PURPOSE: To describe the clinical experience and safety profile of a combination of 23-gauge and 20-gauge transconjunctival sutureless vitrectomy (TSV) METHODS: Thirty-seven eyes of thirty-seven consecutive patients who underwent 23-gauge combined with 20-gauge transconjunctival vitrectomy surgery by a single surgeon from August 2006 through December 2006 were reviewed retrospectively for surgical indications, wound problems, and postoperative complications. RESULTS: Thirty-seven eyes, including eyes with proliferative diabetic retinopathy (n=24), macular hole (n=3), epiretinal membrane (n=3), vitreous hemorrhage due to branch retinal vein occlusion and choroidal neovascular membrane (n=3), vitreous opacity secondary to uveitis (n=1), rhegmatogenous retinal detachment (n=1), and vitreoretinal traction syndrome (n=1), underwent operation. Seven eyes at 23-gauge sclerotomy sites and 15 eyes at 20-gauge sclerotomy sites had subconjunctival hemorrhage. Three eyes required sutures at 20-gauge sclerotomy sites intraoperatively due to wound leakage. One wound hemorrhage occurred at a 23-guage sclerotomy site. Vitreous hemorrhage (4 eyes), hyphema (2 eyes), and vitreous hemorrhage with hyphema (1 eye) occurred postoperatively. Postoperative hypotony, retinal detachment, and other complications did not occur. CONCLUSIONS: A combination of 23-gauge and 20-gauge transconjunctival sutureless vitrectomy which was created by modifying transconjunctival sutureless vitrectomy systems published previously guarded against sclerotomy wounds and a variety of vitreoretinal surgical indications.
Choroid ; Diabetic Retinopathy ; Epiretinal Membrane ; Eye ; Hemorrhage ; Humans ; Hyphema ; Membranes ; Retinal Detachment ; Retinal Perforations ; Retinal Vein Occlusion ; Retrospective Studies ; Sutures ; Traction ; Uveitis ; Vitrectomy ; Vitreous Hemorrhage

PURPOSE: To evaluate the efficacy and safety of partial fluid air exchange at the end of 23-gauge transconjunctival sutureless vitrectomy to prevent postoperative hypotony. METHODS: Fifty-five eyes in 49 consecutive patients who underwent partial fluid air exchange at the end of 23-gauge sutureless vitrectomy by a single surgeon at Gil Hospital between August 2007 and February 2008 were recruited for this study. Intraocular pressure (IOP), visual acuity and post-operative complications were evaluated. RESULTS: Surgical indications included proliferative diabetic retinopathy (n=31), epiretinal membrane (n=9), nondiabetic vitreous hemorrhage (n=5), vitreous opacities (n=3), and others (n=7). Two eyes showed hypotony (<6 mmHg) on postoperative day 1 and resolved within a week without any supplemental procedures. Other complications included choroidal detachment in 1 eye, hyphema in 1 eye, and transient IIOP in 2 eyes. In 38 eyes in which combined cataract surgery was performed, air bubble-related complications including iris capture by the IOL in 3 eyes (7.9%) and opacification of the posterior capsule in 11 eyes (28.9%) occurred. No case of retinal detachment or endophthalmitis was observed. The final best corrected visual acuity was 20/40 or better in 14 eyes (25.5%). CONCLUSIONS: The partial fluid air exchange shows promise as an effective and safe procedure for prevention of postoperative hypotony after sutureless vitrectomy. Air bubble-related complications after combined cataract surgery can be avoided by several techniques.
Cataract ; Choroid ; Diabetic Retinopathy ; Endophthalmitis ; Epiretinal Membrane ; Eye ; Humans ; Hyphema ; Intraocular Pressure ; Iris ; Retinal Detachment ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage

PURPOSE: To report the case of delayed suprachoroidal hemorrhage after Ahmed valve implantation in a neovascular glaucoma (NVG) patient. CASE SUMMARY: A 74-years-old male visited the hospital with ocular pain in the left eye. He had a history of vitrectomy and Intraocular lens (IOL) scleral fixation due to trauma in the left eye. NVG was diagnosed and Ahmed valve was implanted in his left eye. Three days later, hypotony occurred with all quadrant choroidal detachment. Next day, raised intraocular pressure (IOP) was checked and anterior chamber was flat on slit lamp examination. Vitreous hemorrhage and suprachoroidal hemorrhage were suspected. We performed anterior chamber formation with viscoelastics. The anterior chamber became deeper and hemorrhage gradually decreased. A month later, the patient visited us with severe ocular pain. Raised IOP and shallow anterior chamber due to moderate hyphema and anteriorly placed IOL were found. Retinal detachment was suspected on B-scan. Vitrectomy, IOL removal, silicone oil insertion, and Ahmed valve removal were performed. CONCLUSIONS: We report we experienced one patient of delayed suprachoroidal hemorrhage after Ahmed valve implantation and he had poor prognosis.
Anterior Chamber ; Choroid ; Eye ; Glaucoma, Neovascular ; Hemorrhage ; Humans ; Hyphema ; Intraocular Pressure ; Lenses, Intraocular ; Male ; Prognosis ; Retinal Detachment ; Silicone Oils ; Vitrectomy ; Vitreous Hemorrhage

This is a descriptive study of Tersons syndrome among patients with aneurysmal subarachnoid hemorrhage at the Philippine General Hospital. The incidence of Tersons syndrome was 13.4 percent. There were no statistically significant differences in outcomes among patients with and without Tersons syndrome. (Author)
Human ; EYE DISEASES ; EYE HEMORRHAGE ; RETINAL HEMORRHAGE ; VITREOUS HEMORRHAGE ; VITREOUS HEMORRHAGE/ETIOLOGY ; PROGNOSIS ; ANEURYSM ; SUBARACHNOID HEMORRHAGE

Numerous eye diseases have been examined by means of time-amplitude ultrasonography for a period of more than ten years. A diagnostic ultrasonic examination is of great help in the following pathologic conditions: intraocular foreign body, retinal detachment, vitreous opacities, melanoma of the choroid, retrolental fibrorlasia, as well as in dermoid cysts and abscesses of the anterior orbit, etc. In my investigations, I have reeently also used the EKOLINE 20 ultrasonic equipment and frequencies of 6 to 11 Mc. Time-amplitude ultrasonography were performed on 7 cases (orbital tumor, 2 cases of intraocular foreign body, retinal detachment and vitreous hemorrhage, eale's disease, intraocular tumor and vitreous hemorrhage). In addition to a brief review of literature, Time-amplitude ultrasonography findings of 7 cases of ocular diseases have been reported.
Abscess ; Choroid ; Dermoid Cyst ; Eye Diseases ; Foreign Bodies ; Melanoma ; Orbit ; Retinal Detachment ; Ultrasonics ; Ultrasonography* ; Vitreous Hemorrhage

PURPOSE: To evaluate the results of vitrectomy-assisted intravitreal tissue plasminogen activator (tPA) and SF6 gas injection in the treatment of submacular hemorrhage. METHODS: Thirty-one eyes of 30 consecutive patients with submacular hemorrhages undergoing vitrectomy with intravitreal tPA (50 microg/0.1 ml) and SF6 gas injection and completed 12 months of follow-up were evaluated. RESULTS: The mean duration of visual symptoms was 4.1 days. Submacular blood was completely displaced in all 31 eyes after surgery. The best corrected visual acuity (logMAR) improved to 0.56 +/- 0.46 at 12 months from 1.15 +/- 0.51 at baseline (P = 0.002). The most important factors related to visual acuity at the 12-month follow-up were the underlying etiology for the submacular hemorrhage and visual acuity 3 months after surgery (P = 0.003 and P = 0.000, respectively). The 12-month visual acuity was independent of age, gender, presence of vitreous hemorrhage, sub-ILM hemorrhage, baseline visual acuity, duration of symptoms, and the diameter of the submacular hemorrhage. No retinal detachment or re-submacular hemorrhage developed during the follow-up period. CONCLUSIONS: This surgical technique can effectively displace submacular hemorrhage without complications. The 3-month visual acuity appears to predict the 12-month visual acuity. The final visual acuity was associated with the primary etiology for the submacular hemorrhage.
Eye ; Follow-Up Studies ; Hemorrhage ; Humans ; Retinal Detachment ; Tissue Plasminogen Activator ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage

PURPOSE: To report a case of a full-thickness macular hole caused by Terson syndrome. CASE SUMMARY: A 49-year-old man presented to our clinic with decreased visual acuity in the right eye after a subarachnoid hemorrhage due to spontaneous rupture a middle cerebral artery aneurysm. On the first examination, the corrected visual acuity was hand movement in the right eye and 1.0 in the left eye. There was massive vitreous hemorrhage in the right eye. In the left eye, there was no abnormal ocular finding. He was diagnosed with vitreous hemorrhage due to Terson syndrome and waited for the spontaneous absorption of the vitreous hemorrhage. Six months later, the vitreous hemorrhage was considerably absorbed, but a macular hole was observed. OCT scans showed a full-thickness macular hole with an epiretinal membrane.
Absorption ; Epiretinal Membrane ; Eye ; Hand ; Humans ; Intracranial Aneurysm ; Middle Aged ; Retinal Perforations ; Rupture, Spontaneous ; Subarachnoid Hemorrhage ; Visual Acuity ; Vitreous Hemorrhage

PURPOSE: To report a case of eccentric macular hole formation after surgery for a traumatic macular hole. CASE SUMMARY: A 27-year-old man was admitted to our hospital because of baseball trauma to his left eye. A vitreous hemorrhage and Berlin's edema were found in the macula. One month later, a full thickness macular hole was detected. Vitrectomy and internal limiting membrane (ILM) peeling and gas injection were performed. Two months postoperatively, the primary macular hole was closed, but an eccentric macular hole temporal to the fovea was observed.
Adult ; Baseball ; Edema ; Eye ; Humans ; Membranes ; Retinal Perforations ; Vitrectomy ; Vitreous Hemorrhage

PURPOSE: To evaluate the efficacy and complication of autologous plasmin (AP) injected before vitrectomy for rhegmatogenous retinal detachment (RRD). METHODS: Intravitreal AP injection (0.2 ml) was performed on the eyes without posterior vitreous detachment (PVD) 20 minutes before the vitrectomy for RRD. The extent of PVD was evaluated intraoperatively. Surgical PVD induction was performed and the ease of the procedure was graded. The extent of PVD, ease of PVD induction, and complications (including incidence of iatrogenic retinal break) were compared to those of the control eyes. In order to evaluate complications and measure activated partial thromboplastin time, a microbial culture of injected AP was performed and the rate of postoperative intraocular hemorrhage was investigated. Change in visual acuity and the rate of retinal reattachment were compared in order to evaluate the long-term surgical outcome. RESULTS: The extent of PVD was greater in the AP group than in the control group, and vitreal separation was facilitated by intravitreal AP injection. However, ease of PVD induction and frequency of iatrogenic retinal break found were not significantly different between cases and controls. Neither postoperative intraocular hemorrhage nor systemic coagulation abnormality occurred. Postoperative endophthalmitis and positive microbial culture of the AP solution were also not reported. There was no significant difference in the change in visual acuity and the rate of retinal reattachment between the two groups. CONCLUSIONS: Intravitreal AP injection can facilitate vitrectomy for RRD and has no effect on the rate of retinal reattachment.
Endophthalmitis ; Eye ; Fibrinolysin ; Hemorrhage ; Incidence ; Partial Thromboplastin Time ; Retinal Detachment ; Retinal Perforations ; Retinaldehyde ; Visual Acuity ; Vitrectomy ; Vitreous Detachment

PURPOSE: To analyze retinal tears and to compare the clinical outcomes between retinal tear and rhegmatogenous retinal detachment (RRD) as the cause of dense non-diabetic vitreous hemorrhage in patients who underwent vitreoretinal surgery. METHODS: In a retrospective case series, the medical records of patients who presented dense non-diabetic vitreous hemorrhage and who underwent vitreoretinal surgery between January 2005 and June 2009 were reviewed. Among the 134 patients, 27 patients had dense vitreous hemorrhage caused by retinal tears. The first group had retinal tears only and the second group had accompanying RRD. A comparison of clinical features and postoperative prognoses between the two groups was performed. RESULTS: Among the 27 eyes with non-traumatic retinal tear and RRD, 18 were categorized into the retinal tear group and 9 to the RRD group. The demographic findings between the two studied groups exhibited no significant differences except for time between onset of symptoms and diagnosis. However, the time to diagnosis was significantly delayed in the group with RRD (22.67 +/- 37.47 days) compared to the retinal tear group (5.00 +/- 3.41 days) (p = 0.035). The amount of visual improvement was also greater in the retinal tear group than the RRD group (p = 0.002). CONCLUSIONS: Retinal tears are a major cause of non-diabetic vitreous hemorrhage. Vitreous hemorrhage caused by retinal detachment may result in delayed diagnosis and poor visual recovery. Therefore, early examinations in suspicion of RRD and appropriate treatments are needed in non-diabetic vitreous hemorrhage.
Delayed Diagnosis ; Eye ; Humans ; Medical Records ; Prognosis ; Retinal Detachment ; Retinal Perforations ; Retinaldehyde ; Retrospective Studies ; Vitreoretinal Surgery ; Vitreous Hemorrhage