ANATOMICAL AND VISUAL OUTCOME OF COMBINED PHACO-VITRECTOMY VS VITRECTOMY ALONE

Introduction Separation of Neurosensory retina from RPE(Retinal Pigment Epithelium) is described as retinal detachment. Recently Pars plana vitrectomy has emerged as a preferred surgical treatment for management of uncomplicated primary rhegmatogenous retinal detachment. Various studies have evaluated the results of combined phaco-vitrectomy, the combined approach allows faster visual recovery and has cost effectivity for patient. The rationale of this study is to compare the anatomical and visual outcome of combined phacoemulsification and vitrectomy vs vitrectomy alone Materials and methods This prospective randomized controlled trial was performed at Eye Unit II Mayo Hospital Lahore (tertiary care eye hospital in Lahore), Pakistan from August 2019 to February 2020. 36 patients full filling the inclusion criteria were divided into two groups 18 patients each. Group A was of combined Phaco-vitrectomy and Group B was of vitrectomy only. The Mann-whitney test as test of significance was applied and P≤0.05 was considered statistically significant. Results BCVA done Pre-operatively for Group A and B, P-value was > 0.05 which was insignificant. Best corrected visual acuity at first week post operatively was significantly lower in patients in which we used gasses as internal tamponade as compared those in which we used silicon oil as tamponade. The BCVA at 1 month showed improvements in both groups, however the BCVA in group B was significantly lower than group A, P-value being < 0.05. The BCVA at 3 month showed improvements in both groups, however the BCVA in group B was significantly lower than group A, P-value being < 0.05. Anatomical Outcome was seen as weather retina was attached or detached. In Group A detachment was present in all follow-ups in 2/18 patients while in Group B detachment was present in all follow-ups in 3/18 patients. The P-value was >0.05 and thus the difference between two groups was insignificant. Conclusion visual acuity did not differ among the two groups preoperatively and on first follow-up at 1 week. The P value being >0.05 in both. However there was significant difference between the two group at 1 month and 3 months follow up, P value being < 0.05 in each. The visual acuity was significantly better in Group A i.e combined phaco- vitrectomy. For anatomical outcome no difference was seen between the groups. The P value was > 0.05. So the visual outcome of group A was significantly better than group B while the anatomical outcome was the same. Keywords Phacoemulsification, Three ports pars plana vitrectomy, best corrected visual acuity, retinal detachment.

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MACULAR CHANGES AFTER CATARACT SURGERY: A PROSPECTIVE STUDY.

10.36106/ijsr/1903725 ◽

2019 ◽

pp. 1-3

Author(s):

Ritu Agarwal ◽

Piyush Gupta*

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Visual Outcome ◽

Macular Thickness ◽

Small Incision Cataract Surgery ◽

Corrected Visual Acuity ◽

Group A ◽

Group B ◽

A Prospective Study ◽

Final Visual Outcome

AIM: To evaluate and compare macular thickness changes after uneventful Phacoemulsification and Manual Small Incision Cataract Surgery in correlation with visual acuity. METHOD: Study was conducted on 250 cataract patients they were equally divided into Group A and Group B. Group A patients underwent Phacoemulsification and Group B underwent MSICS. In both groups macular thickness using OCTand Best Corrected Visual Acuity (BCVA) was recorded preoperatively and postoperatively at 1 day, 1, 3, 6 weeks, 3 and 6 months. Macular thickness changes were evaluated and compared with visual acuity. RESULTS: Macular thickness continued to increase from 1 week to 6 months postoperatively which was statistically significant. No correlation found between increased macular thickness and BCVA. CONCLUSION: Increase in macular thickness remained subclinical and there was no impact of increased macular thickness on the final visual outcome.

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Intravitreal bevacizumab (IVB) versus IVB in combination with pars plana vitrectomy for vitreous hemorrhage secondary to proliferative diabetic retinopathy: a randomized clinical trial

International Journal of Retina and Vitreous ◽

10.1186/s40942-021-00296-7 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Danilo Moyses Jorge ◽

José Edísio da Silva Tavares Neto ◽

Omero Benedicto Poli-Neto ◽

Ingrid U. Scott ◽

Rodrigo Jorge

Keyword(s):

Visual Acuity ◽

Diabetic Retinopathy ◽

Proliferative Diabetic Retinopathy ◽

Pars Plana Vitrectomy ◽

Vitreous Hemorrhage ◽

Sao Paulo ◽

Group A ◽

Pars Plana ◽

Group B

Abstract Background The main purpose of this study is to compare the vitreous hemorrhage (VH) score reduction and visual acuity outcomes in patients with VH secondary to proliferative diabetic retinopathy (PDR) treated with intravitreal injections of bevacizumab (IVB) versus IVB and pars plana vitrectomy (IVB and PPV). Methods Patients with VH secondary to PDR were randomized into 2 groups: in Group A, patients were treated with a total of 3 IVB (1.5 mg/0.06 ml) at 8-week intervals; and in Group B, patients received a single IVB (1.5 mg/0.06 ml) and, 7 days later, underwent PPV. Patients received an ophthalmic evaluation that included best-corrected visual acuity (BCVA), indirect ophthalmoscopy, and mode B echography at weeks 8, 16 and 24. VH was classified according to the Diabetic Retinopathy Vitrectomy Study classification as grade 1, 2 or 3. Change in VH score was the primary outcome measure and change in BCVA was the secondary outcome. Results Seventy-three eyes of 66 patients were randomized and 70 eyes completed the 24-week follow-up visit. Mean VH score reduction (± SEM) of 0.4571 ± 0.0283 (p = 0.0014), 1.3429 ± 0.0393 (p < 0.0001) and 1.8286 ± 0.0438 (p < 0.001) was observed in Group A at 8, 16 and 24 weeks after treatment, respectively (Table 2; Fig. 2). In Group B, the reduction of VH score (± SEM) was 2.2571 ± 0.0720 (p = 0.0014), 2.2857 ± 0.0606 (p < 0.0001) and 2.2286 ± 0.0726 (p < 0.001) at 8, 16 and 24 weeks after treatment, respectively. Group comparison revealed a significantly greater reduction in mean VH score in Group B at 8 and 16 weeks after treatment (p < 0.0001). However, at 24 weeks this difference was no longer statistically significant (p = 0.1854). In Group A, mean (± SEM) BCVA showed an improvement of 0.00285 ± 0.0004 (p = 0.971), 0.5371 ± 0.0072 (p < 0.0001), 0.8143 ± 0.0001 (p < 0.0001) and 0.8543 ± 0.0008 (p < 0.0001) compared to baseline at 1, 8, 16 and 24 weeks after treatment, respectively. In Group B, mean (± SEM) BCVA showed an improvement of 0.3657 ± 0.0507 (p = 0.0002), 0.8857 ± 0.0385 (p < 0.0001), 0.9457 ± 0.0499 (p < 0.0001) and 0.9629 ± 0477 (p < 0.0001) compared to baseline at 1, 8, 16 and 24 weeks after treatment, respectively. No significant difference in BCVA improvement was observed between groups at 24 weeks after treatment. Conclusion PPV with preoperative IVB is associated with more rapid clearance of VH and improvement in BCVA than IVB injections alone. However, after 24 weeks of follow-up, the reduction in VH score and BCVA were similar between both treatment strategies. Trial Registration The project is registered in Plataforma Brasil with CAAE number 927354.7.0000.5440 and was approved by the Ethics Committee of the Clinics Hospital of Ribeirao Preto Medicine School of São Paulo University—Ribeirão Preto, São Paulo, Brazil (appreciation number 3.053.397 gave the approval).

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A pilot study on vitrectomy combined with scleral shortening for eyes with myopic macular retinoschisis—2y follow-up results

International Journal of Ophthalmology ◽

10.18240/ijo.2021.02.13 ◽

2021 ◽

Vol 14 (2) ◽

pp. 263-268

Author(s):

Peng Zhang ◽

◽

Ling-Xin Hou ◽

Yu-Hua Hao ◽

Kun Wang ◽

...

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Macular Hole ◽

Pars Plana Vitrectomy ◽

Macular Retinoschisis ◽

Corrected Visual Acuity ◽

Pars Plana ◽

The Mean ◽

Best Corrected Visual Acuity

AIM: To evaluate the effect of vitrectomy combined with scleral shortening for eyes with myopic macular retinoschisis. METHODS: Thirty-seven patients with myopic macular retinoschisis who underwent pars plana vitrectomy (PPV) combined with scleral shortening were reviewed. Axial length (AL), the height of macular retinoschisis, the height of retinal detachment if existed, the diameter of macular hole if existed and best corrected visual acuity (BCVA) were obtained. The preoperative and postoperative parameters were compared. RESULTS: At postoperative 24mo, the mean AL and height of macular retinoschisis were reduced significantly by 0.79 mm and 256.51 μm (t=8.064, P<0.0001; Z=-5.086, P<0.0001) respectively. In addition, the mean height of retinal detachment and diameter of macular hole were also reduced significantly by 365.38 μm and 183.68 μm (Z=-4.457, P=0.000008; Z=-2.983, P=0.003) respectively. Meanwhile, the postoperative BCVA was improved markedly (Z=-2.126, P=0.033). CONCLUSION: Vitrectomy combined with scleral shortening is an effective surgical method for eyes with myopic macular retinoschisis, whether or not macular hole and retinal detachment are present.

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Combining cataract surgery with 25-gauge high-speed pars plana vitrectomy: A prospective study

European Journal of Ophthalmology ◽

10.1177/1120672120902030 ◽

2020 ◽

pp. 112067212090203

Author(s):

Alfonso Savastano ◽

Chiara Lenzetti ◽

Lucia Finocchio ◽

Daniela Bacherini ◽

Fabrizio Giansanti ◽

...

Keyword(s):

Visual Acuity ◽

Postoperative Complications ◽

Prospective Study ◽

Macular Hole ◽

Epiretinal Membrane ◽

Pars Plana Vitrectomy ◽

Visual Outcome ◽

Group A ◽

Pars Plana ◽

Group B

Purpose: To compare visual outcome and postoperative complications of combined 25-gauge pars plana vitrectomy and phacoemulsification with vitrectomy alone surgery in patients with epiretinal membrane and macular hole. Methods: A total of 110 eyes (73 eyes with epiretinal membrane and 37 eyes with macular hole) were enrolled in this prospective study. The eyes were divided into two groups: Group A included 55 eyes which underwent phacovitrectomy at the same time and Group B included 55 eyes which underwent vitrectomy alone. Follow-up visits were at 1, 3, and 6 months. Results: The best-corrected visual acuity correlation by analysis of variance measurement showed statistically non-significant differences between the two groups ( p = 0.32). The post hoc analysis from baseline, 1°, 2°, and 3° follow-ups was not statistically significant ( p > 0.05). The most common postoperative complication was cystoid macular edema that has been detected in 11 patients (10%) (seven eyes in Group A and four eyes in Group B): 2 patients (1.8%) developed a chronic macular edema. Intraocular hypertension occurred in five eyes (4.5%) (three in Group A and two in Group B). Four eyes (3.6%) underwent another surgical procedure for a persistent macular hole (two in Group A and two in Group B). The intraocular lens repositioning was performed one day after surgery in three eyes (2.7%) (Group A). The mean preoperative visual acuity was not different between the two groups ( p = 0.80). Conclusion: No significative differences between combined surgery and vitrectomy alone have been detected, in terms of postoperative complications and visual outcome.

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MACULAR CHANGES AFTER CATARACT SURGERY: A PROSPECTIVE STUDY

10.36106/1903725 ◽

2019 ◽

pp. 1-3

Author(s):

Ritu Agarwal ◽

Piyush Gupta*

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Visual Outcome ◽

Macular Thickness ◽

Small Incision Cataract Surgery ◽

Corrected Visual Acuity ◽

Group A ◽

Group B ◽

A Prospective Study ◽

Final Visual Outcome

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465 No Role for Postoperative Antibiotics in Uncomplicated Appendicitis

British Journal of Surgery ◽

10.1093/bjs/znab134.283 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

N Ayoub ◽

Y Tryliskyy ◽

M K Baig

Keyword(s):

Wound Infection ◽

P Value ◽

Nice Guidelines ◽

Uncomplicated Appendicitis ◽

Perforated Appendix ◽

Group A ◽

Preoperative Antibiotics ◽

Group B ◽

Variable Practice

Abstract Introduction Several studies have shown benefit from use of preoperative antibiotics in reducing postoperative infection after appendectomy as well as efficacy of postoperative antibiotics in complicated appendicitis (defined as perforated appendix or presence of pus in peritoneum). While for uncomplicated appendicitis, several studies showed no benefit from antibiotics postoperatively but there are no clear NICE guidelines till now and so surgeons have different practice based on their preferences. Method This study included patients who had appendectomy for uncomplicated appendicitis in Worthing hospital from 1st July 2019 till 30th June 2020. The end point was 30-day follow up postoperatively for wound infection or collection. Results 90 patients were admitted with uncomplicated appendicitis with age 6-80 years (mean of 31.3). 46 patients (51%) did not receive postoperative antibiotics (group A) and 44 (49%) received postoperative antibiotics (group B) with a variable practice from one dose to 8-day course. postoperatively, only 1 patient (2.1%) in group A developed wound infection requiring drainage while none in group B developed complications (p-value=1). Conclusions Administration of postoperative antibiotics in uncomplicated appendicitis showed no superiority over non-administration. in addition, they add extra cost on NHS. So, their routine use postoperatively is not recommended, however, larger studies are required to confirm this.

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Loss of Visual Acuity after Successful Surgery for Macula-On Rhegmatogenous Retinal Detachment in a Prospective Multicentre Study

Journal of Ophthalmology ◽

10.1155/2015/821864 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Salvatore Di Lauro ◽

Melissa Castrejón ◽

Itziar Fernández ◽

Jimena Rojas ◽

Rosa M. Coco ◽

...

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Visual Loss ◽

Vision Loss ◽

Multicentric Study ◽

Prospective Multicentre Study ◽

Snellen Chart ◽

Pars Plana ◽

Phakic Eyes

Purpose. To quantify the frequency of visual loss after successful retinal detachment (RD) surgery in macula-on patients in a multicentric, prospective series of RD.Methods. Clinical variables from consecutive macula-on RD patients were collected in a prospective multicentric study. Visual loss was defined as at least a reduction in one line in best corrected visual acuity (VA) with Snellen chart. The series were divided into 4 subgroups: (1) all macula-on eyes (n=357); (2) macula-on patients with visual loss at the third month of follow-up (n=53) which were further subdivided in (3) phakic eyes (n=39); and (4) pseudophakic eyes (n=14).Results. Fifty-three eyes (14.9%) had visual loss three months after surgery (n=39phakic eyes;n=14pseudophakic eyes). There were no statistically significant differences between them regarding their clinical characteristics. Pars plana vitrectomy (PPV) was used in 67.2% of cases, scleral buckle in 57.7%, and scleral explant in 11.9% (36.1% were combined procedures).Conclusions. Around 15% of macula-on RD eyes lose VA after successful surgery. Development of cataracts may be one cause in phakic eyes, but vision loss in pseudophakic eyes could have other explanations such as the effect of released factors produced by retinal ischemia on the macula area. Further investigations are necessary to elucidate this hypothesis.

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Comparable Efficacy of Terbinafine and Itraconazole in the Treatment of Tinea Pedis

Bangladesh Journal of Medicine ◽

10.3329/bjmed.v21i2.13615 ◽

2013 ◽

Vol 21 (2) ◽

pp. 74-79

Author(s):

Md Abdul Wahab ◽

Mohammad Jamal Uddin ◽

Biswas Shahen Hassan ◽

Md Zafrul Islam ◽

Ishrat Bhuiyan ◽

...

Keyword(s):

Fungal Infection ◽

Tinea Pedis ◽

Comparable Efficacy ◽

P Value ◽

Mycological Cure ◽

Efficacy Analysis ◽

Group A ◽

Group B

Background: Tinea pedis (athlets foot) is the most common fungal infection. Relapse is common in tinea pedis and may be result of recurrence following inadequate treatment or reinfection. Objective: To evaluate the comparable efficacy of terbinafine and itraconazole in the treatment of tinea pedis. Methods: 120 patients of tinea pedis confirmed by KOH microscopy were included in the study. The study was carried out in three different Hospitals and Private Chambers for a period of 3 years from July 2006 to June 2009. Mean age of the patients was 40.28±10.23. The patients were devided into 2 equal group:A & B. Group- A was given terbinafine 250 mg/day and group-B was given intraconazole 200 mg/day for 2 weeks. Results: Follow up 2 weeks after cessation of therapy revealed clinical and mycological cure of 93.3% in terbinafine group and 86.6% in itraconazole group. Conclusion: Efficacy analysis revealed that terbinafine is superior than itraconazole in the treatment of tinea pedis (P value 0.224). DOI: http://dx.doi.org/10.3329/bjmed.v21i2.13615 Bangladesh J Medicine 2010; 21: 74-79

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Prophylactic corneal cross-linking in LASIK surgery: effects on visual outcome and recovery time

Asian Journal of Ophthalmology ◽

10.35119/asjoo.v17i1.451 ◽

2020 ◽

Vol 17 (1) ◽

pp. 61-68

Author(s):

Dominique Clare Oh ◽

Yiong Huak Chan ◽

Sao Bing Lee ◽

Jovina Li Shuen See

Keyword(s):

Visual Acuity ◽

Side Effects ◽

Recovery Time ◽

Visual Outcome ◽

Cross Linking ◽

Safe Procedure ◽

Distance Visual Acuity ◽

Visual Outcomes ◽

Group A ◽

Group B

Introduction: Collagen cross-linking is a useful adjunct in preventing corneal ectasia after laser-assisted in situ keratomileusis (LASIK). This study aimed to evaluate whether prophylactic cross-linking in IntraLase LASIK affects optimum visual outcome and recovery time in the immediate post-surgery period and is associated with any side effects. Methods: This was a retrospective case study on the right eyes of 100 Chinese subjects aged 18 to 40 years who underwent IntraLase LASIK. Fifty subjects who underwentcross-linking after completing LASIK (Group A) were compared with 50 subjects who did not undergo LASIK (Group B). Cases were evaluated for pre- and post-operative spherical equivalent, uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), recovery time and presence of side effects. Results: At 1 week post-LASIK, mean (SD) UDVA of Group A subjects was poorer than Group B, at 1.05 (0.19) vs 1.17 (0.19) (p = 0.036); however, there was no significant difference in CDVA (p = 0.095). By 1 month post-LASIK, differences in both UDVA and CDVA were insignificant (p = 0.055, 0.106, respectively). Mean recovery time was 2.72 (95% confidence interval [CI] = 0.64-4.7) days longer in Group A (p = 0.010), although by 1 month post-LASIK, both groups were able to achieve CDVA equal to or better than that achieved pre-LASIK. Incidence of mild inflammation and dry eyes post-LASIK was similar in both groups (p = 1.00, 0.749, respectively); no other complications were observed. Conclusion: No differences in visual outcomes at and occurrence of side effects at 1 month post-LASIK were observed between subjects who underwent cross-linking prior to refractive surgery and those who did not. However, the group that underwent cross-linking had a slightly longer mean recovery time. Our study supports prophylactic cross-linking as a safe procedure that does not affect immediate visual outcomes among the Chinese population when used in adjunct with LASIK surgery.

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Vitreoschisis and retinal detachment: New insight in proliferative vitreoretinopathy

European Journal of Ophthalmology ◽

10.1177/11206721211057672 ◽

2021 ◽

pp. 112067212110576

Author(s):

Stanislao Rizzo ◽

Lorenzo de Angelis ◽

Francesco Barca ◽

Daniela Bacherini ◽

Lorenzo Vannozzi ◽

...

Keyword(s):

Retinal Detachment ◽

Proliferative Vitreoretinopathy ◽

Pars Plana Vitrectomy ◽

Rhegmatogenous Retinal Detachment ◽

Vitreous Cortex ◽

Group A ◽

Pars Plana ◽

Group B ◽

Removal Group ◽

Anatomical Success

Purpose To assess the occurrence of peripheral vitreoschisis-induced vitreous cortex remnants (p-VCRs) in primary rhegmatogenous retinal detachment (RD) and investigate whether the presence of p-VCRs results in a greater risk of RD recurrence, secondary to Proliferative Vitreoretinopathy (PVR) development after pars plana vitrectomy (PPV). Methods Patients who underwent PPV for primary rhegmatogenous RD between January 2016 and December 2018 were included. The presence of residual p-VCRs was confirmed intraoperatively using triamcinolone acetonide (TA). Patients with p-VCRs were divided into two groups: Group A comprised of patients who underwent PPV without p-VCR removal, while Group B included patients who underwent PPV with p-VCR removal. Results Four hundred-thirteen eyes with evidence of p-VCR were analyzed. Two-hundred-twenty-three eyes underwent PPV without VCR removal (Group A), while 190 eyes underwent PPV with p-VCR removal (Group B). Primary anatomical success was 91.5% in the Group A and 95.4% in the group B. Retinal re-detachment due to PVR occurred in 17 (7.6%) eyes in Group A and in four (2.1%) eyes in Group B within the first 3 months (p = 0.01). Among group A, in 11 eyes, there was a diffuse posterior PVR grade C, while six eyes were focal PVR grade C. In Group B, we observed four retinal re-detachment due to focal PVR grade C. Conclusion The presence of p-VCRs seems to be associated with a higher incidence of PVR development and might also result in more complex RD recurrence, this suggests the need for more aggressive VCRs removal during the first surgery.

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