Humans ; Male ; Middle Aged ; Retinal Detachment ; surgery ; Vitrectomy ; instrumentation ; methods

No abstract available.
Aphakia/*surgery ; Female ; Humans ; Lens Implantation, Intraocular/*methods ; *Lenses, Intraocular ; Male ; Sclera/*surgery ; *Vitrectomy

BACKGROUNDEndophthalmitis can be a devastating complication after pars plana vitrectomy. The incidence of postvitrectomy endophthalmitis is significantly lower than that of endophthalmitis occurring after other intraocular operations. However, normal post-operative pain and inflammation may mask endophthalmitis and lead to delayed diagnosis and grave visual consequences. This study aimed to summarize the outcomes of cases that underwent pars plana vitrectomy over a 10-year period and to analyze the characteristics of post-vitrectomy endophthalmitis.

METHODSA retrospective observational case study was conducted on all the cases who underwent pars plana vitrectomy in the Beijing Tongren Hospital between January 1, 2002 and March 31, 2012. All cases of endophthalmitis that occurred during a period of 10 years and 3 months were reviewed, and the possible risk factors, clinical findings, causative organism(s), and the sources of infection were analyzed.

RESULTSWithin the 10-year observational period, 14 patients developed endophthalmitis after pars plana vitrectomy. The incidence of post-vitrectomy endophthalmitis (0.05%) was lower than that reported previously from the same center (0.12%). Staphylococcus epidermidis (five patients, 35.71%) was the most common organism identified in aqueous or vitreous cultures. Eight patients (57.14%) had diabetes mellitus. There was no statistically significant difference (P > 0.05) in the incidence of endophthalmitis between period 1 (with antibiotic pretreatment) and period 2 (without antibiotic pretreatment). Surgical procedures for the treatment of endophthalmitis were performed in 10 patients (71.43%).

CONCLUSIONSThis series of cases showed that the incidence of endophthalmitis after pars plana vitrectomy is lower than what was previously reported in our hospital. A variable degree of corneal edema with relatively normal or mildly increased intraocular pressure was one of the commonly observed characteristics of post-vitrectomy endophthalmitis. Staph. epidermidis was the most common causative organism, and antibiotic pretreatment did not lower the incidence of postvitrectomy endophthalmitis.

Adult ; Aged ; Endophthalmitis ; etiology ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Retrospective Studies ; Vitrectomy ; methods

PURPOSE: To evaluate the efficiency of a surgical method using original breaks to drain subretinal fluid without using retinotomy and perfluorocarbon liquid for patients with rhegmatogenous retinal detachment (RRD). METHODS: A retrospective chart review comparing 41 eyes of 41 patients who received vitrectomy, and used original breaks to drain subretinal fluid without using perfluorocarbon liquid, and 40 eyes of 40 patients who received vitrectomy using perfluorocarbon liquid for simple RRD between February 2014 and December 2017 was conducted. All patients were followed for a minimum of 6 months after surgery. RESULTS: The primary anatomical success percentages were 97.6% and 97.5% for groups that did not and did use perfluorocarbon liquid, respectively. Retinal detachment recurred in one eye from both groups. The final success percentage was 100%. The preoperative mean logMAR best-corrected visual acuity (BCVA) of 0.87 ± 0.80 improved to 0.30 ± 0.30 at postoperative 6 months for the group that did not use perfluorocarbon liquid, while it improved from 0.86 ± 0.71 to 0.42 ± 0.52 for the group that did use perfluorocarbon liquid. Both groups showed significant BCVA improvement (p < 0.01). There was no significant difference in the incidence of complications caused by the use of perfluorocarbon liquid. CONCLUSIONS: Using original breaks to drain subretinal fluid without perfluorocarbon liquid in cases with RRD may be an effective and safe surgical technique for functional and anatomical recovery without serious complications.
Drainage ; Humans ; Incidence ; Methods ; Retinal Detachment ; Retinaldehyde ; Retrospective Studies ; Subretinal Fluid ; Visual Acuity ; Vitrectomy

PURPOSE: To compare the predicted and actual refractive errors of hydrophilic, one-piece, C-flex(R)570C (C-flex) intraocular lens (IOL) implantation in simultaneous vitrectomy and lens extraction in various conditions. METHODS: One hundred fifty-nine eyes of patients who had lens extraction between March 2004 and September 2005 were enrolled in a retrospective study. Group 1 had lens extraction and IOL implantation, and Group 2 had lens extraction and IOL implantation with vitrectomy. IOL calculation was done with axial length and keratometry measurements. The actual and predicted refractive errors were compared at 1 and 6 months postoperatively. The factors influencing the postoperative refractive outcomes were analyzed. RESULTS: The mean refractive predictive error (i.e., the actual minus predicted spherical equivalent) was +0.19+/-0.39 D (Diopter) and -0.26+/-0.45 D at 1 and 6 months postoperatively (all: p<0.001) in group 1, and -0.22+/-0.39 D and -0.06+/-0.62 D at 1 and 6 months postoperatively (p=0.013, p=0.399 respectively). In group 2, all surgical factors related to refractive errors were not statistically significant (all: p>0.05). CONCLUSIONS: Refractive errors in combined surgery showed myopic shift of -0.50 D and -0.32 D at 1 and 6 months postoperatively compared with C-flex IOL implantation alone. With the hyperopic tendency of IOL and myopic tendency of vitrectomy, the combined surgery made postoperative refractive errors near emmetropia.
Acrylic Resins ; Aged ; Humans ; *Lens Implantation, Intraocular ; Lenses, Intraocular ; Middle Aged ; Phacoemulsification/*methods ; Refractive Errors/*diagnosis ; Retrospective Studies ; Vitrectomy/*methods

To analyse the results of diabetic vitrectomy according to the severity of proliferation [severe (SPG) vs. less-severe proliferation group (LSPG)], and methods of the operation, which was complete removal of anteroposterior vitreous traction with or without complete removal of preretinal memebrane, we compared both groups by using anatomic success rate and postoperative visual acuities (VA). The results were as follows: The anatomic success rate and postoperative VA were significantly better in LSPG than in SPG. In SPG, anatomic success rate and postoperative VA tended to be better when complete removal of anteroposterior traction was possible than when impossible. In SPG, postoperative VA tended to be better when complete removal of preretinal membrane was possible, but the anatomic success rate was the same for each group. So, when severe proliferation (including table-top elevation of posterior retina), complete removal of anteroposterior traction only can improve the anatomic success rate of the surgery.
Adult ; Aged ; Cell Membrane ; Diabetic Retinopathy/physiopathology/*surgery ; Female ; Humans ; Male ; Middle Aged ; Visual Acuity/physiology ; Vitrectomy/*methods

OBJECTIVETo observe the results of two techniques of posterior chamber intraocular lens (IOL) implantation by a 4-point ciliary sulcus suture fixation combined with vitrectomy.

METHODSLensectomy and vitrectomy combined with posterior chamber IOL implantation by a 4-point scleral fixation was performed in 23 cases with complicated ocular trauma, including 9 eyes had eyeball rupture, vitreous hemorrhage, retinal contusion and traumatic cataract; 6 eyes having eyeball rupture, vitreous hemorrhage, retinal contusion, intraocular foreign body and traumatic cataract; 8 eyes having ocular blunt trauma, vitreous hemorrhage, traumatic cataract and lens dislocation. Two techniques of IOL were randomly assigned: Alcon CZ70BD PMMA suspensory IOL was performed in 12 cases (Group I); Bausch & Lomb Akreos Adapt four-haptic hydrophilic acrylic foldable IOL was performed in 11 cases (Group II). After completed vitrectomy, removed intraocular foreign body and (or) cataract extracted, one-stage IOL implantation by 4-point scleral fixation was performed and the knots of fixation sutures were rotated and buried under the sclera for all patients. The IOL position was adjusted by suture for the best centration.

RESULTThe mean follow-up time was (12.4 +/-1.7) months. The postoperative best-corrected visual acuity (BCVA) was improved in 11 cases (91.7%) of Group I; and BCVA was > or =0.5 in 3 patients(25.0 %). The postoperative BCVA was improved in 11 cases (100 %) of Group II; and BCVA was > or =0.5 in 4 eyes (36.4%). There was no IOL decentration or tilting in two groups.

CONCLUSIONLensectomy and vitrectomy combined with posterior chamber IOL implantation by a 4-point scleral fixation technique is a good method to treat complicated ocular trauma. Two techniques of posterior chamber IOL have both advantages and disadvantages, and can be used accordingly.

Adult ; Cataract Extraction ; Eye Injuries ; surgery ; Female ; Humans ; Lens Implantation, Intraocular ; methods ; Male ; Middle Aged ; Suture Techniques ; Vitrectomy

BACKGROUNDBleb-associated endophthalmitis (BAE) is a rare but severe complication of trabeculectomy with poor outcome. Various surgical methods were explored to treat such patients. However, there is no defined protocol. The aim of this study was to describe a new combined operation, and to demonstrate the outcome of the treatment.

METHODSNine patients with BAE were enrolled in our study. The combined operation including pars plana vitrectomy (PPV), sclera patch graft (SPG) and endoscopic cyclophotocoagulation (ECP) was used to treat these patients.

RESULTSIn the follow-up of 18 - 24 months, all patients with the endophthalmitis were cured, the useful visual acuity was preserved in 7 patients, and the intraocular pressure (IOP) of 8 patients was controlled just after first operation, only one needed another trans-scleral cyclophotocoagulation.

CONCLUSIONThis combined operation is a useful method for treating the patients with BAE, with SPG and vitrectomy to control the endophthalmitis and ECP to balance the postoperative IOP.

Adolescent ; Adult ; Child ; Endophthalmitis ; surgery ; Female ; Glaucoma ; surgery ; Humans ; Male ; Trabeculectomy ; adverse effects ; Visual Acuity ; physiology ; Vitrectomy ; methods ; Young Adult

OBJECTIVESTo evaluate the technical feasibility, safety, outcome, and incidence of complications after combined clear corneal phacoemulsification (PEA) with intraocular lens (IOL) implantation and vitreoretinal surgery.

METHODSCombined operations of PEA and PPV were performed on 52 eyes of 52 patients with cataract and vitreoretinal diseases.

RESULTSThe mean follow-up time was (10.3+/-2.8) months. Postoperatively, visual acuity improved in 46 eyes (88.5%); was unchanged in 6 eyes (11.5%). The best-corrected visual acuities (BCVAs) were the following: 20/40 or better (9 eyes), 20/50 to 20/100 (24 eyes), 20/200 (5 eyes), 20/400 (10 eyes), and fingers counting (FC) to light perception (LP) (4 eyes). In 38 eyes BCVA was 20/200 or better, and in 9 eyes it was 20/40 or better postoperatively. Postoperative complications included posterior capsual opacification (7 eyes); secondary glaucoma (1 eye); and retinal detachment (2 eyes).

CONCLUSIONAlthough further studies are indicated, our study suggests that the combined operation of PPV, PEA and IOL implantation is safe and effective for patients. The visual outcome and complications depended primarily on underlying posterior segment pathology and were not related to the combined procedure technique.

Adult ; Aged ; Cataract ; Female ; Humans ; Lens Implantation, Intraocular ; methods ; Lenses, Intraocular ; Light ; Male ; Middle Aged ; Perception ; Phacoemulsification ; methods ; Time Factors ; Treatment Outcome ; Vision, Ocular ; Visual Acuity ; Vitrectomy ; methods

We report two cases of surgical removal of a retained subfoveal perfluorocarbon liquid (PFCL) bubble through a therapeutic macular hole combined with intravitreal PFCL injection and gas tamponade. Two patients underwent pars plana vitrectomy with PFCL injection for rhegmatogenous retinal detachment. In both cases, a retained subfoveal PFCL bubble was noticed postoperatively by funduscopy and optical coherence tomography. Both patients underwent surgical removal of the subfoveal PFCL through a therapeutic macular hole and gas tamponade. The therapeutic macular holes were completely closed by gas tamponade and the procedure yielded a good visual outcome (best-corrected visual acuity of 20 / 40 in both cases). In one case, additional intravitreal PFCL injection onto the macula reduced the size of the therapeutic macular hole and preserved the retinal structures in the macula. Surgical removal of a retained subfoveal PFCL bubble through a therapeutic macular hole combined with intravitreal PFCL injection and gas tamponade provides an effective treatment option.
Aged ; Female ; Fluorocarbons/*administration & dosage ; Follow-Up Studies ; Fovea Centralis ; Humans ; Intravitreal Injections ; Retinal Perforations/diagnosis/physiopathology/*surgery ; Suction/*methods ; Tomography, Optical Coherence ; Visual Acuity ; Vitrectomy/*methods