1,721,414 research outputs found
Macular versus Retinal Nerve Fiber Layer Parameters for Diagnosing Manifest Glaucoma: A Systematic Review of Diagnostic Accuracy Studies
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Retinal detachment after small-incision, sutureless pars plana vitrectomy: Possible causative agents
No full textBackground and purpose: To identify possible agents causing retinal detachment following small-incision, sutureless vitrectomy. Methods: Computer-based, retrospective analysis to identify all patients who had undergone small-incision sutureless vitrectomy and presented retinal detachment (RD) in the study eye within 6 months postoperatively. The clinical charts of these patients were reviewed. Results: The investigation involved 2,598 small-incision, sutureless vitrectomies. Thirty-seven eyes presented subsequent RD. Indications for sutureless vitrectomy were idiopathic epiretinal membrane (n∈=∈15), idiopathic macular hole (n∈=∈15), recurrent macular hole (n∈=∈1), rhegmatogenous retinal detachment (n∈=∈5) and vitreous haemorrhage due to proliferative diabetic retinopathy (PDR) (n∈=∈1). The median time between sutureless vitrectomy and RD presentation was 51 days (range 11-173 days); mean 59 days (SD 46.5). In 14 eyes (38%), the RD was most likely due to the underlying pathology (e.g., unclosed macular hole, reopening of pre-existing retinal tears, worsening of PDR). Twenty-three eyes (62%) presented with new retinal tears that were not in the proximity of the sclerotomies. Conclusion: In most cases, the RD was not caused by the sutureless technique itself, but was most likely due to the underlying pathology, or due to new retinal tears that were not in the proximity of the sclerotomies. © 2010 Springer-Verlag
Comparative study between a standard 25-gauge vitrectomy system and a new ultrahigh-speed 25-gauge system with duty cycle control in the treatment of various vitreoretinal diseases
No full textAIM:: To compare a standard 25-gauge vitrectomy system with a new ultrahigh-speed (UHS) 25-gauge system with duty cycle control for pars plana vitrectomy. METHODS:: In this prospective, controlled clinical trial, 120 patients (divided into 2 groups of 60 patients) underwent a 3-port pars plana vitrectomy for the treatment of epiretinal membranes, macular holes, retinal detachment, and complications of diabetic retinopathy. Evaluations were performed preoperatively, intraoperatively, on the first 3 postoperative days, and at 1 week, 1 month, and 3 months. Main outcome measures were vitrectomy time, induction of posterior vitreous detachment, and intra- and postoperative complications. Vitrectomy time included retinal manipulation, but did not include wound opening and closure. RESULTS:: The duration of surgery was significantly different between the groups. Patients in the new UHS 25-gauge group had a significantly shorter duration of vitrectomy time (P < 0.0001). Mean overall vitrectomy time was 1,583.7 ± 875.4 seconds (26 minutes) in the standard 25-gauge group and 1,106.3 ± 575.9 seconds (18 minutes) in the UHS 25-gauge group. Twenty-nine patients (48.3%) in the standard group and 27 patients (45.0%) in the UHS group experienced induction of posterior vitreous detachment. Thirteen patients (21.7%) in the standard 25-gauge group and 1 patient (1.7%) in the new UHS group had intraoperative iatrogenic retinal breaks. CONCLUSION:: The new-generation UHS 25-gauge system may provide a new paradigm of high-flow, smaller-diameter instrumentation, thus increasing the efficiency of the small-gauge technique and the safety of the surgery. © The Ophthalmic Communications Society, Inc
The combined use of perfluorohexyloctane (F6H8) and silicone oil as an intraocular tamponade in the treatment of severe retinal detachment
No full textBackground: The purpose of this study was to investigate the combined use of perfluorohexyloctane (F6H8) and 1,000-centistoke silicone oil as a long-term intraocular tamponade in the treatment of complicated retinal detachment. Methods: Sixty consecutive eyes affected by complicated retinal detachment with (1) retinal breaks of the lower two quadrants and severe proliferative vitreoretinopathy, (2) inferior giant retinal tear, (3) penetrating trauma or (4) choroidal detachment underwent pars plana vitrectomy using a combined internal tamponade of F6H8 and silicone oil. The double filling (DF) was removed after 40-50 days. The anatomical outcome and the complications due to the DF are reported. Results: Retinal reattachment was achieved in all but one patient. Thirty-eight (63%) eyes needed further surgery with silicone oil tamponade. Silicone oil was successfully removed in 22 eyes. Sixteen (27%) eyes had retained silicone oil at the last follow-up examination. One eye showed persistent retinal detachment despite further surgery. Main complications of the DF were recurrent retinal detachment of the upper retina in six (10%) eyes and membrane formation in 25 (42%) eyes. Conclusions: A combined internal tamponade of F6H8 and silicone oil may be a useful tool in the treatment of complicated retinal detachment involving the lower quadrants of the retina. © Springer-Verlag 2006
Incidence of retinal detachment after small-incision, sutureless pars plana vitrectomy compared with conventional 20-gauge vitrectomy in macular hole and epiretinal membrane surgery
No full textPurpose: The purpose of this study was to evaluate the incidence of retinal detachment (RD) after a small-incision, sutureless vitrectomy compared with conventional 20-gauge vitrectomy in macular hole and epiretinal membrane surgery and to investigate the clinical features and possible causative agents. Methods: The authors performed a computerized database analysis to retrospectively identify all patients who underwent vitrectomy at our institution between March 2001 and March 2009 for epiretinal membrane and macular hole. The authors further investigated the clinical features of patients who showed RD within 6 months postoperatively in the study eye. The incidence rate and clinical features of the affected eyes were analyzed. Results: During the study period, 2,432 vitrectomies were performed for epiretinal membrane and macular hole. The incidence of RD was 1.7% (31 of 1,862) after sutureless 25- or 23-gauge vitrectomy and 1.2% (7 of 570) after conventional 20-gauge vitrectomy. The difference was not statistically significant. Moreover, the difference between 25-gauge surgery (28 of 1,580) and 23-gauge surgery (3 of 282) was not statistically significant. In 9 of 38 cases (24%), the RD was probably attributable to the underlying pathology (e.g., an unclosed macular hole and reopening of preexisting retinal tears). Twenty-one eyes (76%) presented new retinal tears that were not related to the sclerotomies in both groups. Conclusion: The incidence of RD after macular surgery is not increased in small-gauge, sutureless vitrectomy compared with the standard 20-gauge procedure. In most cases, the RD is not caused by the surgical technique itself but caused by new retinal breaks. © The Ophthalmic Communications Society, Inc
Sutureless 25-gauge vitrectomy for idiopathic macular hole repair
No full textBackground: We investigated the feasibility and safety of a 25-gauge, transconjunctival sutureless vitrectomy system for macular hole repair. Methods: Eighty-four eyes of 77 consecutive patients with idiopathic macular hole were operated on using a transconjunctival sutureless 25-gauge vitrectomy system. A complete vitrectomy was performed using triamcinolone acetonide to visualize the vitreous gel and to remove the posterior vitreous cortex. The macular hole was covered with autologous whole blood, and the internal limiting membrane (ILM) was stained with indocyanine green. The ILM was peeled and a fluid-air exchange performed. The globe was filled with gas, and the patient was kept in a prone position for 1 week. Surgery-related complications, macular hole closure on optical coherence tomography (OCT) and visual outcome were evaluated. Results: No intra- or postoperative complications were recorded. It was noted in particular that sclerotomies did not require sutures. No postoperative hypotony or endophthalmitis was observed. OCT showed macular hole closure in 93% of the cases. The median preoperative best-corrected visual acuity was 20/200 and improved significantly (p<0.05) to a median best-corrected visual acuity of 20/67 (median follow-up 6.5 months). Conclusion: A 25-gauge transconjunctival sutureless vitrectomy, visualization of the vitreous with triamcinolone acetonide, protection of the macular hole with autologous whole blood and staining of the ILM using indocyanine green are safe and efficient techniques for macular hole repair. © Springer-Verlag 2007
Convective Movements Immediately after Iridotomy: Gush Sign
No full textA 56-year-old man presented with iris bombé secondary to pupillary seclusion due to recurrent anterior uveitis (Fig A). Extensive peripheral anterior synechiae (yellow asterisks) were observed with OCT (Solix Full-range OCT; Optovue Inc). Pupillary seclusion (blue asterisks) was also detected. Nd-YAG laser peripheral iridotomy was performed in a superotemporal location (at 10 o’clock). The patency was confirmed by the hole occurrence in iridis (red asterisks; Fig B). High-definition convective movements (i.e., gush sign) in the anterior chamber were detected (white asterisks) 5 minutes after iridotomy when pigmental cells mixed with blood cells, present owing to minimal bleeding, were set in motion (Fig B-C) (Magnified version of Fig A-C is available online at www.aaojournal.org)
Swept-source OCT reduces the risk of axial length measurement errors in eyes with cataract and epiretinal membranes
Full text linkAimsTo compare the biometric data from partial coherence interferometry (PCI) and swept-source OCT (SS-OCT) in patients with age-related cataract and epiretinal membrane (ERM): ERM, ERM with foveoschisis and macular pseudohole.Methods49 eyes of 49 subjects including 36 ERM, 9 ERM foveoschisis and 4 macular pseudohole were analysed to evaluate the axial length (AL) measurements and the presence of AL measurement errors, defined basing on the shape of the biometric output graphs and on the concordance of AL values between instruments. Eyes with ERM were divided in four stages according to OCT features (i.e. presence/absence of the foveal pit, presence of ectopic inner foveal layers, disrupted retinal layers).ResultsThe devices provided similar mean AL measurements in all subgroups, with differences <0.1 mm in 41/49 cases (83.6%). AL measurement errors were observed in ERM stages 3 and 4, characterized by ectopic inner foveal layers, and were significantly more frequent with the PCI (8/17, 47%) as compared with the SS-OCT device (2/17, 12%), p = 0.02. The refractive prediction error in cases with AL measurement errors was significantly greater using the PCI compared to the SS-OCT device (p<0.05).ConclusionBoth devices provide reliable biometric data in the majority of patients and can be used in the preoperative assessment of patients with age-related cataract and ERM. In eyes with ectopic inner foveal layers, attention should be paid as AL measurement and refractive prediction errors may occur, more frequently with the PCI device
Management of Optic Disk Pit-associated Macular Detachment with Human Amniotic Membrane Patch
No full textPURPOSE: To report a new surgical technique involving a human amniotic membrane patch (hAM) to solve a serous macular detachment associated with optic nerve head pit.METHODS: Three eyes of three patients affected by macular detachment associated with optic nerve head pit were enrolled. A 23-gauge pars plana vitrectomy were performed. hAM patch was implanted inside the optic nerve pit; air was used as endotamponade. The patients were instructed to maintain face-down position for the first days after surgery.RESULTS: The subretinal fluid gradually resolved during 6 months of follow-up, and visual acuity improved to 20/25 at the sixth month after surgery. We did not observe a recurrence of subretinal fluid during the 6 months of follow-up. No postoperative complications were reported during the follow-up.CONCLUSION: Implant of the hAM may be effective to repair optic disk pit maculopathy. All the cases were successful with encouraging visual acuity recovery
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