center ◽  
Postoperative Endophthalmitis ◽  
Eye Care ◽  
Ocular Pain ◽  
Hand Motion ◽  
Gram Positive Bacteria ◽  
Exogenous Endophthalmitis ◽  
Mean Time

Aims: To describe endophthalmitis profile in a tertiary eye care center. Study Design: Retrospective study. Place and Duration of Study: The ophthalmology department of The Mohammed V Military Medical Training Hospital in Rabat, and covering all patients hospitalized for endogenous and exogenous endophthalmitis between January the 1st 2014, and 31 of December 2018. Methodology: We included 41 eyes from 41 patients with endophthalmitis. Results: On a total of 41 eyes, mean age was 53,8 years, with a sex ratio of 1,7. Mean time from onset of symptoms to presentation was 8 +/- 4 days (3 to 32) for postoperative endophthalmitis, and 13 +/- 9 days (2 – 30) for other causes. 98% of patients presented decreased vision, and 88% showed ocular pain. 94% of patients had a visual acuity less than hand motion. Gram positive bacteria were isolated in 76% of the patients. Conclusion: Our epidemiological, clinical and microbial findings are similar to some occidental and other oriental series.

Arthrodesis of the Wrist for Osteoarthritis: Outcome with a Minimum Follow-up of 4 Years

2003 ◽  
Vol 28 (6) ◽  
pp. 575-577 ◽  
Author(s):  
L. DE SMET ◽  
J. TRUYEN
Keyword(s):  
Pain Relief ◽  
Grip Strength ◽  
Contralateral Side ◽  
Dash Score ◽  
Wrist Arthrodesis ◽  
Additional Surgery ◽  
The Mean ◽  
Mean Time ◽  
Manual Activity

The outcome of total wrist arthrodesis was reviewed in 36 patients with osteoarthritis after a minimum follow-up of 4 years. Pain relief was not complete, and although 20 were pain free at rest, only six were pain-free during manual activity. Grip strength was 63% of the contralateral side and the DASH score remained high. Only 21 of the 34 could be re-employed. The mean time off work was 14 months. Complications were numerous and additional surgery was required in 21 patients.

A comparison of long-term outcomes of translaminar facet screw fixation and pedicle screw fixation: a prospective study

2007 ◽  
Vol 7 (3) ◽  
pp. 287-292 ◽  
Author(s):  
Jayshree Tuli ◽  
Sagun Tuli ◽  
Marc E. Eichler ◽  
Eric J. Woodard
Keyword(s):  
Prospective Study ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Long Term Outcomes ◽  
Time To Surgery ◽  
Significant Difference ◽  
The Mean ◽  
Mean Time

Object In this paper, the authors compare the long-term outcomes of translaminar facet screw fixation (TFSF) and pedicle screw fixation (PSF) in the treatment of degenerative lumbosacral disease. Methods This prospective analytical study was performed to compare the long-term outcomes of TFSF and PSF for degenerative lumbosacral disease. Outcomes were defined as the need for reoperation for the development of a nonunion, end-fusion degeneration, or for explantation of hardware. Results A total of 77 patients were analyzed. Thirty-seven patients underwent PSF and 40 received TFSF. Twenty-three of the 77 patients required a reoperation: 13 (32.5%) of the 40 patients in the TFSF group and 10 (27%) of the 37 the patients in the PSF group. The overall mean time to reoperation (regardless of outcome) was 4.05 years. For patients in the TFSF group the mean time to reoperation was 2.94 years, whereas it was 4.35 years in the PSF group (p = 0.34). Nonunion was noted in seven of the 40 patients in the TFSF group and one of 37 in the PSF group. The mean time to surgery for nonunion for patients in the TFSF group was 3.46 years and for those in the PSF group it was 6.27 years (p = 0.04). Surgery for end-fusion degeneration was performed in two patients in the TFSF group and five in the PSF group (p = 0.43). Explantation of hardware was performed in two patients with TFSF and four patients with PSF. Multivariable analysis revealed a statistically significant difference in the time to surgery for nonunion between PSF and TFSF (p = 0.048), with a hazard ratio of 0.097 (95% confidence interval 0.01–0.98). Conclusions Findings from the current prospective study suggest that there is an increased risk of requirement for a reoperation for nonunion among TFSF cases compared with PSF cases.

scholarly journals Plasma Rich in Growth Factors in Macular Hole Surgery

2022 ◽  
Vol 12 (1) ◽  
pp. 57-69
Author(s):  
Ronald M. Sánchez-Ávila ◽  
Carlos A. Robayo-Esper ◽  
Eva Villota-Deleu ◽  
Álvaro Fernández-Vega Sanz ◽  
Álvaro Fernández-Vega González ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Growth Factors ◽  
Adjuvant Therapy ◽  
Macular Hole ◽  
Silicone Oil ◽  
Internal Limiting Membrane ◽  
Internal Limiting Membrane Peeling ◽  
Pars Plana ◽  
The Mean

The aim of this study was to evaluate the use of PRGF (plasma rich in growth factors) as an adjuvant to PPV (pars plana vitrectomy) in recurrent, persistent, or poor prognosis MH (macular hole). Patients with MH were treated with PPV plus adjuvant therapy (PRGF membrane (mPRGF) and injectable liquid PRGF (iPRGF)). The anatomical closure of MH and postoperative BCVA (best-corrected visual acuity) were evaluated. Eight eyes (eight patients) were evaluated: myopic MH (MMH, n = 4), idiopathic MH (IMH, n = 2), iatrogenic n = 1, traumatic n = 1. The mean age was 53.1 ± 19.3 years. Hence, 66.7% (n = 4) of patients previously had internal limiting membrane peeling. Five patients (62.5%) received mPRGF and iPRGF, and three patients (37.5%) received iPRGF. Gas tamponade (C3F8) was placed in seven cases and one case of silicone oil. Anatomic closure of MH was achieved in seven eyes (87.5%) and BCVA improved in six cases. In the MMH group, visual acuity improved in two lines of vision. Follow-up time was 27.2 ± 9.0 months. No adverse events or MH recurrences were recorded during follow-up. The use of PRGF as an adjuvant therapy to PPV can be useful to improve anatomical closure and visual acuity in MH surgery.

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