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Results of pars plana vitrectomy in 24 cases of endophthalmitis.  [cached]
Gadkari S,Kamdar P,Jehangir R,Shah N
Journal of Postgraduate Medicine , 1991,
Abstract: Twenty four cases of endophthalmitis were subjected to pars plana vitrectomy. A final vitreous clearance was obtained in 62.50% cases. Visual improvement occurred in 41.67% cases. It was concluded that prompt detection and early and vigorous therapy--medical and surgical--is the mainstay in the management of endophthalmitis.
Pars plana vitrectomy and silicone oil tamponade for acute endophthalmitis treatment
Siqueira, Rubens Camargo;Gil, Aline Degasperi Cote;Canamary, Fabio;Minari, Mirian;Jorge, Rodrigo;
Arquivos Brasileiros de Oftalmologia , 2009, DOI: 10.1590/S0004-27492009000100006
Abstract: purpose: to evaluate the outcomes of pars plana vitrectomy and silicone oil injection for the treatment of infectious endophthalmitis. methods: 35 cases of endophthalmitis secondary to phacoemulsification (20 patients), trabeculectomy (8 patients), perforating trauma (2 patients), trauma (2 patients), corneal transplantation (1 patient), vitrectomy (1 patient) and corneal ulceration (1 patient) were retrospectively studied. patients were separated into two groups: group 1 (n=24): intravitreal antibiotic injection, associated with topical and oral antibiotics; group 2 (n=11): vitrectomy with intravitreal antibiotic injection and silicone oil injection. the follow-up ranged from 1 to 48 months (mean of 16 months). results: from 24 patients in group 1, 11 patients (45.83%), had infection controlled with intravitreal antibiotic injection only; 13 patients (54.15%) regressed to uncontrolled endophthalmitis, in which two patients (8.33%) were submitted to evisceration and one patient (4.16%) had corneal melting. the remaining 10 patients (41.66%) with uncontrolled endophthalmitis were submitted to pars plana vitrectomy and silicone oil injection. six patients (25%) from group i had retinal detachment during the first month of follow-up and also required pars plana vitrectomy and silicone oil injection. in group 2 patients (n=11), all of them had controlled infection at the first procedure. in one case (9.09%), a severe proliferatative vitreoretinopathy induced loss of vision. conclusion: these results suggest that silicone oil tamponade might be beneficial in the treatment strategy of infectious endophthalmitis.
Clinical profile and visual outcome following pars plana vitrectomy in acute post-operative endophthalmitis  [PDF]
R Thapa,G Paudyal
Nepalese Journal of Ophthalmology , 2011, DOI: 10.3126/nepjoph.v3i2.5260
Abstract: Introduction: Endophthalmitis following cataract surgery is a rare but devastating ocular complication where delay in treatment not only results in vision loss but also in difficulty to save the eye ball. Objective: To explore the clinical profile and visual outcome following pars plana vitrectomy (PPV) in acute endophthalmitis after cataract surgery. Materials and methods: This is a retrospective interventional case series study conducted at Tilganga Institute of Ophthalmology (TIO), Nepal. All consecutive cases of acute endophthalmitis following cataract surgery treated with PPV from January 2005 to August 2010 were included in the study. Results: There were a total of 34 cases (34 eyes) treated with PPV. The age range was 8 - 93 years with mean age of 56.9 ± 19.5 years. The mean duration of presentation and duration following cataract surgery was 7.7 ± 8.1days and 13 ± 11.6 days respectively. Small incision cataract surgery was done in 75 % of cases followed by phacoemulsification (15.6 %). The mean duration of the last follow -up was 4.3 months. Vision was improved in two-thirds of cases (67.67 %) with a good vision of 6/18 or better in 17.6 %. Among the available vitreous samples of 22 cases, 36.36 % had an abnormality in Gram and Giemsa stains and culture was positive in 13.6 % of cases. Conclusion: Despite the late presentation, the majority of eyes were salvaged with improvement of vision in 67.67 %, with a good vision of 6/18 or better in 17.6 4 % of cases following PPV in acute post operative endophthalmitis. Key words: Endophthalmitis, vitrectomy, cataract surgery, visual outcome DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5260 Nepal J Ophthalmol 2011; 3(2): 102-108
Transconjunctival 25-gauge pars plana vitrectomy and internal limiting membrane peeling for chronic macular edema  [cached]
Cho M,D'Amico DJ
Clinical Ophthalmology , 2012,
Abstract: Minhee Cho, Donald J D'AmicoWeill Cornell Medical College, Department of Ophthalmology, New York, NY, USABackground: The purpose of this study was to investigate the visual and anatomic outcomes in patients with chronic macular edema who underwent 25-gauge pars plana vitrectomy with internal limiting membrane peeling.Methods: This study was a retrospective chart review of 24 eyes from 21 patients who underwent 25-gauge pars plana vitrectomy and indocyanine green-assisted internal limiting membrane peeling for chronic macular edema. Preoperative and postoperative spectral-domain optical coherence tomography (OCT) was examined for macular thickness and macular volume. Outcomes and variables were analyzed using the two-tailed t-test and Spearman's rank correlation coefficient.Results: Twenty-four eyes from 11 men and 10 women of mean age 69 (range 55–84) years were included. Four patients (17%) had chronic macular edema from uveitis, four (17%) from retinal vein occlusion, and 16 (67%) from diabetes. Mean visual acuity was 20/103 preoperatively and 20/87 postoperatively (P = 0.55). Sixty-three percent of the eyes had improved vision (47% better than 20/40), 21% maintained the same vision, and 17% had worse vision. Forty-seven percent of improved eyes and 30% of total eyes gained more than two lines of visual acuity (range -9 to +7 lines). Mean macular thickness was 455 μm preoperatively and 396 μm postoperatively (P = 0.29). Mean macular volume was 7.9 mm3 preoperatively and 7.5 mm3 postoperatively (P = 0.51). The strongest predictor of postoperative visual acuity was initial visual acuity (r = 0.673, P = 0.0003).Conclusion: Even though a majority of patients had improved vision and decreased macular thickening after 25-gauge pars plana vitrectomy with internal limiting membrane peeling for chronic macular edema of various etiologies, the difference in visual acuity or macular thickening did not reach statistical significance.Keywords: chronic macular edema, diabetes mellitus, internal limiting membrane peeling, 25-gauge vitrectomy, uveitis, vein occlusion
Transconjunctival 25-gauge pars plana vitrectomy and internal limiting membrane peeling for chronic macular edema
Cho M, D'Amico DJ
Clinical Ophthalmology , 2012, DOI: http://dx.doi.org/10.2147/OPTH.S33391
Abstract: ansconjunctival 25-gauge pars plana vitrectomy and internal limiting membrane peeling for chronic macular edema Original Research (1354) Total Article Views Authors: Cho M, D'Amico DJ Published Date July 2012 Volume 2012:6 Pages 981 - 989 DOI: http://dx.doi.org/10.2147/OPTH.S33391 Received: 28 April 2012 Accepted: 15 May 2012 Published: 06 July 2012 Minhee Cho, Donald J D'Amico Weill Cornell Medical College, Department of Ophthalmology, New York, NY, USA Background: The purpose of this study was to investigate the visual and anatomic outcomes in patients with chronic macular edema who underwent 25-gauge pars plana vitrectomy with internal limiting membrane peeling. Methods: This study was a retrospective chart review of 24 eyes from 21 patients who underwent 25-gauge pars plana vitrectomy and indocyanine green-assisted internal limiting membrane peeling for chronic macular edema. Preoperative and postoperative spectral-domain optical coherence tomography (OCT) was examined for macular thickness and macular volume. Outcomes and variables were analyzed using the two-tailed t-test and Spearman's rank correlation coefficient. Results: Twenty-four eyes from 11 men and 10 women of mean age 69 (range 55–84) years were included. Four patients (17%) had chronic macular edema from uveitis, four (17%) from retinal vein occlusion, and 16 (67%) from diabetes. Mean visual acuity was 20/103 preoperatively and 20/87 postoperatively (P = 0.55). Sixty-three percent of the eyes had improved vision (47% better than 20/40), 21% maintained the same vision, and 17% had worse vision. Forty-seven percent of improved eyes and 30% of total eyes gained more than two lines of visual acuity (range -9 to +7 lines). Mean macular thickness was 455 μm preoperatively and 396 μm postoperatively (P = 0.29). Mean macular volume was 7.9 mm3 preoperatively and 7.5 mm3 postoperatively (P = 0.51). The strongest predictor of postoperative visual acuity was initial visual acuity (r = 0.673, P = 0.0003). Conclusion: Even though a majority of patients had improved vision and decreased macular thickening after 25-gauge pars plana vitrectomy with internal limiting membrane peeling for chronic macular edema of various etiologies, the difference in visual acuity or macular thickening did not reach statistical significance.
Use of 25% sulfur hexafluoride gas mixture may minimize short-term postoperative hypotony in sutureless 25-gauge pars plana vitrectomy surgery  [cached]
Barak Y,Heroman JW,Schaal S
Clinical Ophthalmology , 2013,
Abstract: Yoreh Barak, James W Heroman, Shlomit SchaalDepartment of Ophthalmology and Visual Sciences, University of Louisville, Louisville, KY, USABackground: The purpose of this study was to compare postoperative intraocular pressures and percentage of vitreous cavity gas fill one day following 25-gauge pars plana vitrectomy with 20% versus 25% sulfur hexafluoride (SF6) gas fill.Methods: This was a retrospective review of 187 consecutive cases of 25-gauge pars plana vitrectomy with complete fluid/gas exchange. The main outcome measures included percentage of gas fill of the vitreous cavity and intraocular pressure on postoperative day one.Results: Fifty eyes underwent 25-gauge pars plana vitrectomy with 20% SF6 tamponade and 137 with 25% SF6 tamponade. On postoperative day one in the 20% SF6 group, there were five (10%) patients with hypotony (intraocular pressure ≤ 5 mmHg) and none in the 25% SF6 group. Mean intraocular pressure was 9 ± 2.5 mmHg and 16.8 ± 2.4 mmHg for the 20% SF6 and 25% SF6 groups, respectively (P < 0.01). None of the patients had postoperative intraocular pressure > 23 mmHg. Mean vitreous cavity gas fill on postoperative day one was 70.7% ± 10% in the 20% SF6 group and 89.5% ± 2.2% in the 25% SF6 group (P < 0.01). There was no difference in the number of phakic patients needing cataract surgery between the groups.Conclusion: A slightly expansile concentration of 25% SF6 gas can be safely and beneficially used in 25-gauge vitrectomy surgery to increase the amount of gas fill in the vitreous cavity and prevent postoperative hypotony.Keywords: hypotony, 25-gauge pars plana vitrectomy, sulfur hexafluoride
Acute endophthalmitis following 23-gauge sutureless transconjunctival vitrectomy
?eki? Osman,?akir Mehmet,Yazgan Serpil,Yilmaz ?
Indian Journal of Ophthalmology , 2011,
Abstract: We report a case that developed acute postoperative endophthalmitis after transconjunctival sutureless vitrectomy using the 23-gauge system. A 66-year-old man underwent non-sutured 23-gauge pars plana vitrectomy for epimacular membrane. Since the patient developed signs of acute endophthalmitis and decreased visual acuity to counting fingers on the second postoperative day, re-vitrectomy with silicone oil was performed. The patient responded well to re-vitrectomy, injection of silicone oil and intravitreal antibiotic injections. Methicillin resistant Staphylococcus epidermidis was cultured from vitreous samples. Silicone oil was extracted at 11 months. The patient remains stable at 14 months with a final visual acuity of 20/50.
Combined 20-gauge and 23-gauge pars plana vitrectomy for the management of posteriorly dislocated lens: a case series
Pipat Kongsap
Clinical Ophthalmology , 2010, DOI: http://dx.doi.org/10.2147/OPTH.S11837
Abstract: mbined 20-gauge and 23-gauge pars plana vitrectomy for the management of posteriorly dislocated lens: a case series Case Series (4726) Total Article Views Authors: Pipat Kongsap Published Date June 2010 Volume 2010:4 Pages 625 - 628 DOI: http://dx.doi.org/10.2147/OPTH.S11837 Pipat Kongsap Department of Ophthalmology, Prapokklao Hospital, Chanthaburi, Thailand; Affiliated with the Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand Objective: To present a new surgical approach for the management of posteriorly dislocated lens by using a combination of 20-gauge (20G) and 23-gauge (23G) pars plana vitrectomy. Design: An interventional case series Methods: This technique was performed on six patients (five men, one woman; mean age, 66.67 years; range, 66–72 years). Two 23G trans-conjunctival sclerotomy ports were created for infusion and illumination along with a 20G sclerotomy port for introducing the vitrectomy probe or fragmatome. Results: This procedure was successfully performed on six eyes. On postoperative day one, the media were clear and the retina could be seen by indirect ophthalmoscopy. Hyphema developed in one eye and resolved within a week. There were no observed cases of retinal tear, wound leakage, hypotony, or endophthalmitis. The post-operative follow-up period ranged from three to twelve months (mean, 8.1 months). By the final visit, two patients had achieved a visual acuity of 20/40 or better, three patients, 20/70, and one patient, 20/200. Conclusion: The combination of 20G and 23G pars plana vitrectomy is an efficacious and safe procedure for management of posteriorly dislocated lens.
Use of 25% sulfur hexafluoride gas mixture may minimize short-term postoperative hypotony in sutureless 25-gauge pars plana vitrectomy surgery
Barak Y, Heroman JW, Schaal S
Clinical Ophthalmology , 2013, DOI: http://dx.doi.org/10.2147/OPTH.S40108
Abstract: e of 25% sulfur hexafluoride gas mixture may minimize short-term postoperative hypotony in sutureless 25-gauge pars plana vitrectomy surgery Original Research (480) Total Article Views Authors: Barak Y, Heroman JW, Schaal S Published Date February 2013 Volume 2013:7 Pages 423 - 426 DOI: http://dx.doi.org/10.2147/OPTH.S40108 Received: 08 November 2012 Accepted: 11 December 2012 Published: 28 February 2013 Yoreh Barak, James W Heroman, Shlomit Schaal Department of Ophthalmology and Visual Sciences, University of Louisville, Louisville, KY, USA Background: The purpose of this study was to compare postoperative intraocular pressures and percentage of vitreous cavity gas fill one day following 25-gauge pars plana vitrectomy with 20% versus 25% sulfur hexafluoride (SF6) gas fill. Methods: This was a retrospective review of 187 consecutive cases of 25-gauge pars plana vitrectomy with complete fluid/gas exchange. The main outcome measures included percentage of gas fill of the vitreous cavity and intraocular pressure on postoperative day one. Results: Fifty eyes underwent 25-gauge pars plana vitrectomy with 20% SF6 tamponade and 137 with 25% SF6 tamponade. On postoperative day one in the 20% SF6 group, there were five (10%) patients with hypotony (intraocular pressure ≤ 5 mmHg) and none in the 25% SF6 group. Mean intraocular pressure was 9 ± 2.5 mmHg and 16.8 ± 2.4 mmHg for the 20% SF6 and 25% SF6 groups, respectively (P < 0.01). None of the patients had postoperative intraocular pressure > 23 mmHg. Mean vitreous cavity gas fill on postoperative day one was 70.7% ± 10% in the 20% SF6 group and 89.5% ± 2.2% in the 25% SF6 group (P < 0.01). There was no difference in the number of phakic patients needing cataract surgery between the groups. Conclusion: A slightly expansile concentration of 25% SF6 gas can be safely and beneficially used in 25-gauge vitrectomy surgery to increase the amount of gas fill in the vitreous cavity and prevent postoperative hypotony.
Combined 20-gauge and 23-gauge pars plana vitrectomy for the management of posteriorly dislocated lens: a case series  [cached]
Pipat Kongsap
Clinical Ophthalmology , 2010,
Abstract: Pipat KongsapDepartment of Ophthalmology, Prapokklao Hospital, Chanthaburi, Thailand; Affiliated with the Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandObjective: To present a new surgical approach for the management of posteriorly dislocated lens by using a combination of 20-gauge (20G) and 23-gauge (23G) pars plana vitrectomy.Design: An interventional case seriesMethods: This technique was performed on six patients (five men, one woman; mean age, 66.67 years; range, 66–72 years). Two 23G trans-conjunctival sclerotomy ports were created for infusion and illumination along with a 20G sclerotomy port for introducing the vitrectomy probe or fragmatome.Results: This procedure was successfully performed on six eyes. On postoperative day one, the media were clear and the retina could be seen by indirect ophthalmoscopy. Hyphema developed in one eye and resolved within a week. There were no observed cases of retinal tear, wound leakage, hypotony, or endophthalmitis. The post-operative follow-up period ranged from three to twelve months (mean, 8.1 months). By the final visit, two patients had achieved a visual acuity of 20/40 or better, three patients, 20/70, and one patient, 20/200.Conclusion: The combination of 20G and 23G pars plana vitrectomy is an efficacious and safe procedure for management of posteriorly dislocated lens.Keywords: lensectomy, fragmatome, sutureless vitrectomy
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