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

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.

2002 ◽  
Vol 12 (6) ◽  
pp. 518-522 ◽  
Author(s):  
M.I. Stefaniotou ◽  
M.V. Aspiotis ◽  
G.D. Kitsos ◽  
CHR.D. Kalogeropoulos ◽  
I.C. Asproudis ◽  
...  

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.


2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Hui-Jin Chen ◽  
Chang-Guan Wang ◽  
Hong-Liang Dou ◽  
Xue-Feng Feng ◽  
Kang Feng ◽  
...  

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.


2021 ◽  
pp. 112067212110128
Author(s):  
Mumin Hocaoglu ◽  
Murat Karacorlu ◽  
M. Giray Ersoz ◽  
Isil Sayman Muslubas ◽  
Serra Arf

Purpose: To describe the treatment outcomes and prognostic factors of retinotomy/retinectomy for rhegmatogenous retinal detachment (RD) complicated anterior inferior proliferative vitreoretinopathy (PVR). Methods: Retrospective, nonrandomized, single-center case series. The outcomes of 126 cases of retinotomy/retinectomy for RD complicated by advanced (Grade C) anterior inferior PVR managed consistently by one surgeon during a 15-year period were evaluated. Results: Forty-two eyes (33%) had primary RDs and 84 (67%) had recurrent RDs. The extent of retinotomy/retinectomy varied: 90° in 21 eyes (17%), >90° to <180° in 49 eyes (39%), and ⩾180° to ⩽240° in 56 eyes (44%). The retinotomy/retinectomy location was peripheral in 58 eyes (46%) and equatorial in 68 eyes (54%). The mean follow-up period was 43 ± 42 months. The silicone oil (SO) was removed from 98% of the eyes. The single-operation success rate after the primary retinectomy was 87%, and the final attachment rate was 94%. Visual acuity improved from 20/630 to 20/160 ( p < 0.001). Vision ⩾20/200 was achieved in 101 eyes (80%). Good visual outcome was correlated positively with preoperative VA ( p = 0.02), previous vitrectomy with gas tamponade ( p = 0.007), and was negatively correlated with number of previous RD operations ( p = 0.01), larger extent of RD ( p = 0.02) and more extensive retinotomy/retinectomy ( p = 0.04). Conclusions: An appropriate and timely intervention, including vitrectomy alone, inferior relaxing retinotomy/retinectomy and standard SO tamponade provide satisfactory outcomes for RDs complicated by PVR. Lesser extension of grade C PVR at baseline, such as PVR limited to one quadrant should encourage vitreoretinal specialists to consider retinotomy/retinectomy at a milder clinical stage of PVR development.


Pathogens ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 1046
Author(s):  
Robert Kuthan ◽  
Anna K. Kurowska ◽  
Justyna Izdebska ◽  
Jacek P. Szaflik ◽  
Anna Lutyńska ◽  
...  

This report describes the first case of an ocular infection induced by Purpureocillium lilacinum in Poland. The patient was a 51-year-old immunocompetent contact lens user who suffered from subacute keratitis and progressive granulomatous uveitis. He underwent penetrating keratoplasty for corneal perforation, followed by cataract surgery due to rapid uveitic cataract. A few weeks later, intraocular lens removal and pars plana vitrectomy were necessary due to endophthalmitis. The patient was treated with topical, systemic, and intravitreal voriconazole with improvement; however, the visual outcome was poor. The pathogen was identified by MALDI-TOF MS.


2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Katarzyna Nowomiejska ◽  
Tomasz Choragiewicz ◽  
Dorota Borowicz ◽  
Agnieszka Brzozowska ◽  
Joanna Moneta-Wielgos ◽  
...  

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.


Despite improvements in vitreoretinal surgery techniques, rhegmatogenous retinal detachment is still one of the major causes of visual loss in the world. Pneumatic retinopexy (PR), scleral buckle, and pars plana vitrectomy (PPV) are the modalities that are used in the treatment of retinal detachment. Intraocular gases, which are frequently used in PR and PPV, are indispensable molecules due to their tamponade effects. In order to get favorable postoperative outcomes, the proper type of gas selection should be made by considering the properties of the gases, indications, potential complications, and findings of the patients together.


2020 ◽  
Vol 29 (4) ◽  
pp. 328
Author(s):  
Nilay KANDEMIR BESEK ◽  
Gurkan ERDOGAN ◽  
Erdem ERIS ◽  
Mehmet Onur ER ◽  
Orcun SONMEZ ◽  
...  

2020 ◽  
pp. 247412642097455
Author(s):  
Kunyong Xu ◽  
Eric K. Chin ◽  
David R.P. Almeida

Purpose: We describe the outcome of a 23-year-old man undergoing vitreoretinal surgery for a macula-off rhegmatogenous retinal detachment secondary to a giant retinal tear. Methods: Patient underwent combined 25- gauge 3-port pars plana vitrectomy with scleral buckle, perfluorocarbon liquid, and perfluoropropane gas tamponade. During surgery, triamcinolone inadvertently entered the subretinal space and was retained. Results: The subretinal triamcinolone deposits spontaneously absorbed over a 2-month period. No adverse sequelae were associated with this complication. Conclusion: This may support avoiding aggressive mechanical removal of iatrogenic subretinal triamcinolone in the context of retinal detachment repair.


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