PURPOSE: The purpose of this study is to investigate new prognostic factors in associated with primary anatomical failure after scleral buckling (SB) for uncomplicated rhegmatogenous retinal detachment (RRD). METHODS: The medical records of patients with uncomplicated RRD treated with SB were retrospectively reviewed. Eyes with known prognostic factors for RRD, such as fovea-on, proliferative vitreoretinopathy, pseudophakia, aphakia, multiple breaks, or media opacity, were excluded. Analysis was performed to find correlations between anatomical success and various parameters, including age. RESULTS: This study analyzed 127 eyes. Binary logistic regression analysis revealed that older age (≥35) was the sole independent prognostic factor (odds ratio, 3.5; p = 0.022). Older age was correlated with worse preoperative visual acuity (p < 0.001), shorter symptom duration (p < 0.001), presence of a large tear (p < 0.001), subretinal fluid drainage (p < 0.001), postoperative macular complications (p = 0.048), and greater visual improvement (p = 0.003). CONCLUSIONS: Older age (≥35) was an independent prognostic factor for primary anatomical failure in SB for uncomplicated RRD. The distinguished features of RRD between older and younger patients suggest that vitreous liquefaction and posterior vitreous detachment are important features associated with variation in surgical outcomes.
Aphakia ; Drainage ; Humans ; Logistic Models ; Medical Records ; Pseudophakia ; Retinal Detachment* ; Retinaldehyde* ; Retrospective Studies ; Scleral Buckling* ; Subretinal Fluid ; Tears ; Visual Acuity ; Vitreoretinopathy, Proliferative ; Vitreous Detachment

PURPOSE: To assess the prognostic factors associated with anatomical success of scleral buckle (SB) for rhegmatogenous retinal detachment (RRD) in high myopia patients. METHODS: The medical records of RRD in highly myopic eyes treated with SB from January 2009 to December 2013 were reviewed retrospectively. Cases with history of intraocular surgery including phacoemulsification and vitrectomy were excluded. Correlations between anatomical success and the parameters of age, sex, preoperative visual acuity, axial length, presence of large tear, presence of horseshoe tear, the number of tears, involved fovea, and extent of detachment were analyzed. RESULTS: This study included 80 eyes of 80 patients. Average age and axial length were 32.3 ± 13.4 and 26.753 ± 0.961 mm, respectively. Sixty-nine eyes (86.3%) were reattached following primary surgery. Univariate analysis revealed that age (p = 0.011), presence of large tear (p = 0.002), and presence of horseshoe tear (p = 0.044) were correlated with anatomical success after SB. Based on multivariate logistic regression analysis, age was the sole independent prognostic factor (odds ratio = 1.086, 95% confidence interval = 1.022~1.154, p = 0.004). CONCLUSIONS: A younger age is associated with a higher rate of primary anatomical success of SB for RRD in highly myopic eyes. In young, highly myopic patients with RRD, SB should be considered as the primary procedure.
Humans ; Logistic Models ; Medical Records ; Myopia ; Phacoemulsification ; Retinal Detachment* ; Retinaldehyde* ; Retrospective Studies ; Scleral Buckling* ; Tears ; Visual Acuity ; Vitrectomy

PURPOSE: To investigate the effectiveness of the pediatric blood culture bottle for vitreous sample culture in endophthalmitis patients. METHODS: All consecutive cases with clinically suspected endophthalmitis treated and cultured in our institution between January 2009 and June 2013 were included in the study. Vitreous samples were obtained by vitreous needle aspiration (tap), anterior chamber aspiration, or mechanized vitreous biopsy (vitrectomy). The samples obtained using the conventional method until August 2011 were classified as group I. Since August 2011, the BacT/Alert PF pediatric blood culture bottle (bioMerieux, Marcy l'Etoile, France) was used for culture in group II. We investigated age, gender, biopsy method, cause of infection, use of antibiotics, bacterial culture, and culture positive rate. RESULTS: Thirty-three cases were included in group I and 17 cases in group II. There was no significant difference in age, gender, sampling technique, cause of infection, and use of antibiotics between the 2 groups. The culture positive rate in group II (60.7%) was significantly higher than group I (33.3%, p = 0.032). In group II, Enterococcus feacalis was the most common pathogen (8 eyes). In group I, Streptococcus pneumoniae and Pseudomonas aeruginosa were confirmed in 3 cases. CONCLUSIONS: The pediatric blood culture bottle can be used successfully in the examination of clinically suspected endophthalmitis. The method showed higher culture positive rate compared with the conventional method. This technique is simple and maintaining a supply of fresh agar media is not necessary.
Agar ; Anterior Chamber ; Anti-Bacterial Agents ; Biopsy ; Endophthalmitis* ; Enterococcus ; Humans ; Needles ; Pseudomonas aeruginosa ; Streptococcus pneumoniae

PURPOSE: To evaluate 0.025% brilliant blue G (BBG) for staining the internal limiting membrane (ILM) during vitrectomy. METHODS: In a retrospective, non-comparative clinical case series, we analyzed consecutive 111 patients who underwent pars plana vitrectomy and removal of the ILM after staining using BBG solution. BBG was dissolved and diluted with balanced salt solution at a concentration of 0.025% and then sterilized by filtering through a 0.22 microm millipore filter. The prepared BBG solution was injected into the vitreous cavity over the macula after removal of the vitreous and excessive solution was removed immediately. RESULTS: The ILM was successfully removed without use of additional adjuvant in all cases. Mean best corrected visual acuity (log MAR) was significantly improved from 0.80 +/- 0.44 at baseline to 0.40 +/- 0.39 at 6 months postoperatively (p < 0.001). One case each of endophthalmitis and diabetic papillopathy developed. The relationship when using BBG solution was not identified as complications were not observed in the other patients who underwent vitrectomy using the same BBG solution on the same day. One idiopathic epiretinal membrane patient had visual acuity loss more than 2 lines. During the follow-up period, other complications suspected to be associated with the use of BBG solution were not observed. CONCLUSIONS: A BBG solution (0.025%) was effective in staining the ILM for removal. Complications associated with the use of BBG solution were not observed.
Endophthalmitis ; Epiretinal Membrane ; Follow-Up Studies ; Humans ; Membranes* ; Micropore Filters ; Retrospective Studies ; Visual Acuity ; Vitrectomy*

PURPOSE: To determine the myopic shift and cataract change after lens sparing vitrectomy (LSV) in patients with idiopathic epiretinal membrane (ERM) in their 5th and 6th decade of life. METHODS: The medical records of patients undergoing LSV for idiopathic ERM from 2008 to 2012 were reviewed. Patients with previous intraocular surgery, preoperative significant cataract, under 40 or over 60 years of age and a follow-up period of less than 6 months were excluded. The change in refractive errors, visual acuity, and cataract grade were evaluated for 6 months after LSV as well as the correlation between myopic shift and cataract change at 6 months after LSV. RESULTS: Twenty-eight eyes were included in this study. The cataract status worsened by 1.07 levels, myopia progressed by 3.13 diopters (p < 0.001), and uncorrected visual acuity (log MAR) decreased from 0.73 to 0.98 (p = 0.022) at 6 months after LSV. Additional cataract surgery was performed in 22 eyes (78.6%) at 13.6 months on average during the follow-up period (average 16.9 months). In 6 eyes (21.4%) having myopic change below 1.0 diopters, crystalline lens was preserved for 36 months after vitrectomy. Conversely, 22 eyes (78.6%) with myopic change over 1.5 diopters required cataract surgery. Therefore, myopic change over 1.5 diopters could be a major postoperative change predicting the necessity for cataract surgery (p < 0.001). CONCLUSIONS: LSV for ERM caused a significant myopic shift and cataract changes in patients in their 5th and 6th decade of life and additional cataract surgery was required in 78.6% of patients within 3 years after vitrectomy. The myopic shift over 1.5 diopters at 6 months after vitrectomy could be a major postoperative change predicting the necessity for cataract surgery.
Cataract* ; Epiretinal Membrane* ; Follow-Up Studies ; Humans ; Lens, Crystalline ; Medical Records ; Myopia ; Refractive Errors ; Visual Acuity ; Vitrectomy*

PURPOSE: To evaluate 0.025% brilliant blue G (BBG) for staining the internal limiting membrane (ILM) during vitrectomy. METHODS: In a retrospective, non-comparative clinical case series, we analyzed consecutive 111 patients who underwent pars plana vitrectomy and removal of the ILM after staining using BBG solution. BBG was dissolved and diluted with balanced salt solution at a concentration of 0.025% and then sterilized by filtering through a 0.22 microm millipore filter. The prepared BBG solution was injected into the vitreous cavity over the macula after removal of the vitreous and excessive solution was removed immediately. RESULTS: The ILM was successfully removed without use of additional adjuvant in all cases. Mean best corrected visual acuity (log MAR) was significantly improved from 0.80 +/- 0.44 at baseline to 0.40 +/- 0.39 at 6 months postoperatively (p < 0.001). One case each of endophthalmitis and diabetic papillopathy developed. The relationship when using BBG solution was not identified as complications were not observed in the other patients who underwent vitrectomy using the same BBG solution on the same day. One idiopathic epiretinal membrane patient had visual acuity loss more than 2 lines. During the follow-up period, other complications suspected to be associated with the use of BBG solution were not observed. CONCLUSIONS: A BBG solution (0.025%) was effective in staining the ILM for removal. Complications associated with the use of BBG solution were not observed.
Endophthalmitis ; Epiretinal Membrane ; Follow-Up Studies ; Humans ; Membranes* ; Micropore Filters ; Retrospective Studies ; Visual Acuity ; Vitrectomy*

PURPOSE: To determine the myopic shift and cataract change after lens sparing vitrectomy (LSV) in patients with idiopathic epiretinal membrane (ERM) in their 5th and 6th decade of life. METHODS: The medical records of patients undergoing LSV for idiopathic ERM from 2008 to 2012 were reviewed. Patients with previous intraocular surgery, preoperative significant cataract, under 40 or over 60 years of age and a follow-up period of less than 6 months were excluded. The change in refractive errors, visual acuity, and cataract grade were evaluated for 6 months after LSV as well as the correlation between myopic shift and cataract change at 6 months after LSV. RESULTS: Twenty-eight eyes were included in this study. The cataract status worsened by 1.07 levels, myopia progressed by 3.13 diopters (p < 0.001), and uncorrected visual acuity (log MAR) decreased from 0.73 to 0.98 (p = 0.022) at 6 months after LSV. Additional cataract surgery was performed in 22 eyes (78.6%) at 13.6 months on average during the follow-up period (average 16.9 months). In 6 eyes (21.4%) having myopic change below 1.0 diopters, crystalline lens was preserved for 36 months after vitrectomy. Conversely, 22 eyes (78.6%) with myopic change over 1.5 diopters required cataract surgery. Therefore, myopic change over 1.5 diopters could be a major postoperative change predicting the necessity for cataract surgery (p < 0.001). CONCLUSIONS: LSV for ERM caused a significant myopic shift and cataract changes in patients in their 5th and 6th decade of life and additional cataract surgery was required in 78.6% of patients within 3 years after vitrectomy. The myopic shift over 1.5 diopters at 6 months after vitrectomy could be a major postoperative change predicting the necessity for cataract surgery.
Cataract* ; Epiretinal Membrane* ; Follow-Up Studies ; Humans ; Lens, Crystalline ; Medical Records ; Myopia ; Refractive Errors ; Visual Acuity ; Vitrectomy*

PURPOSE: To compare concentration of cytokines in the vitreous of rabbit eyes after photocoagulation using a short-pulse pattern scanning laser (PASCAL) or a conventional laser. METHODS: Laser photocoagulation was performed using PASCAL (duration 0.02 seconds) in the right eyes and a conventional laser (duration 0.1 seconds) in the left eyes of 13 pigmented rabbits. To obtain ophthalmoscopically similar mild burns, power was adjusted during the photocoagulation. The rabbits were sacrificed at 1, 3 or 7 days after photocoagulation to investigate histological changes. Levels of interleukins (IL)-1beta, IL-6, IL-8 and tumor necrosis factor (TNF)-alpha in the vitreous humors of ten rabbits were measured using enzyme-linked immunosorbent assay before treatment and at 1, 3 and 7 days after photocoagulation. RESULTS: Histological changes were comparable between the two groups. IL-1beta and TNF-alpha were not detectable. IL-6 did not change significantly. IL-8 increased at day 3 and day 7, but no significant difference was observed between the two groups (p>0.05). CONCLUSIONS: When ophthalmoscopically similar mild burn intensity was achieved, conventional and PASCAL treatments of rabbit eyes caused no difference in intravitreal concentration of inflammatory cytokines.
Burns ; Cytokines* ; Enzyme-Linked Immunosorbent Assay ; Interleukin-6 ; Interleukin-8 ; Interleukins ; Light Coagulation* ; Rabbits* ; Tumor Necrosis Factor-alpha ; Vitreous Body

PURPOSE: To report early capsular block syndrome (CBS) after phacoemulsification with posterior chamber intraocular lens (IOL) insertion combined with vitrectomy. METHODS: Medical records of 622 eyes of 589 patients who had combined phacoemulsification, IOL implantation and vitrectomy between March 2009 and December 2011 were retrospectively reviewed. Among patients with CBS occurring within 1 month of surgery, the patient's baseline characteristics, type of IOL and ophthalmic viscoelastic devices were analyzed. RESULTS: Nine patients (1.45%) developed CBS with typical capsular bag distension. All CBS occurred within 2 weeks after the surgery. Hydrophilic, large optics and no angulation between optic and haptic were related with the occurrence of CBS. Nd:YAG laser capsulotomy (5 eyes), and surgical capsulectomy (2 eyes) resolved CBS successfully. In 2 eyes with gas tamponade, CBS resolved without intervention with the absorption of gas. CONCLUSIONS: CBS may develop after phacoemulsification with PC IOL insertion combined with vitrectomy and/or vitreous tamponade. Hydrophilic material, large optics and no angulation were risk factors of capsular block by enhancing adhesion between the capsulorrhexis and the optic.
Absorption ; Capsulorhexis ; Eye ; Humans ; Lenses, Intraocular ; Medical Records ; Phacoemulsification ; Retrospective Studies ; Risk Factors ; Vitrectomy

PURPOSE: To compare lens-save and simultaneous phacoemulsification with intraocular lens implantation in primary vitrectomy for phakic rhegmatogenous retinal detachment (RRD). METHODS: A retrospective comparative analysis of 54 consecutive eyes from 54 phakic RRD patients who underwent vitrectomy with a minimum of 12 months of follow-up was performed. The patients were divided into the vitrectomy group and the combined group (patients who underwent vitrectomy with concurrent cataract surgery). The main outcome measures were the best corrected visual acuity (BCVA), anatomical success rate, complications and cataract status according to LOCSIII grading. RESULTS: Baseline characteristics were similar in both groups, except for age and cataract status. The mean age was 46.9 year in the vitrectomy group (n = 20) and 60.5 years in the combined group (n = 34) (p < 0.001). The postoperative BCVA (log MAR) improved from 1.27 and 1.30 at baseline to 0.45 and 0.28 at 12 months (p < 0.05), respectively, which was not a significant difference between the 2 groups. In the vitrectomy group, cataract status was changed from 1.8 at baseline to 2.5 at 12 months (p = 0.001). Two patients (11.1%) had an additional cataract surgery performed. The primary anatomical success rate was 90.0% in the vitrectomy group and 94.1% in the combined group. CONCLUSIONS: The vitrectomy group and combined group had similar results in the repair of phakic RRD. Although postoperative cataract progression was noted, lens should be saved in vitrectomy for young patients, as significant cataract is uncommon.
Cataract ; Eye ; Follow-Up Studies ; Humans ; Lens Implantation, Intraocular ; Lenses, Intraocular ; Outcome Assessment (Health Care) ; Phacoemulsification ; Retinal Detachment ; Retinaldehyde ; Retrospective Studies ; Visual Acuity ; Vitrectomy