1,720,987 research outputs found
Cauterization for the prevention of leaking sclerotomies after 23-gauge transconjunctival pars plana vitrectomy: an easy way to obtain sclerotomy closure.
No full textINTRAVITREAL DEXAMETHASONE IMPLANT FOR REFRACTORY MACULAR EDEMA SECONDARY TO VITRECTOMY FOR MACULAR PUCKER.
Full text linkPurpose: To study the efficacy of a single 0.7 mg dexamethasone intravitreal implant in vitrectomized eyes with refractory macular edema secondary to combined cataract extraction and macular pucker removal.
Methods: In 8 eyes of 8 consecutive patients with refractory macular edema secondary to combined cataract extraction and 25-gauge vitrectomy with internal limiting membrane peeling for macular pucker removal, the injection of the 0.7 mg dexamethasone implant was performed. Best-corrected visual acuity, central retinal thickness measured by spectral domain optical coherence tomography, and intraocular pressure were evaluated at baseline, 1 month, and 6 months.
Results: After a mean follow-up of 6.75 +/- 0.71 months, best-corrected visual acuity was significantly increased (P < 0.0001) from 20/50 to 20/23 (P < 0.0001), mean central retinal thickness decreased significantly from 439 +/- 45 [mu]m to 296 +/- 49 [mu]m (P < 0.0001), and intraocular pressure changed significantly (P = 0.02) from 14.63 +/- 1.19 to 16 +/- 0.93. In no case postoperative hypotony or other complication was observed.
Conclusion: A single injection of the 0.7 mg dexamethasone intravitreal implant resulted effective in the treatment of refractory macular edema secondary to combined cataract extraction and vitrectomy for macular pucker removal allowing a stable visual acuity recovery
Cauterization for the prevention of leaking sclerotomies after 23-gauge transconjunctival pars plana vitrectomy: an easy way to obtain sclerotomy closure.
No full textCauterization for the prevention of leaking sclerotomies after 23-gauge
transconjunctival pars plana vitrectomy: an easy way to obtain sclerotomy
closure
Anterior capsule staining using micronized triamcinolone in the absence of red reflex.
No full textWe describe a technique to stain the anterior lens capsule with micronized triamcinolone to perform a continuous curvilinear capsulorhexis (CCC) during phacoemulsification in the absence of a red reflex due to vitreous hemorrhage. After a self-sealing clear corneal tunnel incision is performed using a 2.75 mm blade, a dispersive ophthalmic viscosurgical device (OVD) is injected to protect the iridocorneal angle. An air bubble as large as possible is injected into the center of the anterior chamber, and a small amount of micronized triamcinolone is then injected as needed to stain the anterior lens capsule. The OVD injection permits the removal of excessive triamcinolone and protects the corneal endothelium from damage during phacoemulsification. A capsulorhexis forceps is used to perform the CCC. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned
Oxane HD vs silicone oil and scleral buckle in retinal detachment with proliferative vitreoretinopathy and inferior retinal breaks.
No full textBACKGROUND: To compare pars plana vitrectomy (PPV) with 1300 cs silicone oil and scleral buckle (SB) vs PPV with Oxane HD tamponade for rhegmatogenous retinal detachment (RRD) with inferior retinal breaks (IRB).
METHODS: Twenty eyes of 20 consecutive patients with primary inferior RRD and PVR >or=CP2 were alternatively assigned to PPV and 1300 cs silicone oil and segmental SB in the inferior periphery (group 1, n = 10) or PPV with Oxane HD (group 2, n = 10) in order of presentation. Silicone oil/Oxane HD removal was performed 12 weeks after surgery. Subjects were followed up for 6 months from oil removal.
RESULTS: Operative time was lower in Oxane HD group (P = 0.012). In both groups, the retina was primary reattached at the third month after oil removal in nine eyes (90%). At the end of follow-up, retina was reattached in nine eyes (90%) in group 1 (including one eye with oil in situ), and in eight eyes (80%) in group 2 (P > 0.05).
CONCLUSIONS: Silicone oil+SB and Oxane HD appear equal for primary RRD with IRB, but a large multi-centre study is required. Oxane HD permitted a reduced operative time
Triamcinolone-assisted pars plana vitrectomy for proliferative vitreoretinopathy.
No full textAbstract
PURPOSE: To determine whether triamcinolone acetonide (TAAC) staining facilitates posterior hyaloid and epiretinal membrane (ERM) removal in patients undergoing pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) with proliferative vitreoretinopathy (PVR).
METHODS: Ten consecutive pseudophakic patients (10 eyes) underwent PPV for RRD with PVR. After a core PPV, a few drops of a commercially available TAAC aqueous suspension (40 mg/mL) with vehicle were injected into the mid vitreous cavity to visualize the posterior hyaloid, thus allowing a complete posterior hyaloidectomy. Next, 0.1 to 0.2 mL of TAAC was applied on the retinal surface to visualize and peel the ERMs. The tamponading agent was silicone oil (1,300 cs) in eight eyes and perfluropropane (C3F8 14%) in two eyes. The minimal follow-up period in all patients was 4 months.
RESULTS: In all patients, intraoperative staining with TAAC consistently improved direct visualization and delineation of the posterior hyaloid and ERMs and facilitated their removal. No adverse reaction related to the use of TAAC was observed immediately postoperatively or 4 months after surgery.
CONCLUSIONS: Intravitreal TAAC may be an important adjuvant tool in the delineation of posterior hyaloid and ERMs, allowing for a more complete and safer ERM removal in the surgical management of PVR complicating RRD. It is well tolerated with all its vehicle if used at low concentration and rapidly removed during surgery
Macular hole following conventional repair of bullous retinal detachment using air injection (D-ACE procedure).
No full textAbstract
PURPOSE: Sequential drainage of subretinal fluid (D), injection of air (A), cryotherapy (C), and application of local explants (E) (D-ACE) sequence was introduced in order to overcome the problems encountered in managing superior bullous detachments from multiple large equatorial breaks. The authors recently observed the occurrence of a full-thickness macular hole in one patient developing the day after he underwent a D-ACE procedure.
METHODS: A 61-year-old man presented a bullous retinal detachment in the right eye extending from the 9:30 to the 2 o'clock position, and posteriorly to the vascular arcades two retinal tears were noted, at the equator at 11 o'clock, and anterior to the equator at 12 o'clock. The patient underwent a D-ACE procedure. Subretinal fluid was drained above the lateral rectus muscle at the equator. One and a half milliliters of air were injected 3.5 mm from the limbus midway between the superior and the medial rectus insertions. Cryotherapy was applied to the retinal breaks. A 240 encircling band was used in conjunction with a 276 tyre segment at the level of the tears.
RESULTS: One day after surgery, the retina was flat, but a full-thickness macular hole could be seen with a surrounding cuff of subretinal fluid.
CONCLUSIONS: The mechanisms proposed to explain the occurrence of full-thickness macular holes after D-ACE may involve the concurrence of scleral elongation and vitreofoveal traction by means of previous partial posterior vitreous detachment with persistent posterior attachments at the fovea
Triamcinolone-assisted pars plana vitrectomy for proliferative vitreoretinopathy.
No full textAbstract
PURPOSE: To determine whether triamcinolone acetonide (TAAC) staining facilitates posterior hyaloid and epiretinal membrane (ERM) removal in patients undergoing pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) with proliferative vitreoretinopathy (PVR).
METHODS: Ten consecutive pseudophakic patients (10 eyes) underwent PPV for RRD with PVR. After a core PPV, a few drops of a commercially available TAAC aqueous suspension (40 mg/mL) with vehicle were injected into the mid vitreous cavity to visualize the posterior hyaloid, thus allowing a complete posterior hyaloidectomy. Next, 0.1 to 0.2 mL of TAAC was applied on the retinal surface to visualize and peel the ERMs. The tamponading agent was silicone oil (1,300 cs) in eight eyes and perfluropropane (C3F8 14%) in two eyes. The minimal follow-up period in all patients was 4 months.
RESULTS: In all patients, intraoperative staining with TAAC consistently improved direct visualization and delineation of the posterior hyaloid and ERMs and facilitated their removal. No adverse reaction related to the use of TAAC was observed immediately postoperatively or 4 months after surgery.
CONCLUSIONS: Intravitreal TAAC may be an important adjuvant tool in the delineation of posterior hyaloid and ERMs, allowing for a more complete and safer ERM removal in the surgical management of PVR complicating RRD. It is well tolerated with all its vehicle if used at low concentration and rapidly removed during surgery
Intravitreal bevacizumab for treatment-naïve subfoveal occult choroidal neovascularization in age-related macular degeneration.
No full textPURPOSE: This study aimed to evaluate the efficacy of multiple injections of intravitreal bevacizumab for treatment-naïve subfoveal occult choroidal neovascularization (CNV) in age-related macular degeneration (AMD).
METHODS: Twelve eyes of 12 patients (mean age 76 +/- 6 years) with mean best corrected visual acuity (BCVA) of 20/100 and occult subfoveal CNV at fluorescein angiography (FA), indocyanine-green (ICG) angiography and optical coherence tomography (OCT), showing intra- or subretinal fluid with or without retinal pigment epithelial detachment (PED), underwent multiple intravitreal injections (mean 2.4 +/- 0.7) of 1.25 mg (0.05 ml) bevacizumab. Visual acuity and OCT findings were assessed at the end of follow-up.
RESULTS: After a mean follow-up of 5.7 +/- 2 months, BCVA improved from 20/100 (range 20/50-20/303) to 20/60 (range 20/28-20/200) (p = 0.038). Five eyes (42%) increased BCVA by > or = 3 lines, six eyes (50%) increased BCVA by < 3 lines and one eye (8%) remained stable. Macular thickness decreased from 298 +/- 71 microm to 223 +/- 72 microm (p = 0.017). No ocular or systemic side-effects were observed.
CONCLUSIONS: Short-term results suggest that multiple intravitreal injections of 1.25 mg bevacizumab are well tolerated and associated with significant improvements in BCVA and decreased retinal thickness by OCT in most patients with treatment-naïve occult CNV. Further evaluation of intravitreal bevacizumab for the treatment of occult CNV is warranted
- …
