Silicone oil has been used successfully in vitreoretinal surgery for many years. But complications from the use of silicone oil as a long-acting internal tamponade may develop. They include glaucoma, keratopathy, oil emulsification, and cataract. For patients requiring silicone oil removal and cataract surgery, both operations can be performed in a combined procedure. After phacoemulsification, a posterior continuous curvilinear capsulorhexis(PCCC) is performed, followed by irrigation of balanced salt solution(BSS)into vitreous cavity allowing flow out of silicone oil through the PCCC and intraocular lens(IOL)is implanted into remaining capsular bag. This technique offers faster visual rehabilitation, shorter operation time and reduces the risk of peripheral retinal defect, vitreous hemorrhage that may be caused by traditional oil removal through sclerostomy.
Capsulorhexis* ; Cataract ; Glaucoma ; Humans ; Phacoemulsification* ; Rehabilitation ; Retinaldehyde ; Sclerostomy ; Silicone Oils* ; Vitreoretinal Surgery ; Vitreous Hemorrhage

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

OBJECTIVES: To assess the inadvertent intraocular retention of perfluorocarbon liquid (PFCL) after vitreoretinal surgery and their complications. METHODS: We retrospectively reviewed the medical records of 108 patients who underwent vitreoretinal surgeries using intraoperative PFCL (perfluoro-n-octane (C8F18), 0.69 centistoke at 25degrees C, PERFLUORN(R), Alcon, USA) and the removal of PFCL through fluid-air exchange. The analysis was focused on the occurrence of intraocular retained PFCL, diagnoses,surgicalprocedures,andcomplications. RESULTS: Retinal detachment (51 cases, 47%) was the most common surgery which used PFCL intraoperatively. Other causes were vitreous hemorrhage (24 cases, 22%), posteriorly dislocated lens (22 cases, 21%), and trauma (11 cases, 10%). Intraocular PFCL was found in a total of 9 (8.3%) eyes. PFCL bubbles remained in anterior chamber and vitreous cavity were observed in 4 cases and subretinal retained PFCL was observed in 5 cases. Three of 5 cases of subretinal PFCL exhibited in subfoveal space. Among the three subfoveal cases, macular hole developed after PFCL removal in 1 case, epiretinal membrane in the area where had been PFCL bubble. However, we observed no complications in 1 case of subfoveal PFCL that was removed by surgery. PFCL in anterior chamber and vitreous cavity were in 4 cases. CONCLUSIONS: The presence of subfoveal PFCL might affect visual and anatomic outcomes. However, subfoveal PFCL may induce visual complications, and therefore requires special attention.
Anterior Chamber ; Epiretinal Membrane ; Humans ; Medical Records ; Retinal Detachment ; Retinal Perforations ; Retrospective Studies ; Vitrectomy* ; Vitreoretinal Surgery ; Vitreous Hemorrhage

OBJECTIVETo examine the prognosis of preretinal hemorrhage following vitrectomy and silicone oil tamponade for severe proliferative diabetic retinopathy.

METHODSClinical data of 76 cases of proliferative diabetic retinopathy treated with vitrectomy and silicone oil infusion tamponade in Sir Run Run Shaw Hospital from October 2006 to September 2013 were retrospectively reviewed. Intraoperative bleeding,postoperative preretinal bleeding,blood reabsorption time, and preretinal fibrosis were assessed.

RESULTSAll preretinal hemorrhage developed within 1 week after surgery, blood was distributed in thin and scattered patterns (32 cases), thick and localized patterns (25 cases) or thick and scattered patterns (19 cases). The preretinal hemorrhage was ceased in 1 day after operation in 35 cases, in 2 days after operation in 18 cases, in two weeks after operation in 23 case. Recurrent hemorrhage occurred within 1 week after operation in 15 cases. Thin blood was largely reabsorbed in about two weeks, and thick blood was largely reabsorbed in about five weeks. Fibrosis tissue was resulted in 15 cases(34.1%) with thick blood.

CONCLUSIONMost of preretinal hemorrhage occurs within 1 week after surgery and is reabsorpted with 5 weeks in patients with proliferative diabetic retinopathy undergoing vitrectomy and silicone oil tamponade. The major complication of preretinal bleeding is the formation of preretinal fibrosis.

Diabetic Retinopathy ; surgery ; Fibrosis ; Humans ; Postoperative Complications ; Prognosis ; Retrospective Studies ; Silicone Oils ; therapeutic use ; Vitrectomy ; Vitreous Hemorrhage ; epidemiology

The authors report two cases of X-linked juvenile retinoschisis (XLRS) manifested as bilateral vitreous hemorrhage as early as in an 1-month-old infant and in a 3-month-old infant. The one-month-old male infant showed massive bilateral vitreous hemorrhage. During vitrectomy, thin membrane representing an inner part of schisis cavity was excised and intraschisis hemorrhage was evacuated. As intraschisis cavities were cleared, the stump of inner layer appeared as the demarcation line between the outer layer of the schisis retina and non-schisis retina. The other three-month-old male infant presenting with esodeviation also showed bilateral vitreous hemorrhage. Typical bilateral retinoschisis involving maculae could be seen through vitreous hemorrhage in both eyes on fundus examination. Spontaneous absorption of hemorrhage was observed on regular follow-up. XLRS could be manifested as massive hemorrhage inside or outside of the schisis cavity early in infancy.
Diagnosis, Differential ; Electroretinography ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Male ; Retinoschisis/*complications/diagnosis ; Vitrectomy ; Vitreous Hemorrhage/diagnosis/*etiology/surgery

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

PURPOSE: To evaluate the efficacy and safety of vitreoretinal surgery using a 23-gauge transconjunctival sutureless vitrectomy (TSV) system for various vitreoretinal diseases. METHODS: A retrospective, consecutive, interventional case series was performed for 40 eyes of 40 patients. The patients underwent vitreoretinal procedures using the 23-gauge TSV system, including idiopathic epiretinal membrane (n=7), vitreous hemorrhage (n=11), diabetic macular edema (n=10), macular hole (n=5), vitreomacular traction syndrome (n=5), diabetic tractional retinal detachment (n=1), and rhegmatogenous retinal detachment (n=1). Best corrected visual acuity (BCVA), intraocular pressure (IOP), and intra- and post-operative complications were evaluated. RESULTS: Intraoperative suture placement was necessary in 3 eyes (7.5%). The median BCVA improved from 20/400 (LogMAR, 1.21+/-0.63) to 20/140 (LogMAR, 0.83+/-0.48) at 1 week (p=0.003), 20/100 (LogMAR, 0.85+/-0.65) at 1 month (p=0.002), 20/100 (LogMAR, 0.73+/-0.6) at 3 months (p=0.001). In 1 eye, IOP was 5 mmHg at 2 hours and 4 mmHg at 5 hours, but none of the eyes showed hypotony after 1 postoperative day. No serous postoperative complications were observed during a mean follow-up of 8.4+/-3.4 months (range 3-13 months) CONCLUSIONS: The 23-gauge TSV system shows promise as an effective and safe technique for a variety of vitreoretinal procedures. It appears to be a less traumatic, more convenient alternative to 20-gauge vitrectomy in some indications.
Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Male ; Middle Aged ; Retinal Diseases/*surgery ; Retrospective Studies ; *Suture Techniques ; Treatment Outcome ; Visual Acuity ; Vitrectomy/*methods ; Vitreous Hemorrhage/*surgery

In the process of closing scleral wounds caused by various conditions, incarceration of conjunctiva, Tenon's capsule, or vitreous in the wound can occur unexpectedly. We created such conditions experimentally in order to discover their intraocular complications. The experimental materials consisted of 12 albino rabbits (24 eyes) divided into two groups (Groups I & II). Vitrectomy was performed in the Group I rabbits (12 eyes) but not in the Group II rabbits (12 eyes). Flaps of conjunctiva and Tenon's capsule were made and inserted into the vitreous cavity through the sclerotomy site, which was soon closed. Fundal examination of the rabbits was carried out using an indirect ophthalmoscope at intervals after the procedure; first at 3 days, then at 1, 3, and 6 weeks, and then at 3 months and 6 months, respectively. Enucleation of the rabbits' eyes 4 from two different rabbits at each of these intervals was carried out, and the extracted eyes were examined under a light microscope at each interval. The results are summarized as follows: 1. All rabbit eyes studied showed intraocular fibrovascular proliferation. 2. The extent of tissue proliferation, which was proportional to the amount of vitreous hemorrhage, was greater in Group II than in Group I. 3. The proliferated tissue developed to "band" by three weeks postexperiment, after which it gradually regressed. 4. The fibrovascular band was made of fibroblasts, stromal matrix, and capillaries.
Animals ; Cell Division ; Conjunctiva/pathology ; Eye Injuries/surgery ; Fundus Oculi ; Postoperative Complications ; Rabbits ; Retinal Diseases/pathology ; Retinal Vessels/*pathology ; Sclera/*surgery ; Vitrectomy ; Vitreous Hemorrhage/pathology

INTRODUCTIONTo report surgical outcomes of 25-gauge transconjunctival vitrectomy combined with cataract surgery for the management of a variety of vitreoretinal diseases.

MATERIALS AND METHODSA retrospective, interventional case study was conducted. Chart review of a consecutive series of 150 eyes of 144 patients who underwent 25-gauge vitrectomy combined with phacoemulsification and intraocular lens implantation for epiretinal membrane (n = 62), refractory macular oedema associated with retinal vascular disorders (n = 29), idiopathic macular hole (n = 21), non-clearing vitreous haemorrhage (n = 18), rhegmatogenous retinal detachment (n = 11), tractional retinal detachment associated with proliferative diabetic retinopathy (n = 7), and subretinal haemorrhage (n = 2). Main outcome measures included preand postoperative visual acuity, operating time, intraocular pressure, intra- and postoperative complications.

RESULTSThe mean follow-up period was 9.7 months (range, 6 to 26). The mean overall visual acuity improved from 20/100 preoperatively to 20/38 at final visit (P <0.001). Statistically significant improvement of visual acuity was also observed in each subgroup. Operative time was shortened in macular surgery. No intraoperative complications were noted attributable to small-gauge instruments and no cases required conversion to 20-gauge standard instrumentation. However, 12 eyes (8%) required suture placement to at least one sclerotomy site. Postoperative intraocular pressure remained stable in most cases except 18 eyes (13%) with transient hypotony during the first week after surgery. One case of retinal detachment but no case of endophthalmitis was observed throughout the follow-up period.

CONCLUSIONS25-gauge vitrectomy combined with cataract surgery is a safe and effective system for the management of a variety of vitreoretinal diseases, especially cases requiring minimal intraocular manipulation. Further study is recommended to evaluate potential postoperative complications.

Aged ; Female ; Humans ; Lens Implantation, Intraocular ; Male ; Middle Aged ; Phacoemulsification ; Retinal Diseases ; complications ; surgery ; Treatment Outcome ; Vitrectomy ; methods ; Vitreous Hemorrhage ; complications ; surgery

Examination of a 36-year-old man with naked visual acuity of 20/20 revealed a floating, conspicuous cyst of Cysticercus cellulosae in the vitreous cavity of the right eye. A vitreous traction band from the vitreous base and the optic disc was connected to the lodging bulb of the cyst. In the superonasal area, an ovoid retinal break surrounded by a white retinal lesion with two elliptical retinal hemorrhages was found, and this seems to be the previous lodging site of the cyst. A pars plana vitrectomy was performed to remove the parasite, and laser photocoagulation was carried out around the retinal break. Four months after the operation, the patient was satisfied with naked visual acuity of 25/20 without any complication in the affected eye.
Adult ; Animals ; Cysticercosis/*diagnosis/physiopathology/surgery ; Cysticercus/*isolation & purification ; Eye Diseases/diagnosis ; Eye Infections, Parasitic/*diagnosis/physiopathology/surgery ; Humans ; Laser Coagulation ; Male ; Retinal Hemorrhage/etiology/surgery ; Retinal Perforations/etiology/surgery ; Visual Acuity ; Vitrectomy ; Vitreous Body/*parasitology/surgery