PURPOSE: To evaluate the efficacy of vitrectomy in patients with diabetic macular edema. METHODS: The results of pars plana vitrectomy in 10 eyes were analyzed. Major outcome measurements were preoperative and postoperative best corrected visual acuity, fundus findings of macula, and postoperative complications. All eyes had at least 4 months of follow- up after surgery. RESULTS: The improvement of visual acuity up to 2 lines on the chart was found in 5 eyes (50%) after the surgery and six eyes (60%) showed improvement in macular edema. The complications after surgery were vitreous hemorrhage in 1 eye and submacular exuadates in 1 eye. CONCLUSIONS: Vitrectomy may be beneficial for patients with diabetic macular edema.
Humans ; Macular Edema* ; Postoperative Complications ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage

PURPOSE: The purpose of this study is to evaluate the clinical results of 23-gauge sutureless vitrectomy. METHODS: We retrospectively analyzed 111 eyes that had undergone 23-gauge sutureless vitrectomy. The eyes underwent surgery from February 2006 to July 2006 and were examined for surgical outcome as well as intraoperative and postoperative complications. RESULTS: The preoperative best corrected visual acuity (BCVA) was 1.43+/-0.12 and increased to 0.88+/-0.11 (P>0.01). Thirteen (11.7%) of 111 eyes developed intraoperative complications, and 21 (18.9%) of 111 eyes developed postoperative complications. Intraoperative complications included wound.leaking (seven eyes), conjunctival suture (three eyes), and difficult insertion (two eyes). Postoperative complications included postoperative hypotony (seven eyes), vitreous hemorrhage (seven eyes), hyphema (five eyes), and infectious endophthalmitis (two eyes). CONCLUSIONS: Unlike 20-gauge vitrectomy, sutureless 23-gauge vitrectomy offers all the advantages of minimally invasive sutureless vitrectomy.
Endophthalmitis ; Eye ; Hyphema ; Intraoperative Complications ; Postoperative Complications ; Retrospective Studies ; Sutures ; Visual Acuity ; 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

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

PURPOSE: We compared the surgical outcomes of vitrectomy for proliferative diabetic retinopathy between younger and older groups. METHODS: We reviewed the data of 185 patients (227 eyes) who had undergone vitrectomy and endolaser photocoagulation and who were followed up for at least 6 months. We divided them into two age-based groups: less than 40 years of age (52 eyes), and more than 40 years of age (175 eyes). We compared preoperative status, surgical outcomes, and postoperative complications. RESULTS: Postoperative visual acuity improved in 75.0% in the younger group, and 68.6% in the older group, and the difference was not statistically significant. The proportion of eyes with good visual acuity of 0.6 or better was statistically significantly (Ed-confirm this addition) higher in the younger group (30.8%) than in the older group (17.1%). The proportion of eyes with postoperative visual acuity of no light perception was statistically significantly higher in the younger group. The visual acuity in the patients who lacked photocoagulation was poorer in the younger group. Postoperative recurrent vitreous hemorrhage, corneal epithelial defect, and additional operation rate was more prevalent in the younger group. CONCLUSIONS: We found no significant difference in the overall postoperative results between younger and older patients. Early panretinal photocoagulation and vitrectomy can be helpful to maintain visual function of young patients. Special care is needed to prevent postoperative complications.
Diabetic Retinopathy* ; Humans ; Light Coagulation ; Postoperative Complications ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage ; Young Adult

PURPOSE: To describe an unusual case of rapidly progressive outer retinal necrosis (PORN) with vitreous hemorrhage in a 41-year-old woman with acquired immunodeficiency syndrome (AIDS), who had retinitis developed from what was probably varicellar-zoster virus combined with cytomegalovirus (CMV) and herpes simplex type 1,2, as proven by the polymerase chain reaction restriction fragment length polymorphism method (PCR-RFLP). METHODS: This study is a case report detailing clinical follow-up and an aqueous humor test by PCR-RFLP. RESULTS: The deep, white retinal lesions coalesced and progressively expanded in a circumferential manner, with sparing of the perivascular retina. However, retinal and vitreous hemorrhages, unusual findings for PORN, could be noted around the optic nerve. Varicellar-zoster virus (VZV), cytomegalovirus (CMV), and herpes simplex types 1,2 (HSV-1,2) were detected in the aqueous humor by PCR. CONCLUSIONS: PORN has been described as a variant of necrotizing herpetic retinopathy, occurring particularly in patients with AIDS. Although the etiologic agent has been reported to be VZV, concurrent or combined etiologic agents can include HSV-1, HSV-2, and CMV in AIDS patients. Therefore, combined antiviral therapy with acyclovir and ganciclovir could be more reasonable as an initial therapy.
Vitreous Hemorrhage/*complications ; Retinitis/*complications/pathology/*virology ; Necrosis ; Humans ; *Herpes Zoster ; Female ; Disease Progression ; Adult ; Acquired Immunodeficiency Syndrome/*complications

Submacular hemorrhage from various causes induces the irreversible damage to the retina, leading to poor visual outcome. Surgery for removal of submacular hemorrhage was performed but the general results were not satisfactory in spite of better surgical technique. We took this study to identify the effectiveness and safety of intravitreal injection of tissue plasminogen activator(tPA) and SF6 for displacement of submacular hemorrahge. Thirteen patients who have submacular hemorrhage had undergone intravitreal injection of tPA and SF6 and positioned face down for about 1 week. Postoperative complication, best corrected visual acuity, final visual acuity, amount of displacement related to the duration of submacular hemorrhage and causal diseases were checked retrospectively. The average age of the patients was 64. Six eyes(46.2%) improved visual acuity by 2 lines or more, and 2 eyes(15.4%) lost visual acuity 2 lines or more. Complications included vitreous hemorrhage in 2 eyes, increased intraocular pressure in 2 eyes. Causes were trauma in 3 eyes and age-related macular degeneration in 10 eyes. The final visual results after 5 months or longer were related with macular lesion. Complete displacement was achieved in 10 eyes, partial displacement in 4 eyes at 1 month. The authors concluded that brief prone position after intravitreal injection of tPA and SF6 is rapid and effective method for displacement of submacular hemorrhage.
Hemorrhage* ; Humans ; Intraocular Pressure ; Intravitreal Injections* ; Macular Degeneration ; Plasminogen ; Postoperative Complications ; Prone Position ; Retina ; Retrospective Studies ; Visual Acuity ; Vitreous Hemorrhage

Diabetic Retinopathy ; complications ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Retinal Vein Occlusion ; complications ; Vitrectomy ; Vitreous Hemorrhage ; etiology ; surgery

PURPOSE: To investigate the results of 23-gauge sutureless vitrectomy and preoperative bevacizumab in diabetic retinopathy cases. METHODS: A total of 212 eyes received pars plana vitrectomy by a single surgeon for proliferative diabetic retinopathy and were followed up for at least 6 months. The change of visual acuity and operative complications among the 20-gauge vitrectomy (group I, 86 eyes), 23-gauge vitrectomy (group II, 30 eyes), and 23-gauge vitrectomy with preoperative intravitreal bevacizumab (IVB) injection (group III, 96 eyes) were retrospectively analyzed. RESULTS: One month postoperatively, visual improvement was better in groups II and III than in group I. Three months postoperatively, visual improvement was better in group III than in groups I and II. Six months postoperatively, visual improvement in group III was better than in group I, but there was no significant difference between group II and III. Intraoperative retinal breaks and postoperative vitreous hemorrhage were less common in group III than in groups I and II. CONCLUSIONS: In patients with proliferative diabetic retinopathy, 23-gauge sutureless vitrectomy showed faster visual recovery compared with 20-gauge vitrectomy, and vitrectomy with preoperative bevacizumab had less intraoperative and postoperative complications than vitrectomy without preoperative bevacizumab.
Antibodies, Monoclonal, Humanized ; Diabetic Retinopathy ; Eye ; Humans ; Postoperative Complications ; Retinal Perforations ; Retrospective Studies ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage ; Bevacizumab

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