scholarly journals Comparison of safety and effectiveness between 23-gauge and 25-gauge vitrectomy surgery in common vitreoretinal diseases

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248164
Author(s):  
Aleksandra Sedova ◽  
Irene Steiner ◽  
Rene Peter Matzenberger ◽  
Michael Georgopoulos ◽  
Christoph Scholda ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Gauge Group ◽  
Vitreoretinal Surgery ◽  
Vitreous Hemorrhage ◽  
Gauge Groups ◽  
Department Of Ophthalmology ◽  
Vitreoretinal Diseases ◽  
The Difference ◽  
23 Gauge ◽  
25 Gauge Vitrectomy

Purpose To assess and compare safety and effectiveness between 23-gauge and 25-gauge vitrectomy systems for the treatment of common vitreoretinal diseases in non-vitrectomized eyes. Methods Retrospective evaluation of patients who underwent pars plana vitrectomy from April 2018 to December 2019 at the Department of Ophthalmology and Optometry at the Medical University of Vienna (MUV) for the following indications: macular epiretinal membrane, macular hole, macular lamellar hole, vitreous hemorrhage, vitreous opacities, vitreomacular traction syndrome and macular edema. Results 201 eyes of 195 patients that underwent 23-gauge (n = 105 eyes) or 25-gauge (n = 96 eyes) vitrectomy were included in this study. The mean best-corrected visual acuity (BCVA) improved at 1–3 months postoperatively and beyond 3 months in both gauge groups. Risk of any complication within 1 month postoperatively was lower in the 25-gauge group, but the difference was statistically not significant (HR [95% CI]: 0.95 [0.53; 1.70], p = 0.85). Intraocular pressure less than 5 mmHg was observed in 2 eyes (2%) in the 23-gauge group at the first postoperative day. Intraocular pressure elevation over 25 mmHg occurred in 5 eyes (2 eyes, 2%, in 23-gauge and 3 eyes, 3%, in 25-gauge group) at postoperative day 1, between 7 and 28 days in 5 cases (2 eyes, 2%, in 23-gauge and 3 eyes, 3%, in 25-gauge group), and in 2 eyes (2%) of the 23-gauge group at postoperative day 145 and 61, respectively. Retinal detachment occurred in 1 eye (1%) in the 23-gauge and in 3 eyes (3%) in the 25-gauge group. We did not observe any cases of endophthalmitis. Conclusion Results in terms of safety, surgical success and visual outcomes for the treatment of common vitreoretinal surgery indications seem to be comparable between 23-gauge and 25-gauge vitrectomy systems, indicating that the two gauge systems can be used equally in the clinical routine.

scholarly journals Changes in Day 1 Post-Operative Intraocular Pressure Following Sutureless 23-Gauge and Conventional 20-Gauge Pars Plana Vitrectomy

2013 ◽  
Vol 7 (1) ◽  
pp. 42-47 ◽  
Author(s):  
Emily Gosse ◽  
Richard Newsom ◽  
Peter Hall ◽  
Jonathan Lochhead
Keyword(s):  
Intraocular Pressure ◽  
Gauge Group ◽  
Vitreoretinal Surgery ◽  
Retrospective Case ◽  
Gauge Groups ◽  
Sutureless Technique ◽  
Transconjunctival Sutureless Vitrectomy ◽  
23 Gauge ◽  
Sutureless Vitrectomy ◽  
Air Exchange

Background/Aims: The benefits associated with transconjunctival sutureless vitrectomy techniques are continuing to be defined. The purpose of this study was to compare the incidence of extreme changes in day 1 intraocular pressure (IOP) following 23-gauge sutureless vitrectomy compared with conventional 20-gauge vitrectomy. Methods: Fifty consecutive 23-gauge and 50 consecutive 20-gauge cases were included; eyes with a history of previous vitreoretinal surgery were excluded. 23-gauge surgery was completed with passive fluid air exchange where no long acting tamponade was indicated. The surgery remained sutureless unless a leak was visible at the end of the procedure. Data were collected by retrospective case note review. Statistical analysis was carried out using Fisher’s exact and chi-square tests. Results: Twenty-two percent (11/50) of 23-gauge vitrectomies required suturing of one or more ports. On the first post-operative day hypotony (IOP<5mmHg) occurred in 1/50 eyes in the 20- and 23-gauge groups. Raised pressure (IOP>21mmHg) occurred in 30% (15/50) of eyes in the 20-gauge group and 8% (4/50) of eyes in the 23-gauge group; IOP>30mmHg only occurred in the 20-gauge group (3/50). Conclusion: Fluid air exchange following 23-gauge vitrectomy is associated with very low risk of day 1 hypotony. This predominantly sutureless technique appears to reduce the incidence and magnitude of early post-operative IOP elevation compared with conventional 20-gauge vitrectomy.

scholarly journals Outcome and Complications of Combined Phacoemulsification and 23-Gauge Pars Plana Vitrectomy

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Selcuk Sizmaz ◽  
Ebru Esen ◽  
Puren Isik ◽  
Burcu Cam ◽  
Nihal Demircan
Keyword(s):  
Intraocular Pressure ◽  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Intraoperative Complications ◽  
Vitreous Hemorrhage ◽  
Patient Demographics ◽  
Posterior Synechia ◽  
Pars Plana ◽  
23 Gauge

Background. With the advances in surgical tools, simultaneous removal of cataract associated with vitreoretinal disorders is gaining popularity. This combined surgery offers several advantages besides limitations. The aim of this study is to assess the outcome and complications of phacoemulsification combined with pars plana vitrectomy (PPV). Patients and Methods. In this retrospective review, medical charts of patients undergoing phacovitrectomy for coexisting cataract and various vitreoretinal disorders were analyzed. Patient demographics, retinal diagnosis, visual acuities (VA) in logMAR, intraocular pressure (IOP), intraoperative and postoperative complications were assessed. Clear corneal phacoemulsification and 23-gauge transconjunctival PPV were administered in all cases. Results. Eighty-four eyes of 64 (76.2%) males and 20 (23.8%) females were enrolled. The average age of patients was 59.5 ± 13.8 (18–81). The average period of follow-up was 7.2 ± 7.5 months (1–36). The vitreoretinal diagnoses were as follows: 28 (33.3%) rhegmatogenous retinal detachment, 23 (27.4%) vitreous hemorrhage, 12 (14.3%) intraocular foreign body, 12 (14.3%) epiretinal membrane, 4 (4.8%) macular hole, 4 (4.8%) tractional retinal detachment, and 1 (1.2%) vitreomacular traction. The most common intraoperative complications were miosis and rupture of the posterior capsule (92.9% and 8.3%, respectively). In 8 (9.5%) cases, there was fibrin in the anterior chamber. Posterior synechia developed in 7 (8.3%) of cases. No severe increase in intraocular pressure was evident. Conclusion. Phacoemulsification combined with PPV is a safe and efficient way of management in cases where cataract coexists with vitreoretinal pathologies.

scholarly journals Study On the Effectiveness and Safety of FCVB Implantation

2019 ◽  
Author(s):  
Xiangyang Zhang ◽  
Xuemin Tian ◽  
Baike Zhang ◽  
Lisa Guo ◽  
Xiaodan Li ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Vitreous Body ◽  
Vitreous Cavity ◽  
Fundus Photography ◽  
Vitreoretinal Disease ◽  
Applanation Tonometer ◽  
Retinal Reattachment ◽  
Vitreoretinal Diseases ◽  
The Difference

Abstract Background: To investigate the efficacy and safety of the foldable capsular vitreous body(FCVB) in the treatment of vitreoretinal diseases. Methods: A retrospective analysis was conducted involving 20 patients (20 eyes) who underwent FCVB implantation in our hospital from September 2017 to April 2018. All the patients underwent vitrectomyand FCVB implantation, a standard three-port vitrectomy was performed, and the FCVB was implanted into the vitreous cavity. At 6 months after surgery, the visual acuity chart, Goldmann applanation tonometer, fundus photography, B-ultrasound examination, and optical coherence tomography (OCT) examination were performed on the treated eyes.The patients’ vision, intraocular pressure, retinal reattachment, and FCVB status were observed. Results: Compared with the preoperative measurements, there was no change in visual acuity in 18 eyes at 6 months after FCVB implantation, and the difference was not significant (P=1.000); the intraocular pressure of these 18 eyes returned to normal, and the difference was significant (P=0.00001); in fundus photographyimages of these 18 eyes, B-ultrasound,OCT showed good retinal reattachment, FCVB distributed well in the vitreous cavity and evenly supported the vitreous retina and there was no obvious abnormality. The eyes were symmetrical, and the eyeball activity was normal. One patient developed eyeball atrophy after surgery, and one patient developed ocular inflammation after surgery. The condition improved after treatment. Conclusions: FCVB is an effective and safe vitreous substitute during the 6-month implantation period and is able to maintain eye shape, intraocular pressure and good aesthetics. Keywords: Vitreoretinal disease; vitrectomy; FCVB; intraocular pressure.

scholarly journals Comparative Study of Intraocular Pressure Measurements with Airpuff, iCare and Goldmann Applanation Tonometers

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Umair Tariq Mirza ◽  
M. Usman Sadiq ◽  
M. Irfan Sadiq ◽  
Ali Raza ◽  
Waseem Ahmed Khan
Keyword(s):  
Intraocular Pressure ◽  
Analytical Study ◽  
P Value ◽  
Pressure Measurements ◽  
Goldmann Applanation Tonometer ◽  
Department Of Ophthalmology ◽  
Applanation Tonometer ◽  
The Mean ◽  
The Difference ◽  
Azad Kashmir

Purpose:  To compare the difference in intraocular pressure (IOP) measurements by Airpuff, iCare and Goldmann Applanation Tonometers (GAT). Study Design:  Comparative analytical study. Place and Duration of Study:  Department of Ophthalmology, Mohi-ud-Din Teaching Hospital, Mirpur Azad Kashmir, from June 2020 to August 2020. Methods:  Twenty-five patients (50 eyes) were included in this study. IOP was measured in each eye firstly by Airpuff tonometery, then by iCare tonometery and lastly by Goldmann applanation tonometer. Three consecutive readings were taken in each eye. If there was a difference of 2 mm Hg or more among the readings, measurement was repeated. Once we got three readings, their average was taken and analyzed. Comparison of IOP readings between these tonometers was done. Results:  Mean IOP was 15.84 ± 2.736 mm Hg with Airpuff Tonometer, 14.48 ± 2.435 mm Hg with iCare Tonopen and 14.74 ± 2.489 mm Hg with Goldman Applanation Tonometer. The difference between the mean Airpuff and Goldman Applanation Tonometer readings was 1.10 mm Hg which was not statistically significant (p-value = 0.083). The difference between the mean Goldman Applanation Tonometer and iCare Tonopen readings was 0.26 mm Hg which is also not statistically significant (p-value = 0.867). But, the difference between the mean iCare Tonopen and Airpuff Tonometer readings was -1.36 mm Hg which was statistically significant (p-value = 0.02). Conclusion:  It is concluded that IOP readings taken by iCare Tonopen and Airpuff Tonometer are comparable to those taken by Goldman Applanation Tonometer and iCare Tonopen underestimates the IOP when compared with Airpuff Tonometer. Key Words:  Airpuff Tonometer, Glaucoma, Goldmann Applanation Tonometer, iCare Tonometer, Intraocular Pressure.

scholarly journals Incidence and Risk Factors of Iatrogenic Retinal Breaks: 20-Gauge versus 25-Gauge Vitrectomy for Idiopathic Macular Hole Repair

2020 ◽  
Vol 2020 ◽  
pp. 1-4 ◽  
Author(s):  
Norio Fujiwara ◽  
Goji Tomita ◽  
Fumihiko Yagi
Keyword(s):  
Retinal Detachment ◽  
Macular Hole ◽  
Gauge Group ◽  
Posterior Vitreous Detachment ◽  
Idiopathic Macular Hole ◽  
Gauge Groups ◽  
Vitreous Detachment ◽  
Retinal Breaks ◽  
Lattice Degeneration ◽  
25 Gauge Vitrectomy

Purpose. We compared the incidences of iatrogenic retinal breaks and postoperative retinal detachment between eyes that underwent 20-gauge vitrectomy and those that underwent 25-gauge vitrectomy for idiopathic macular hole repair. Methods. This retrospective nonrandomized consecutive observational case series included 185 eyes of 183 patients (130 eyes of 129 patients and 55 eyes of 54 patients in the 20- and 25-gauge groups, respectively). We assessed the relationship between the incidence of retinal breaks and postoperative retinal detachment and related this to posterior vitreous detachment and lattice degeneration. Results. The incidences of iatrogenic retinal breaks were 36.9% and 12.7% in the 20-gauge and 25-gauge groups, respectively. These groups did not differ in their respective frequencies of posterior vitreous detachment (the 20-gauge group: 31.5% and the 25-gauge group: 27.3%) and lattice degeneration (the 20-gauge group: 14.6% and the 25-gauge group: 7.3%). Among eyes without lattice degeneration, the 20-gauge group showed a higher incidence of iatrogenic retinal breaks than the 25-gauge group. However, among the eyes with lattice degeneration, the frequency of retinal breaks did not differ between the two surgery types, and four cases of postoperative retinal detachment were reported in both groups. Conclusions. The incidence of retinal breaks related to idiopathic macular hole surgery is higher among patients undergoing 20-gauge vitrectomy than among those undergoing 25-gauge vitrectomy. Posterior vitreous detachment and lattice degeneration are associated with considerably increased incidences of retinal break.

scholarly journals Study On the Effectiveness and Safety of Foldable Capsular Vitreous Body Implantation

2019 ◽  
Author(s):  
Xiangyang Zhang ◽  
Xuemin Tian ◽  
Baike Zhang ◽  
Lisa Guo ◽  
Xiaodan Li ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Vitreous Body ◽  
Vitreous Cavity ◽  
Fundus Photography ◽  
Applanation Tonometer ◽  
Retinal Reattachment ◽  
Vitreoretinal Diseases ◽  
The Difference ◽  
Implantation Period

Abstract Background: To investigate theefficacy and safety of the foldable capsular vitreous body(FCVB) in the treatment of vitreoretinal diseases. Methods: A retrospective analysis was conducted involving 20 patients (20 eyes) who underwent FCVB implantation in our hospital from September 2017 to April 2018. All the patients underwent vitrectomyand FCVB implantation, a standard three-port vitrectomy was performed, and the FCVB was implanted into the vitreous cavity. At 6 months after surgery, the visual acuity chart, Goldmann applanation tonometer, fundus photography, B-ultrasound examination, and optical coherence tomography (OCT) examination were performed on the treated eyes.The patients’ vision, intraocular pressure, retinal reattachment, and FCVB status were observed. Results: Compared with the preoperative measurements, there was no change in visual acuity in 18 eyes at 6 months after FCVB implantation, and the difference was not significant (P=1.000); the intraocular pressure of these 18 eyes returned to normal, and the difference was significant (P=0.00001); in fundus photographyimages of these 18 eyes, B-ultrasound,OCT showed good retinal reattachment, FCVB distributed well in the vitreous cavity and evenly supported the vitreous retina and there was no obvious abnormality. The eyes were symmetrical, and the eyeball activity was normal. One patient developed eyeball atrophy after surgery, and one patient developed ocular inflammation after surgery. The condition improved after treatment. Conclusions: FCVB is an effective and safe vitreous substitute during the 6-month implantation period and is able to maintain eye shape, intraocular pressure and good aesthetics.

scholarly journals Intraocular Pressure Reduction after Femtolaser Assisted Cataract Surgery and Its Association with the Use of Ultrasound

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 437
Author(s):  
Hana Abouzeid ◽  
Walter Ferrini ◽  
Murielle Bochud
Keyword(s):  
Intraocular Pressure ◽  
Linear Regression ◽  
Cataract Surgery ◽  
Anterior Chamber ◽  
Anterior Chamber Depth ◽  
Multiple Linear Regression Model ◽  
Study Data ◽  
Department Of Ophthalmology ◽  
Duration Of Surgery ◽  
Ocular Pressure

Background and Objectives: To quantify the change in intraocular pressure (IOP) after phacoemulsification in patients having undergone femtolaser assisted cataract surgery (FLACS), and study the influence of the use of ultrasound on this change. Setting: Jules-Gonin Eye Hospital, University Department of Ophthalmology, Lausanne, Switzerland. Materials and Methods: Interventional study. Methods: All consecutive cases operated with FLACS and with complete data for the studied parameters were selected for inclusion in the study. Data had been prospectively collected and was analysed retrospectively. Linear regression was performed to explore the association of change in IOP with time of measure, ultrasound use, sex, age, and duration of surgery. Results: There was a mean decrease in intraocular pressure of 2.5 mmHg (CI 95% −3.6; −1.4, p < 0.001) postoperatively. No association between the change in intraocular pressure and ultrasound time or effective phaco time was observed when the data were analyzed one at a time or in a multiple linear regression model. There was no association with sex, age, nuclear density, presence of pseudoexfoliation, duration of surgery, and time of ocular pressure measurement. Eyes with preoperative IOP ≥ 21 mmHg had a more significant IOP reduction after surgery (p < 0.0001) as did eyes with an anterior chamber depth <2.5 mm (p = 0.01). Conclusion: There was a decrease in intraocular pressure six months after FLACS in our study similar to that in the published literature for standard phacoemulsification. The use of ultrasound may not influence the size of the decrease, whereas the preoperative IOP and anterior chamber depth do. FLACS may be as valuable as standard phacoemulsification for cases where IOP reduction is needed postoperatively.

Incidence of Intraocular Pressure Spike and Other Adverse Events after Vitreoretinal Surgery

Ophthalmology ◽  
2006 ◽  
Vol 113 (1) ◽  
pp. 42-47 ◽  
Author(s):  
Nicholas G. Anderson ◽  
Mitchell S. Fineman ◽  
Gary C. Brown
Keyword(s):  
Intraocular Pressure ◽  
Adverse Events ◽  
Vitreoretinal Surgery ◽  
Pressure Spike

scholarly journals Intraocular Pressure Changes Following Different Keratoplasty Techniques and Association with Cornea Parameters and anterior Chamber Depth

2021 ◽  
Author(s):  
Gülşah Gümüş ◽  
cigdem altan ◽  
yusuf yildirim ◽  
nilay kandemir besek ◽  
selim genç ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Corneal Thickness ◽  
Anterior Chamber Depth ◽  
Early Postoperative Period ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Anterior Lamellar Keratoplasty ◽  
The Difference ◽  
Pressure Changes

Abstract Purpose To evaluate early intraocular pressure (IOP) changes following different keratoplasty techniques and to investigate the relationship between corneal thickness (CT), keratometry values, anterior chamber depth (ACD) and IOP changes. Methods We included patients who underwent penetrating keratoplasty (PK), deep anterior lamellar keratoplasty (DALK) and Descemet membrane endothelial keratoplasty (DMEK). ACD, CT, and keratometry measurements were repeated postoperatively at hour 24, week 1, and month 1. IOP measurements were repeated at postoperative hours 6 and 24, week 1, and month 1 by Tono-Pen XL. Results Twenty-two patients underwent PK, 12 patients underwent DALK, and 19 patients underwent DMEK. The difference between the IOP preoperatively and 6 hours postoperatively and between the IOP preoperatively and 24 hours postoperatively were statistically significant in the three types of surgery (p < 0.05 for each). The difference between preoperative and postoperative week 1 IOP was statistically significant only in the PK group (p = 0.023). When the IOP was compared between the three types of surgeries, the IOP at postoperative week 1 in the PK group was significantly higher than the DALK and DMEK groups (p = 0.021). There was no correlation between ACD, corneal thickness, K values, and IOP in any group. Conclusion IOP may increase in all types of keratoplasty during the first hours after surgery, but PK has a risk of high IOP longer in the early postoperative period. PK patients should be followed more carefully during postoperative week 1 to check for an increase in IOP.

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