scholarly journals Posterior Approach in Management of Phacomorphic Angle Closure

2021 ◽  
Vol 12 (2) ◽  
pp. 717-723
Author(s):  
Andi Muhammad Ichsan ◽  
Geraldi Ayub Fujiwan Tombe ◽  
Anastasia Vanny Launardo ◽  
Junely Vimala Jaury ◽  
Andi Pratiwi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Pars Plana Vitrectomy ◽  
Posterior Approach ◽  
Corneal Thickness ◽  
Angle Closure ◽  
Management Technique ◽  
Laser Peripheral Iridotomy ◽  
Anterior Lens Capsule ◽  
Definitive Therapy ◽  
Pars Plana

This article presents a case of posterior lensectomy through 3-port pars plana vitrectomy for the management of phacomorphic angle closure. A 67-year-old man presented to the outpatient department with headache and decreased vision in his left eye for the past 3 days. Visual acuity 2/60, intraocular pressure (IOP) >60 mm Hg, and the anterior chamber (AC) depth Van Herick grade 1. A complete ophthalmologic examination revealed a phacomorphic angle closure. Serial management was performed consisting of mannitol 20% intravenously, laser peripheral iridotomy, and trabeculectomy. However, the depth of the AC became more shallow, and the IOP remained high. Lens extraction as definitive therapy could not be performed because of the adhesion of the iris and anterior lens capsule to the corneal endothelium; thus, posterior lensectomy using 3-port pars plana vitrectomy, and phacofragmatome was performed. Once the corneal thickness was returned to normal, and the AC depth was sufficient, the patient underwent secondary intraocular lens implantation. A significant improvement in visual acuity, normal IOP, and AC depth were achieved after the management of the posterior approach. Thus, this posterior approach should be considered a good option of management technique in cases with phacomorphic angle closure with very shallow AC depth and a fragile cornea.

scholarly journals Combined pars plana glaucoma drainage device placement and vitrectomy using a vitrectomy sclerotomy site for tube placement: a case series

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Enchi Kristina Chang ◽  
Sanchay Gupta ◽  
Marika Chachanidze ◽  
John B. Miller ◽  
Ta Chen Chang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Pars Plana Vitrectomy ◽  
Case Series ◽  
Tube Placement ◽  
Glaucoma Drainage Device ◽  
Drainage Device ◽  
Glaucoma Drainage Devices ◽  
Pars Plana ◽  
Sclerotomy Site

Abstract Purpose The purpose of this study is to report the safety and efficacy of pars plana glaucoma drainage devices with pars plana vitrectomy using one of the vitrectomy sclerotomy sites for tube placement in patients with refractory glaucoma. Methods Retrospective case series of 28 eyes of 28 patients who underwent combined pars plana glaucoma drainage device and pars plana vitrectomy between November 2016 and September 2019 at Massachusetts Eye and Ear. Main outcome measures were intraocular pressure (IOP), glaucoma medication burden, best corrected visual acuity, and complications. Statistical tests were performed with R and included Kaplan-Meier analyses, Wilcoxon paired signed-rank tests, and Fisher tests. Results Mean IOP decreased from 22.8 mmHg to 11.8 mmHg at 1.5 years (p = 0.002), and mean medication burden decreased from 4.3 to 2.1 at 1.5 years (p = 0.004). Both IOP and medication burden were significantly lower at all follow-up time points. The probability of achieving 5 < IOP ≤ 18 mmHg with at least 20% IOP reduction from preoperative levels was 86.4% at 1 year and 59.8% at 1.5 years. At their last visit, three eyes (10.7%) achieved complete success with IOP reduction as above without medications, and 14 eyes (50.0%) achieved qualified success with medications. Hypotony was observed in 1 eye (3.6%) prior to 3 months postoperatively and 0 eyes after 3 months. Visual acuity was unchanged or improved in 23 eyes (82.1%) at their last follow-up. Two patients had a visual acuity decrease of > 2 lines. Two eyes required subsequent pars plana vitrectomies for tube obstruction, and one eye had transient hypotony. Conclusions The results of pars plana glaucoma drainage device and pars plana vitrectomy using one of the vitrectomy sclerotomy sites for tube placement are promising, resulting in significant IOP and medication-burden reductions through postoperative year 1.5 without additional risk of postoperative complications. Inserting glaucoma drainage devices into an existing vitrectomy sclerotomy site may potentially save surgical time by obviating the need to create another sclerotomy for tube placement and suture one of the vitrectomy ports.

Vitrectorhexis in penetrating eye injuries in adults

2018 ◽  
Vol 29 (6) ◽  
pp. 689-693
Author(s):  
Miklós D Resch ◽  
Anikó Balogh ◽  
Gábor L Sándor ◽  
Zsuzsanna Géhl ◽  
Zoltán Zsolt Nagy
Keyword(s):  
Foreign Body ◽  
Pars Plana Vitrectomy ◽  
Anterior Segment ◽  
Posterior Chamber ◽  
Ocular Injury ◽  
Eye Injuries ◽  
Anterior Capsule ◽  
Safe Alternative ◽  
Anterior Lens Capsule ◽  
Pars Plana

Introduction: Vitrectorhexis is an alternative for manual continuous curvilinear capsulorhexis originally developed for paediatric cataract surgery. The aim of our study was the evaluation of the technique in adult patients with penetrating ocular injury and traumatic cataracts. Methods: Eight eyes of 8 patients (23–41 years, all males) had penetrating mechanical corneal trauma. Anterior lens capsule was penetrated in all cases and additional posterior capsule defect in five cases. Intraocular foreign body was detected in one case in the crystalline lens and in two cases in the posterior segment. Standard 23G infusion cannula and vitreous cutter were applied to perform anterior capsule opening, removal of lens material, anterior vitrectomy and pars plana vitrectomy if needed. No phacoemulsification or irrigation/aspiration probe was used. Results: Vitrectorhexis could be performed in 7 out of 8 cases with the preservation of peripheral anterior capsule; primary implantation of posterior chamber intraocular lens was possible in all cases (in the bag in three eyes and into the sulcus in five eyes). Anterior chamber was stable in all cases intraoperatively, and no dropped nucleus or lens fragment loss was observed. Surgery was combined with pars plana vitrectomy in three cases, with foreign body removal (when necessary). No postoperative complication occurred. Conclusion: Vitrectorhexis was found to be an effective and safe alternative method in the management of complex anterior segment trauma cases. With its use, traditional cataract surgical devices can be substituted and additional benefits of vitreous cutter can be utilized in selected cases, especially in young adults.

scholarly journals A Female Case of X-Linked Retinoschisis with Macular Hole Bilaterally

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
A. Altun
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Surgical Experience ◽  
Flap Technique ◽  
Macular Holes ◽  
Female Case ◽  
Pars Plana

Purpose. We aimed at reminding that X-linked retinoschisis may also be seen in female patients and share our vitreoretinal surgical experience. Methods. The patient underwent pars plana vitrectomy including the closure of the macular holes with inverted ILM flap technique bilaterally. Lens extractions were performed by phacoemulsification during the removal of silicone oil endotamponade. Patient. An 18-year-old girl with X-linked retinoschisis and large macular holes in both eyes presented to the clinic of ophthalmology. It was confirmed that the patient had RS1 mutation Results. Nine-month-follow-up was uneventful for retinal findings. Significant improvement in visual acuity was achieved, and macular holes were remained closed. Conclusion. In cases with large macular holes due to XLR, an inverted ILM flap technique might be safe and effective. Four-month-silicone-endotamponade might be sufficient.

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 Visual Outcomes and Prognostic Factors after Pars Plana Vitrectomy for Traumatic Endophthalmitis

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Tao Jiang ◽  
Jing Jiang ◽  
Renping Wang ◽  
Jianlin Lei ◽  
Yang Zhou
Keyword(s):  
Visual Acuity ◽  
Prognostic Factors ◽  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Primary Treatment ◽  
Visual Prognosis ◽  
Visual Outcomes ◽  
Pars Plana ◽  
Vitrectomy Surgery ◽  
Better Than

Purpose. To evaluate visual outcomes and identify prognostic factors after pars plana vitrectomy (PPV) surgery for traumatic endophthalmitis. Methods. Medical records of 121 consecutive patients (121 eyes) diagnosed with traumatic endophthalmitis that had undergone pars plana vitrectomy were retrospectively reviewed. Results. 121 patients, aged from 6 to 71 years, all underwent PPV surgery. 113 cases had improved best corrected visual acuity (BCVA) after surgery and 60% of them obtained BCVA better than fingers counting (FC). Good final visual prognosis was significantly associated with time between trauma and initial treatment less than 12 hrs (40% versus 98%; P<0.001), time between trauma and PPV treatment less than 24 hrs (62% versus 98%; P<0.001), laceration length less than 10 mm (63% versus 96%; P<0.001), and presenting VA better than LP (42% versus 96%; P<0.001), while gender, type of laceration, presence of IOFB or retinal detachment, and the use of silicone oil tamponade were not significant factors resulting in better BCVA. Bacteria were identified in 43.8% of specimens and most of the microorganisms were identified as nonvirulent ones. Conclusions. Pars plana vitrectomy surgery was preferred as a primary treatment option for traumatic endophthalmitis. A good final visual prognosis was significantly associated with timely treatment, prompt vitrectomy surgery, shorter length of laceration, and better presenting visual acuity.

Subinternal Limiting Membrane Hemorrhage Related to Laser Exposure in 2 Young Patients

2018 ◽  
Vol 2 (4) ◽  
pp. 244-247 ◽  
Author(s):  
Stanislao Rizzo ◽  
Ruggero Tartaro ◽  
Andrea Giorni ◽  
Alfonso Savastano
Keyword(s):  
Visual Acuity ◽  
Clinical Condition ◽  
Pars Plana Vitrectomy ◽  
Young Patients ◽  
Laser Exposure ◽  
Retinal Damage ◽  
Pars Plana

Purpose: Lasers can be sight damaging, because they can produce severe and permanent retinal damage. Methods: This paper reports two cases of subinternal limiting membrane (sub-ILM) hemorrhage related to laser exposure. Results: The first patient was only observed for the reason that the retinal localization was extramacular; for the second patient, we decided to perform ultraspeed (7500 cuts per minute) 27-gauge pars plana vitrectomy (PPV) because of the foveal position of the hemorrhage and because of the nonimprovement of his clinical condition. The first patient recovered 20/20 Snellen after 10 days without intervention, whereas the second patient recovered 15/20 Snellen the day after surgery; 15 days later, his visual acuity was 20/20 Snellen. Conclusions: Sub-ILM hemorrhage after exposure to lasers can be treated using an ultraspeed 27-gauge PPV. This tool can be considered safe and effective on non–self-resolving sub-ILM hemorrhage.

scholarly journals Effect of Bevacizumab Injection before Vitrectomy on Intravitreal Hemorrhage in Pseudophakic Patients with Proliferative Diabetic Retinopathy

2013 ◽  
Vol 5 ◽  
pp. OED.S12352 ◽  
Author(s):  
Mehmet Demir ◽  
Ersin Oba ◽  
Efe Can ◽  
Orhan Kara ◽  
Sonmez Cinar
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Pars Plana Vitrectomy ◽  
Intravitreal Bevacizumab ◽  
Central Macular Thickness ◽  
Intraoperative Bleeding ◽  
Corrected Visual Acuity ◽  
Pars Plana ◽  
The Mean

We evaluated the effect of intravitreal bevacizumab (IVB) injection before pars plana vitrectomy (PPV) on intravitreal hemorrhage (VH) during and after vitrectomy for postoperative the first day and the first month in pseudophakic patients with proliferative diabetic retinopathy (PDR). This retrospective study was performed on 44 eyes of 44 patients who underwent vitrectomy for PDR. Patients were divided into PPV (n = 22 eyes) and PPV + IVB (n = 22 eyes) groups. Injection of bevacizumab (1.25 mg/0.05 mL) was performed 3 days before vitrectomy. Outcomes of visual acuity as well as intraoperative and postoperative VH were compared between the two groups. One month after surgery, visual acuity improved in PPV and PPV + IVB groups ( P = 0.005, P = 0.006), respectively. There was no difference between the two groups in best corrected visual acuity at baseline and after vitrectomy ( P = 0.71). Intraoperative bleeding into the vitreous was recorded in 14 (63.6%) cases in the PPV group and in 7 (31.8%) cases in the PPV + IVB group. The first month, intravitreal hemorrhage was recorded in six patients in the PPV group and in two patients in the PPV + IVB group ( P = 0.03). The mean pre-postoperative central macular thickness was similar in both groups. Intravitreal injection of IVB before vitrectomy decreased the rate of VH at the time of surgery and at the first postoperative month in patients with PDR.

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

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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