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 assess the trends in pars plana vitrectomy surgery rates and factors affecting rate change between 2002 and 2013 in South Korea. METHODS: Data from National Health Insurance Service-National Sample Cohort 2002–2013, which represents 1,025,340 samples with a sampling rate of 2.2% from the total eligible Korean population, was analyzed. RESULTS: A total of 3,816 vitrectomy procedures were performed (male, 2,010; female, 1,806) from 2002 to 2013. Annual rates of vitrectomy increased from 15.1 (in 2002) to 49.4 (in 2013) per 100,000 individuals, and this trend was prominent in those aged 60 years or older. As for the anesthetic method, vitrectomy under local anesthesia increased more prominently than vitrectomy under general anesthesia. The most common diagnoses associated with vitrectomy were diabetic retinopathy, retinal detachment, epiretinal membrane, and macular hole. CONCLUSIONS: The average annual rate of vitrectomy surgery was 31.5 per 100,000 between 2002 and 2013, and the rate has steadily increased.
Anesthesia, General ; Anesthesia, Local ; Cohort Studies* ; Diabetic Retinopathy ; Diagnosis ; Epiretinal Membrane ; Female ; Humans ; Incidence ; Korea* ; Methods ; National Health Programs ; Republic of Korea ; Retinal Detachment ; Retinal Perforations ; Vitrectomy*

PURPOSE: To evaluate the clinical effectiveness of pneumatic retinopexy as a treatment method for pseudophakic retinal detachment. METHODS: A retrospective chart review was conducted of medical records of 38 patients who underwent pneumatic retinopexy using SF6 gas from January 2003 to December 2011 and who were observed during a follow-up period longer than 6 months. Primary and final success rates and final visual acuity were analyzed. Primary success was defined as retinal attachment at the last visit without additional surgery. Final success was defined as retinal reattachment at the last visit regardless of additional surgery. RESULTS: The mean patient age was 58.47 ± 17.00 years. All retinal tears were located in the upper retina (from 8 to 4 o'clock). Preoperative mean visual acuity was 1.17 ± 1.00 log MAR, and postoperative mean visual acuity was 0.42 ± 0.48 log MAR. The primary success rate was 61%, and patients with re-detached retina underwent repeat pneumatic retinopexy or other surgery such as scleral buckling or pars plana vitrectomy. At the final visit, all of the patients demonstrated successful results. CONCLUSIONS: Pneumatic retinopexy does not result in strabismus or refractive error, and the final success rate was 66% in our study. Therefore, pneumatic retinopexy can be considered as an effective management technique for some pseudophakic retinal detachment patients.
Follow-Up Studies ; Humans ; Medical Records ; Methods ; Refractive Errors ; Retina ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Retrospective Studies ; Scleral Buckling ; Strabismus ; Treatment Outcome ; Visual Acuity ; Vitrectomy

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

PURPOSE: To evaluate the accuracy of postoperative refractive outcomes of combined phacovitrectomy for epiretinal membrane (ERM) in comparison to cataract surgery alone. MATERIALS AND METHODS: Thirty-nine eyes that underwent combined phacovitrectomy with intraocular lens (IOL) implantation for cataract and ERM (combined surgery group) and 39 eyes that received phacoemulsification for cataract (control group) were analyzed, retrospectively. The predicted preoperative refractive aim was compared with the results of postoperative refraction. RESULTS: In the combined surgery group, refractive prediction error by A-scan and IOLMaster were -0.305+/-0.717 diopters (D) and -0.356+/-0.639 D, respectively, compared to 0.215+/-0.541 and 0.077+/-0.529 in the control group, showing significantly more myopic change compared to the control group (p=0.001 and p=0.002, respectively). Within each group, there was no statistically significant difference in refractive prediction error between A-scan and IOLMaster (all p>0.05). IOL power calculation using adjusted A-scan measurement of axial length based on the macular thickness of the normal contralateral eye still resulted in significant postoperative refractive error (all p<0.05). Postoperative refraction calculated with adjusted axial length based on actual postoperative central foveal thickness change showed the closest value to the actual postoperative achieved refraction (p=0.599). CONCLUSION: Combined phacovitrectomy for ERM resulted in significantly more myopic shift of postoperative refraction, compared to the cataract surgery alone, for both A-scan and IOLMaster. To improve the accuracy of IOL power estimation in eyes with cataract and ERM, sequential surgery for ERM and cataract may need to be considered.
Aged ; Biometry/methods ; Case-Control Studies ; Cataract Extraction ; Epiretinal Membrane/*surgery ; Eye ; Female ; Humans ; *Lens Implantation, Intraocular ; *Lenses, Intraocular ; Male ; Optics and Photonics ; Phacoemulsification/*methods ; Postoperative Period ; Refraction, Ocular/physiology ; Retrospective Studies ; Treatment Outcome ; Vision Tests ; Visual Acuity ; Vitrectomy/*methods

A 58-year-old man admitted to our opthalmology department with the complaint of branch retinal vein occlusion. He was treated with intravitreal Ozurdex in the right eye. Two days after the injection, the patient presented with ocular pain and the visual acuity was hand movement. A diagnosis of endophthalmitis was made. We performed emergent pars plana vitrectomy (PPV) and the implant was removed from the vitreous cavity using a retinal forceps. A combination of vancomycin 1.0 mg and amikacin 0.4 mg was injected intravitreally. However, because of the blurring in the vitreus one week after the procedure, phacoemulsification and a repeat PPV was performed. Five days after the last procedure the signs and symptoms of endophthalmitis were resolved. Our case demonstrated that endophthalmitis could develop after intravitreal implantation of Ozurdex. Surgical removal of the implant and immediate vitrectomy seems to be a useful treatment option in these cases.
Device Removal/methods ; Dexamethasone/administration & dosage/*adverse effects ; Diagnosis, Differential ; Drug Implants/*adverse effects ; Endophthalmitis/diagnosis/*etiology/surgery ; Eye Infections, Bacterial/diagnosis/*etiology/surgery ; Glucocorticoids/administration & dosage/adverse effects ; Humans ; Intravitreal Injections/adverse effects ; Male ; Middle Aged ; Retinal Vein Occlusion/diagnosis/*drug therapy ; Vitrectomy

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

PURPOSE: To evaluate the causes of secondary macular hole after vitrectomy and the possibility of their prevention. METHODS: 27 patients (28 eyes) who experienced macular hole formation after vitrectomy were reviewed retrospectively. Age, sex, operation methods, duration between the vitrectomy and the secondary macular hole surgery and causes of the primary vitrectomy were recorded. Best-corrected visual acuity (BCVA) before and after primary vitrectomy; preoperative and postoperative macular findings with optical coherence tomography and fundus examination; and BCVA before and after macular hole surgery were analyzed. RESULTS: Of the 2945 eyes that had undergone vitrectomy, 28 eyes (0.96%) experienced macular hole formation. As causes of primary vitrectomy, 12 eyes had proliferative diabetic retinopathy, 6 eyes had rhegmatogenous retinal detachment, 2 eyes had branch retinal vein occlusion, 3 eyes had age-related macular degeneration and 5 eyes had trauma such as eyeball rupture or intraocular foreign body. The mean duration between primary vitrectomy and macular hole formation was 20.4 months (4 days-115 months). The estimated causes of macular hole formation included cystoid macular edema (CME) (n = 13), thinning of the macula (n = 6), thickening of internal limiting membrane or recurrence of preretinal membrane (PRM) (n = 7), recurrence of subretinal hemorrhage (n = 1) and macular damage during vitrectomy (n = 2). Final BCVA after macular hole surgery decreased in most cases compared to BCVA before macular hole formation except in 7 eyes (25%). CONCLUSIONS: Close observation of the macula after primary vitrectomy especially in eyes with continuous CME, and recurrent PRM and proper management on them including timely removal of the tangential traction force are necessary for preventing macular hole formation. In addition, surgeons should make efforts not to exert excessive tractional force on the macula to avoid iatrogenic damage during removal of the preretinal membrane.
Diabetic Retinopathy ; Foreign Bodies ; Hemorrhage ; Humans ; Macular Degeneration ; Macular Edema ; Membranes ; Methods ; Recurrence ; Retinal Detachment ; Retinal Perforations* ; Retinal Vein Occlusion ; Retrospective Studies ; Rupture ; Tomography, Optical Coherence ; Traction ; Visual Acuity ; Vitrectomy*

In this case series, we assessed a new technique, the intrascleral pocket procedure of transscleral fixation (TF) of the intraocular lens (IOL) in post-vitrectomized eyes. We performed the transscleral fixation of IOL in four aphakic patients who underwent pars plana vitrectomy. Two points 180degrees apart were marked at the limbus. A 2-mm-sized intrascleral pocket was created by lamellar dissection using a crescent blade without conjunctival dissection. A 2.8-mm clear corneal incision (CCI) was made using a keratome. Prolene sutures were exteriorized through the CCI pocket and a three-piece foldable acrylic IOL was injected via CCI and the ends of the haptics were exteriorized through the CCI. The prolene sutures for each haptic in the intrascleral pocket bed were then tied and knots were buried under scleral flaps. No patient had complaints such as conjunctival irritation, and visual acuity was almost identical to preoperative best-corrected visual acuity at day 1 postoperatively. IOLs were well placed without tilting or subluxation. They had no wound dehiscence or endophthalmitis postoperatively. The intrascleral pocket procedure of TF without the need for conjunctival dissection is a successful method for sulcus fixation in post-vitrectomized eyes predisposed to developing glaucoma.
Aged ; Aged, 80 and over ; Aphakia/*surgery ; Female ; Humans ; Lens Implantation, Intraocular/*methods ; *Lenses, Intraocular ; Male ; Middle Aged ; Sclera/*surgery ; Sutures ; Treatment Outcome ; *Vitrectomy

PURPOSE: The 2.2-mm microincision cataract surgery and small-gauge vitrectomy system is known to result in less surgically-induced astigmatism (SIA) in comparison to conventional surgical methods. We compared the amounts of SIA after combined phacoemulsification and 23-gauge transconjunctival sutureless vitrectomy (23G-TSV) using the 2.2-mm microincision and 2.75-mm standard incision methods. METHODS: We studied 59 patients (61 eyes) who underwent combined phacoemulsification and 23G-TSV from November 2008 to September 2012. Twenty-eight patients (28 eyes) underwent 2.2-mm microincision coaxial phacoemulsification, and 31 patients (33 eyes) underwent 2.75-mm standard incision phacoemulsification. SIA was evaluated using Naeser's polar method with the simulated keratometric values obtained from corneal topography. Preoperative and 1-week and 1-month postoperative KP (Naeser's polar value along the specific axis) and DeltaKP values were compared between the 2.2-mm microincision and 2.75-mm standard incision groups. RESULTS: One week after surgery, both groups exhibited similar amounts of SIA (-DeltaKP[120], 0.40 +/- 0.41 vs. 0.51 +/- 0.56 diopters [D]; p = 0.390). One month after surgery, however, the amount of SIA was significantly smaller in the 2.2-mm microincision group as compared to the 2.75-mm standard incision group (-DeltaKP[120], 0.31 +/- 0.54 vs. 0.56 +/- 0.42 D; p = 0.045). CONCLUSIONS: In combined phacoemulsification with 23G-TSV, 2.2-mm microincision coaxial phacoemulsification induces less SIA than does 2.75-mm standard coaxial phacoemulsification.
Aged ; Astigmatism/diagnosis/*etiology ; *Cataract ; Cornea/surgery ; Corneal Topography/methods ; Female ; Humans ; Lens Implantation, Intraocular/*adverse effects/methods ; Male ; Middle Aged ; Phacoemulsification/*adverse effects/methods ; Postoperative Complications/diagnosis/etiology ; Sclera/surgery ; Vitrectomy/*adverse effects/instrumentation/methods