scholarly journals Five-Port Combined Limbal and Pars Plana Vitrectomy for Infectious Endophthalmitis

2016 ◽  
Vol 7 (3) ◽  
pp. 567-569 ◽  
Author(s):  
Kunyong  Xu ◽  
Eric K. Chin ◽  
David R.P. Almeida

Pars plana vitrectomy for acute infectious endophthalmitis can be challenging due to severe inflammation in the anterior chamber creating significant media opacity. We describe a surgical technique combining limbal based vitrectomy and pars plana vitrectomy to manage acute infectious endophthalmitis. Limbal based vitrectomy facilitates removal of anterior chamber fibrin and inflammatory membranes for safe and optimal posterior pars plana vitrectomy.

2021 ◽  
pp. 247412642110284
Author(s):  
Srinath Soundararajan ◽  
Cason B. Robbins ◽  
Henry L. Feng ◽  
Sharon Fekrat

Purpose: This work describes the clinical management and outcomes in cases of presumed infectious endophthalmitis following intravitreal injection at a tertiary academic medical center. Methods: A retrospective review took place of eyes that presented to the Duke Eye Center over a 9-year period and were diagnosed with intravitreal injection–related endophthalmitis. Clinical presentation, management, microbiologic yield, visual outcomes, and complications were abstracted from medical records. Results: Of 23 eyes diagnosed with postinjection endophthalmitis, 52.2% underwent anterior chamber tap (33.3% of which first underwent dry needle vitreous tap), 47.8% underwent needle vitreous tap, 17.4% underwent neither, and none underwent pars plana vitrectomy (PPV) for initial management. Subsequent PPV was performed in 6 eyes (26.1%). Mean visual acuity (VA) improved by 50 Early Treatment Diabetic Retinopathy Study letters at 6 months. Eyes that underwent initial anterior chamber tap had worse presenting VA than those that did not ( P = .01). Eyes undergoing subsequent PPV had worse VA at presentation ( P = .02) and at 6 months ( P < .001). Eyes presenting with VA of hand motion (20/8000) or worse were more likely to undergo subsequent PPV ( P = .02). Conclusions: Eyes with intravitreal injection–related endophthalmitis presenting with VA of hand motion or worse were more likely to undergo subsequent PPV. Future studies with larger cohorts may reveal whether earlier vitrectomy should be considered in these patients.


Author(s):  
Alireza Khodabande ◽  
Massood Mohammadi ◽  
Hamid Riazi-Esfahani ◽  
Shahab Karami ◽  
Massood Mirghorbani ◽  
...  

Abstract Background To evaluate changes in anterior segment morphology on anterior segment optical coherence tomography (AS-OCT) following pars plana vitrectomy (PPV) without tamponade. Methods Patients who underwent PPV without tamponade for epiretinal membrane were evaluated. Eligible patients underwent intraocular pressure (IOP) measurement and AS-OCT preoperatively as well as 1 month and 6 months post-operatively. Anterior chamber width (ACW), anterior chamber depth (ACD), trabecular iris angle (TIA), angle opening distance at 500 and 750 µm (AOD), and trabecular iris space area at 500 and 750 µm (TISA) at four quadrants were recorded and analyzed. Additionally, the mean values of TIA (MTIA), AOD (MAOD), and TISA (MTISA) for each eye (mean of four quadrants) were analyzed. Results 23 patients completed the study. The mean age of participants was 56.4 ± 3.6 years of age and 13/23 (56%) were female. Mean IOP of patients was 18.1 ± 1.1, 18.3 ± 1.1, and 18.1 ± 1.2 preoperatively,1 month post-operatively, and 6 months post-operatively, respectively. (p = 0.83). No difference was detected post-operatively in measurements of ACW, ACD, MTIA, MAOD500, MAOD750, MTISA500, and MTISA750. Conclusion Pars plana vitrectomy without tamponade was not associated with changes in anterior chamber morphology.


2021 ◽  
Vol 14 (5) ◽  
pp. e240983
Author(s):  
Sunila Jain ◽  
Kar Yen Phoong

A 49-year-old gentleman presented with a 1-day history of painful deterioration of vision in his right eye. He was lifting heavy weights just before this visual loss. On examination, his vision was perception of light in that eye, with a medically uncontrollable high intraocular pressure and hyphaema almost completely filling his anterior chamber. An ultrasound performed suggested a working diagnosis of a Valsalva related ‘eight ball’ bleed. After an anterior chamber washout, he had another episode of bleeding three days later. A pars plana vitrectomy was performed and the sample obtained was sent off to the laboratory, revealing a choroidal melanoma. Following enucleation, the histology confirmed a large necrotic spindle cell melanoma, with a haemorrhagic background. Fortunately, no liver metastasis was found. Since his diagnosis 3 years ago, he continues to be followed up in an artificial eye clinic and has regular liver scans under the care of his oncologist.


2018 ◽  
Vol 49 (9) ◽  
pp. 708-711
Author(s):  
Nandini Venkateswaran ◽  
Linda A. Cernichiaro-Espinosa ◽  
Catherin Negron ◽  
Brenda Fallas ◽  
Xiao Yi Zhou ◽  
...  

2020 ◽  
Vol 9 (12) ◽  
pp. 3994
Author(s):  
Tommaso Rossi ◽  
Guido Ripandelli

Purpose is to review the pathogenic mechanism for ocular hypertension and glaucoma development after pars plana vitrectomy. Both acute and chronic causes are considered, and special attention is paid to the theories and clinical evidence on the risk of developing Open Angle Glaucoma (OAG) after Pars Plana Vitrectomy (PPV). Most existing scientific literature on the issue agree on the role of ascorbate as an oxygen scavenger within the vitreous chamber. Oxygen tension in the vitreous and anterior chamber is maximum inn proximity of the retinal surface and endothelium, respectively and steeply decreases toward the lens, on both sides, and trabecular meshwork. Vitreous removal and, to a lesser extent, liquefaction, greatly reduces oxygen tension gradient in vitreous chamber while cataract extraction has similar effects on anterior chamber oxygen gradients. Oxygen derivatives originated from the cornea and retina are actively reduced by the vitreous gel and/or the crystalline lens. Vitreous removal and cataract extraction reduce drastically this function. Most reported clinical series confirm this hypothesis although protocol difference and follow-up length greatly impact the reliability of results.


Ophthalmology ◽  
1995 ◽  
Vol 102 (2) ◽  
pp. 211-216 ◽  
Author(s):  
Susan M. Malinowski ◽  
William F. Mieler ◽  
Steven B. Koenig ◽  
Dennis P. Han ◽  
Jose S. Pulido

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