Clinical Characteristics and Outcomes of Malignant Glaucoma after Different Procedures Treated with Pars Plana Vitrectomy: A 10-Year Retrospective Study

Background and objectives: Despite established common risk factors, malignant glaucoma (MG) remains a rare condition with challenging management. We aimed to analyze differences in risk factors for MG after different surgeries and outcomes after pars plana vitrectomy (PPV). Materials and Methods: This retrospective study included cases of MG treated with PPV between January 2005 and December 2015 in the Department of Ophthalmology, Lithuanian University of Health Sciences, Kaunas, Lithuania. Results: A total of 39 cases were analyzed: 23 (59%) after cataract surgery, 13 (33.3%) after trabeculectomy, and 3 (7.7%) after other interventions. Characteristics among the groups did not differ. Intraocular lens refractive power was significantly higher in the cataract group, in which intraocular pressure (IOP) before MG was significantly greater in the affected eye. Normotension was achieved in 92.3%, and a normal anterior chamber in 75%. Additional measures included eye drops (n = 24), trabeculectomy (n = 5), bleb revision (n = 2), synechiotomy (n = 4), and cyclophotocoagulation (n = 1). The proportion of drop-free patients significantly increased after PPV compared with that before MG development (38.5% versus 15.4%). Complications were observed in 11 cases: choroidal detachments with spontaneous resolution (n = 2); retinal detachment (n = 1); constant mydriasis (n = 1), neovascular glaucoma (n = 1); obstruction of filtrating zone by iris (n = 1) and by blood clot (n = 1); posterior synechia formation causing IOP rise (n = 4 (all resolved after synechiotomy)). The cataract group experienced significantly fewer complications than the trabeculectomy group (17.4% vs. 53.8%, respectively). Conclusions: There were no differences in the risk of MG among the different surgeries. However, higher IOP in the predisposed eye (versus contra-lateral eye) could indicate additional risk of MG after cataract surgery. PPV afforded reliable treatment for MG and the possibility for glaucoma patients to discontinue topical treatment.

Download Full-text

Nucleus Drop or Intraocular Lens Drop Underwent Pars Plana Vitrectomy due to Complication of Cataract Surgery

International Journal of Retina ◽

10.35479/ijretina.2019.vol002.iss002.73 ◽

2019 ◽

Vol 2 (2) ◽

Author(s):

Noviana Kurniasari Vivin ◽

Ari Djatikusumo ◽

Elvioza Elvioza ◽

Gitalisa Andayani ◽

Anggun Rama Yudantha ◽

...

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Intraocular Lens ◽

Pars Plana Vitrectomy ◽

Iol Implantation ◽

Secondary Iol Implantation ◽

Choice Of Procedure ◽

Department Of Ophthalmology ◽

Pars Plana

Abstract Background: The incidence of nucleus drop or intraocular lens (IOL) drop as the complication of phacoemulsification increases due to the increased frequency of phacoemulsification. Pars plana vitrectomy (PPV) followed by endofragmentation and secondary IOL implantation is the choice of procedure for management. This study aims to determine the frequency, outcomes, and complication of PPV in the case of nucleus drop or IOL drop in the Department of Ophthalmology, Fakultas Kedokteran Universitas Indonesia – Rumah Sakit Cipto Mangunkusumo (FKUI-RSCM) Methods: This study is a retrospective descriptive study conducted in the Vitreoretinal Division of the Department of Ophthalmology, FKUI - RSCM. Research data was taken from the medical records of all nucleus drop or IOL drop patients underwent PPV in January 2017-December 2017. Results: There were 19 cases studied. The incidence of nucleus drop occurred in phacoemulsification surgery techniques (94.7%) and ECCE techniques (5.3%). Vitrectomy surgery was performed ≤2 weeks in 31.6% and >2 weeks in 68.4% after the patient first arrived at the vitreoretinal clinic. Most pre-PPV visual acuity was 1/60-6/60 (47.1%). In the final follow-up, visual acuity improved from 6/45 to 6/6 occurred in 42.2% of cases. Complication after PPV and secondary IOL implantation include elevated IOP (10.5%), IOL decentration (5.3%), corneal decompensation (5.3%), macular edema (5.3%), and retinal detachment (5.3%). Conclusion: Nucleus drop or IOL drop generally occurs in phacoemulsification cataract surgery techniques. Improved visual acuity was achieved after PPV and secondary IOL implantation at the end of the follow-up period. Most common post-PPV complication is elevated IOP.

Download Full-text

Postoperative Endophthalmitis following Cataract Surgery in Asia

ISRN Ophthalmology ◽

10.5402/2011/917265 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Jin A Choi ◽

Sung Kun Chung

Keyword(s):

Risk Factors ◽

Cataract Surgery ◽

Pars Plana Vitrectomy ◽

Causative Organism ◽

Postoperative Endophthalmitis ◽

Asian Populations ◽

Initial Visual Acuity ◽

Culture Positivity ◽

History Of ◽

Pars Plana

Postoperative endophthalmitis is a rare clinical occurrence. However, it remains one of the most serious complications following cataract surgery because of its poor prognosis. We investigated the epidemiologic trends in postoperative endophthalmitis following cataract surgery, particularly in Asian populations. The incidence of postcataract endophthalmitis was generally consistent with epidemiologic data reported from Caucasian populations. The most frequently occurring causative organism was coagulase-negative Staphylococci in most studies of Asian populations. However, Pseudomonas aeruginosa and Nocardia were found to be the most common microorganisms in several studies. The rates of culture positivity were slightly lower than in Caucasian studies. In the evaluation of risk factors of poor visual outcomes, initial visual acuity and virulence of the causative microorganisms were generally found to be the most important risk factors. A history of pars plana vitrectomy was found to be the major risk factors for developing endophthalmitis in several studies.

Download Full-text

Prior pars plana vitrectomy and its association with adverse intraoperative events during cataract surgery

Acta Ophthalmologica ◽

10.1111/aos.14947 ◽

2021 ◽

Author(s):

Lucy I. Mudie ◽

Jennifer L. Patnaik ◽

Anne M. Lynch ◽

Ronald E. Wise

Keyword(s):

Cataract Surgery ◽

Pars Plana Vitrectomy ◽

Pars Plana

Download Full-text

Prevalence and risk factors of ellipsoid zone damage after pars plana vitrectomy for idiopathic epiretinal membrane

Retina ◽

10.1097/iae.0000000000003321 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Michał Post ◽

Maria Vittoria Cicinelli ◽

Emma Clara Zanzottera ◽

Alessandro Marchese ◽

Francesco Bandello ◽

...

Keyword(s):

Risk Factors ◽

Epiretinal Membrane ◽

Pars Plana Vitrectomy ◽

Ellipsoid Zone ◽

Idiopathic Epiretinal Membrane ◽

Pars Plana

Download Full-text

Risk factors for postoperative eye pain in patients with non-painful eye disease undergoing pars plana vitrectomy: the VItrectomy Pain (VIP) study

Minerva Anestesiologica ◽

10.23736/s0375-9393.21.14294-4 ◽

2021 ◽

Vol 87 (5) ◽

Author(s):

Elisabetta BANDERA ◽

Simone PIVA ◽

Eros GAMBARETTI ◽

Cosetta MINELLI ◽

Francesco RIZZO ◽

...

Keyword(s):

Risk Factors ◽

Pars Plana Vitrectomy ◽

Eye Disease ◽

Eye Pain ◽

Pars Plana

Download Full-text

Corneal Higher-Order Aberrations after Microhook ab Interno Trabeculotomy and Goniotomy with the Kahook Dual Blade: Preliminary Early 3-Month Results

Journal of Clinical Medicine ◽

10.3390/jcm10184115 ◽

2021 ◽

Vol 10 (18) ◽

pp. 4115

Author(s):

Hiromitsu Onoe ◽

Kazuyuki Hirooka ◽

Hideaki Okumichi ◽

Yumiko Murakami ◽

Yoshiaki Kiuchi

Keyword(s):

Risk Factors ◽

Visual Acuity ◽

Retrospective Study ◽

Cataract Surgery ◽

Higher Order ◽

Higher Order Aberrations ◽

Postoperative Changes ◽

The Mean ◽

Kahook Dual Blade ◽

Ab Interno

We examined postoperative corneal higher-order aberrations (HOAs) present after combined phacoemulsification with either microhook ab interno trabeculotomy (μLOT-Phaco) or goniotomy, using the Kahook Dual Blade (KDB-Phaco). Retrospective study: A total of 45 eyes underwent μLOT-Phaco and KDB-Phaco (LOT-Phaco) procedures, with 21 eyes that underwent cataract surgery alone used as controls. Visual acuity and corneal HOAs, coma-like aberrations, and spherical-like aberrations were analyzed before and at 1, 2, and 3 months after the surgeries. Risk factors that could potentially influence HOAs were evaluated. No significant postoperative changes were noted for corneal HOAs, coma-like aberrations, and spherical-like aberrations after cataract surgery alone. The mean corneal HOAs, coma-like aberrations, and spherical-like aberrations were 0.222 ± 0.115 μm, 0.203 ± 0.113 μm, and 0.084 ± 0.043 μm at baseline and 0.326 ± 0.195 μm (p < 0.001), 0.302 ± 0.289 μm (p = 0.03), and 0.150 ± 0.115 μm (p < 0.001) at 3 months after LOT-Phaco, respectively. Results of the analysis for risk factors suggested that a longer incision in Schlemm’s canal could influence corneal HOAs, coma-like aberrations, and spherical-like aberrations after LOT-Phaco. Although no significant postoperative changes were observed in corneal HOAs and coma-like or spherical-like aberrations after cataract surgery alone, a significant increase in corneal HOAs and coma-like or spherical-like aberrations remained after the LOT-Phaco procedure.

Download Full-text

Pars Plana Vitrectomy in the Management of Phakic and Pseudophakic Malignant Glaucoma

Archives of Ophthalmology ◽

10.1001/archopht.1996.01100140275003 ◽

1996 ◽

Vol 114 (9) ◽

pp. 1073 ◽

Cited By ~ 45

Author(s):

J. William Harbour

Keyword(s):

Pars Plana Vitrectomy ◽

Malignant Glaucoma ◽

Pars Plana

Download Full-text

Endoscopy-Assisted Vitrectomy Outcomes During Silicone Oil Removal After Complex Retinal Detachment Repair

Journal of VitreoRetinal Diseases ◽

10.1177/2474126419861850 ◽

2019 ◽

Vol 3 (6) ◽

pp. 445-451 ◽

Cited By ~ 1

Author(s):

Natalia Vila ◽

Emmanouil Rampakakis ◽

Flavio Rezende

Keyword(s):

Retrospective Study ◽

Retinal Detachment ◽

Pars Plana Vitrectomy ◽

Silicone Oil ◽

Endoscopic Examination ◽

Oil Removal ◽

Visualization System ◽

Silicone Oil Removal ◽

Pars Plana ◽

The Mean

Purpose: This retrospective study recorded intraoperative findings during silicone oil removal and postoperative anatomical outcomes comparing endoscopy-assisted pars plana vitrectomy (E-PPV) vs pars plana vitrectomy (PPV) alone after proliferative vitreoretinopathy (PVR)-related retinal detachment (RD) repair. Methods: This single-center retrospective study included patients who underwent PPV for silicone oil removal after RD with PVR from July 2009 to January 2017. Patients with diabetic tractional RD, history of trauma, uveitis, or endophthalmitis were excluded. After 2013, an endoscopic visualization system (E2 MicroProbe; Endo Optiks) was used in a nonrandomized fashion. Data collection included reattachment rate, intraoperative endoscopic findings and phthisis rate. Results: Fifty-four eyes of 54 patients were included. The mean participant age was 58.4 ± 12.9 years and 36 (65.5%) participants were male. The mean (± SD) follow-up duration after oil removal was 24.3 ± 20.1 months. E-PPV combined with wide-angle visualization system was performed in 26 (48.1%) of the patients; the surgical management was modified after endoscopic examination in 17 (65.4%) of the cases. Reattachment rate in the E-PPV group was 96.2% compared with 76.0% in the PPV-alone group ( P = .04). Conclusions: E-PPV for silicone oil removal appears to be advantageous for prevention of RD recurrence, thus achieving better reattachment rates. A thorough examination is facilitated by endoscopic visualization and contributory factors for anterior PVR can be identified and treated.

Download Full-text