Hybrid 20/23-G pars plana vitrectomy in endophthalmitis and trauma: a strategic approach

2017 ◽  
Vol 28 (1) ◽  
pp. 94-97
Author(s):  
Daraius Shroff ◽  
Priyanka Gupta ◽  
Charu Gupta ◽  
Neelam Atri ◽  
Ranjan Dutta ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Silicone Oil ◽  
Vitreous Surgery ◽  
Safety And Efficacy ◽  
Suprachoroidal Space ◽  
Strategic Approach ◽  
Pars Plana ◽  
Silicone Oil Tamponade ◽  
Difficult Cases

Purpose: To assess the safety and efficacy of hybrid vitreous surgery combining active 23-G ports with a sutured 20-G 6-mm infusion cannula for performing vitrectomy in endophthalmitis and trauma. Methods: This is a retrospective analysis of 10 eyes with endophthalmitis and 10 eyes with trauma requiring vitreous surgery, having corneal clarity suitable for vitrectomy and best-corrected visual acuity (BCVA) greater than or equal to light perception. All patients underwent hybrid 20/23-G vitrectomy. Intraoperative notes were analyzed for peroperative complications. The BCVA and retinal status at 3 months were analyzed. Results: In the endophthalmitis group, patients ranged from 5 to 85 years of age and showed varied etiologies. Retinal detachment was present in 5 eyes, which received silicone oil tamponade. Mean preoperative logMAR visual acuity (VA) was 2.29 ± 0.45, which improved to 1.10 ± 0.72 at 3 months postoperatively (p<0.001). Trauma cases ranged from 21 to 75 years of age. Retinal detachment was present in 9 out of 10 eyes, all of which received silicone oil tamponade. Preoperative logMAR VA was 2.26 ± 0.71, which improved to 1.33 ± 0.50 postoperatively (p<0.001). At 3 months postsurgery, the retina was attached in all eyes in both groups. Conclusions: The longer sutured 20-G cannula was easier to visualize through fibrin, exudates, and hemorrhage and did not slip out or enter the suprachoroidal space in any of our cases. The 23-G active ports and vitrectomy cutter enhanced safety and efficacy. Hybrid vitrectomy enabled safe surgery in these difficult cases.

scholarly journals Tonic Pupil Following Pars Plana Vitrectomy and Endolaser

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Benyamin Ebrahim ◽  
Larry Frohman ◽  
Marco Zarbin ◽  
Neelakshi Bhagat
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Retrobulbar Anesthesia ◽  
Tonic Pupil ◽  
Suprachoroidal Space ◽  
Pars Plana ◽  
Silicone Oil Tamponade

Tonic pupil was observed in a 67 year-old patient following a retinal detachment repair with pars plana vitrectomy, endolaser and silicone oil tamponade performed under retrobulbar anesthesia. The probable location of disturbance is the postganglionic parasympathetic fibers in the short ciliary nerves along their course to the pupil in the suprachoroidal space. A likely explanation for this phenomenon is injury to short ciliary nerves by endolaser treatment.

scholarly journals Surgical Management of Traumatic Retinal Detachment with Primary Vitrectomy in Adult Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Katarzyna Nowomiejska ◽  
Tomasz Choragiewicz ◽  
Dorota Borowicz ◽  
Agnieszka Brzozowska ◽  
Joanna Moneta-Wielgos ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Silicone Oil ◽  
Vitreoretinal Surgery ◽  
Eye Injuries ◽  
Primary Vitrectomy ◽  
Eye Trauma ◽  
Open Globe ◽  
Pars Plana ◽  
23 Gauge

Purpose.To evaluate functional and anatomical results of pars plana vitrectomy (PPV) in the retinal detachment (RD) followed by severe eye trauma.Methods.Retrospective analysis of medical records of forty-one consecutive patients treated with 23-gauge PPV due to traumatic RD. Age, gender, timing of PPV, visual acuity, and presence of intraocular foreign body (IOFB) and proliferative vitreoretinopathy (PVR) were included in the analysis.Results.Mean age of patients was 47 years; the majority of patients were men (88%). Closed globe injury was present in 21 eyes and open globe injury in 20 eyes (IOFB in 13 eyes, penetration injury in 4 eyes, and eye rupture in 3 eyes). Mean follow-up period was 14 months; mean timing of PPV was 67 days. Twenty-seven (66%) eyes had a functional success; 32 eyes (78%) had anatomical success. As a tamponade silicone oil was used in 33 cases and SF6 gas in 8 cases.Conclusions.Severe eye injuries are potentially devastating for vision, but vitreoretinal surgery can improve anatomical and functional outcomes. Among analysed pre- and intra- and postoperative factors, absence of PVR, postoperative retinal attachment, and silicone oil as a tamponade were related to significantly improved visual acuity.

scholarly journals Evaluation of macular vessel density changes after vitrectomy with silicone oil tamponade in patients with rhegmatogenous retinal detachment

2021 ◽  
Vol 14 (6) ◽  
pp. 881-886
Author(s):  
Jian Jiang ◽  
◽  
Ya-Ding Jia ◽  
Rui Li ◽  
Jin-Xiu Zhou ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Vessel Density ◽  
Capillary Plexus ◽  
Long Time ◽  
Pars Plana ◽  
Silicone Oil Tamponade ◽  
Over Time ◽  
Fellow Eyes

AIM: To evaluate macular microvasculature changes in eyes after pars plana vitrectomy (PPV) and intraocular silicone oil (SO) tamponade for macula-off rhegmatogenous retinal detachment (RRD) using optical coherence tomography angiography (OCTA). METHODS: Totally 19 eyes (19 patients) with macula-off RRD who underwent PPV and intraocular SO tamponade were retrospectively reviewed. The parafoveal superficial capillary plexus (SCP) vessel density (VD), deep capillary plexus (DCP) VD, choriocapillaris plexus (CCP) VD, and foveal macular thickness were evaluated using OCTA throughout 16wk postoperatively. The values of healthy fellow eyes were used as control. RESULTS: The parafoveal SCP, DCP, and CCP VDs were significant increased over time in RRD eyes during the 12wk postoperatively, then decreased at 16wk postoperatively (all P<0.01). The ratios of RRD eyes and fellow healthy eyes (r/f ratios) of the SCP and DCP VDs were lower than those of the CCP VD postoperatively (all P<0.05). There were not significant differences in the r/f ratios between SCP and DCP VDs postoperatively (all P>0.05). CONCLUSION: The parafoveal SCP, DCP, and CCP VDs gradually recover over time after PPV surgery with SO tamponade. Long-time SO tamponade might decrease postoperative macular VDs. Compared to parafoveal CCP VD, the parafoveal SCP and DCP VDs were more vulnerable in RRD eyes postoperatively.

scholarly journals MODIFIED SCLERAL BUCKLING WITH A NON-CONTACT WIDE ANGLE VIEWING SYSTEM AND A 25G CHANDELIER ENDOILLUMINTOR

2016 ◽  
Vol 21 (4) ◽  
pp. 219 ◽  
Author(s):  
Tehmina Jahangir ◽  
Haroon Tayyab ◽  
Muhammad Naeem ◽  
Qasim Lateef ◽  
Asad Aslam Khan
Keyword(s):  
Retinal Detachment ◽  
Silicone Oil ◽  
Sampling Technique ◽  
Scleral Buckling ◽  
Wide Angle ◽  
Department Of Ophthalmology ◽  
Scleral Buckling Procedure ◽  
Pars Plana ◽  
Silicone Oil Tamponade ◽  
Convenience Sampling

AbstractPurpose:To evaluate the outcome of scleral buckling surgery using a wide angle non-contact viewing system and chandelier endoillumination for per-operative fundus visualization in patients with non-complex rhegmatogenous retinal detachments.Materials and Methods:This was a prospective, interventional study carried out at the Department of Ophthalmology, Mayo Hospital Lahore over a period of six months. Non-probability convenience sampling technique was employed. Fifteen eyes of fifteen pati-ents underwent modified scleral buckling procedure for rhegmatogenous retinal detachment using a 25G Awh Chandelier (inserted into the sclera through the pars plana) and wide angle viewing system to view the fundus intraoperatively instead of the conventional Indirect Ophthalmoscope.Results:The mean age of the patients in this study group was 41.9 12.4 years. Out of fifteen patients, 13 had flat retinas postoperatively. Two patients had to undergo pars plana vitrectomy with silicone oil tamponade due to development of retinal detachment secon-dary to PVR.Conclusion:Modified scleral buckling with the con-current use of a chandelier light and wide angle viewing system provides an easier and more convenient means of visualizing the fundus under panoramic viewing conditions intraoperatively.Key Words:Wide angle viewing system. Retinal detachment. Scleral buckling. Endoillumination.

scholarly journals Outcomes of Silicone Oil Removal in Complex Retinal Detachment

2018 ◽  
Vol 10 (2) ◽  
pp. 124-129
Author(s):  
Ritesh Shah ◽  
Raghunandan Byanju ◽  
Sangita Pradhan
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Ocular Hypertension ◽  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Visual Outcome ◽  
Complication Rates ◽  
Oil Removal ◽  
Silicone Oil Removal ◽  
Pars Plana

Introduction: Pars plana vitrectomy in combination with intraocular tamponade with silicone oil is a standard technique in the treatment of complex retinal detachment. Although the use of silicone oil has improved the results of retinal detachment surgery, its removal is recommended due to the ocular complications related to its long term use. However, retinal redetachment can occur after silicone oil removal. Objective: To evaluate the anatomical and visual outcome after silicone oil removal (SOR) in eyes with complicated retinal detachment. Material and Methods: We retrospectively analyzed 64 eyes of 64 consecutive patients of silicone oil removal over a period of 12 months. All eyes had undergone standard 3 ports pars plana vitrectomy with silicone oil placement for complicated retinal detachment. Cases that completed at least 1 month follow up duration after SOR were included in the study. Anatomical success after SOR was achieved in 56 of 64 eyes (87.5%). Seven of 8 redetachments (87.5%) were seen in eyes with silicone oil tamponade duration of less than 6 months. Visual acuity improved or was stabilized in 49 of 64 eyes (76.6%). Using paired T-test, it was found that there was no significant difference in pre and post SOR visual acuity. Postoperative ocular hypertension, corneal decompensation, band shaped keratopathy and hypotony was observed in 9.4%, 4.7%, 6.4% and 21.9% respectively. Conclusion: Although there was no significant improvement in visual acuity, redetachment and complication rates were comparable to other studies. The duration of endotamponade was not significantly associated with the redetachment rate. Key words: Silicone oil removal, Redetachment, Visual outcome, Keratopathy, ocular hypertension.

The Influence of Silicone Oil on the Ganglion Cell Complex After Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment

2018 ◽  
Vol 24 (29) ◽  
pp. 3476-3493 ◽  
Author(s):  
Dorota Raczyńska ◽  
Kamila Mitrosz ◽  
Krystyna Raczyńska ◽  
Leopold Glasner
Keyword(s):  
Retinal Detachment ◽  
Ganglion Cell ◽  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Cell Complex ◽  
Ganglion Cell Complex ◽  
Pars Plana ◽  
Silicone Oil Tamponade ◽  
The Impact ◽  
Sd Oct

Purpose: Pars plana vitrectomy (PPV) and silicone oil endotamponade have been used as a treatment in rhegmatogenous retinal detachment (RRD). Improvement in the modality of spectral-domain optical coherence tomography (SD-OCT) allows for the assessment of ganglion cell layer-inner plexiform layer (GCL-IPL) in the macular region. Information about the GCL-IPL status may be a response to the question as to why the visual recovery after PPV with silicone oil tamponade is incomplete. The aim of the study was to evaluate the impact of silicone oil on GCL-IPL and compare it with other endotamponade types such as Sulfur hexafluoride gas (SF6), Perfluoropropane gas (C3F8) used during PPV performed due to RRD. Patients and Methods: The study involved 57 eyes after PPV and 57 healthy, control eyes of patients with primary RRD who had undergone successful PPV. The patients were divided into three subgroups depending on the endotamponade type, and were tracked with complete ophthalmological examination during a period of 6 months. PPV with internal tamponade silicone oil, 24% SF6 or 14% C3F8 was performed. The medical records were reviewed and compared between the groups. Results: SD-OCT analysis detected a significant reduction of average GCL-IPL thickness and reduction of GCLIPL parameter in almost all examined sectors in the group with silicone oil endotamponade during all follow-up visits (P<0.05). The study showed a significant vision deterioration in the silicone oil group in comparison with the SF6 group on all follow-up visits (P<0.05). Conclusion: This is the first in vivo SD-OCT study describing the toxic effect of silicone oil endotamponade on GCL-IPL complex after PPV for RRD. The study confirmed that the GCL-IPL complex value can be a predictive factor for assessing the final visual acuity. SD-OCT should be recommended as a clinical standard in the followup treatment of patients after PPV for RRD, especially with the use of silicone oil endotamponade. Plain Language Summary: The aim of the study was to examine the impact of silicone oil on the ganglion cell complex. The ganglion cell is a neuron type located in the retina and takes part in transmitting visual information from the retina to the brain. Silicone oil is a substance used during eye surgery called pars plana vitrectomy. This tamponade type acts to hold the retina in a proper position. However, during the retinal detachment, which is the separation of the retina from the layer underneath, a reduction of neurons is observed. We decided to use a new technology device called SD-OCT to determine the thickness of the ganglion cell complex. We compared the impact of silicone oil with other tamponade types. We found that silicone oil causes a reduction in the ganglion cell complex. Moreover, we observed vision deterioration in eyes treated with a silicone oil tamponade. The research describes the toxic effect of silicone oil on ganglion cells. Ganglion cell values may be used to determine visual improvement or deterioration after eye surgery with silicone oil tamponade. SD-OCT should be a clinical standard in monitoring patients with silicone oil tamponade.

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