Outcomes of 27 gauge pars plana vitrectomy for a variety of posterior segment diseases

2021 ◽  
Vol 71 (11) ◽  
pp. 2570-2575
Author(s):  
Muhammad Amer Awan ◽  
Fiza Shaheen ◽  
Kholood Janjua
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Tertiary Care ◽  
Operating Time ◽  
Retinal Vasculitis ◽  
Posterior Segment ◽  
Care Hospital ◽  
Silicon Oil ◽  
Operative Complications ◽  
Pars Plana

Objective:  To report our experience with 27 gauge (27G) pars plana vitrectomy (PPV) system for a variety of simple to complex posterior segment disorders Methods: Single center, Retrospective, Cohort study. Data of 665 eyes of 574 patients that underwent 27G PPV for a variety of indications from July 2015 to June 2019 at a tertiary care hospital was analyzed. Results: Common surgical indications included; Diabetic tractional retinal detachment (196, 29.5%), vitreous haemorrhage (191, 28.7%), full thickness macular hole (80, 12%), epiretinal membrane (66, 9.9%), endophthalmitis (26, 3.9%), tractional diabetic macular edema (14, 2.1%), ectopia lentis (11, 1.7%), dropped lens matter (13, 2%) and others (68, 10.2%). Mean operating time was 62 ± 37 minutes. With the exception of 2 cases where 20G fragmatome was utilized, no case required conversion to 20 gauge system while a 25G trocar was used for the silicon oil injection. Per-operative complications included; iatrogenic retinal tear (2 eyes, 0.3%) and supra choroidal silicon oil migration (1 eye, 0.15%). Post-operative complications were raised IOP (7 eyes, 1%), endophthalmitis (1 eye, 0.15%), hemorrhagic occlusive retinal vasculitis (1 eye, 0.15%) and retinal detachment (2 eyes, 0.3%). Mean Visual Acuity improved from 1.62 ± 0.68 logarithm of minimum angle of resolution (logMAR) to 0.4 ± 0.38 logMAR (P <0.001). Conclusion: With 3 months follow up time, 27 G PPV has proved to be a safe and effective system for both simpler and complex retinal pathologies requiring significant surgical manipulation. Continuous...

The Common Indications of Pars plana vitrectomy (PPV) for posterior Segment Ocular diseases in patients from a Private Retina Clinic

2021 ◽  
Vol 15 (10) ◽  
pp. 2759-2762
Author(s):  
Sidrah Riaz ◽  
Umair Tariq Mirza ◽  
Kashif Iqbal ◽  
Muhammad Tariq Khan ◽  
Khurram Azam Mirza ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Survey Methods ◽  
Vitreous Hemorrhage ◽  
Posterior Segment ◽  
Ocular Diseases ◽  
Silicon Oil ◽  
Pars Plana ◽  
Age Range ◽  
Anatomical Success

Purpose: To evaluate common indications and anatomical outcomes of PPV for posterior segment ocular diseases in patients presenting at private retina clinic in Lahore Study design: Cross sectional survey Methods and materials: Over the period of three years, from 1st April 2017 to 3oth April 2020, all patients fulfilling inclusion criterion, were included in study after approval from hospital ethical committee. After taking history and detailed ocular examination, diagnosis was confirmed by B scan or OCT, Hepatitis B & C screening done. The patient age, gender, laterality of eye, lens status, macular status, type of retinal pathology, type of anesthesia, procedure done and type of vitreous tamponade if used were noted. All procedures were performed by a single surgical team and patients were followed for six months for anatomical success or any complication. Data was analyzed by SPSS 25. Results: Out of 266 total patients, 168 (63.2%) were males and 98 (36.8%) were females. Right eye was involved in 125 (47%) and left in 141 (53%). Age range was from 2 years to 83years, mean age for males was 47.30, for females 48.07 years, median age was 50 years, mean age for GA was 30.62 years and 51.71 for LA patients. The highest incidences of posterior segment ocular problems were observed in patients with age range 51 to 60 years. The commonest indication for posterior segment surgery were RRD seen in 107 (40.23%), ROSO in 51 (19.17%) and vitreous hemorrhage 33 (12.41%). Endophthalmitis was indication in 20 (7.52%), dropped nucleus in 11 (4.13%), Macular hole in 7 (2.63%) and ERM in 3 (1.13%). Asteroid hyalosis, intraocular IOFB and diagnostic vitrectomy were least common indication, each seen in 1 (0.5%) patient. Silicon oil was most commonly used Endo tamponade used in 138 (51.88%) patients. All patients were followed for 6 months with vision and retinal status. All patients who underwent pars plana vitrectomy surgery were stable with anatomical success rate till 6 months postoperatively except 10 (3.76%) who required re do operation for retinal detachment or some other complications. Conclusion: Current practice in ophthalmology shows increased frequencies of internal approach (PPV) for vitreoretinal diseases rather external approach (SB). Silicon oil was most common internal tamponade used. Diabetic retinopathy was important cause of vitreous hemorrhage and TRD. Patients should be educated regarding regular fundoscopy and good systemic control of diabetes. Higher incidence of retinal detachment among all age groups needs awareness and education about its warning ocular symptoms. Key words: PPV (Pars plana vitrectomy), RRD (Rhegmatogenous retinal detachment), SB (Scleral buckling), TRD (Tractional retinal detachment), ROSO (removal of silicon oil), GA (general anesthesia), LA (local anesthesia)

scholarly journals Retinal detachment in the eye with the choroidal coloboma

2014 ◽  
Vol 142 (11-12) ◽  
pp. 717-720 ◽  
Author(s):  
Dragan Vukovic ◽  
Sanja Petrovic-Pajic ◽  
Predrag Paovic
Keyword(s):  
Retinal Detachment ◽  
Silicone Oil ◽  
Surgical Techniques ◽  
Case Series ◽  
Scleral Buckling ◽  
Posterior Segment ◽  
Scleral Buckle ◽  
Silicon Oil ◽  
Encircling Band ◽  
Pars Plana

Introduction. Choroidal coloboma is a congenital defect caused by an inadequate closure of embryonic fissure. About 40% of the eyes with the choroidal coloboma (CHC) develop the retinal detachment (RD). It is extremely difficult to manage these cases due to the lack of pigmentation at the site of choroidal coloboma. Outline of Cases. This is a case series of five patients with CHC and RD who were successfully operated using one of two different surgical techniques: pars plana vitrectomy (PPV) + silicone oil internal tamponade and/or scleral buckle with encircling band with laser photocoagulation (SB+EB+LPC) around the coloboma. The purpose of this paper is to present how to successfully handle patients with CHC, who have concurrent retinal detachment in the same eye and to compare two different techniques and indications for the predominant use of one of them in a specific case. Conclusion. Both surgical techniques can be applied with equal success in the operation of retinal detachment in eyes with the chorioidal coloboma. Which one will be used depends only of the posterior segment of eye findings. We use scleral buckling in cases with RD accompanied by CHC when the peripheral break is evident and there are no breaks in the coloboma itself. We also perform, 2-3 days after surgery, laser burns around the coloboma, which is our modification of this technique. In all other cases it is indicated to perform PPV+silicon oil internal tamponade.

scholarly journals Posterior Segment Retained Intraocular Foreign Body: A Study from Western Nepal

2021 ◽  
Vol 13 (1) ◽  
pp. 22-30
Author(s):  
Bikram Bahadur Thapa ◽  
Sweta Singh ◽  
Gyanendra Lamichhane ◽  
Shanti Gurung ◽  
Saurav Piya
Keyword(s):  
Visual Acuity ◽  
Foreign Body ◽  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Large Diameter ◽  
Visual Outcome ◽  
Posterior Segment ◽  
Intraocular Foreign Body ◽  
Pars Plana ◽  
The Mean

Introduction: Posterior segment retained Intraocular foreign body (IOFB) management is challenging. Facility of pars plana vitrectomy (PPV) and availability of well trained vitreo retina surgeons are the basic need to accomplish this work.  Encircling band provide permanent 360° support to close the anterior retinal break and prevent traction on the retina. The objective of this study is to analyse the clinical characteristics and predictors of the final visual outcome and survival of the globe in cases of retained IOFB in the posterior eye segment. Materials and methods: A hospital based retrospective observational study was conducted. All the patients of retained IOFB in the posterior segment presented from January 2016 to June 2019 were enrolled. Patients presented with visual acuity of NPL were excluded. Statistical analysis was performed using a variety of tests using SPSS version 21.   Results: Forty eyes of 40 patients were included. The mean age was 27.08±10.68 years (range 5-66). 95% of our patients were male. Most of them (52.5%) worked on the farm. 26(65%) of 40 eyes had Zone I injury. The median time spent before presentation was 13.5 day. Retinal detachment, vitreous hemorrhage, and endophthalmitis were present in 15, 23 and 5 eyes, respectively, before IOFB removal. The mean LogMAR visual acuity was improved significantly from 2.50±0.87 to 1.33± 1.01 (p=0.003). Poor presenting visual acuity, retinal detachment and large diameter of IOFB were found as the predictor of poor final visual acuity. Conclusion:  Pars plana vitrectomy by a vitreo retinal surgeon can give encouraging results in the cases of retained posterior segment IOFB. Poor presenting visual acuity, large diameter of IOFB and RD before IOFB removal are predictors of poor visual outcome.

Primary Combined Pars Plana Vitrectomy and Phacoemulsification With Anterior Segment Removal of Posterior Segment Intraocular Foreign Bodies: A 30-Month Longitudinal Study

2018 ◽  
Vol 2 (2) ◽  
pp. 79-86
Author(s):  
Razek Georges Coussa ◽  
Fares Antaki ◽  
Ali Dirani ◽  
Thomas Cordahi ◽  
Radwan Ajlan ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Foreign Bodies ◽  
Anterior Segment ◽  
Posterior Segment ◽  
Long Term Results ◽  
Open Globe ◽  
Pars Plana

Purpose: To describe a surgical technique and report visual and anatomical outcomes after primary combined pars plana vitrectomy (PPV) and phacoemulsification in patients with posterior segment intraocular foreign bodies (IOFBs) removed via the anterior chamber without enlarging preexisting sclerotomies. Posterior IOFBs are generally managed in a stepwise surgery consisting of phacoemulsification/lensectomy for traumatic cataract removal then PPV and removal of IOFB through enlarged sclerotomies. Enlarged sclerotomies may carry a significant risk of hypotony, vitreous hemorrhage, vitreous and retinal incarceration, and rhegmatogenous retinal detachment with proliferative vitreoretinopathy. Limited studies exist on long-term results of primary anterior segment removal of posterior IOFB combined with primary phacoemulsification. Methods: Medical records of consecutive patients who had ocular lacerations and posterior segment IOFB between October 2003 and June 2017 in a university hospital were reviewed. Patients who received a combined primary IOFB removal and phacoemulsification were included in the study. The postoperative evolution including visual acuity and complications were all recorded. Results: Thirteen patients (13 eyes) were included in the study. All patients were men, and the average age at presentation was 38 years. All IOFB were metallic, and their size ranged from 2 to 7 mm. All patients were operated within 24 hours of presentation. Six (46%) of the 13 lacerations were corneal, and 7 (54%) were scleral. Overall, 9 of 13 (69%) had a final postoperative best-corrected visual acuity equal to or better than 20 of 25. There were 3 (23%) postoperative complications of recurrent rhegmatogenous retinal detachment that occurred within the first postoperative year. Conclusion: Primary combined PPV and phacoemulsification with the removal of IOFB via the anterior segment is a safe and promising approach for repairing open globe injuries. Our results demonstrate the favorable prognostic benefit of this technique, which is recommended in cases with small corneal laceration and posterior segment pathology resulting from IOFB.

scholarly journals 212 Outcomes Of 25-Gauge Pars Plana Vitrectomy Surgery in Primary Rhegmatogenous Retinal Detachment in Pakistan: A Multi-Center Study

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
S Z M Hussain ◽  
M A Awan ◽  
M A R Siddiqui
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Tertiary Care ◽  
National Study ◽  
P Value ◽  
Retinal Surgery ◽  
Pars Plana ◽  
Anatomical Success

Abstract Aim To evaluate the primary anatomical success and visual outcomes in patients with rhegmatogenous retinal detachment (RRD) undergoing 25-gauge pars plana vitrectomy (25g PPV) surgery in Pakistan. Method This is a five-year retrospective, interventional cohort study of 418 consecutive patients with RRD who underwent 25g PPV. Surgeries were performed by two experienced surgeons at tertiary care hospitals in Pakistan. Consecutive patients, who underwent 25 g PPV surgery as treatment for RRD between October 2013-October 2018 were included. We excluded patients who had a history of previous retinal surgery or who did not complete the 4-8 weeks primary outcome visit. Data was collected from the patient’s files by using a pro forma. SPSS version 23.0 (IBM SPSS Statistics, Armonk, NY) was used. A p-value of &lt; 0.5 was considered significant. Results We identified 452 patients through coding system of hospitals who underwent 25g PPV surgery between October 2013-October 2018. Secondary retinal surgery and incomplete follow up cases were excluded. A total of 441 patients’ files were reviewed for the study, out of which 418 patients met the criteria for final analysis. Males were in a higher number 284 (67.9 %). The average age was 49±15.8. In our study, 186 (44.4%) patients were phakic at the time of presentation. At 2 months follow up, the primary anatomical success rate was 87.1 %. Conclusions Surgical outcomes of RRD with 25g PPV surgery in our study were similar to the outcomes reported in the developed world. We propose a prospective multicenter national study to prospectively evaluate the risk factors for RRD surgical failure in the Pakistani population.

scholarly journals Treatment of Localized Retinal Redetachment in Silicon Oil Filled Eyes

2019 ◽  
Vol 34 (2) ◽  
Author(s):  
Muhammad Tariq Khan Sidrah Riaz Qasim Lateef Chaudhry
Keyword(s):  
Retinal Detachment ◽  
Local Anesthesia ◽  
Pars Plana Vitrectomy ◽  
Case Series ◽  
Proliferative Retinopathy ◽  
Retinal Break ◽  
Time Saving ◽  
Silicon Oil ◽  
Retinal Reattachment ◽  
Pars Plana

Purpose: To assess the success rate of retinal reattachment surgery in localized re-detachment in Silicon oil filled eyes which had previously undergone primary retinal detachment (RD) repair with pars plana vitrectomy (PPV) with silicon oil. Study Design: Retrospective cross sectional case series. Place and Duration: Farooq Hospital and Medicare eye centre, Lahore from October 2016 to November 2017. Material and Methods: All those patients were included in our study who underwent primary retinal attachment surgery with pars plana vitrectomy (PPV) and silicon oil for complicated retinal detachment as an internal tamponade and later presented with localized inferior retinal detachment within 6 months of previous RD repair. Patients with total detachment, extensive PVR, retinal shortening, gas tamponade, total Re RD, and external scleral buckle were excluded. Two ports were made under local anesthesia instead of three conventional ports, simple non irrigation vitrectomy technique was used to achieve retinal reattachment under silicon oil without exchange of SO. Results: Ten eyes of ten patients were included, eight (8) males and two (2) females. The age range was from 18 to 79 years. Most common cause of re detachment (RD) in all cases was proliferative retinopathy (PVR) followed by retinal break. The new retinal break was identifiable in three (3) cases. All cases attained anatomical success in term of complete retinal attachment after second operation in one year follow up period. Conclusion: Simple non irrigation vitrectomy surgical technique under local anesthesia is effective, economical and time saving as compared to complicated three port vitrectomy with oil exchange. Keywords: Silicon oil, rhegmatogenous retinal detachment, proliferative retinopathy, retinal break, Perflourocarbon.

scholarly journals Microperimetry-Assessed Functional Alterations and OCT-Changes in Patients after Retinal Detachment Surgery Using Pars Plana Vitrectomy and SF6 Tamponade

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1157
Author(s):  
María D. Díaz-Barreda ◽  
Isabel Bartolomé-Sesé ◽  
Ana Boned-Murillo ◽  
Antonio Ferreras ◽  
Elvira Orduna-Hospital ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Structural Changes ◽  
Cross Sectional Study ◽  
Retinal Sensitivity ◽  
Cross Sectional ◽  
Swept Source ◽  
Integrity Assessment ◽  
Integrity Index ◽  
Pars Plana

Background: We study the retinal function measured by macular integrity assessment microperimetry (MAIA) and structural changes assessed by scanning swept source optical coherence tomography (SS-OCT) between healthy individuals and patients undergoing pars plana vitrectomy (PPV) after rhegmatogenous retinal detachment (RRD). Methods: Cross-sectional study. Early Treatment Diabetic Retinopathy Study (ETDRS) grids were measured by SS-OCT and compared with the MAIA parameters. Results: Thirty-eight eyes with RRD (19 macula-on and 19 macula-off) were compared with 113 healthy eyes. The retinal sensitivity and average total threshold were reduced in all sectors in the RRD group; macular integrity index was increased. Macular thicknesses in total retina and ganglion cell layer (GCL)++ protocols were higher in the RRD group in nasal outer (NO) and central (C) sectors and only in C sector for GCL+ protocol. Thicknesses were lower in total retina, GCL++ protocols in the temporal outer (TO) sector and in the GCL+ protocol in NO sector. Best-corrected visual acuity (BCVA) correlated moderately with retinal sensitivity in all sectors and in just several sectors with time between the date of surgery and the test. The central nasal (CN) sector thickness and the average total threshold were higher in the macula-on subgroup. Conclusions: RRD and subsequent surgery results in functional and structural changes, especially in individuals with macular detachment.

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