Pars plana vitrectomy

Purpose To compare the 27G versus 25G vitrectomy in patients with epiretinal membrane (ERM). Patients and methods Sixty pseudophakic eyes of 60 consecutive patients treated by pars plana vitrectomy (PPV) using 27G (30 eyes) or 25G (30 eyes) were prospectively evaluated including eye's inflammation, surgery time, ERM ? ILM removal time and complications. Additionally, 1, 3, 7, 14, 30, 90 and 180 days after PPV, the following were estimated: intraocular pressure (IOP), sclerotomy wound closure time, distance best corrected visual acuity (DBCVA), foveal macular thickness (FMT) and surgically induced astigmatism (SIA). Results The eye's inflammation resolved within 30 days after surgery in both groups. The surgery and ERM ? ILM times were longer in the 27G group (p B 0.02). The most common postoperative complication was hypotony in both groups, more common in 25G group (23.3% vs. 10% of eyes). In 27G group, the mean IOP prior to 180 days postoperatively was higher (p \ 0.05) and the sclerotomy wound closure time was shorter (p \ 0.001). Mean DBCVA values (7, 14, 30 days after surgery) were significantly better in 27G group (p \ 0.001). The mean FMT values were similarly and significantly reduced in both groups 1 day postoperatively (p \ 0.05) as compared to preop-erative values and then stabilized during follow-up. Mean SIA was lower in 27G group 30, 90 and 180 days after surgery (p \ 0.001). Conclusion The use of 27G PPV in patients with ERM significantly reduced sclerotomy wound closure time and surgically induced astigmatism, better stabilized intraocular pressure and allowed to achieve faster visual acuity improvement, as compared to 25G PPV.

Purpose: To report the effectiveness of combined surgery for neovascular glaucoma. Methods: Six eyes of six consecutive patients with neovascular glaucoma underwent the combined surgery: trabeculectomy with Mitomycin C, Pars Plana Vitrectomy (PPV), endolaserpanretinal photocoagulation, intravitreal and intracameral injection of bevacizumab. Results: The intraocular pressure returned to normal range soon after operation. The neovascularization of iris regressed in a few days. Mild hyphema developed in three patients. All six patients had improved or stable visual acuity, and achieved normal intraocular pressure without antiglaucoma medications three months after operation. Conclusions: This combined surgery may break the vicious cycle of neovascularglaucoma and preserve useful vision in these patients.

Purpose To compare the 27G versus 25G vitrectomy in patients with epiretinal membrane (ERM). Patients and methods Sixty pseudophakic eyes of 60 consecutive patients treated by pars plana vitrectomy (PPV) using 27G (30 eyes) or 25G (30 eyes) were prospectively evaluated including eye’s inflammation, surgery time, ERM + ILM removal time and complications. Additionally, 1, 3, 7, 14, 30, 90 and 180 days after PPV, the following were estimated: intraocular pressure (IOP), sclerotomy wound closure time, distance best corrected visual acuity (DBCVA), foveal macular thickness (FMT) and surgically induced astigmatism (SIA). Results The eye’s inflammation resolved within 30 days after surgery in both groups. The surgery and ERM + ILM times were longer in the 27G group (p ≤ 0.02). The most common postoperative complication was hypotony in both groups, more common in 25G group (23.3% vs. 10% of eyes). In 27G group, the mean IOP prior to 180 days postoperatively was higher (p 

To investigate the effectiveness of open-loop, one-piece, flexible, Kelman-style, all-polymethylmethacrylate (PMMA) anterior chamber intraocular lenses (AC IOLs) in patients undergoing pars plana vitrectomy surgery for a variety of vitreoretinal disorders. Fifteen patients (6 women and 9 men) underwent combined pars plana vitrectomy with insertion of an open-loop AC IOL. Postoperative results were evaluated. The average preoperative visual acuity of 20/360 (logMAR scale, 1.25 +/- 0.80) improved to 20/52 (logMAR scale, 0.42 +/- 0.35) after an average follow-up of 10.2 months (range, 1-41 months). Of 15 eyes, 7 (47%) achieved a visual acuity of better than 20/40. There was no evidence of glaucoma exacerbation or corneal decompensation. Visual acuity was limited primarily by chronic cystoid macular edema in 4 (27%) of 15 eyes. In this preliminary series of patients, open-loop, flexible, all-PMMA, Kelman-style AC IOLs appear to be well tolerated and represent a viable, simple alternative to transscleral fixation of a posterior chamber IOL or surgical aphakia in patients undergoing vitrectomy surgery.

BackgroundTo gather information on the effect of postoperative face-down posturing following combined phacoemulsification and vitrectomy for macular hole surgery in order to assist in the design of a larger definitive study.MethodsThirty phakic patients with stage II–IV full-thickness macular hole had combined phacoemulsification and pars plana vitrectomy with internal limiting membrane peel and 14% perfluoropropane (C3F8) gas. At the conclusion of

BackgroundTo gather information on the effect of postoperative face-down posturing following combined phacoemulsification and vitrectomy for macular hole surgery in order to assist in the design of a larger definitive study.MethodsThirty phakic patients with stage II–IV full-thickness macular hole had combined phacoemulsification and pars plana vitrectomy with internal limiting membrane peel and 14% perfluoropropane (C3F8) gas. At the conclusion of

Background  Several surgical techniques have been described for the treatment of retinal detachment (RD) associated to myopic macular hole (MMH). In this retrospective study, the anatomical and functional outcomes of pars plana vitrectomy (PPV) with long-term tamponade, using either 1000 cSt silicone oil (SO) or heavy silicone oil (HSO), are compared. Methods  Forty-two eyes affected by RD associated with MMH were included.

To evaluate the safety and visual outcomes of combined phacoemulsification and sutureless 23-gauge vitrectomy for concomitant cataract and vitreoretinal diseases. Retrospective consecutive interventional case series. 114 eyes of 111 patients underwent combined sutureless 23-gauge vitrectomy and phacoemulsification surgery between 1 January 2006 and 1 March 2009. Main outcome measures were visual acuity and perioperative complications. All patients had at least 3 months follow-up (mean 263 days). The main vitreoretinal surgical indications were intractable cystoid macular oedema, epiretinal membrane and retinal detachment. Mean logMAR visual acuity improved from baseline 20/192 to 20/129 at 3 months (p=0.005). Mean intraocular pressure (IOP) increased from baseline 15.8 mm Hg to 17.7 mm Hg (p=0.033) on postoperative day 1 and then decreased by postoperative month 3 to 14.8 mm Hg (p=0.019). 110 (96.5%) eyes had significant pre-existing macular disease, and 93 (81.6%) received preoperative treatments. 82 (71.9%) patients required supplemental treatment(s) at a mean of 91.5 days, most commonly intravitreal injections to reduce vascular leakage or YAG capsulotomy. Hypotony, defined as IOP <5, was observed in four (3.5%) patients, and no patient developed endophthalmitis. Capsular tears were more frequent in eyes with a history of previous radiation or vitrectomy. Combined phacoemulsification and sutureless 23-gauge vitrectomy surgery was safely and effectively used for cataracts and a variety of complex vitreoretinal diseases.

Purpose: To show how a Turkish public eye care centre in Turkey initiated Six Sigma principles to reduce the number of complications occurring during and after pars plana vitreoretctomy surgeries. Method: Data were collected for two years. To analyse the complications among 2272 patients, main tools of Six Sigma's Define-Measure-Analyse-Improve-Control (DMAIC) improvement cycle such as SIPOC table, Fishbone Diagram and, Failure, Mode and Effect Analysis were implemented. Sources and root causes of twenty-two types of complications were identified and reported. Results: For a successful pars plana vitrectomy procedure, experience of vitreoretinal surgeon, attention of vitreoretinal surgeon, patient's anatomy were determined to be the "critical few" factors whereas, sterilization and hygiene, amount of silicone oil and amount of gas were found to be the "trivial many" factors. The most frequently occurring complication was found to be subconjunctival haemorrhage. Conclusion: The sigma level of the overall process was measured to be 3.8559. The surgical team concluded that twelve of the complications should be significantly reduced by taking the necessary preventive measures. Institutional ethics committee approval has been taken due to retrospective nature of this study.