scholarly journals Small-Gauge Pars Plana Vitrectomy for the Management of Symptomatic Posterior Vitreous Detachment after Phacoemulsification and Multifocal Intraocular Lens Implantation: A Pilot Study from the Pan-American Collaborative Retina Study Group

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Rodrigo M. Navarro ◽  
Leonardo M. Machado ◽  
Ossires Maia ◽  
Lihteh Wu ◽  
Michel E. Farah ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Pars Plana Vitrectomy ◽  
Posterior Vitreous Detachment ◽  
Case Series ◽  
Intraocular Lenses ◽  
Wilcoxon Test ◽  
Multifocal Iol ◽  
Vitreous Detachment ◽  
Multifocal Intraocular Lenses ◽  
Pars Plana

Purpose.To determine the efficacy of 23-gauge pars plana vitrectomy (PPV) for symptomatic posterior vitreous detachment (PVD) on visual acuity (VA) and quality after multifocal intraocular lenses (IOLs).Methods. In this prospective case series, patients who developed symptomatic PVD and were not satisfied with visual quality due to floaters and halos after multifocal IOL implantation underwent PPV. Examinations included LogMAR uncorrected visual acuity (UCVA), intraocular pressure, biomicroscopy, and indirect ophthalmoscopy at baseline and 1, 7, 30, and 180 days postoperatively. Ultrasonography and aberrometry were performed. The Visual Functioning Questionnaire 25 (VFQ-25) was administered preoperatively and at 30 days postoperatively. Both the postoperative UCVA and questionnaire results were compared to preoperative findings using the Wilcoxon test.Results. Sixteen eyes of 8 patients were included. VA significantly improved from 0.17 to 0.09 postoperatively (P=0.017). All patients reported improvement of halos, glare, and floaters. VFQ-25 scores significantly improved in general vision (P=0.023), near activities (P=0.043), distance activities (P=0.041), mental health (P=0.011), role difficulties (P=0.042), and driving (P=0.016).Conclusion. PPV may increase UCVA and quality of vision in patients with bilateral multifocal IOLs and symptomatic PVD. Larger studies are advised.

scholarly journals Combined pars plana glaucoma drainage device placement and vitrectomy using a vitrectomy sclerotomy site for tube placement: a case series

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Enchi Kristina Chang ◽  
Sanchay Gupta ◽  
Marika Chachanidze ◽  
John B. Miller ◽  
Ta Chen Chang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Pars Plana Vitrectomy ◽  
Case Series ◽  
Tube Placement ◽  
Glaucoma Drainage Device ◽  
Drainage Device ◽  
Glaucoma Drainage Devices ◽  
Pars Plana ◽  
Sclerotomy Site

Abstract Purpose The purpose of this study is to report the safety and efficacy of pars plana glaucoma drainage devices with pars plana vitrectomy using one of the vitrectomy sclerotomy sites for tube placement in patients with refractory glaucoma. Methods Retrospective case series of 28 eyes of 28 patients who underwent combined pars plana glaucoma drainage device and pars plana vitrectomy between November 2016 and September 2019 at Massachusetts Eye and Ear. Main outcome measures were intraocular pressure (IOP), glaucoma medication burden, best corrected visual acuity, and complications. Statistical tests were performed with R and included Kaplan-Meier analyses, Wilcoxon paired signed-rank tests, and Fisher tests. Results Mean IOP decreased from 22.8 mmHg to 11.8 mmHg at 1.5 years (p = 0.002), and mean medication burden decreased from 4.3 to 2.1 at 1.5 years (p = 0.004). Both IOP and medication burden were significantly lower at all follow-up time points. The probability of achieving 5 < IOP ≤ 18 mmHg with at least 20% IOP reduction from preoperative levels was 86.4% at 1 year and 59.8% at 1.5 years. At their last visit, three eyes (10.7%) achieved complete success with IOP reduction as above without medications, and 14 eyes (50.0%) achieved qualified success with medications. Hypotony was observed in 1 eye (3.6%) prior to 3 months postoperatively and 0 eyes after 3 months. Visual acuity was unchanged or improved in 23 eyes (82.1%) at their last follow-up. Two patients had a visual acuity decrease of > 2 lines. Two eyes required subsequent pars plana vitrectomies for tube obstruction, and one eye had transient hypotony. Conclusions The results of pars plana glaucoma drainage device and pars plana vitrectomy using one of the vitrectomy sclerotomy sites for tube placement are promising, resulting in significant IOP and medication-burden reductions through postoperative year 1.5 without additional risk of postoperative complications. Inserting glaucoma drainage devices into an existing vitrectomy sclerotomy site may potentially save surgical time by obviating the need to create another sclerotomy for tube placement and suture one of the vitrectomy ports.

Anatomical and functional outcomes of surgery of rhegmatogenous retinal detachment

1970 ◽  
Vol 2 (2) ◽  
pp. 132-137 ◽  
Author(s):  
H Sharma ◽  
SN Joshi ◽  
JK Shrestha
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Success Rate ◽  
Pars Plana Vitrectomy ◽  
Rhegmatogenous Retinal Detachment ◽  
Case Series ◽  
Scleral Buckling ◽  
Pars Plana ◽  
A Prospective Study ◽  
Physiological Outcome

Introduction: Rhegmatogenous retinal detachment (RRD) is a potentially blinding condition. Objective: To evaluate the anatomical and functional outcome of surgery of RRD. Materials and methods: A prospective study of interventional case series was designed including 50 consecutive patients with RRD in a tertiary level eye center in Kathmandu. The patients underwent scleral buckling (SB) or pars plana vitrectomy (PPV) according to the proliferative vitreo-retinopathy (PVR) changes. All the patients had at least 3 months of follow-up. The anatomical and physiological outcome measures were primary retinal reattachment and improvement in visual acuity respectively. The surgery was considered successful when there was attachment of retina after the first surgery. Results: The mean age of these patients at the time of presentation was 46.24 ± 19.82 years. Of 50, sixty-six percent of the patients underwent SB and 34 % underwent PPV. Primary surgical success rate was 88 %. While comparing the initial best corrected visual acuity (BCVA) with the final, 72% had an improvement, 12 % unchanged and 16 % had a deteriorated visual acuity. Conclusion: The visual acuity improves and the anatomical success rate is high in the majority of the patients after surgery for rhegmatogenous retinal detachment. Keywords: rhegmatogenous retinal detachment; scleral buckling; pars plana vitrectomy; anatomical outcome; physiological outcome DOI: 10.3126/nepjoph.v2i2.3720 Nep J Oph 2010;2(2) 132-137

scholarly journals Comparison of visual performance between monofocal and multifocal intraocular lenses of the same material and basic design

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Hirotaka Tanabe ◽  
Hitoshi Tabuchi ◽  
Tomohiro Shojo ◽  
Tomofusa Yamauchi ◽  
Kosuke Takase
Keyword(s):  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Wald Test ◽  
Intraocular Lenses ◽  
Visual Performance ◽  
Basic Design ◽  
Night Time ◽  
Multifocal Iol ◽  
Multifocal Intraocular Lenses ◽  
Near Visual Acuity

Abstract To compare the visual performance of a monofocal intraocular lens (IOL) (ZCB00) and a multifocal IOL (ZMB00) of the same material and basic design, we evaluated postoperative parameters at 10 weeks after the last surgery in cataract patients who underwent bilateral ZCB00 or ZMB00 implantation from December 13, 2010, to July 29, 2019, with the right and left lenses implanted within 3 months of each other. The study enrolled 2,230 eyes of 1,115 patients. The monofocal group comprised 904 eyes of 452 patients (72.3 ± 6.8 years; females/males, 268/184), and the multifocal group comprised 1,326 eyes of 663 patients (67.0 ± 7.8 years; females/males, 518/145). Contrast sensitivity (4.0/2.5/1.6/1.0/0.7 degrees), contrast sensitivity with glare (1.6/1.0/0.7 degrees), and the VFQ-25 score for driving at night were significantly better in the monofocal group (p < 0.00068, Wald test). Uncorrected intermediate/near visual acuity and near spectacle independence were significantly better in the multifocal group (p < 0.00068, Wald test). The two IOL groups had different characteristics in terms of contrast sensitivity, night-time driving, uncorrected intermediate/near visual acuity and near spectacle independence.

scholarly journals Postoperative Endophthalmitis Caused by Cutibacterium (Formerly Propionibacterium) Acnes: Case Series and Review

2021 ◽  
pp. 1-10
Author(s):  
Benjamin J. Fowler ◽  
Darlene Miller ◽  
Xiaohe Yan ◽  
Nicolas A. Yannuzzi ◽  
Harry W. Flynn Jr.
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Clinical Features ◽  
Pars Plana Vitrectomy ◽  
Case Series ◽  
Postoperative Endophthalmitis ◽  
Cutibacterium Acnes ◽  
Pars Plana ◽  
Microbiologic Diagnosis

We report the clinical features, treatment strategies and outcomes in a series of patients with infectious endophthalmitis after cataract surgery caused by <i>Cutibacterium acnes (C. acnes)</i>, formerly known as <i>Propionibacterium acnes (P. acnes)</i>. This retrospective case series includes six eyes of six patients with chronic postoperative endophthalmitis caused by culture-proven <i>C. acnes</i>from December 2010 to July 2019 at a University referral center. All patients underwent prior cataract extraction with intraocular lens (CE/IOL) implantation. The mean time between cataract surgery and the microbiologic diagnosis of endophthalmitis was 7.4 ± 5.2 months (range 1.5–17 months). The average time from obtaining the specimen to culture positivity was 7.7 ± 4.4 days (range 3–15 days). Three eyes (50%) presented with hypopyon and three eyes (50%) presented with prominent keratic precipitates without hypopyon. Presenting visual acuity ranged from 20/25 to 2/200. Initial treatments included intravitreal antibiotics alone (<i>n</i> = 2), pars plana vitrectomy (PPV) with partial capsulectomy and intravitreal antibiotics (<i>n</i> = 3), and pars plana vitrectomy with IOL removal and intravitreal antibiotics (<i>n</i> = 1). Follow-up treatments included IOL removal (<i>n</i> = 2), intravitreal antibiotics (<i>n</i> = 1), and topical antibiotics (<i>n</i> = 1). The best-corrected visual acuity at last follow-up was 20/70 or better in all patients. In a literature review, the clinical features and treatment outcomes for all case series of delayed-onset postoperative endophthalmitis caused by <i>C. acnes</i>(<i>n</i> = 120) are listed<i>.</i> A definitive cure (the absence of recurrent inflammation) was achieved in 100% of patients that underwent IOL removal, in 77% of those that underwent PPV/partial capsulectomy and intravitreal antibiotics, and in 18% of cases treated with intravitreal antibiotics alone. Endophthalmitis after CE/IOL caused by <i>C. acnes</i>is characterized by slowly progressive intraocular inflammation and has a protracted course from surgery to microbiologic diagnosis. Visual outcomes are generally favorable, but IOL explantation may be necessary for definitive cure.

scholarly journals Scleral Fixation of Akreos AO60 Intraocular Lens Using Gore-Tex Suture: An Eye on Visual Outcomes and Postoperative Complications

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Mariana Leuzinger-Dias ◽  
Mário Lima-Fontes ◽  
Rita Rodrigues ◽  
Cláudia Oliveira-Ferreira ◽  
Carolina Madeira ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Postoperative Complications ◽  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Case Series ◽  
Scleral Fixation ◽  
Open Globe ◽  
Pars Plana ◽  
The Mean ◽  
Clinical Records

Purpose. “In-the-bag” placement of an IOL is the Holy Grail for any cataract surgeon. However, in the absence of capsular integrity, alternative surgical options to place the IOL must be sought. We aim to report the clinical outcomes and safety profile of scleral-fixated Akreos AO60 intraocular lens implantation using Gore-Tex suture, combined with pars plana vitrectomy. Methods. This is a single-center, retrospective case series descriptive study. Electronic clinical records of all patients subjected to scleral fixation of a Bausch and Lomb Akreos AO60 IOL combined with pars plana vitrectomy, between April 1, 2017, and August 1, 2021, were reviewed. Data concerning age, sex, laterality, past ophthalmological history, pre- and postoperative best-available visual acuity, surgical indication, and intra- and postoperative complications were collected. Measured outcomes were the differences in best-available visual acuity and frequency of postoperative complications. Results. A total of 37 eyes (20 right eyes and 17 left eyes) from 36 patients (16 females and 20 males) were included in the statistical analysis. The mean age at time of surgery was 72.0 ± 12.4 years. The mean follow-up period was 548.9 days (range 39–1564 days). Globally, the mean best-available logMAR visual acuity improved from 1.61 preoperatively (0.025 decimal equivalent) to 0.57 postoperatively (0.3 decimal equivalent), this difference being statistically significant ( P < 0.001 ). Indications for surgery included aphakia due to complicated cataract surgery (24.3%; n = 9); subluxated IOL due to closed trauma (21.6%; n = 8); PEX-related subluxated IOL (16.2%; n = 6); non-traumatic, non-PEX-related subluxated IOL (18.9%; n = 7); subluxated crystalline lens due to closed trauma (8.1%; n = 3); aphakia due to open-globe injury (5.4%; n = 2); silicone-induced IOL opacification (2.7%; n = 1); and aphakia post-endophthalmitis (2.7%; n = 1). Postoperative complications included transient ocular hypertension (27.0%; n = 10), transient corneal edema (18.9%; n = 7), cystoid macular edema (18.9%, n = 7), self-limited hypotension (5.4%, n = 2), self-limited vitreous hemorrhage (2.7%, n = 1), central retinal vein occlusion (2.7%, n = 1), late retinal detachment (2.7%, n = 1), and Akreos IOL opacification (2.7%, n = 1). No suture-related complications were observed. Conclusion. There was a statistically significant improvement in visual acuity after scleral fixation of Akreos AO60 intraocular lens using Gore-Tex suture, with no suture-related problems recorded. This procedure seems to be a valuable alternative for posterior chamber IOL placement when secondary IOL implantation is required.

Surgical outcome of pars plana vitrectomy: a retrospective study in a peripheral tertiary eye care centre of Nepal

1970 ◽  
Vol 2 (1) ◽  
pp. 39-44
Author(s):  
S Subedi ◽  
MK Sharma ◽  
BR Sharma ◽  
I Kansakar ◽  
K Dhakwa ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Outcome ◽  
Pars Plana Vitrectomy ◽  
Case Series ◽  
Vitreous Haemorrhage ◽  
Retinal Break ◽  
Duration Of Symptoms ◽  
Main Indication ◽  
Operative Complications ◽  
Pars Plana

Back ground: Trans-pars plana vitrectomy (TPPV) is an effective surgical procedure to retain the useful vision in vitreoretinal diseases. Objective: To evaluate the surgical outcome of pars plana vitreoretinal surgery. Study design: Retrospective non-comparative interventional case series. Materials and methods: A hospital-based retrospective interventional study of series of cases was carried out in retina clinic of Lumbini Eye Institute, Nepal, over a period of one-and-a-half years. Records of 64 patients who underwent vitreo-retina surgeries were reviewed. Demography, duration of symptoms, risk factors and indications, preoperative and post-operative visual acuity, intra-operative and post-operative complications were analyzed. Outcome measurement: The parameters studied were post-operative visual acuity and complications. Results: Of 64 patients, 61 % presented 2 months after the onset of symptoms. Preoperatively, 65.5 % had visual acuity of hand motions to 3/60 followed by perception of light only in 26.6 %.The main indication for TPPV was vitreous haemorrhage (VH), in 53 %. The visual acuity improved to better than 6/60 in patients with VH (68 %), whereas, overall, in 72 % of the subjects, it improved by 2 lines postoperatively. The commonest intra-operative complications were iatrogenic retinal break (5, 7.8%) at the sclerostomy site. Conclusion: The main indication for TPPV is vitreous haemorrhage. Useful vision can be restored by pars plana vitrectomy in the majority of the patients. Retinal break is the commonest complication of TPPV. Keywords: Trans-pars plana vitrectomy; vitreous haemorrhage; visual outcome; retinal break. DOI: 10.3126/nepjoph.v2i1.3703 Nep J Oph 2010;2(1) 39-44

Transscleral Suture Fixation and Anterior Chamber Intraocular Lenses Implanted after Removal of Posteriorly Dislocated Crystalline Lenses

1997 ◽  
Vol 7 (4) ◽  
pp. 370-374 ◽  
Author(s):  
W. Omulecki ◽  
J. Nawrocki ◽  
J. Sempinska-Szewczyk ◽  
A. Synder
Keyword(s):  
Visual Acuity ◽  
Anterior Chamber ◽  
Pars Plana Vitrectomy ◽  
Good Alternative ◽  
Observation Time ◽  
Intraocular Lenses ◽  
Posterior Chamber ◽  
Safe Procedure ◽  
Visual Rehabilitation ◽  
Pars Plana

The surgical technique is described for simultaneous removal of posteriorly dislocated crystalline lenses and implantation of anterior chamber (AC) or scleral fixation posterior chamber (PC) intraocular lenses (IOL) using pars plana vitrectomy. Twenty-two patients underwent this complex operation. Observation time ranged from 2 to 10 months (mean 5 months). Best-corrected post-operative visual acuity was 1.0 in half the patients in the AC group (n=12), and in 80% of the PC group (n=10). It was less than 0.5 in 25% of cases in the AC group whereas all PC patients had visual acuity 0.5 or better. In nine cases with pre-operative ocular hypertension, post-operative intraocular pressure became normal, although topical glaucoma therapy was necessary in three patients in the AC group and in one from the PC group. No severe complications were found. Removal of posteriorly dislocated crystalline lens using pars plana vitrectomy and limbal incision is a safe procedure. Simultaneous AC or transscleral PC lens implantation is a good alternative to contact lenses. Visual rehabilitation was good in both groups of patients, although post-operative visual acuity was better after PC transscleral fixation than after AC surgery.

scholarly journals Management of Vasoproliferative Tumors of the Retina with Macular Complications by Pars Plana Vitrectomy Combined with Episcleral Cryotherapy

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Wenhua Zhang ◽  
Zeyuan Qiang ◽  
Hao Song ◽  
Xiaoli Li ◽  
Handong Dan ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Pars Plana Vitrectomy ◽  
Tumor Regression ◽  
Case Series ◽  
Morphological Structure ◽  
Mean Values ◽  
Pars Plana ◽  
The Mean ◽  
The Difference

Objective. To evaluate the efficacy of pars plana vitrectomy (PPV) combined with episcleral cryotherapy in treating vasoproliferative tumors of the retina (VPTR) with macular complications. Methods. In this retrospective noncomparative interventional case-series analysis, we included 11 eyes of ten patients diagnosed with VPTR. All patients underwent comprehensive ophthalmic examinations and were treated with PPV combined with episcleral cryotherapy. Best-corrected visual acuity (BCVA), tumor activity, retinal morphological structure, and postoperative complications were evaluated. Results. Macular complications included epimacular membrane (n = 10), macular hole (n = 3), and macular edema (n = 1). Tumors were treated with triple freeze-thaw episcleral cryotherapy during PPV. The mean logarithm of minimal angle of resolution (logMAR) BCVA dropped from 0.62 ± 0.58 to 0.39 ± 0.46. The difference between the mean values of logMAR BCVA before and after treatment was statistically significant (t = 2.48, P = 0.033 ). The tumor activity was controlled effectively in nine cases. Compared with preoperative tumor activity, tumor activity after treatment was significantly lower ( P < 0.01 ). The increase of central retinal thickness and the disruption of retinal layers were associated with macular holes, macular edema, and retinal proliferative membrane. After the treatment, visual acuity improved in 91% of the cases, and 73% had no long-term complications. Conclusion. PPV combined with episcleral cryotherapy promoted tumor regression, preserved retinal integrity, and improved visual acuity. Thus, the combination of PPV with episcleral cryotherapy can be considered effective and safe for the management of VPTR with macular complications.

Perfluorohexyloctane Endotamponade for Treatment of Subfoveal Hemorrhage

2002 ◽  
Vol 12 (6) ◽  
pp. 534-536 ◽  
Author(s):  
J.B. Jonas ◽  
M. Jäger
Keyword(s):  
Visual Acuity ◽  
Pars Plana Vitrectomy ◽  
Case Series ◽  
Age Related Macular Degeneration ◽  
Subretinal Hemorrhage ◽  
Epiretinal Membranes ◽  
Additional Tool ◽  
Primary Surgery ◽  
Age Related ◽  
Pars Plana

Purpose To report on the use of perfluorohexyloctane as a heavy liquid to temporarily tamponade the fovea for the prevention of recurrent massive subfoveal hemorrhage in patients with exudative age-related macular degeneration (ARMD). Methods The case series comprised seven patients with acute massive subfoveal hemorrhage due to exudative ARMD. The patients underwent pars plana vitrectomy, drainage of the subretinal blood, and foveal endotamponade with perfluorohexyloctane. The perfluorohexyloctane was removed 80.4 ± 38.1 days (median 98 days; range 22–118 days) after the primary surgery in a second pars plana intervention. Results In six patients (85.7%) the subretinal hemorrhage removed during the first pars plana vitrectomy did not recur after removal of perfluorohexyloctane. In the seventh, however, a subretinal hemorrhage re-developed five days after release of perfluorohexyloctane. No large epiretinal membranes were observed. In six eyes (85.7%), the retina remained attached after removal of perfluorohexyloctane but in one eye proliferative vitreoretinopathy developed, with central retinal detachment. After the first pars plana vitrectomy, visual acuity increased slightly but not significantly (p=0.25), from 0.03 ± 0.03 to 0.05 ± 0.07. Intraocular pressure rose from 15.0 ± 1.9 mm Hg to 24.9 ± 16.9 mm Hg. After a follow-up of 69.7 ± 121.0 days after removal of the perfluorohexyloctane, final visual acuity was 0.02 ± 0.04. Conclusions Perfluorohexyloctane may be a useful additional tool for preventing the recurrence of subfoveal re-bleeding in exudative ARMD.

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