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: 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

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

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

PURPOSE: To determine the efficacy and safety of intravitreal triamcinolone acetonide given to treat diabetic macular edema that was unresponsive to a prior laser photocoagulation. METHODS: An intravitreal injection of 4 mg triamcinolone acetonide was given to 25 eyes with a clinically significant diabetic macular edema (CSME) that failed to respond to conventional treatment within an average of 7.56 months after laser photocoagulation. There were 13 females and 4 bilateral cases. The mean age was 60.4 +/- 6.9 years. The response to treatment was monitored functionally by a visual acuity assessment and anatomically by an OCT macular thickness at 1-, 2-, and 6-month intervals after the injection. RESULTS: After the intravitreal injection of triamcinolone acetonide, 18 out of 25 eyes (72%), 20 out of 25 eyes (80%), and 13 out of 18 eyes (72%) showed improvement of the mean visual acuity at the 1-, 2-, and 6-month follow-up intervals. The central macular thickness as measured by the OCT decreased by 43%, 45%, and 20%, respectively, over these same intervals from an initial pretreatment mean of 498.7 +/- 131.6 micro meter. The postoperative complications were an intraocular pressure elevation (3 eyes), and cataract (3 eyes). However, there were no serious postoperative complications such as retinal detachment, vitreous hemorrhage and endophthalmitis. CONCLUSIONS: An intravitreal injection of triamcinolone acetonide may be useful for treating a diabetic macular edema that is resistant to conventional laser photocoagulation.
Cataract ; Endophthalmitis ; Female ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Intravitreal Injections* ; Light Coagulation ; Macular Edema* ; Postoperative Complications ; Retinal Detachment ; Triamcinolone Acetonide ; Triamcinolone* ; Visual Acuity ; Vitreous Hemorrhage

Medical record of 66 eyes which had undergone pars plana vitrectomy for the treatment of proliferative diabetic retinopathy were reviewed to study their clinical features, incidences and types of complications, visual outcome, and visual prognostic factors. The final visual outcome showed the improvement in 50[76%] eyes, no change in 13[20%]eyes, and the worsening in 3[4%] eyes. Preoperative prognostic factors favoring final visual acuity included the followings:1]insulin dependent diabetes mellitus which developed before 30 years of age, 2]absence of iris neovascularization, 3]absence of tractional macular detachment. Postoperative complications included vitreous hemorrhage in 34[52%]eyes, cataract in 12[19%]eyes, increased intraocular pressure in 6[10%]eyes, rhegmatogenous retinal detachment in 4[6%]eyes, choroidal effusion in 3[5%]eyes, corneal epithelial defect in 2[3%]eyes, neovascular glaucoma in 1[2%] eye. Postoperative complications associated with poor visual outcome were rhegmatogenous retinal detachment and neovascular glaucoma.Intraoperative complication of iatrogenic retinal tear did not seem to deteriorate the final visual acuity.
Cataract ; Choroid ; Diabetes Mellitus ; Diabetic Retinopathy* ; Glaucoma, Neovascular ; Incidence ; Intraocular Pressure ; Iris ; Medical Records ; Postoperative Complications ; Retinal Detachment ; Retinal Perforations ; Traction ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage