Surgical outcomes of minimally invasive vitrectomy surgery in Eales’ disease

Introduction: The results of surgical outcomes of 20 gauge pars plana vitrectomy in Eales’ disease are available in the scientific literature. However, all these studies have been done using the 20 gauge vitrectomy systems and most studies have been conducted in a retrospective manner. Objective: To evaluate the outcomes and safety of 23 gauge vitrectomy in complications of Eales’ disease. Materials and methods: Study design: Consecutive interventional case series. Participants: Seventy-six eyes of 72 nonconsecutive patients undergoing 23-gauge vitrectomy for complications of Eales’ disease were enrolled. The participants were followed up for a minimum of one year. Intervention: The participants underwent a complete demographic, medical and ophthalmic evaluation. A 23-gauge vitrectomy was performed. Endotamponade was used when necessary. Perioperative and postoperative events were recorded. Primary outcome measures were visual acuity and complications arising due to surgery. Results: Indication for surgery was non-clearing vitreous hemorrhage in 89.4% (68/76) and secondary retinal detachment in 10.6% (8). Visual acuity improved from Log Mar 1.80 ± 0.19 units preoperatively to Log Mar 0.47±0.59. Best-corrected visual acuity equivalent to Snellen 6/9 was achieved in 77. 6% of eyes. . Surgical failure was seen in 6.5% cases. Four cases were lost due to progression to neovascular glaucoma and 1 case was lost to severe residual retinal detachment. Iatrogenic portside retinal breaks occurred in 3.9% (3), post-vitrectomy retinal detachment 2.6% ( 2), hypotony 1.3% (1) and cataract in 38.1% (28) cases. Conclusion: 23-gauge sutureless vitrectomy in patients with Eales’ disease is a safe and effective technique with acceptable level of risk and complications. Nepal J Ophthalmol 2013; 5(10): 182-189 DOI: http://dx.doi.org/10.3126/nepjoph.v5i2.8710

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Internal Limiting Membrane Flap in the Management of Retinal Detachment due to Paracentral Retinal Breaks

Journal of Ophthalmology ◽

10.1155/2019/4303056 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7

Author(s):

Yen-Chih Chen ◽

Chung-May Yang ◽

San-Ni Chen

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Structural Changes ◽

Rhegmatogenous Retinal Detachment ◽

Case Series ◽

Major Complication ◽

Internal Limiting Membrane ◽

Fluid Exchange ◽

Membrane Peeling ◽

Retinal Breaks

Purpose. To describe the technique and outcomes of using either inverted or free internal limiting membrane flap in the management of retinal detachment due to paracentral retinal breaks. Methods. This retrospective observational case series includes nine patients who received surgery for retinal detachment due to paracentral retinal breaks developed either from primary rhegmatogenous origin, or secondary iatrogenic retinal breaks after prior membrane peeling, or during surgery for tractional retinal detachment. Either inverted or free internal limiting membrane flaps were inserted in the identified breaks, followed by air fluid exchange and gas tamponade. Visual acuity and structural changes were evaluated. Results. Nine eyes were included. One had primary rhegmatogenous retinal detachment, one had highly myopic eye with peripapillary atrophic hole, three had secondary retinal detachment after membrane peeling for foveoschisis or macular pucker, one had recurrent retinal detachment due to proliferative vitreoretinopathy, one had combination of tractional and rhegmatogenous retinal detachment, and two had iatrogenic breaks during surgery. The retinal breaks of all eyes were sealed with retina attached postoperatively. Visual acuity in logarithm of minimal angle of resolution improved from 1.18 ± 0.55 preoperatively to 0.74 ± 0.47 postoperatively (p=0.04). Conclusion. Internal limiting membrane flap technique can be a surgical approach selectively for retinal detachment due to paracentral retinal breaks with difficulty for laser application. The retina can be attached successfully and achieve good visual outcome without major complication. This trial is registered with NCT03707015.

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Double Retinal Tamponade for Treatment of Rhegmatogenous Retinal Detachment with Proliferative Vitreoretinopathy and Inferior Breaks

Journal of Ophthalmology ◽

10.1155/2020/6938627 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Mohamed Farouk Abdelkader ◽

Shaaban Abd-Elhamid Mehany Elwan ◽

Ahmed Shawkat Abdelhalim

Keyword(s):

Retinal Detachment ◽

Proliferative Vitreoretinopathy ◽

Rhegmatogenous Retinal Detachment ◽

Case Series ◽

Short Term ◽

Retinal Breaks ◽

Case Series Study ◽

Retinal Reattachment ◽

Simultaneous Use ◽

One Year

Purpose. To evaluate the efficacy and safety of the simultaneous use of short-term perfluoro-n-octane (PFO) with perfluoropropane (C3F8) gas to achieve retinal reattachment in eyes with rhegmatogenous retinal detachment (RRD) with proliferative vitreoretinopathy (PVR) grade C and multiple retinal breaks including inferior breaks. Design. This is a prospective interventional case series study. Patients and Methods. The study was a prospective noncomparative interventional study. It included 30 eyes of 30 patients who had RRD with PVR grade C and multiple retinal breaks including inferior tears attending the vitreoretinal unit of Minia University Hospital, Egypt. The mean age was 50.2 ± 10.63 years; 18 patients were females and 12 were males. Combined phacoemulsification and 23 G pars plana vitrectomy (PPV) with double retinal tamponade by C3F8 and PFO were done, and PFO was removed in 10–14 days. The patients were followed up for one year. The primary outcome was to achieve successful retinal reattachment, and the secondary outcomes were visual improvement and occurrence of complications. Results. Successful retinal reattachment was obtained in 28 eyes out of 30 (93.3%), and 2 eyes (6.7%) had recurrent RD. Best-corrected distance visual acuity (BCDVA) in logMAR was significantly improved from baseline 1.74 ± 0.05 to 0.93 ± 0.04, 0.82 ± 0.05, 0.80 ± 0.07, and 0.73 ± 0.055 at follow-up visits 3, 6, and 9 months and one year, respectively ( P ≤ 0.001 ). There were no serious ocular complications recorded. Conclusions. The results of this study indicated that primary vitrectomy with simultaneous use of both C3F8 and short-term PFO as retinal tamponades was effective and safe in the management of complex cases of RRD with PVR grade C and inferior breaks. This trial is registered with NCT04168255.

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Lyophilized amniotic membrane patch (LAMPatch) as a replacement of tamponades in the treatment of primary rhegmatogenous retinal detachment

International Journal of Retina and Vitreous ◽

10.1186/s40942-020-00264-7 ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Mario Saravia ◽

Luis Zeman ◽

Alejandro Berra

Keyword(s):

Intraocular Pressure ◽

Retinal Detachment ◽

Amniotic Membrane ◽

Case Series ◽

Pressure Rise ◽

Human Amniotic Membrane ◽

Retinal Breaks ◽

23 Gauge ◽

Membrane Patch

Abstract Background The basis of retinal detachment repair is sealing the retinal breaks. In order to seal the retinal breaks, chorioretinal adhesion around these lesions has to be achieved. Laser retinopexy is not immediate thus necessitates the use of a temporal endotamponade to maintain both tissues in apposition. We propose the use of a patch of lyophilized human amniotic membrane (LAMPatch) in order to occlude the retinal tear effectively until the chorioretinal adhesion is settled, overcoming the risks and limitations of the current tamponades. Methods 23-gauge vitrectomy was performed on eyes with primary retinal detachment with single retinal breaks of less than one-hour extension. A LAMPatch was deployed over the retinal breaks after retina was repositioned with perfluorocarbon. Neither gas nor silicon oil were injected. Results Six eyes of six patients with total or partial retinal detachment were included. Retinas remained reattached in all cases until the end on follow-up (3, 5 months). Best-corrected visual acuity at 1-week postop was between 20/30 and 20/100. Neither elevations of intraocular pressure, cataracts nor signs of inflammation were registered during follow-up. No second surgeries were needed. Conclusion This technique has proven to be safe and effective in this small case series. No intraocular pressure rise, inflammation or cataracts were registered until last follow-up visit.

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The Evaluation of Silicon Oil Evacuation Procedure In Cipto Mangunkusumo Hospital Indonesia

International Journal of Retina ◽

10.35479/ijretina.2019.vol002.iss001.58 ◽

2019 ◽

Vol 2 (1) ◽

Author(s):

Triwijayanti Triwijayanti ◽

Ari Djatikusumo ◽

Andi Arus Victor ◽

Elvioza Elvioza ◽

Gitalisa Andayani Adriono ◽

...

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Standard Procedure ◽

Vitreous Hemorrhage ◽

Secondary Glaucoma ◽

Silicon Oil ◽

Retinal Breaks ◽

Retinal Reattachment ◽

Expulsive Hemorrhage ◽

Minor Side Effect

Background: Injection of Silicon oil is a standard procedure for vitreous replacement in vitrectomy procedure for retinal detachment cases. It acts as a great tamponading agent for reattachment of retinal breaks or retinal detachment. Despite its minor side effect, silicon oil could cause several complications such as cataract, endothelia decompensation, increased intraocular pressure, and secondary glaucoma. Thus needed to be evacuated after the retinal reattachment is stabilized. Following evacuation procedure, visual acuity are known to be significantly improved. However, some cases shows decreased of visual acuity due to retinal redetachment, optic nerve damage due to secondary glaucoma, hypotonym vitreous hemorrhage, expulsive hemorrhage, and cornea abnormality. Methods: A retrospective descriptive study of retinal detachment patients underwent silicon oil evacuation procedure in Cipto Mangunkusumo Hospital, Indonesia from September 2017 until Januari 2018. Results: There were seventy seven cases of retinal detachment undergoes silicon oil evacuation within period of September 2017-Januari 2018. There were improvement of visual acuity (greater than 6/60) after one month of silicon oil evacuation. Anatomical retinal reattachment was successfully observed in 91% patient. The most occuring complication after silicon oil evacuation includes secondary glaucoma and retinal redetachment. Conclusion: Silicon oil evacuation is a standard procedure following a vitrectomy in retinal detachment cases. The evacuation procedure yields in positive benefit for patient in term of visual acuity and anatomical structure.

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Outcomes of 23-Gauge Vitrectomy Combined with Phacoemulsification, Panretinal Photocoagulation, and Trabeculectomy without Use of Anti-VEGF Agents for Neovascular Glaucoma with Vitreous Hemorrhage

Journal of Ophthalmology ◽

10.1155/2016/3097379 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7

Author(s):

Hua Yan

Keyword(s):

Vitreous Hemorrhage ◽

Neovascular Glaucoma ◽

Panretinal Photocoagulation ◽

Light Perception ◽

Anti Vegf ◽

The Mean ◽

23 Gauge ◽

One Year ◽

Time Point

Purpose. To evaluate the outcomes of 23-gauge vitrectomy combined with phacoemulsification, PRP and trabeculectomy without use of anti-VEGF-agents for NVG. Methods. Eighteen eyes of 18 patients with NVG underwent 23-gauge vitrectomy combined with phacoemulsification, PRP and trabeculectomy without use of anti-VEGF agents. The preoperative BCVA ranged from light perception to 0.2. The preoperative IOP ranged from 38 mmHg to 64 mmHg with a mean of 54±8 mmHg. The average follow-up time was 14.5±3 months with a range from 11 to 24 months. Results. The postoperative VA increased in 14 eyes and was stable in 4 eyes at the final follow-up. The mean IOP was 12±3 mmHg at postoperative day 1. The mean IOP was 15±2 mmHg, 16±3 mmHg, 23±5 mmHg, 28±4 mmHg, 22±5 mmHg, 17±3 mmHg, and 19±4 mmHg at postoperative days 2 and 3, 1, 2, 3, and 12 weeks, and 1 year postoperatively, respectively, with a range from 10 to 30 mmHg at the final follow-up time point of one year. The IOP was significantly lower than the preoperative one 12 weeks postoperatively (p<0.05). Conclusion. 23-gauge vitrectomy combined with phacoemulsification, PRP, and trabeculectomy without use of anti-VEGF-agents is a safe and effective method in treating NVG.

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Surgical Management of Traumatic Retinal Detachment with Primary Vitrectomy in Adult Patients

Journal of Ophthalmology ◽

10.1155/2017/5084319 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 5

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.

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Mid-term prognosis of type I Boston keratoprosthesis reimplantation

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-317598 ◽

2020 ◽

pp. bjophthalmol-2020-317598

Author(s):

Soumaya Bouhout ◽

Marie-Claude Robert ◽

Mona Harissi-Dagher

Keyword(s):

Retinal Detachment ◽

Retention Rate ◽

Case Series ◽

Type I ◽

Light Perception ◽

Visual Rehabilitation ◽

Boston Keratoprosthesis ◽

Kaplan Meier ◽

Primary Endpoints ◽

One Year

AimTo examine the mid-term visual and anatomical prognosis of patients who require reimplantation of a second Boston keratoprosthesis type 1 (B-KPro).MethodsRetrospective observational case series of 122 patients (141 eyes) who received a B-KPro at a single institution were reviewed. Eyes that underwent a second B-KPro were included in the study. Primary endpoints were B-KPro retention, final visual acuity 20/200 and loss of light perception. Secondary endpoints included the occurrence of postoperative complications.ResultsSeventeen eyes (12%) required a B-KPro reimplantation. Corneal melt was the most common indication for replacement (88%). Mean follow-up time after the second B-KPro was 4.4±2.1 years. The Kaplan-Meier analysis estimated the second B-KPro retention rate at 79% over 8 years. Retroprosthetic membrane (RPM, 53%) was the most common complication. Forty-one per cent of the eyes suffered from corneal melt following their second B-KPro. One year after the second B-KPro, 47% of the patients retained a vision 20/200. Seven eyes (41.2%) lost light perception, which was secondary to an inoperable retinal detachment in five cases. Four eyes (24%) developed phthisis following inoperable retinal detachment (n=3) or endophthalmitis (n=1).ConclusionB-KPro reimplantation is a potentially sight- and globe-saving procedure for eyes with B-KPro failure, but the prognosis is guarded. B-KPro reimplantation can salvage ambulatory vision in a third of patients while another third of patients progress to loss of light perception. RPM and retinal detachment were important obstacles to visual rehabilitation while recurrent corneal melt was responsible for most cases of anatomical failure.

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23-Gauge Pars Plana Vitrectomy with Pars Plana Baerveldt Tube Placement for Refractory Glaucoma

European Journal of Ophthalmology ◽

10.5301/ejo.5000027 ◽

2011 ◽

Vol 22 (1) ◽

pp. 90-94 ◽

Cited By ~ 3

Author(s):

Anton M. Kolomeyer ◽

Robert D. Fechtner ◽

Marco A. Zarbin ◽

Neelakshi Bhagat

Keyword(s):

Visual Acuity ◽

Survival Curve ◽

Case Series ◽

Tube Placement ◽

Refractory Glaucoma ◽

Tube Insertion ◽

Combined Procedure ◽

Pars Plana ◽

23 Gauge ◽

Baerveldt Tube

Purpose To describe a case series of combined 23-gauge vitrectomy and pars plana Baerveldt tube insertion for intraocular pressure (IOP) control in eyes with glaucoma resistant to maximum tolerated medical therapy and/or having failed previous IOP-lowering procedures. Methods Eight consecutive patients (8 eyes) undergoing a combined procedure were identified and included in this study. Outcome measures included preoperative and final best-corrected visual acuity (VA), IOP, number of glaucoma medications, and complications. Changes in IOP and glaucoma medications were compared by a paired t test. A Kaplan-Meier survival curve was constructed to evaluate IOP control as a function of time. Results Mean patient age was 70.9 years while the mean follow-up time was 12.1 months. Open angle glaucoma was diagnosed in 5 (68%) eyes. Six (75%) eyes were pseudophakic. All eyes received a 250-mm2 pars plana Baerveldt tube. Vision remained the same or improved in 6 (75%) eyes. Mean preoperative IOP and number of glaucoma medications were significantly (p<0.05) reduced by the combined procedure. Visual acuity of 5 (63%) eyes improved or remained unchanged. Six (75%) eyes encountered minor complications not requiring a return to the operating room. One (13%) eye underwent drainage of hemorrhagic choroidals on postoperative day 12. Conclusions A combined 23-gauge vitrectomy and pars plana Baerveldt tube insertion could be considered a useful procedure in reducing IOP and the number of glaucoma medications in eyes with refractory glaucoma.

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Comparisons of Visual and Surgical Outcomes after Reuse or Replacement of Dislocated in-the-Bag Intraocular Lens

Journal of Ophthalmology ◽

10.1155/2018/7342917 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Takayuki Baba ◽

Tomohiro Nizawa ◽

Toshiyuki Oshitari ◽

Shuichi Yamamoto

Keyword(s):

Visual Acuity ◽

Endothelial Cell ◽

Intraocular Lens ◽

Refractive Error ◽

Surgical Outcomes ◽

Case Series ◽

Cell Loss ◽

Significant Difference ◽

Group A ◽

Group B

Purpose. To compare the visual and surgical outcomes after a reuse or a replacement of a dislocated in-the-bag intraocular lens (IOL). Methods. This was a retrospective, nonrandomized case series at a single ophthalmological institution. Cases with an in-the-bag dislocation of an IOL were treated by pars plana vitrectomy and the reuse or the replacement of the IOL. The lens was held by intrascleral fixation of the haptics of the IOL under both conditions. The same dislocated IOL was reused in 6 eyes (group A) or it was replaced with another IOL in the other 9 eyes (group B). The pre- and postoperative parameters analyzed included the visual acuity, refractive error, corneal endothelial cell density, and intraocular pressure (IOP). Results. There was no significant difference between the two groups in the postoperative visual acuity (P=0.388), refractive error (P=0.955), IOP (P=0.529), and endothelial cell loss (P=0.940). A breakage or a tilting of the IOL was observed and required replacement in three eyes in the reuse group (P=0.044). Conclusions. Half of the cases with reused in-the-bag dislocated IOL had a breakage or a tilting of the IOL. The replacement of the in-the-bag dislocated IOL is better than the reuse of the IOL with intrascleral haptics fixation.

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Vitreous Hemorrhage after Aneurismal Rupture: Terson Syndrome

Arquivos Brasileiros de Neurocirurgia Brazilian Neurosurgery ◽

10.1055/s-0036-1581085 ◽

2016 ◽

Vol 37 (03) ◽

pp. 163-166

Author(s):

Rodrigo Souza ◽

Guilherme Aguiar ◽

Sarah Weber ◽

Juan Flores ◽

Mario Conti ◽

...

Keyword(s):

Visual Acuity ◽

Cerebral Aneurysm ◽

Ultrasound Examination ◽

Vitreous Hemorrhage ◽

Terson Syndrome ◽

Microsurgical Clipping ◽

Intraocular Hemorrhage ◽

Neurosurgical Treatment ◽

One Year ◽

Spontaneous Subarachnoid Hemorrhage

Introduction Terson syndrome is described as an intraocular hemorrhage consequent to a spontaneous subarachnoid hemorrhage (SSAH). In the present article, we describe cases of patients who underwent neurosurgical treatment of ruptured cerebral aneurysm at our institution over a period of one year, and who were diagnosed with Terson syndrome. Methods The present study included patients with a diagnosis of SSAH by rupture of a cerebral aneurysm who underwent treatment in our neurosurgical service from December 2009 to December 2010. The patients were followed-up for a minimum of 20 months. We have also performed a literature review and compared the data with those available in the current literature. Results The present study included 34 patients, 18 (53%) of which underwent endovascular treatment, and 16 (47%) who underwent microsurgical clipping. In the sample, the mortality was 14.7% (5 patients), the same percentage of patients who were diagnosed with Terson Syndrome, which is an incidence of 14.7%. Regarding the ophthalmologic evaluation, all patients had vitreous hemorrhage detected by an ultrasound examination, which was unilateral in only two patients. Visual acuity improved in all patients, being incomplete in only one of them. Conclusion Terson syndrome is relatively common and is associated with higher mortality. With the existence of an effective treatment, it should be investigated in all patients with SSAH.

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