It was not until 1919 that the treatment of retinal detachment began to plan on rationale line by Jule Gonin, Who was the first to appriciate the pathological significance of retinal break and therapeutic effect of closing these. Since after the first Gonin's suggestion, various surgical techniques for rhegmatogenous retinal detachment was reoprted in the literatures. Recently the authors had been experienced good surgical results of 45 eyes, beililg operated. The authors employed encircling procedurs and segmental buckling procedure with implants. The segmental buckling procedure was modified from the pocket technique, being employed in the case of simple posterior vitreous detachment. The encircling procedure followed the Crock and Galbraith technique modified from Schepens, being employed in the case of to tal posterior vitreous detachment with collapse. 36 eyes out of 45 eyes was much successful, and no postoperative complication was occurred.
Postoperative Complications ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Vitreous Detachment

Penetrating ocular injuries with intraretinal foreign body(IRFB) are increasing and may result in significant visual morbidity. We evaluated retrospectively 22 eyes of 22 patients who had undergone pars plana vitrectomy for removal of IRFB at Dong-a University Hospital from July 1990 to June 1996. The majority of patients were adult male(95.5%). The nature of all IRFB was magnetic property and the causes of injury were hammering and cutting work(77.3%). Preoperatively, eyes were complicated with vitreous hemorrhage and opacity(59.1%), traumatic cataract(45.%), retinal detachment(36.4%), and corneal opacity(22.7%). Postoperative complications included vitreous hemorrhage and opacity(36.4%), retinal detachment(22.7%), and proliferative vitreoretinopathy(18.2%). In our study, poor visual prognosis was obtained in cases of corneal entrance site, IRFB larger than 2mm in size, IRFB located posterior to equator and IRFB associated with retinal detachment.
Adult ; Foreign Bodies* ; Humans ; Postoperative Complications ; Prognosis ; Retinal Detachment ; Retinaldehyde ; Retrospective Studies ; Vitrectomy* ; Vitreous Hemorrhage

Operation on vitreous body has been almost forbidden till the past few years. However, after the report on pars plana vitrectomy in early 1970's, it has been received favorably as effective operation for treatment of many diseases of vitreous body. So, the clinical and statistical evaluation of the 60 pars plana vitrectomies using a device of VISC X which were operated at the Dept. of Ophth. St. Mary's Hospital, Catholic Medical College from July, 1977 to April 1979 was done. The follow up period ranged from 2 wks to 21 months. The results were as follows; 1. Among the four major causes requiring pars plana vitrectomy, the highest percentage was occupied by Trauma (33 cases-55.0%) followed by diabetic retinopathy (11 cases-18.3%), hypertensive retinopathy (3 cases-5.0%) and central retinal vein occlusion (3 cases-5.0%). 2. Postoperative improvement of visual acuity was seen in 26 cases (43.3%). There was no change in vision in 17 cases (28.3%) and decrease of visual acuity occured in 17 cases (28.3%). Vitreous opacity and hemorrhage patients without proliferative changes showed improvement in 55.2% where as patients with proliferative changes showed improvement in only 32.3% of cases. 3. The complications during operation were vitreous hemorrhage (7 cases-11.7%), hyphema (4 cases-6.7%), retinal detachment (3 cases-5.0%) and traumatic cataract (2 cases-3.3%). The postoperative complications were ocular hypotonY(11 cases-18.3%), vitreous hemorrhage (9 cases-15.0%) and retinal detachment (9-cases-13.3%). We found that pars plana vitrectomy using a device of VISC X is effective method in rarious cases of vitreous diseases with or without proliferative change which has not been able to treat effectively before.
Cataract ; Diabetic Retinopathy ; Follow-Up Studies ; Hemorrhage ; Humans ; Hypertensive Retinopathy ; Hyphema ; Postoperative Complications ; Retinal Detachment ; Retinal Vein ; Visual Acuity ; Vitrectomy* ; Vitreous Body ; Vitreous Hemorrhage

PURPOSE: To evaluate the advantages and complications of triamcinolone acetonide (TA)-assisted pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). METHODS: We retrospectively examined 110 eyes with vitreous hemorrhage or tractional retinal detachment resulting from a PDR after surgery. The TA-assited PPV [TA(+)] consisted of 58 eyes, and the conventional PPV[TA(-)]group consisted of 52 eyes. The improvement in vision, residual vitreous cortex (VC) pattern, and postoperative complications were studied. RESULTS: The residual VC pattern was divided into 3 groups: the focal type in 34 eyes (58.6%): the diffuse type in 22 eyes (37.9%): and no residual VC, seen in 2 eyes (3.4%). The TA (+) group had a lower incidence of rebleeding (p=0.0149) and of a preretinal membrane (p=0.0138) than the TA (-) group. No apparent persistant ocular hypertension occurred in any eyes. CONCLUSIONS: Triamcinolone-assisted PPV appears to be potentially useful to remove residual VC and to protect from postoperative complications.
Diabetic Retinopathy* ; Incidence ; Membranes ; Ocular Hypertension ; Postoperative Complications ; Retinal Detachment ; Retrospective Studies ; Traction ; Triamcinolone Acetonide ; Vitrectomy* ; Vitreous Hemorrhage

PURPOSE: This study evaluated the effect of tissue plasminogen activator (TPA) on adhesion between the internal limiting membrane and the vitreous cortex in patients with diabetic macular edema. METHODS: This retrospective study included 14 eyes of 14 patients with diabetic macular edema without posterior vitreous detachment. The fourteen eyes were divided into two groups. In the first group, vitrectomy and internal limiting membrane (ILM) removal were performed after intravitreal TPA 0.1 cc (50 ug) injection the day before vitrectomy and in the second group, vitrectomy and ILM removal were performed without previous injection of TPA. We observed the ILM using electron microscopy and verified the effects of the TPA. RESULTS: Spontaneous posterior vitreous detachment occurred in 3 of 7 eyes in the first group. Internal limiting membranes removed by vitrectomy showed a smooth surface in 4 of 7 eyes in the first group and in 1 of 7 eyes in the second group. Seven eyes of the first group and 6 eyes of the second group revealed decreased foveal thickness and increased visual acuity 90 days postoperatively. CONCLUSIONS: Preoperative intravitreal TPA injection was helpful for achieving posterior vitreous detachment and for decreasing possible postoperative complications involving in remnant vitreous cortex in patients with diabetic macular edema.
Eye ; Humans ; Macular Edema ; Membranes ; Microscopy, Electron ; Postoperative Complications ; Retrospective Studies ; Tissue Plasminogen Activator ; Visual Acuity ; Vitrectomy ; Vitreous Detachment

PURPOSE: To evaluate the effectiveness of a combined procedure of peeling the internal limiting membrane with vitrectomy in diabetic macular edema. METHODS: This study comprised 16 eyes of 16 patients hospitalized during a 1-year period. They were randomized to either a vitrectomy group (10 eyes in 10 patients) or to a combined procedure group (6 eyes in 6 patients). Preoperative and postoperative macular center thickness, best corrected visual acuity and postoperative complications 4 months postoperative were investigated. RESULTS: There were no statistically significant differences in the mean values of preoperative and postoperative best corrected visual acuity (logMAR) between the two groups. The mean values of preoperative and postoperative macular center thickness in the vitrectomy group were respectively 509.50+/-36.77 and 332.60+/-91.73; while in the combined procedure group, they were 516.17+/-55.43 and 333.83+/-51.64. Again, there were no statistically significant differences between the two groups. At the 4-month follow-up, decreased visual acuity was found in 3 eyes of the vitrectomy group and in 2 eyes of the combined procedure group. Vitreous hemorrhage (3 eyes) and tractional retinal detachment (1 eye) were found in the vitrectomy group and vitreous hemorrhage (2 eyes) was diagnosed in the combined group. CONCLUSIONS: In our study, vitrectomy with peeling of the internal limiting membrane was not more effective than vitrectomy alone in decreasing macular edema or in improving best corrected visual acuity. Additional studies of the combined procedure are needed to verify this result.
Follow-Up Studies ; Humans ; Macular Edema* ; Membranes ; Postoperative Complications ; Retinal Detachment ; Traction ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage

The retrospective study of fifty nine eyes which underwent the vitrectomy for proliferative diabetic retinopathy was performed to determine the clinical feature, incidence of postoperative complication, and showed that the final visual acuity improved in 34(58%) eyes, unchanged in 14(23%), and worsened in 11(19%). Postoperative complcations included cataract, vitreous hemorrhage, increased intraocular pressure, corneal epithelial defect, retinal detachment and iris neovascularization. The postoperative complications associated with poor visual outcomes were iris neovascularization, increased intraocular pressure and retinal detachment.
Cataract ; Diabetic Retinopathy ; Incidence ; Intraocular Pressure ; Iris ; Postoperative Complications ; Retinal Detachment ; Retrospective Studies ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage

More intraoperative and postoperative complications of diabetic vitrectomy may result in poor visual prognosis. Sixty eye (49 patients) underwent vitrectomy for complications of proliferative diabetic retinopathy. Iatrogenic retinal breaks occurred in 6 (10%) of 60 eyes. Postoperative vitreous emorrhage was complicated in 13 (21%) of 60 eyes. Postoperative vitreous hemorrhage cleared spontaneously in one eye. Fluid-air exchange alone was successful in clearing the vitreous cavity in 4 eyes. Two eyes in which clearing does not occur in the postexchange period underwent repeated vitrectomy. Remaining 6 eyes required repeated vitrectomy. Choroidal effusion occurred in 4 eyes (7%) and resolved spontaneously within one week. Neovascular glaucoma occurred in 4 eyes (7%) and was treated with glaucoma implant surgery in 2 eyes, trabeculectomy with Mitomycin C in 1 ye, and cyclophotocoagulation in 1 eye. Retinal detachment developed postoperatively in 3 eyes (5%) and was treated successfully. Corneal epithelial defect persisting more than one week was present in 2 eyes (3%). Accidental mechanical lens damage occurred in one eye. The anatomical success rate was 98% (59 eyes). Visual acuity of 0.025 or better was obtained in 49 eyes (82%). Minimizing intraoperative complications as well as properly managing postoperative complications produced better surgical results.
Choroid ; Diabetic Retinopathy* ; Glaucoma ; Glaucoma, Neovascular ; Incidence* ; Intraoperative Complications ; Mitomycin ; Postoperative Complications ; Prognosis ; Retinal Detachment ; Retinal Perforations ; Trabeculectomy ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage

From Nov. 1990 to Dec. 1994, authors have experienced 12 patients(13 eyes) diagnosed as posterior lens dislocation. The clinical results were evaluated in aspeets of sex and age distribution, preoperative and postoperative visual acuity, operative method, postoperative complication. The average age of patients was 57.8 years old and average follow-up period was 11.5 months. Male were 58%. They have history of ocular trauma in all 13 eyes. Dislocated lens was removed by extraction with lens spoon or loop through corneoscleral incision in 3 eyes and pars planar vitrectomy followed by lens lift with needle and extraction through corneoscleral incision in 7 eyes or with perfluorocarbon liquid and extraction with spoon or loop in 3 eyes. The best corrected visual acuity was improved in 10 eyes and remained the same in 2 patient(3 eyes) who was visited our hospital more than 10 years after dislocation and associated with optic nerve atrophy, macular degeneration, bullous keratopathy. Postoperative complications included glaucoma, choroidal detachment, retinal detachment, persistent vitreous inflammation, vitreous hemorrhage, bullous keratopathy.
Age Distribution ; Atrophy ; Choroid ; Dislocations ; Follow-Up Studies ; Glaucoma ; Humans ; Inflammation ; Lens Subluxation* ; Macular Degeneration ; Male ; Needles ; Optic Nerve ; Postoperative Complications ; Retinal Detachment ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage

PURPOSE: To evaluate 25-gauge transconjunctival sutureless vitrectomy for primary repair of rhegmatogenous retinal detachment (RRD). METHODS: We performed a retrospective study of 46 consecutive eyes of 46 patients who underwent 25-gauge transconjunctival sutureless vitrectomy to repair primary RRD. Outcome measures included single surgery anatomical success rate, final anatomical success rate, postoperative visual acuity, and surgical complications. RESULTS: Forty eyes were phakic and six eyes were pseudophakic. Twenty-six eyes had superior quadrant retinal tear, 12 eyes had inferior quadrant tear and eight eyes had both. The mean operation time was 56.3 minutes. The single surgery anatomical success rate was 93.48% (43/46). Two eyes with recurrent retinal detachment underwent fluid gas exchange: one received barrier laser treatment in the outpatient clinic, and the other underwent reoperation; the final success rate was 100%. The best corrected visual acuity improved from 1.34 log MAR to 0.48 log MAR (p < 0.01) in macula - off patients (30 eyes) and from 0.32 log MAR to 0.07 log MAR (p = 0.279) in macula - on patients (16 eyes). Postoperative complications included wound leaking (two eyes), cataract progression (13 eyes), vitreous hemorrhage (one eye), transient hypotony (one eye), and increased intraocular pressure (seven eyes). CONCLUSIONS: Primary repair of RRD using 25-gauge transconjunctival vitrectomy resulted in an excellent final anatomical success rate and postoperative visual outcomes.
Ambulatory Care Facilities ; Cataract ; Humans ; Intraocular Pressure ; Outcome Assessment (Health Care) ; Postoperative Complications ; Reoperation ; Retinal Detachment* ; Retinal Perforations ; Retrospective Studies ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage ; Wounds and Injuries