scholarly journals Heads-Up Macular Surgery with a 27-Gauge Microincision Vitrectomy System and Minimal Illumination

2016 ◽  
Vol 7 (3) ◽  
pp. 543-547 ◽  
Author(s):  
Hiroshi Kunikata ◽  
Toshiaki Abe ◽  
Toru Nakazawa
Keyword(s):  
Case Series ◽  
Macular Disease ◽  
3 Dimensional ◽  
Illumination System ◽  
Invasive Method ◽  
Microincision Vitrectomy Surgery ◽  
Intraoperative Visualization ◽  
Vitrectomy Surgery ◽  
Vitrectomy System

Objective: We combined heads-up 3-dimensional (3D) 27-gauge microincision vitrectomy surgery (27GMIVS) with a very low-intensity illumination system. Methods: This study was based on a retrospective, interventional case series of 6 eyes of 6 patients with macular disease. All patients underwent heads-up 3D 27GMIVS and the power of the intraocular illuminator was set to its minimum level, 1% (approximately 0.1 lm), throughout the surgery. Results: We found that the procedure was easy when the heads-up 3D system was used, but not through the eyepiece of a microscope. All surgeries were successfully finished without any complications. Postoperative visual acuity was restored or maintained in all eyes during the follow-up period. Conclusion: Heads-up, 3D system-assisted 27GMIVS with minimal illumination enabled excellent intraoperative visualization of retinal tissues, caused minimal phototoxicity to the macular retinal cells, and might therefore represent the next step in the development of an ideal, minimally invasive method of treating macular disease.

scholarly journals Successful Removal of Large Intraocular Foreign Body by 25-Gauge Microincision Vitrectomy Surgery

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Hiroshi Kunikata ◽  
Megumi Uematsu ◽  
Toru Nakazawa ◽  
Nobuo Fuse
Keyword(s):  
Foreign Body ◽  
Case Series ◽  
Intraocular Foreign Body ◽  
Corneal Incision ◽  
Corneal Endothelial Cell Density ◽  
Successful Removal ◽  
Microincision Vitrectomy Surgery ◽  
A New Technique ◽  
Vitrectomy Surgery

We describe a new technique for removing a large intraocular foreign body by 25-gauge microincision vitrectomy surgery (25G-MIVS). Noncomparative interventional case series were performed at a single centre. Two patients with a long smooth intraocular vitreal foreign body underwent phacoemulsification and aspiration, intraocular lens implantation, 25G-MIVS, and extraction of the foreign body. The foreign body was removed through a posterior capsulorhexis, anterior continuous curvilinear capsulorhexis, and a corneal incision. In both cases, the foreign body was safely removed through the corneal incision, and IOL was implanted and well positioned. The surgical incision did not require suturing. No postoperative complications associated with this technique were found. The corneal endothelial cell density was maintained over 2000 cells/mm2in both cases during recent follow-up examinations. Our findings indicate that 25G-MIVS with this technique can be used to extract a long slender smooth foreign body. It is safe, without complications, and can be performed without enlarging the 25-gauge sclerotomy.

scholarly journals 25-Gauge Microincision Vitrectomy to Treat Vitreoretinal Disease in Glaucomatous Eyes after Trabeculectomy

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Hiroshi Kunikata ◽  
Naoko Aizawa ◽  
Nobuo Fuse ◽  
Toshiaki Abe ◽  
Toru Nakazawa
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Case Series ◽  
Glaucoma Surgery ◽  
Neovascular Glaucoma ◽  
Vitreoretinal Disease ◽  
Microincision Vitrectomy Surgery ◽  
Vitrectomy Surgery

Purpose. To determine the feasibility of using 25-gauge microincision vitrectomy surgery (25GMIVS) to treat vitreoretinal disease in glaucomatous eyes which have previously undergone trabeculectomy (TLE).Methods. A consecutive, interventional case series. We performed 25GMIVS in 15 glaucomatous eyes that had undergone TLE. Follow-up period was 11.5 months.Results. 25GMIVS was successfully used and led to improvement in visual acuity (P<0.01). We performed 25GMIVS for proliferative diabetic retinopathy with neovascular glaucoma in 53% of eyes (8 of 15). Although 3 eyes needed further TLE following 25GMIVS, final IOP was below 21 mmHg in all eyes except one eye (93%) and was comparable to pre-25GMIVS IOP (P=0.20) without an increase in the number of glaucoma medications (P=0.14).Conclusions. 25GMIVS is a feasible treatment for vitreoretinal disease in eyes with preexisting TLE, effective in both significantly improving BCVA and preserving the filtering bleb, while not excluding further glaucoma surgery.

scholarly journals Vitrectomy for endophthalmitis: 5-year study of outcomes and complications

2020 ◽  
Vol 5 (1) ◽  
pp. e000423 ◽  
Author(s):  
Guy Simon Negretti ◽  
WengOnn Chan ◽  
Carlos Pavesio ◽  
Mahiul Muhammed Khan Muqit
Keyword(s):  
Case Series ◽  
Vitreoretinal Surgery ◽  
Endogenous Endophthalmitis ◽  
Final Visit ◽  
Retrospective Case ◽  
Tertiary Centre ◽  
Early Vitrectomy ◽  
Exogenous Endophthalmitis ◽  
Vitrectomy Surgery

Background/AimsTo analyse the complications and outcomes of vitrectomy surgery for endophthalmitis.MethodsThis was a retrospective case series. All cases that underwent 23-gauge vitrectomy surgery for endophthalmitis at a tertiary centre between 1 February 2013 and 1 February 2018 were included. Main outcome measures were as follows: visual acuity (VA) at final visit and post-vitrectomy complications.Results33 patients were included in the study with 20 men and 13 women, average age 63 years. Main post-surgical causes for endophthalmitis included phacoemulsification (n=9), trabeculectomy (n=5), intravitreal injection (n=5), corneal graft (n=4), vitreoretinal surgery (n=3) and endogenous endophthalmitis (n=6). Average follow-up was 18 months (SD 14). 21/33 (64%) patients had baseline perception of light VA. Analysis of exogenous endophthalmitis cases only demonstrated: mean LogMAR VA improved significantly from 2.68 to 1.66 (p=0.001). At final follow-up, 12% had VA of 6/12 or better, and 28% had VA of 6/36 or better. Vitrectomy within 7 days resulted in improved final VA outcomes (1.49 vs 2.16 LogMAR, p=0.032). Complications included retinal detachment (24.2%), macular hole (3%), hypotony (6%), suprachoroidal haemorrhage (3%) and enucleation/evisceration (6%).ConclusionVitrectomy for endophthalmitis leads to VA gains in some cases. Surgical outcomes may be improved with early vitrectomy performed within 7 days of the initial event for exogenous endophthalmitis. Patients should be advised of the potential risk of severe complications with/and without surgery.

Minimally Invasive Microincision Vitrectomy Surgery with an Intraoperative Dexamethasone Implant for Refractory Diabetic Macular Edema

2016 ◽  
Vol 235 (3) ◽  
pp. 150-156 ◽  
Author(s):  
Dong Hoon Lee ◽  
Yoon Jeon Kim ◽  
Young Hee Yoon
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Retinal Thickness ◽  
Safe Alternative ◽  
Corrected Visual Acuity ◽  
Refractory Diabetic Macular Edema ◽  
History Of ◽  
Microincision Vitrectomy Surgery ◽  
Vitrectomy Surgery

Purpose: To evaluate the 1-year results of 25-gauge microincision vitrectomy surgery (MIVS25) combined with intraoperative dexamethasone (DEX) implant for persistent diabetic macular edema (DME). Methods: This study enrolled patients who had a history of DME for ≥12 months and underwent MIVS25 and DEX implant injection. Best corrected visual acuity (BCVA) and central retinal thickness (CRT) were assessed postoperatively. Results: Eighteen eyes were included in the analysis. Preoperatively, logMAR BCVA was 0.90 and CRT was 594 µm on average. CRT decreased until the 3-month follow-up visit and tended to increase at 6 months, but stabilized at 12 months with additional treatments in five eyes at 5 months postoperatively. Statistically significant improvement in BCVA was noted 1 month after treatment and at each subsequent follow-up visit (p < 0.001). Conclusion: MIVS25 combined with DEX implant injection might be utilized as an effective and safe alternative treatment for intractable DME.

scholarly journals Management of Severe Equinovalgus in Patients With Cerebral Palsy by Naviculectomy in Combination With Midfoot Arthrodesis

2017 ◽  
Vol 38 (9) ◽  
pp. 1011-1019 ◽  
Author(s):  
Chakravarthy U. Dussa ◽  
Leonhard Döderlein ◽  
Raimund Forst ◽  
H. Böhm ◽  
Albert Fujak
Keyword(s):  
Cerebral Palsy ◽  
Case Series ◽  
Success Rates ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Revision Operation ◽  
3 Dimensional ◽  
Joint Deformity ◽  
The Mean

Background: Equinovalgus deformity is the second most common deformity in cerebral palsy and may be flexible or rigid. Several operative methods from joint sparing to arthrodesis have been described with varying success rates. The aim of this study was to investigate the effectiveness of naviculectomy in combination with midfoot arthrodesis (talo-cuneiform and calcaneocuboid arthrodesis) in the correction of a rigid equinovalgus foot deformity in cerebral palsy. Methods: Forty-eight rigid equinovalgus feet were operated upon in 30 patients from 2008 to 2013. Of these, 44 feet in 26 patients with cerebral palsy (Gross Motor Function Classification System III, IV, or V) with follow-up of more than 2 years were included in the study. The mean age at surgery was 18.1 years. The outcomes were measured objectively using radiographic angles and subjectively using 5 questions to be answered by the caregiver. The feet were then graded into excellent, good, fair, and poor. The mean follow-up was 5.0 ± 1.7 years. Results: Excellent to good results were obtained in 81% of the feet. Both objective and subjective outcomes improved significantly postoperatively ( P < .001). Three feet in 2 patients were graded as poor and underwent a revision operation for pain and recurrence. Conclusions: Naviculectomy in combination with midfoot arthrodesis enabled a good 3-dimensional correction of the forefoot. However, the procedure did not necessarily correct the fixed subtalar joint deformity. Several additional bony and soft-tissue procedures were necessary to achieve a complete correction in these difficult feet. Level of Evidence: Level IV, retrospective case series.

scholarly journals Clinical Outcomes Of Beveled Tip, Ultra-High Speed, 25-Gauge Pars Plana Vitrectomy System

2021 ◽  
Author(s):  
HARVEY S. UY ◽  
VICENTE LORENZO O. CABAHUG ◽  
JOSE CARLO M. ARTIAGA ◽  
PIK SHA CHAN ◽  
JORDAN T. FAMADICO
Keyword(s):  
Clinical Outcomes ◽  
Pars Plana Vitrectomy ◽  
High Speed ◽  
Operative Time ◽  
Case Series ◽  
Corrected Distance Visual Acuity ◽  
Pars Plana ◽  
Prospective Case Series ◽  
Vitrectomy Surgery ◽  
Vitrectomy System

Abstract OBJECTIVE To report clinical outcomes of a 25-gauge, beveled-tip, 10000 cuts-per-minute (cpm) microincisional vitrectomy surgery (MIVS) system. METHODS Prospective case series of eyes undergoing primary pars plana vitrectomy (PPV) for common indications. Main outcome measures were: rate of achieving surgical objectives, operative time, number of surgical steps, use of ancillary instruments, corrected distance visual acuity (CDVA), and adverse events (AE). RESULTS Surgical objectives were achieved in all eyes. Mean total operative, core, shave and total vitrectomy times were 1891 ± 890, 204 ± 120, 330 ± 320, 534 ± 389 seconds, respectively. Mean number of surgical steps was 4.3 ± 1.5. Mean number of ancillary instruments used was 4.5 ± 1.9. Mean CDVA improved by 0.53 ± 0.56 logMAR units (P < 0.001) after 3 months. Postoperative AE included elevated IOP (8%), hypotony (6%), and re-detachment (2%). Majority (82%) had no postoperative discomfort. CONCLUSION Beveled-tip, 10000 cpm MIVS system effectively and safely performs common vitreoretinal procedures and may reduce operative time and ancillary instrumentation.

A Multicenter Study of Pediatric Macular Holes: Surgical Outcomes With Microincisional Vitrectomy Surgery

2019 ◽  
Vol 4 (1) ◽  
pp. 22-27
Author(s):  
Nikisha Kothari ◽  
Sarah P. Read ◽  
Caroline R. Baumal ◽  
Antonio Capone ◽  
Emmanuel Chang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Pediatric Patients ◽  
Case Series ◽  
Closure Rate ◽  
Primary Vitrectomy ◽  
Modest Improvement ◽  
Macular Holes ◽  
Vitrectomy Surgery

Purpose: Pediatric macular holes occur often related to trauma and rarely require surgical intervention. The purpose of the present study was to evaluate outcomes of microincisional vitrectomy surgery. Methods: A multicenter retrospective consecutive case series was conducted of pediatric patients undergoing surgery for macular hole repair. Results: A total of 31 eyes from 8 centers were included in this study. The mechanism of macular hole development was blunt trauma in 30 eyes (97%) and industrial laser in 1 eye (3%). The rate of anatomic closure after primary vitrectomy was 81% (25 eyes); the final anatomic closure rate after a secondary vitrectomy was 94% (29 eyes). There was a statistically significant improvement in visual acuity from initial presentation (20/164) to final follow-up (20/100) ( P = .009). Conclusions: Microincisional vitrectomy surgery for pediatric macular holes results in substantial anatomic success and modest improvement in visual acuity.

scholarly journals Intraoperative Optical Coherence Tomography-Assisted 27-Gauge Vitrectomy in Eyes with Vitreoretinal Diseases

2015 ◽  
Vol 6 (2) ◽  
pp. 216-222 ◽  
Author(s):  
Hiroshi Kunikata ◽  
Toru Nakazawa
Keyword(s):  
Optical Coherence Tomography ◽  
Real Time ◽  
Case Series ◽  
Retinal Disease ◽  
Optical Coherence ◽  
Vitreoretinal Disease ◽  
Intraoperative Optical Coherence Tomography ◽  
Vitreoretinal Diseases ◽  
Microincision Vitrectomy Surgery ◽  
Intraoperative Visualization

Objective: To report intraoperative optical coherence tomography (iOCT)-assisted 27-gauge microincision vitrectomy surgery (MIVS) in eyes with vitreoretinal disease. Methods: A retrospective, interventional case series performed at a single center, including 6 eyes with retinal disease that underwent iOCT-assisted 27-gauge MIVS. Results: The advantages of iOCT were most notable when it was used to evaluate, in real time, different macular areas: the pre-macula, in vitreomacular traction or epiretinal membrane; the intra-macula, in macular edema or macular hole; and the sub-macula, in macular detachment. Real-time imaging and the minimization of shadows cast on the underlying tissues by the 27-gauge instrumentation made it possible to quickly select the best procedure at each critical juncture of the surgery. No patients experienced any complications. Conclusion: Real-time iOCT imaging during 27-gauge MIVS provided excellent intraoperative visualization of retinal tissues without causing significant obstructions to the surgeon. The positive feedback from the system allowed the surgeon to better judge the necessity of additional surgical procedures.

Scleral buckling with chandelier illumination system in rhegmatogenous retinal detachment surgery: a large case series

2020 ◽  
Vol 1 (3) ◽  
pp. 203-206
Author(s):  
Valerio Piccirillo ◽  
◽  
Carlo Irregolare ◽  
Antonello Iovine ◽  
Agostino Diplomatico ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Case Series ◽  
Scleral Buckling ◽  
Surgical Time ◽  
Illumination System ◽  
Before And After ◽  
Group A ◽  
Group B

AIM: To evaluate advantages of chandelier illumination system during scleral buckling (SB) procedures for rhegmatogenous retinal detachment (RRD) surgery. METHODS: In this comparative, retrospective study, 72 eyes of 72 patients undergoing SB for RRD at Minerva Hospital (Santa Maria Capua Vetere, Italy), divided in 2 groups of 36 eyes each were collected. In one group (A) eyes underwent SB with chandelier, in the other one (B) eyes underwent SB without using chandelier illumination system. Every eye of both groups was checked before surgery and at 1, 3, 7, 14, 30, 90 and 180d follow up. Parameters such as additional procedures, best spectacles visual acuity (BSVA; measured with Snellen Lines as decimal fraction), surgical time and retinal breaks recurrences had been analyzed before and after surgery and statistical comparison have been run between two groups. RESULTS: A significant (P<0.01) improvement in BSVA was observed at 6mo follow up in both groups; comparing groups A and B, no significant clinical differences was found in recurrences rate whereas mean surgical time in group A was statistically lower than the group B ones. CONCLUSION: According to results observed, even if they need to be confirmed in further studies with larger population, chandelier illumination system could be considered a valuable tool for SB surgery in eyes affected by RRD.

A 29/30-GAUGE DUAL-CHANDELIER ILLUMINATION SYSTEM FOR PANORAMIC VIEWING DURING MICROINCISION VITRECTOMY SURGERY

Retina ◽  
2011 ◽  
Vol 31 (6) ◽  
pp. 1231-1233 ◽  
Author(s):  
Hirokazu Sakaguchi ◽  
Yusuke Oshima ◽  
Kohji Nishida ◽  
Carl C Awh
Keyword(s):  
Illumination System ◽  
Microincision Vitrectomy Surgery ◽  
Vitrectomy Surgery
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