Lack of Toxicity During Long-Term Follow-Up of Intraocular Metallic Fragments After Pars Plana Vitrectomy

Aim: To evaluate long term macular changes following pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling for diabetic macular edema (DME) Methods: Forty eligible eyes of 37 patients were included in this retrospective study. Best corrected visual acuity (BCVA), central macular thickness (CMT) and 5-mm macular volume (5-MV) were examined preoperatively and at postoperative 1st, 2nd, 3rd, 6th, 12th, 24th months and final visits. Response to surgical treatment was considered as recurrence, reincrease and recovery of DME based on macular changes. Results: Mean follow-up time was 51.1±19.0 months following surgery. Recurrence (n=5) and reincrease (n=17) of DME was observed in 22 eyes (55%) and additional treatments were applied. Recovery of DME was observed in 18 eyes (45%). Preoperative and final visit mean BCVAs (logMAR) were 1.08±0.37 and 0.93±0.45, respectively (p=0.02). Preoperative and final visit mean CMTs were 514.74±155.65 µm and 281.87±112.58 µm, respectively (p<0.001). The 5-MV significantly decreased following surgery (8.18±1.57 mm3 to 6.52±1.39 mm3) (p<0.001). DME was present in 12 eyes (%30) at final visit. Conclusion: Although PPV with ILM peeling had an efficacy in DME management, this effect tends to decrease over time such that considerable amount of patients required additional treatment.

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Long-term Results of Pars Plana Vitrectomy and Silicone Oil for Complications of Diabetic Retinopathy

European Journal of Ophthalmology ◽

10.1177/112067219400400109 ◽

1994 ◽

Vol 4 (1) ◽

pp. 52-58 ◽

Cited By ~ 28

Author(s):

I. Karel ◽

B. Kalvodová

Keyword(s):

Diabetic Retinopathy ◽

Pars Plana Vitrectomy ◽

Silicone Oil ◽

Posterior Pole ◽

Vitreous Haemorrhage ◽

Long Term Results ◽

Diabetic Patients ◽

Pars Plana

Pars plana vitrectomy (PPV) with silicone oil implantation (SOI) was performed for advanced proliferative diabetic retinopathy (PDR) in 110 eyes of 98 diabetic patients. In, 77 eyes (70%) it was a primary SOI as part of the initial operation; in 33 eyes (30%) it was a secondary SOI in reoperations. Indications for SOI were traction retinal detachment of the posterior pole, combined traction and rhegmatogenous detachment, vitreous haemorrhage with florid vascularised fibrous proliferations, and recurrent vitreous haemorrhage after PPV. The patients were followed up for 24 to 72 months, with a mean of 53 months. At the end of follow-up, anatomical success was achieved in 63 eyes (57%), and functional success with visual acuity 0.01 and better in 35 eyes (32%). Functional failures were caused by retinal redetachment in 47 eyes (43%), by secondary glaucoma in 10 eyes (9%), retinal ischemia in 15 eyes (13%) and keratopathy in three eyes (3%). The functional success rate decreased with follow-up from 67% after six months to 50% by 60 months after SOI. Silicone oil bubble in the anterior chamber, rubeosis iridis, cataract, and glaucoma were the most frequent postoperative complications. PPV with SOI was highly effective in many serious complications of advanced PDR. Functional success was mostly lasting and markedly improved the quality of life of these patients.

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Clinical Spectrum and Long-Term Anatomical and Functional Outcomes of Pars Plana Vitrectomy in Retinal Detachments Associated With Choroidal Coloboma

Journal of VitreoRetinal Diseases ◽

10.1177/2474126419893542 ◽

2019 ◽

Vol 4 (2) ◽

pp. 103-109

Author(s):

Naresh Babu Kannan ◽

Sagnik Sen ◽

Piyush Kohli ◽

Obuli Ramachandran ◽

Kim Ramasamy

Keyword(s):

Pars Plana Vitrectomy ◽

Silicone Oil ◽

Care Center ◽

Tertiary Care ◽

Visual Outcome ◽

Patients Âgés ◽

Pars Plana ◽

23 Gauge

Purpose: Choroidal coloboma (CC) eyes are associated with a high risk of retinal detachment (RD), which are challenging to repair. Methods: We retrospectively evaluated medical records of 30 patients with CC associated with RD who underwent pars plana vitrectomy at our tertiary care center. Data recorded were age, CC and RD morphology, breaks, resurgeries performed, and final outcome. Results: Patients’ ages ranged from 2 to 49 years. CC was present in 53 of 60 eyes (88%), with 41 of 60 eyes (68.3%) associated with iris coloboma. RD was present in 36 of 53 CC eyes (67.9%), with 10 of 53 (18.9%) having bilateral RD. Thirty-one eyes with RD underwent 23-gauge pars plana vitrectomy. Colobomatous region breaks were detected in 5 of 31 eyes (16.1%), peripheral breaks only in 12 of 31 (38.7%), and both types in 3 of 31 eyes (9.7%). Silicone oil endotamponade was used in 29 of 31 eyes (93.5%) and perfluoropropane (C3F8) in 2 of 31 eyes (6.45%). Median postoperative follow-up duration was 31.5 months. Fourteen of 31 eyes (45.2%) developed redetachment requiring resurgery, with 50% developing within 6 months. Eighteen of 31 eyes (58.1%) maintained retinal attachment at last follow-up without endotamponade, whereas the rest were oil filled. Final visual outcome between macula-involved and macula-spared CC eyes was not significantly different; however, best visual acuity achieved any time during follow-up was significantly better in macula-spared eyes. Conclusions: RD surgery in CC eyes has a risk of frequent redetachments and subnormal gain of vision over the long term, especially in colobomas involving the macula. Endolaser in 360° peripheries in addition to barrage of the margin of the coloboma may be considered to help maintain the attached retina.

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Long-term Clinical Outcomes of Vitrectomy with 360° Laserpexy or Scleral Encircling in Rhegmatogenous Retinal Detachment

Annals of Optometry and Contact Lens ◽

10.52725/aocl.2021.20.4.150 ◽

2021 ◽

Vol 20 (4) ◽

pp. 150-157

Author(s):

Min Jin Kim ◽

Sung Jin Lee ◽

Kyung Seek Choi

Keyword(s):

Retinal Detachment ◽

Success Rate ◽

Clinical Outcomes ◽

Pars Plana Vitrectomy ◽

Rhegmatogenous Retinal Detachment ◽

Pars Plana ◽

Anatomical Success ◽

Anatomical Success Rate

Purpose: To compare long-term clinical outcomes of pars plana vitrectomy (PPV) combined with intraoperative 360° laserpexy and pars plana vitrectomy combined with scleral encircling for the treatment of primary rhegmatogenous retinal detachment (RRD).Methods: This retrospective, comparative case study included 70 patients who had at least 1 year of follow-up after vitrectomy for primary uncomplicated RRD from 2015 to 2019. The patients were divided into two groups. Group I included 34 patients who underwent PPV + 360° laserpexy (LP), while group II included 36 patients who underwent PPV + scleral encircling (SE). Main outcome measures were the anatomical success rate, the functional success rate, final best-corrected visual acuity (BCVA), and the incidence of post-operative complications. We also examined the long-term changes in axial length, corneal curvature, and refractive error before and after surgery.Results: LP and SE groups showed no significant differences with respect to the primary anatomical success rate (97.05% and 94.44%, respectively; p = 0.592) or the functional success rate (BCVA ≥ 20/40 at final follow-up; 82.35% and 77.78%, respectively; p = 0.635). Detachment reoccurred in three cases (one in the LP group and two in the SE group) because of proliferative vitreoretinopathy; both cases in the SE group had successful anatomical re-attachment after repeating the PPV procedure. Complications included post-operative epiretinal membrane and cystic macular edema, as well as increased intraocular pressure.Conclusions: Primary vitrectomy combined with 360° laserpexy has effectiveness similar to vitrectomy combined with scleral encircling in patients with RRD in long-term clinical outcomes.

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Therapy and prevention for mental health: What if mental diseases are mostly not brain disorders?

Behavioral and Brain Sciences ◽

10.1017/s0140525x1800105x ◽

2019 ◽

Vol 42 ◽

Cited By ~ 2

Author(s):

John P. A. Ioannidis

Keyword(s):

Mental Health ◽

Mental Disease ◽

Brain Disorders ◽

Social Stressors ◽

Labor Education ◽

Mental Diseases ◽

Long Term Follow Up ◽

Political Decisions

AbstractNeurobiology-based interventions for mental diseases and searches for useful biomarkers of treatment response have largely failed. Clinical trials should assess interventions related to environmental and social stressors, with long-term follow-up; social rather than biological endpoints; personalized outcomes; and suitable cluster, adaptive, and n-of-1 designs. Labor, education, financial, and other social/political decisions should be evaluated for their impacts on mental disease.

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