Pain During Pars Plana Vitrectomy With Sub-tenon Anesthesia

2019 ◽  
Author(s):  
Keyword(s):  
Pars Plana Vitrectomy ◽  
Pars Plana

Transscleral Extraction of an Intraocular Foreign Body From the Posterior Segment of the Eye Without Pars Plana Vitrectomy

2020 ◽  
Vol 76 (1) ◽  
pp. 14-23
Author(s):  
Štěpán Rusňák ◽  
Lenka Hecová
Keyword(s):  
Foreign Body ◽  
Pars Plana Vitrectomy ◽  
Young Patients ◽  
Vitreous Body ◽  
Visual Control ◽  
Intraocular Foreign Body ◽  
Survey Study ◽  
Surgical Method ◽  
Eye Trauma ◽  
Pars Plana

Purpose: Penetrating eye trauma with an intraocular foreign body is very frequent, especially in men in their productive age. Pars plana vitrectomy would be the standard surgical method at our department. However, in indicated cases (metallic intraocular bodies in the posterior eye segment in young patients with well transparent ocular media without detached ZSM and without any evident vitreoretinal traction) transscleral extraction of the intraocular foreign body is performed using the exo magnet, eventually endo magnet with a minimal PPV without PVD induction under the visual control of endo-illumination. Materials and Methods: Between June 2003 and June 2018, 66 eyes of 66 patients diagnosed with a penetrating eye trauma caused by an intraocular foreign body located in the posterior eye segment were treated. In 18 eyes (27,3 %) with a metallic foreign body in vitreous (body) or in retina, no PPV or a minimal PPV without PVD was used as a surgical method. In the remaining 48 eyes (72,7 %), a standard 20G, respectively 23G PPV method were used together with PVD induction and the foreign body extraction via endo or exo magnet. Conclusions: As demonstrated by our survey/study, in the cases of a thoroughly considered indication an experimented vitreoretinal surgeon can perform a safe NCT transscleral extraction from the posterior eye segment via exo magnet, eventually endo magnet under the visual control of a contact display system with a minimal PPV. Thereby, the surgeon can enhance the patient´s chance to preserve their own lens and its accommodative abilities as well as reduce the risk of further surgical interventions of the afflicted eye.

Aerosol generation through pars plana vitrectomy

2020 ◽  
pp. bjophthalmol-2020-317214
Author(s):  
Hasan Naveed ◽  
Fong May Chew ◽  
Hanbin Lee ◽  
Edward Hughes ◽  
Mayank A Nanavaty
Keyword(s):  
Pars Plana Vitrectomy ◽  
Ex Vivo ◽  
Dynamic Changes ◽  
Aerosol Generation ◽  
Significant Difference ◽  
Optical Particle Counter ◽  
Pars Plana ◽  
23 Gauge ◽  
Set Up ◽  
Ex Vivo Study

PurposeTo assess whether pars plana vitrectomy (PPV) is an aerosol-generating procedure (AGP) in an ex vivo experimental model.MethodsIn this ex vivo study on 10 porcine eyes, optical particle counter was used to measure particles ≤10 μm using cumulative mode in the six in-built channels: 0.3 μm, 0.5 μm, 1 μm, 2.5 μm, 5 μm and 10 μm aerosols during PPV. Two parts of the study were as follows: (1) to assess the pre-experimental baseline aerosol count in the theatre environment where there are dynamic changes in temperature and humidity and (2) to measure aerosol generation with 23-gauge and 25-gauge set-up. For each porcine eye, five measurements were taken for each consecutive step in the experiment including pre-PPV, during PPV, fluid–air exchange (FAX) and venting using a flute with 23-gauge set-up and a chimney with 25-gauge set-up. Therefore, a total of 200 measurements were recorded.ResultsWith 23-gauge and 25-gauge PPV, there was no significant difference in aerosol generation in all six channels comparing pre-PPV versus PPV or pre-PPV versus FAX. Venting using flute with 23-gauge PPV showed significant reduction of aerosol ≤1 μm. Air venting using chimney with 25-gauge set-up showed no significant difference in aerosol of ≤1 μm. For cumulative aerosol counts of all particles measuring ≤5 μm, compared with pre-PPV, PPV or FAX, flute venting in 23-gauge set-up showed significant reduction unlike the same comparison for chimney venting in 25-gauge set-up.ConclusionPPV and its associate steps do not generate aerosols ≤10 μm with 23-gauge and 25-gauge set-ups.

scholarly journals Pars plana vitrectomy versus scleral buckling for repairing simple rhegmatogenous retinal detachments

2019 ◽  
Author(s):  
Ljubo Znaor ◽  
Aleksej Medic ◽  
Susanne Binder ◽  
Ana Vucinovic ◽  
Josipa Marin Lovric ◽  
...  
Keyword(s):  
Pars Plana Vitrectomy ◽  
Scleral Buckling ◽  
Pars Plana

scholarly journals 27-Gauge Vitrectomy for Symptomatic Vitreous Floaters with Topical Anesthesia

2017 ◽  
Vol 8 (1) ◽  
pp. 35-39 ◽  
Author(s):  
Zhong Lin ◽  
Nived Moonasar ◽  
Rong Han Wu ◽  
Robin R. Seemongal-Dass
Keyword(s):  
Postoperative Complications ◽  
Minimally Invasive ◽  
Pars Plana Vitrectomy ◽  
Topical Anesthesia ◽  
Retrobulbar Anesthesia ◽  
Vitreous Floaters ◽  
Pars Plana ◽  
Vitrectomy Surgery ◽  
Surgery Duration

Purpose: Traditionally acceptable methods of anesthesia for vitrectomy surgery are quite varied. However, each of these methods has its own potential for complications that can range from minor to severe. The surgery procedure of vitrectomy for symptomatic vitreous floaters is much simpler, mainly reflecting in the nonuse of sclera indentation, photocoagulation, and the apparently short surgery duration. The use of 27-gauge cannulae makes the puncture of the sclera minimally invasive. Hence, retrobulbar anesthesia, due to its rare but severe complications, seemed excessive for this kind of surgery. Method: Three cases of 27-gauge, sutureless pars plana vitrectomy for symptomatic vitreous floaters with topical anesthesia are reported. Results: The vitrectomy surgeries were successfully performed with topical anesthesia (proparacaine, 0.5%) without operative or postoperative complications. Furthermore, none of the patients experienced apparent pain during or after the surgery. Conclusion: Topical anesthesia can be considered for 27-guage vitrectomy in patients with symptomatic vitreous floaters.

scholarly journals Postprocedural Endophthalmitis or Postprocedural Intraocular Inflammation: A Diagnostic Conundrum

2021 ◽  
pp. 418-424
Author(s):  
Aisha Al Busaidi ◽  
Ahmed Al-Hinai
Keyword(s):  
Pars Plana Vitrectomy ◽  
Povidone Iodine ◽  
Complete Recovery ◽  
Neovascular Glaucoma ◽  
Intraocular Inflammation ◽  
Aqueous Samples ◽  
Patient Counseling ◽  
Pars Plana ◽  
Culture Negative ◽  
Office Procedures

We experienced an atypical endophthalmitis occurring post consecutively performed in-office procedures; an intravitreal injection (IVI) of ranibizumab followed by an anterior chamber (AC) paracentesis performed twice in an eye with neovascular glaucoma (NVG). A 52-year-old diabetic male who was asymptomatic developed signs of endophthalmitis and decreased vision without pain in his left eye a few days post-IVI and AC paracentesis. The condition worsened after an initial vitreous tap and injection of antibiotics. Cultures of vitreous and aqueous samples were negative. Complete resolution occurred after a pars plana vitrectomy with IVI of antibiotics and steroid with removal of a dense “yellowish-brown” fibrinous plaque. The absence of pain, presence of a peculiar colored fibrin, mild-to-moderate vitritis without retinitis, negative cultures, and complete recovery despite the fulminant presentation; favor a diagnosis of inflammation over infection. We hypothesize that a micro-leak from a 26-gauge AC tap tract might have served as an entry port for 5% povidone-iodine from the ocular surface thus inciting inflammation. However, an exuberant inflammatory response that can be typically seen in NVG eyes after intraocular procedures cannot be excluded. Various causes of inflammation post-procedures, both toxic and nontoxic should be considered in atypical culture-negative fulminant endophthalmitis cases with good outcome posttreatment. Any minor ocular procedure may carry a risk of such complication. Patient counseling and care must be exercised in performing these procedures.

Sign in / Sign up

Export Citation Format

Share Document