Treatment of dystrophic calcification on a silicone intraocular lens with pars plana vitrectomy

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Mehta N

2014-07-01

Full Text Available Nitish Mehta,1 Roger A Goldberg,2 Chirag P Shah21University of Massachusetts Medical School, Worcester, MA, USA; 2Department of Retina, Ophthalmic Consultants of Boston, Boston, Massachusetts, USAPurpose: Dense, vision-obscuring calcification on the posterior aspect of silicone intraocular lenses (IOLs is often not amenable to neodymium:yttrium-aluminum-garnet capsulotomy, and, in prior reports, has required IOL exchange. We report the successful removal of dense calcium deposition on the posterior surface of a three-piece silicone lens using pars plana vitrectomy (PPV.Materials and methods: A 23-gauge PPV was performed using the Stellaris® vitrectomy system. A light pipe was used to retroilluminate the IOL, and a dense fibrous tissue setting with a low cut-rate and high aspiration rate was able to clear the visual axis of the dystrophic calcification without damaging the IOL optic.Results: Visual acuity improved from 20/100 to 20/25.Conclusion: Small-gauge PPV may be utilized to remove dense dystrophic calcium deposits on the lens surface in lieu of IOL exchange. Keywords: cataract surgery, technique, Nd:YAG capsulotomy, IOL exchange

Bilateral optic neuropathy and intraretinal deposits after pars plana vitrectomy in amyloidosis

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Rossetti Alberto

2015-01-01

Full Text Available Pathological examination of material from a nonextensive pars plana vitrectomy (PPV in the right eye provided a diagnosis of nonfamilial amyloidosis in a 68-year-old woman, who presented with bilateral glass wool-like vitreous opacities. Genetic testing revealed a Tyr114Cys mutation in the transthyretin gene. Six months after PPV, perimetry showed intense constriction with a temporal island and central scotoma in the right eye. An extensive PPV was performed in the left eye. Spectral domain optical coherence tomography evidenced bilateral epimacular amyloid deposits and unreported reflective spots within the inner retina. One year later, visual acuity had decreased to 20/400 in the left eye, with mild vitreous opacity, pale cupped optic disc and inferior altitudinal field defect. Bilateral diurnal intraocular pressure, transiently increased after PPV, never exceeded 16 mmHg with medication. Our patient presented optic nerve blood supply impairment, due to amyloidosis, which caused optic atrophy. Epiretinal and intraretinal deposit detection could aid in diagnosing patients with suspected amyloidosis.

Indications and visual outcome of first hundred pars plana ...

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Objective: To review the indications and visual outcome of the first one hundred pars plana vitrectomies performed at the newly established surgical retina unit of Makkah Specialist Eye Hospital, Kano, Kano State, Nigeria. Materials and Methods: Aretrospective chart review was performed. Data recorded from the patient ...

Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Nontractional Diabetic Macular Edema.

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Ulrich, Jan Niklas

2017-01-01

Diabetes mellitus remains the leading cause of blindness among working age Americans with diabetic macular edema being the most common cause for moderate and severe vision loss. To investigate the anatomical and visual benefits of pars plana vitrectomy with inner limiting membrane peeling in patients with nontractional diabetic macular edema as well as correlation of integrity of outer retinal layers on spectral domain optical coherence tomography to visual outcomes. We retrospectively reviewed the charts of 42 diabetic patients that underwent vitrectomy with internal limiting membrane peeling for nontractional diabetic macula edema. The integrity of outer retinal layers was evaluated and preoperative central macular thickness and visual acuity were compared with data at 1 month, 3 months and 6 months postoperatively. The student t-test was used to compare the groups. 31 eyes were included. While no differences were seen at 1 and 3 months, there was significant improvement of both central macular thickness and visual acuity at the 6 months follow up visit compared to preoperatively (357, 427 microns; p=0.03. 20/49, 20/82; p=0.03) . Patients with intact external limiting membrane and ellipsoid zone had better preoperative vision than patients with outer retinal layer irregularities (20/54, 20/100; p=0.03) and greater visual gains postoperatively (20/33, ppeeling can improve retinal anatomy and visual acuity in patients with nontractional diabetic macular edema. Spectral domain optical coherence tomography may help identify patients with potential for visual improvement.

Five-year outcomes of pars plana vitrectomy for macular edema associated with branch retinal vein occlusion

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Nishida A

2017-02-01

Full Text Available Akihiro Nishida,1,2 Hiroshi Kojima,1,2 Takanori Kameda,1,2 Michiko Mandai,1,3 Yasuo Kurimoto1,2 1Department of Ophthalmology, Kobe City Medical Center General Hospital, 2Department of Ophthalmology, Institute of Biomedical Research and Innovation, 3Laboratory for Retinal Regeneration, RIKEN Center for Developmental Biology, Chuo-ku, Kobe, Hyogo, Japan Purpose: Long-term outcomes of pars plana vitrectomy (PPV for macular edema (ME associated with branch retinal vein occlusion (BRVO have been previously reported, but the studies did not report the number of additional treatments after surgery. During 5 years of follow-up, we therefore investigated the efficacy and safety of PPV for BRVO and evaluated the incidence of additional treatments. Methods: We retrospectively reviewed the medical records of 25 eyes of 24 patients who underwent PPV for ME associated with BRVO and were followed up for at least 5 years. Best-corrected visual acuity was measured, and foveal thickness was assessed by optical coherence tomography. Additional treatments were also investigated. Results: The logarithm of the minimal angle of resolution (logMAR improved from 0.53±0.23 at baseline to 0.16±0.25 at 5 years (P<0.0001. The foveal thickness decreased from 535±222 µm at baseline to 205±143 µm at 5 years (P<0.0001. For the eyes with residual ME, the following additional treatments were performed within 5 years of follow-up: sub-Tenon injection of triamcinolone acetonide in two eyes, intravitreal injection of bevacizumab in three eyes, grid laser photocoagulation in one eye, and direct photocoagulation of macroaneurysm in one eye. Additional surgeries were performed in two eyes: for one eye, phacoemulsification extraction of the ocular lens and intraocular lens implantation were performed because of cataract progression, and for the other eye, additional PPV was done for postoperative retinal detachment. Conclusion: PPV was effective for resolution of ME

Multicenter study of pars plana vitrectomy for optic disc pit maculopathy: MACPIT study.

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Avci, R; Kapran, Z; Ozdek, Ş; Teke, M Y; Oz, O; Guven, D; Yilmaz, S; Kaderli, B; Durukan, A H; Sobaci, G; Unver, Y B; Akduman, L; Kaynak, S; Dogan, I; Inan, U U

2017-09-01

PurposeTo evaluate surgical intervention with pars plana vitrectomy (PPV) for correction of optic disc pit maculopathy (ODP-M).Patients and methodsRetrospective chart review from 13 centres of 51 eyes of 50 patients with ODP-M who underwent PPV between 2002-2014. Anatomic and final best-corrected visual acuity (BCVA) outcomes were evaluated for all cases with different adjuvant techniques.ResultsThere were 23 males and 27 females with median age 25.5 (6-68) years. Preoperative median foveal thickness was 694.5 (331-1384) μm and improved to 252.5 (153-1405) μm. Median BCVA improved from 20/200 (20/20000 to 20/40) to 20/40 (20/2000 to 20/20) with 20/40 or better in 31 eyes. Complete retinal reattachment was achieved in 44 eyes (86.3%) at 7.1 (5.9) months. The good surgical outcomes were achieved in different adjuvant groups. Median follow-up was 24 (6 to 120) months.ConclusionsThese results confirm the long-term effectiveness of PPV for ODP-M. Prospective studies are needed to determine the effectiveness of any adjuvant technique in improving the success of PPV for ODP-M.

Pars plana vitrectomy compared with pars plana vitrectomy combined with scleral buckle in the primary management of noncomplex rhegmatogenous retinal detachment.

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Orlin, Anton; Hewing, Nina J; Nissen, Michael; Lee, Sangwoo; Kiss, Szilard; DʼAmico, Donald J; Chan, R V Paul

2014-06-01

To compare pars plana vitrectomy (PPV) with PPV combined with scleral buckle (PPV/SB) in the treatment of primary, noncomplex rhegmatogenous retinal detachment in an academic setting. Retrospective review of 74 consecutive cases that underwent either PPV or PPV/SB for primary rhegmatogenous retinal detachment at New York Presbyterian Hospital, Weill Cornell Medical College. Fifty-two eyes underwent PPV alone while 22 eyes had PPV combined with SB. All eyes had a minimum of 2 months of follow-up. The main outcome measure was single surgery anatomical success. Patients in the PPV/SB group were less likely to be phakic (P = 0.05) and more likely to have an inferior retinal break (P = 0.001) when compared with the PPV group. Between groups, there was no difference in eyes with peripheral retinal lattice degeneration (P = 0.929), multiple breaks (P = 0.801), breaks seen preoperatively (P = 0.095), or those presenting with the macula off retinal detachment (P = 0.548). The majority of patients in both groups underwent small-gauge surgery (23 G or 25 G) (P = 0.65). Attachment of the retina was obtained in 100% of the patients in both groups at most recent follow-up. Single surgery anatomical success was similar between groups (83% PPV vs. 86% PPV/SB; P = 0.695). Mean best-corrected Snellen visual acuity improved in both groups (P = 0.75), with a final best-corrected Snellen visual acuity of 0.418 logMAR in the PPV group and 0.479 logMAR in the PPV/SB group (P = 0.61). When comparing PPV with PPV/SB, no difference in single surgery anatomical success existed after evaluating eyes with inferior breaks (P = 0.68), pseudophakia (P = 0.75), or when small-gauge surgery was performed (P = 0.76). We did not find significant differences in single surgery anatomical success, final anatomical success, or change in visual acuity when comparing PPV with PPV/SB in the repair of primary noncomplex rhegmatogenous retinal detachment in an academic setting where vitreoretinal fellows

Early simultaneous fundus autofluorescence and optical coherence tomography features after pars plana vitrectomy for primary rhegmatogenous retinal detachment.

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Dell'Omo, Roberto; Mura, Marco; Lesnik Oberstein, Sarit Y; Bijl, Heico; Tan, H Stevie

2012-04-01

To describe fundus autofluorescence and optical coherence tomography (OCT) features of the macula after pars plana vitrectomy for rhegmatogenous retinal detachment. Thirty-three eyes of 33 consecutive patients with repaired rhegmatogenous retinal detachment with or without the involvement of the macula were prospectively investigated with simultaneous fundus autofluorescence and OCT imaging using the Spectralis HRA+OCT (Heidelberg Engineering, Heidelberg, Germany) within a few weeks after the operation. Fundus autofluorescence imaging of the macula showed lines of increased and decreased autofluorescence in 19 cases (57.6%). On OCT, these lines corresponded to the following abnormalities: outer retinal folds, inner retinal folds, and skip reflectivity abnormalities of the photoreceptor inner segment/outer segment band. Other OCT findings, not related to abnormal lines on fundus autofluorescence, consisted of disruption of photoreceptor inner segment/outer segment band and collection of intraretinal or subretinal fluid. The presence of outer retinal folds significantly related to metamorphopsia but did not relate to poor postoperative visual acuity. Partial-thickness retinal folds occur commonly after vitrectomy for rhegmatogenous retinal detachment repair and may represent an important anatomical substrate for postoperative metamorphopsia. Fundus autofluorescence and OCT are both sensitive techniques for the detection of these abnormalities.

Nonarteritic anterior ischemic optic neuropathy following pars plana vitrectomy for macular hole treatment: case report.

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Cunha, Leonardo Provetti; Cunha, Luciana Virgínia Ferreira Costa; Costa, Carolina Ferreira; Monteiro, Mário Luiz Ribeiro

2016-01-01

Herein, we report a case of nonarteritic anterior ischemic optic neuropathy (NAION) following uneventful pars plana vitrectomy for macular hole treatment. A 56-year-old previously healthy woman presented with a full-thickness macular hole in right eye (OD) and small cup-to-disc ratios in both eyes. Five days after surgery, she noticed sudden painless loss of vision in OD and was found to have an afferent pupillary defect and intraocular pressure of 29 mmHg. Fundus examination showed right optic disc edema and the resolution of a macular hole with an inferior altitudinal visual field defect. Erythrocyte sedimentation rate, C-reactive protein levels, and general physical examination findings were normal. She was treated with hypotensive eyedrops and oral prednisone, resulting in mild visual improvement and a pale optic disc. A combination of face-down position and increased intraocular pressure due to a small optic disc cup were considered as potential mechanisms underlying NAION in the present case. Vitreoretinal surgeons should be aware of NAION as a potentially serious complication and be able to recognize associated risk factors and clinical findings.

Comparison of the Effectiveness of Pars Plana Vitrectomy with and without Internal Limiting Membrane Peeling for Idiopathic Retinal Membrane Removal: A Meta-Analysis

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Hanhan Liu

2015-01-01

Full Text Available We conducted a meta-analysis of published retrospective studies and compared the effectiveness of pars plana vitrectomy with and without internal limiting membrane (ILM peeling for idiopathic epiretinal membrane (IERM. The results revealed that patients in the IERM+ILM peeling group had better BCVA after surgery within 12 months than those in IERM peeling group. But patients in the IERM peeling group showed better BCVA in the 18th month. More retrospective studies or randomized controlled trials are required to investigate and compare the long-term effect of IERM removal with and without ILM peeling.

Comparison of the Effectiveness of Pars Plana Vitrectomy with and without Internal Limiting Membrane Peeling for Idiopathic Retinal Membrane Removal: A Meta-Analysis

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Liu, Hanhan; Zuo, Shanru; Ding, Chun; Dai, Xunzhang; Zhu, Xiaohua

2015-01-01

We conducted a meta-analysis of published retrospective studies and compared the effectiveness of pars plana vitrectomy with and without internal limiting membrane (ILM) peeling for idiopathic epiretinal membrane (IERM). The results revealed that patients in the IERM+ILM peeling group had better BCVA after surgery within 12 months than those in IERM peeling group. But patients in the IERM peeling group showed better BCVA in the 18th month. More retrospective studies or randomized controlled trials are required to investigate and compare the long-term effect of IERM removal with and without ILM peeling. PMID:26693348

Visualization of the macula during elective pars plana vitrectomy in the presence of a dual-optic accommodating intraocular lens.

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Marques, Eduardo F; Ferreira, Tiago B; Castanheira-Dinis, António

2014-05-01

We describe the case of a 69-year-old patient who had pars plana vitrectomy (PPV) for epiretinal membrane removal 18 months after cataract surgery with implantation of a dual-optic accommodating IOL (Synchrony). During PPV, visualization of the macula was perfect, and the postoperative visual outcome was excellent. To our knowledge, this is the first report of retinal visualization during PPV in the presence of a dual-optic accommodating IOL. When choosing a presbyopia-correcting IOL, surgeons should consider the advantage of macula visualization with an IOL with monofocal optics. Dr. Marques is a consultant to Abbott Medical Optics, Inc. No other author has a financial or proprietary interest in any material or method mentioned. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

CHARACTERISTICS OF EPIRETINAL MEMBRANE REMNANT EDGE BY OPTICAL COHERENCE TOMOGRAPHY AFTER PARS PLANA VITRECTOMY.

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Gaber, Raouf; You, Qi Sheng; Muftuoglu, Ilkay Kilic; Alam, Mostafa; Tsai, Frank F; Mendoza, Nadia; Freeman, William R

2017-11-01

To evaluate the incidence, characteristics, and the progression of epiretinal membrane (ERM) remnant edge seen by optical coherence tomography after ERM peeling. A retrospective chart review was conducted for 86 eyes of 85 consecutive patients who were diagnosed with ERM and underwent pars plana vitrectomy for epiretinal membrane peeling between 2013 and 2014. Data collected and analyzed included age, gender, preoperative and postoperative visual acuity, use of indocyanine green dye to stain internal limiting membrane, tamponade used after vitrectomy, ERM edge boundaries, presence of cystoid macular edema, and central foveal thickness. An ERM remnant edge was detected in 33/86 study eyes (38.4%) at the first postoperative optical coherence tomography scan. Compared with those without an ERM remnant, patients with an ERM remnant after surgery were significantly older at baseline and had a higher incidence of ERM recurrence at their last visit. They were not significantly different in terms of gender, preoperative and postoperative visual acuity, reduction of central foveal thickness from baseline, proportion of eyes with preoperative ERM elevation on optical coherence tomography, presence of macular edema before surgery, intraoperative use of indocyanine green staining for ILM peeling, or tamponade used. Based on the edge morphology, we classified the ERM remnant into three types: Type 1 was flat and blended with the retina (14/33 eyes, 42.4%), Type 2 was flat but stepped (17/33 eyes, 51.5%), and Type 3 was elevated (2/33 eyes, 6.0%). A significantly higher risk of ERM recurrence was seen in Type 2 and Type 3 ERM remnants (75% and 100%, respectively) than Type 1 ERM remnants (10%). An ERM remnant edge was detected by optical coherence tomography after ERM peeling in 38.4% of eyes. The presence of a postoperative ERM edge was associated with a higher risk of ERM recurrence, particularly in Type 2 and Type 3 ERM remnants.

Timing of Pars Plana Vitrectomy in Management of Gunshot Perforating Eye Injury: Observational Study

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Hammouda Hamdy Ghoraba

2016-01-01

Full Text Available The aim of this study is to report the difference in either anatomical or functional outcome of vitreoretinal intervention in cases of gunshot perforating eye injury if done 2–4 weeks or after the 4th week after the original trauma. Patients were treated with pars plana vitrectomy and silicon oil. Surgeries were performed in the period from February 2011 until the end of December 2014. 253 eyes of 237 patients were reviewed. 46 eyes were excluded. 207 eyes of 197 patients were analyzed. The included eyes were classified based on the timing of vitrectomy in relation to the initial trauma into two groups: 149 eyes (the first group operated on between the 3rd and the 4th week and 58 eyes (the second group operated on after the 4th week after the trauma. Following one surgical intervention, in the first group, attached retina was achieved in 93.28% of patients. In the second group, attached retina was achieved in 96.55% of patients. All RD cases could be attached by a second surgery. Visual acuity improved in 81.21% of patients, did not change in 15.43% of patients, and declined in 3.35% of patients. In the second group, visual acuity improved in 81.03% of patients, did not change in 12.06% of patients, and worsened in 6.89% of patients. There was no statistically significant difference between the two groups in either anatomical or functional results. We recommend interfering before the 5th week after the trauma as retinal detachment is encountered more in cases operated on after the 4th week. The visual outcome depends on the site of entry and exit (the route of gunshot.

Combined Cataract Extraction With Pars Plana Vitrectomy and Metallic Intraocular Foreign Body Removal Through Sclerocorneal Tunnel Using a Novel "Magnet Handshake" Technique.

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Dhoble, Pankaja; Khodifad, Ashish

2018-01-01

To study the outcomes of combined cataract extraction with pars plana vitrectomy (PPV) and metallic intraocular foreign body (IOFB) removal through a sclerocorneal tunnel using the "magnetic handshake" technique. A retrospective review. Retrospective review of case records of 14 patients from 2010 to 2016 with metallic IOFB and traumatic cataract was performed. Cataract extraction was combined with PPV. Two intraocular magnets (IOMs) introduced through 20-gauge vitrectomy port and sclerocorneal tunnel helped achieve safe delivery of IOFB outside the globe by the "magnetic handshake" technique. All patients were males with a mean age of 33.04 years. A final best corrected visual acuity (BCVA) of 20/60 or better was noted in 10 (71.42%) of 14 patients. Final reattachment with more than 1 surgery was achieved in 13 (92.85%) patients. Postoperative complications included retinal detachment (RD) and phthisis bulbi in 1 (14.28%) patient each. Combined cataract extraction with PPV and metallic IOFB removal through sclerocorneal tunnel using the "magnet handshake" technique gives good visual and surgical outcomes. Copyright 2017 Asia-Pacific Academy of Ophthalmology.

Intraocular Irrigating Solutions. A Clinical Study of BSS Plus ® and Dextrose Bicarbonate Fortified BSS ® as an Infusate during Pars Plana Vitrectomy.

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Samuel Michael

2003-01-01

Full Text Available Purpose: To compare the effect of Balanced Salt Solution Plus (BSS Plus, Alcon Laboratories, Fort Worth, Texas, USA and fortified regular BSS on the cornea and lens, when used for continuous irrigation in pars plana vitrectomy (PPV surgery. Methods: Prospective, investigator masked, randomised study. Forty patients were randomly assigned to undergo PPV using BSS Plus (n=20 or fortified BSS (n=20 [regular BSS, fortified with 10.5 cc. of dextrose in water (D5W and 13.1cc. of 8.4% sodium bicarbonate]. Intraoperative features of the corneal epithelium, postoperative changes in the corneal endothelial cell denstiy (ECD at 3 months, and clarity of the lens during surgery and postoperatively were evaluated. Results: Intraoperative epithelial changes were similar in both groups with 7 (35% of the cases having the epithelium removed in the BSS Plus group and 8 (40% in the BSS fortified group (P=0.23. The mean differences in ECD (3 months versus preoperative in the operated eyes when adjusted for changes in the control eye showed no difference with the type of BSS (P=0.98. Intraoperative lens changes were more significant (P=0.018 in the BSS fortified group. Postoperative lens status at 3 months was similar for both groups. Though there was a trend towards worse postoperative nuclear sclerosis change in the BSS fortified group, it was not significant (P=0.160. Conclusion: Standard BSS fortified with dextrose and bicarbonate is an efficacious infusion fluid during pars plana vitrectomy. Both solutions showed comparable effects on postoperative corneal endothelial cell density and corneal epithelial changes intraoperatively. BSS fortified has more lenticular changes intraoperatively than BSS Plus although no lens had to be removed in either group. The study implications are important since BSS fortified is significantly less expensive than BSS Plus.

Eccentric Macular Hole after Pars Plana Vitrectomy for Epiretinal Membrane Without Internal Limiting Membrane Peeling: A Case Report.

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Garnavou-Xirou, Christina; Xirou, Tina; Kabanarou, Stamatina; Gkizis, Ilias; Velissaris, Stavros; Chatziralli, Irini

2017-12-01

Postoperative eccentric macular hole formation is an uncommon complication after pars plana vitrectomy (PPV) without internal limiting membrane (ILM) peeling for the treatment of epiretinal membrane (ERM). We present a case of eccentric macular hole formation after PPV for ERM without ILM peeling. A 68-year-old male patient presented with ERM and visual acuity of 6/24 in his left eye. He underwent 23-gauge PPV without ILM peeling for treatment of ERM. One week postoperatively the retina was attached and the epiretinal membrane was successfully removed, while visual acuity was 6/9. One month after PPV, a single eccentric retinal hole below the macula was detected using fundoscopy and subsequently confirmed by optical coherence tomography. At this time the visual acuity was 6/9 and the patient reported no symptoms. No further intervention was attempted and at the 9-month follow-up, the visual acuity and the size of the eccentric macular hole remained stable. Eccentric macular holes can be developed after PPV even without ILM peeling and are usually managed conservatively by observation.

New illuminations approaches with single-use micro LEDs endoilluminators for the pars plana vitrectomy

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Koelbl, Philipp Simon; Koch, Frank H. J.; Lingenfelder, Christian; Hessling, Martin

2018-02-01

The illumination of the intraocular space during pars plana vitrectomy always bears the risk of retina damage by irradiation. Conventional illumination systems consist of an external light source and an optical fiber to transfer the visible light (radiation) into the eye. Often xenon arc and halogen lamps are employed for this application with some disadvantageous properties like high phototoxicity and low efficiency. Therefore, we propose to generate the light directly within the eye by inserting a white micro LED with a diameter of 0.6 mm. The LED offers a luminous flux of 0.6 lm of white light with a blue peak @ 450 nm and a yellow peak @ 555 nm. The presented prototypes fit through a standard 23 G trocar and are the first intraocular light sources worldwide. Two different single-use approaches have already been developed: a handguided and a chandelier device. The hand-guided applicator enables a directly navigation and illumination up to a working distance of 6 mm. The chandelier device is much smaller and does not need an active navigation of the light cone. The brightness and homogeneity of the illumination of these LED devices have been successfully tested on porcine eyes. Presented measurements and calculations prove that even for high LED currents and small distances to the retina these intraocular micro LED devices expose the retina to less hazard than conventional illumination sources like fiber based xenon systems. Even under the worst circumstances application durations of 180 hours would be justifiable.

Intraoperative optical coherence tomography in macula involving rhegmatogenous retinal detachment repair with pars plana vitrectomy and perfluoron.

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Toygar, O; Riemann, C D

2016-01-01

PurposeTo investigate microanatomical relationships during surgical repair of macula involving retinal detachment with pars plana vitrectomy (PPV) and perfluoron (PFO) with a microscope-integrated intraoperative optical coherence tomography (iOCT) device.Patients and methodsThis consecutive case series included nine eyes of nine patients with macula involving retinal detachment operated by a single surgeon at the Cincinnati Eye Institute. All patients underwent PPV, PFO injection, endolaser, and air-fluid exchange. The macula was imaged with iOCT before PFO injection, after PFO injection, and after air-fluid exchange in all eyes.ResultsiOCT imaging was ergonomically easy to obtain in all eyes. iOCT clearly demonstrated submacular fluid (SMF) at the beginning of the surgery, macular flattening under PFO in all eyes, small residual SMF under PFO in six of nine eyes, and increased occult SMF following air-fluid exchange in all eyes.ConclusionMicroscope-integrated iOCT is a versatile and powerful imaging modality that holds a great deal of promise in the future. Its confirmation of persistent occult SMF in this small series of macular involving retinal detachment repair with PFO, may inform surgical decision making, and demonstrates a pathophysiological rationale for initial face-down positioning after retinal detachment repair.

Long-term outcomes of pars plana vitrectomy without internal limiting membrane peeling for optic disc pit maculopathy.

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Avci, R; Yilmaz, S; Inan, U U; Kaderli, B; Kurt, M; Yalcinbayir, O; Yildiz, M; Yucel, A

2013-12-01

To evaluate the results of surgical treatment of maculopathy secondary to congenital optic pit anomaly with pars plana vitrectomy (PPV), endolaser to the temporal edge of the optic disc and C3F8 tamponade without internal limiting membrane (ILM) peeling. Thirteen eyes of 12 patients with serous macular detachment and/or macular retinoschisis secondary to congenital optic disc pit (ODP) were included in the study. All eyes underwent PPV, posterior hyaloid removal, endolaser photocoagulation on the temporal margin of the optic disc and 12% C3F8 gas tamponade. Anatomic success and functional outcome determined retrospectively by optical coherence tomography and measurement of best corrected visual acuity (BCVA), respectively were the main outcome parameters. Two lines or more improvement in BCVA was obtained in 11 eyes and 6 of these eyes had 20/40 or better BCVA at the final visit. Subretinal or intraretinal fluid was completely resorbed postoperatively in 12 eyes but a little intraretinal fluid persisted in one eye at the 16-month follow-up. Better visual improvement was observed in patients treated by earlier surgical intervention. PPV, C3F8 gas tamponade and endolaser to the optic disc margin without ILM peeling may yield favourable results in the treatment of ODP maculopathy.

Vitrectomy in double-perforation gunshot injury

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Abd El Alim Mohamed A

2013-11-01

Full Text Available Ahmed Abd El Alim MohamedOphthalmology department, Ain Shams University, Cairo, EgyptObjective: This study sought to evaluate the result of pars plana vitrectomy in patients with gunshot wounds involving double perforation.Methods: This was a retrospective, noncomparative, interventional case series.Results: Eighteen patients (18 eyes with double-perforation gunshot injuries were treated from February 2010 to March 2012. The group included 16 men (88% and two women (11%; the mean age was 24 (15–33 years. In each case, vitrectomy was scheduled 1–6 weeks after repair of the entrance site. Associated retinal detachments were observed in two eyes (11%, retinal incarceration was observed surrounding the exit site in three eyes (16%, and retention of an intraocular foreign body was observed in two cases. After a follow-up period of 8 ± 2 months, two eyes (11% had achieved visual acuity (VA of 0.5, nine eyes (50% had achieved VA between 0.5 and 0.1, and seven eyes (38% had achieved VA between 0.1 and hand movement. The main reasons for functional failure (VA 0.1 to hand movement were macular dragging (due to fibrosis at the exit site near the macula in seven cases (38%, submacular hemorrhage in four cases (22%, and epimacular fibrosis in five cases (27%. All cases developed postoperative exotropia. One case (5% developed postoperative hemorrhage. No cases exhibited signs of postoperative redetachment.Conclusion: The outcome of pars plana vitrectomy in cases with double perforations is variable. Factors including the surgeon's skill level, the time to surgery, and the efficacy of the intraocular tamponade affect the postoperative outcome.Keywords: pars plana vitrectomy, gunshot injury, double perforation

Pars plana vitrectomy with juxtapapillary laser photocoagulation versus vitrectomy without juxtapapillary laser photocoagulation for the treatment of optic disc pit maculopathy: the results of the KKESH International Collaborative Retina Study Group.

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Abouammoh, Marwan A; Alsulaiman, Sulaiman M; Gupta, Vishali S; Mousa, Ahmed; Hirakata, Akito; Berrocal, Maria H; Chenworth, Megan; Chhablani, Jay; Oshima, Yusuke; AlZamil, Waseem M; Casella, Antonio Marcelo; Papa-Oliva, Gabriela; Banker, Alay S; Arevalo, J Fernando

2016-04-01

To compare the functional and anatomic outcomes of pars plana vitrectomy (PPV) with juxtapapillary laser photocoagulation (JLP) versus vitrectomy without JLP in optic disc pit maculopathy. This was a multicentre, retrospective study of 46 consecutive patients with optic disc pit maculopathy presenting at tertiary eye centres between 1992 and 2012. Indications for surgery included distorted or decreased vision. Surgical intervention included PPV, posterior vitreous detachment, with or without gas tamponade. Twenty-four patients received laser photocoagulation at the temporal edge of the optic disc pit (group A) and 22 patients had no laser (group B). Postoperative best-corrected visual acuity (BCVA) and optical coherence tomography findings were the main outcome measures. Mean follow-up was 44 months (range 12-98 months). BCVA in group A improved significantly from 0.7 logMAR (20/100) preoperatively to 0.5 logMAR (20/60) postoperatively (p=0.017). In group B, BCVA improved from 0.7 logMAR (20/100) preoperatively to 0.4 logMAR (20/40) postoperatively (p=0.014). The difference in final BCVA between groups was not statistically significant (p=0.693). The mean central macular thickness (CMT) in group A improved significantly from 750 μm preoperatively to 309 μm at last follow-up (pfinal CMT between groups was not statistically significant (p=0.747). PPV with JLP for optic disc pit maculopathy had similar functional and anatomic outcomes compared with vitrectomy without JLP. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

A retrospective study comparing outcomes of primary rhegmatogenous retinal detachment repair by scleral buckling and pars plana vitrectomy in Finland.

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Sahanne, Sari; Tuuminen, Raimo; Haukka, Jari; Loukovaara, Sirpa

2017-01-01

Rhegmatogenous retinal detachment (RRD) is the most common form of retinal detachment and an ophthalmic emergency. Here, we compared outcomes of primary RRD eyes operated with conventional scleral buckling (SB) with cryoretinopexy to those operated with standard pars plana vitrectomy (PPV). This is an institutional, retrospective, register-based, observational, comparative study. Based on the surgical procedure, 319 eyes of 319 patients were divided into two groups: SB plus cryotherapy (n=50) and PPV (n=269). Changes in intraocular pressure (IOP) and best-corrected visual acuity (BCVA) were recorded at 30 days and reoperation rates within 180 days postoperatively. Eyes operated with PPV had less reoperations within the first 180 days as compared with SB eyes ( P =0.001, log-rank test); however, changes in IOP were more prominent (mean ± standard deviation: +8.1±8.8 vs. +4.4±7.0 mmHg, respectively; P =0.006). Changes in BCVA did not differ between the surgical procedures. PPV was associated with higher primary anatomic success rates and lower risk of reoperation but significant IOP elevation when compared to SB. These factors should be case-specifically considered when choosing treatment modality for primary RRD.

Clinical outcomes after combined Ahmed glaucoma valve implantation and penetrating keratoplasty or pars plana vitrectomy.

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Lee, Jin Young; Sung, Kyung Rim; Tchah, Hung Won; Yoon, Young Hee; Kim, June Gone; Kim, Myoung Joon; Kim, Jae Yong; Yun, Sung-Cheol; Lee, Joo Yong

2012-12-01

To evaluate whether a combination of penetrating keratoplasty (PKP) or pars plana vitrectomy (PPV) and Ahmed glaucoma valve (AGV) implantation affords a level of success similar to that of AGV implantation alone. Eighteen eyes underwent simultaneous PPV and AGV, 14 eyes with PKP and AGV and 30 eyes with AGV implantation alone were evaluated. Success was defined as attainment of an intraocular pressure (IOP) >5 and glaucoma medication. Kaplan-Meier survival analysis was performed to compare cumulative survival between the combined surgery groups and the AGV implantation-alone group. Cox proportional hazard regression analysis was conducted to identify factors predictive of success in each of the three groups. Mean (±standard deviation) preoperative IOP was 30.2 ± 10.2 mmHg in the PKP + AGV, 35.2 ± 9.8 mmHg in the PPV + AGV, and 36.2 ± 10.1 mmHg in the AGV implantation-alone group. The cumulative success rate at 18 months was 66.9%, 73.2%, and 70.8% in the three groups, respectively. Neither combined surgery group differed significantly in terms of cumulative success rate compared with the AGV implantation-alone group (p = 0.556, p = 0.487, respectively). The mean number of preoperative anti-glaucoma medications prescribed was significantly associated with success in the PKP + AGV implantation group (hazard ratio, 2.942; p = 0.024). Either PKP or PPV performed in conjunction with AGV implantation afforded similar success rates compared to patients treated with AGV implantation alone. Therefore, in patients with refractory glaucoma who have underlying corneal or retinal pathology requiring treatment with PKP or PPV, AGV implantation can be performed simultaneously.

A retrospective study comparing outcomes of primary rhegmatogenous retinal detachment repair by scleral buckling and pars plana vitrectomy in Finland

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Sahanne S

2017-03-01

Full Text Available Sari Sahanne,1 Raimo Tuuminen,2 Jari Haukka,3 Sirpa Loukovaara4 1Department of Anesthesiology, Helsinki University Central Hospital, Helsinki, 2Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka, 3Hjelt Institute, Faculty of Medicine, University of Helsinki, 4Unit of Vitreoretinal Surgery, Department of Ophthalmology, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland Background: Rhegmatogenous retinal detachment (RRD is the most common form of retinal detachment and an ophthalmic emergency. Here, we compared outcomes of primary RRD eyes operated with conventional scleral buckling (SB with cryoretinopexy to those operated with standard pars plana vitrectomy (PPV. Methods: This is an institutional, retrospective, register-based, observational, comparative study. Based on the surgical procedure, 319 eyes of 319 patients were divided into two groups: SB plus cryotherapy (n=50 and PPV (n=269. Changes in intraocular pressure (IOP and best-corrected visual acuity (BCVA were recorded at 30 days and reoperation rates within 180 days postoperatively. Results: Eyes operated with PPV had less reoperations within the first 180 days as compared with SB eyes (P=0.001, log-rank test; however, changes in IOP were more prominent (mean ± standard deviation: +8.1±8.8 vs. +4.4±7.0 mmHg, respectively; P=0.006. Changes in BCVA did not differ between the surgical procedures. Conclusion: PPV was associated with higher primary anatomic success rates and lower risk of reoperation but significant IOP elevation when compared to SB. These factors should be case-specifically considered when choosing treatment modality for primary RRD. Keywords: rhegmatogenous retinal detachment, vitrectomy, scleral buckling

Ultrastructural and histopathologic findings after pars plana vitrectomy with a new hypersonic vitrector system. Qualitative preliminary assessment.

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Salvador Pastor-Idoate

Full Text Available Preliminary assessment of a new prototype ultrasound-based hypersonic vitrector (HV by qualitatively examining the histopathological changes in the retina and vitreous body after pars plana vitrectomy (PPV and its ability to fragment vitreous collagen.Fourteen porcine cadaveric eyes, 20 eyes in live swine and six human cadaveric eyes underwent PPV using the HV or a pneumatic guillotine vitrector (GV. An additional 4 porcine crystalline lenses were touched with either the HV or GV for 1 minute. Following PPV, human vitreous was removed and processed for electron microscopy (EM. Eyes and lenses were fixed and sectioned for light microscopy (LM.There were no macroscopic retinal or optic nerve defects associated with either HV or GV PPVs. Cadaveric retinal specimens showed separation of the inner limiting membrane (ILM and vacuolization and fragmentation at the nerve fiber layer (NFL and the ganglion cell layer (GCL. ILM fragmentation and separation were found after PPV in live swine with both vitrectors. Small disruptions of the posterior capsule or structural lens defects were found after HV touch. The EM analysis revealed more fragmentation of human vitreous collagen fibrils after HV compared to GV PPV.LM and EM analysis of retina, vitreous, and crystalline lens after PPV showed similar morphological changes using the HV or the GV. Vitreous fragmentation appeared more effective with the HV. Overall this study suggests that the HV may be a promising new technology. More work is needed to quantitatively assess its safety and efficacy.

[Vitrectomy and gas-fluid exchange for the treatment of serous macular detachment due to optic disc pit: long-term evaluation].

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Moreira Neto, Carlos Augusto; Moreira Junior, Carlos Augusto

2013-01-01

To evaluate 5 patients with serous macular detachment due to optic disc pit that were submitted to pars plana vitrectomy and were followed for at least 7 years. Patients were submitted to pars plana vitrectomy, posterior hyaloid removal, autologous serum injection and gas-fluid exchange, without laser photocoagulation, and were evaluated pre and post-operatively with visual acuity and Amsler grid testing, retinography, and recently, with autofluorescence imaging and high resolution OCT. All 5 eyes improved visual acuity significantly following the surgical procedure maintaining good vision throughout the follow-up period. Mean pre-operative visual acuity was 20/400 and final visual acuity was 20/27 with a mean follow-up time of 13.6 years. No recurrences of serous detachments were observed. OCT examinations demonstrated an attached retina up to the margin of the pit. Serous macular detachments due to optic disc pits were adequately treated with pars plana vitrectomy and gas fluid exchange, without the need for laser photocoagulation, maintaining excellent visual results for a long period of time.

Optic neuropathy causing vertical unilateral hemianopsia after pars plana vitrectomy for a macular hole: A case report.

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Kawashima, Hirohiko; Nagai, Norihiro; Shinoda, Hajime; Tsubota, Kazuo; Ozawa, Yoko

2018-04-01

Recent progress in medical technology has resulted in improved surgical outcomes of pars plana vitrectomy (PPV); with microincision systems, the incidence of procedure-related complications during surgery has been reduced. However, unpredictable visual field defects after PPV remain an unresolved issue. A few reports have shown that damage to the retinal neurofibers owing to dry-up during air/fluid exchange or retinal neurotoxicity of the dye used to visualize the internal limiting membrane (ILM), as well as unintentional removal of retinal neurofibers during ILM peeling, are responsible for such visual field disorders. In this report, we present a case of extensive visual field defect due to optic neuropathy exhibiting vertical hemianopsia after PPV. A 50-year-old woman underwent PPV and cataract surgery for a macular hole and mild cataract under retrobulbar anesthesia with 3.5 mL of xylocaine. At the time of opening an infusion cannula for PPV, the intraocular lens was herniating, with an acute increase in pressure from the posterior eyeball; thus, intraocular pressure configuration level had to be decreased from the default level, whereas the other procedures including 20% SF6 injection were performed without any modification. The macular hole was closed postoperatively. However, the patient experienced nasal hemianopsia, which turned out to be optic neuropathy, as assessed via electric physiological examinations. The pattern of the visual field defect was not typical for glaucoma or anterior ischemic optic neuropathy. Her optic nerve head was pale at the temporal side soon after the surgery, and her blood pressure was low, suggesting that there may have been a congestion of the optic nerve feeder vessels because of the relatively high pressure in the orbit. The space occupancy with xylocaine and extensively stretched and plumped out eye ball with infusion during PPV may have pressed the surrounding tissue of the optic nerve and the feeder vessels. PPV is safe

Valved versus nonvalved cannula small-gauge pars plana vitrectomy for repair of retinal detachments with Grade C proliferative vitreoretinopathy

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Oellers P

2016-05-01

Full Text Available Patrick Oellers, Sandra Stinnett, Paul Hahn Duke Eye Center, Duke University School of Medicine, Durham, NC, USA Purpose: Valved cannulas are a recent addition to small-gauge pars plana vitrectomy (PPV and provide stable intraocular fluidics. The goal of this study was to compare outcomes and postoperative complication rates of valved vs nonvalved cannula small-gauge PPV for repair of retinal detachments (RDs complicated by Grade C proliferative vitreoretinopathy (PVR.Methods: A retrospective chart review of 364 consecutive eyes with either valved or nonvalved cannula PPV for RD repair was performed. The primary outcomes were single surgery and final anatomic success and change in best-corrected visual acuity for repair of RDs complicated by Grade C PVR.Results: We identified 36 eyes in the valved group and 31 eyes in the nonvalved group with Grade C PVR RD. The single surgery success was 83% vs 77% (P=0.555 and the final anatomic success was 94% vs 87% (P=0.404 in the valved vs nonvalved eyes, respectively. The mean final visual acuity gain was −0.36 logarithm of the minimum angle of resolution (logMAR; approximate Early Treatment Diabetes Retinopathy Study [ETDRS] score =17 letters in valved eyes vs −0.33 logMAR (approximate ETDRS score =16 letters in nonvalved eyes (P=0.81. Postoperative complication rates including postoperative day 1 hypotony, hypertony, and anterior chamber fibrin formation; postoperative retention of intraocular or subretinal perfluorocarbon liquid; and subsequent epiretinal membrane peel were not statistically different between groups.Conclusion: Valved cannula PPV yields equivalent visual acuity and anatomic outcomes without increased postoperative complication rates compared to traditional nonvalved cannula PPV for Grade C PVR-associated RD repair. Keywords: 23 gauge, 25 gauge, PVR, RD, chronic, single surgery success, final anatomic success

Twenty-five gauge vitrectomy in uveitis

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Roger Roberto Wada Kamei

2012-04-01

Full Text Available PURPOSE: To evaluate anatomical and functional results of 25-gauge transconjunctival sutureless pars plana vitrectomy in patients with uveitis. METHODS: Vitrectomy was performed on 20 eyes with residual vitritis secondary to infectious and noninfectious uveitis. Patients were evaluated 1 week before surgery and after surgery at day 1, week 1, week 4 and week 12. Visual acuity (VA, intraocular pressure, anterior chamber cells and flare and vitreous haze were measured. RESULTS: Mean VA improved from 2.06 ± 0.94 logMAR before surgery to 0.58 ± 0.46 logMAR at week 12 (p<0.05. No case required conversion to standard 20-gauge instrumentation or suture placement, no intraoperative complications were noted. Transient postoperative hypotony was seen in three eyes. One patient with toxoplasmic retinochoroiditis had a relapse during follow-up. CONCLUSION: 25-gauge vitrectomy has proven its efficacy on cleansing vitreous opacities and improving visual acuity on patients with residual vitritis secondary to uveitis with minimal postoperative inflammation and complications.

Success Rates of Vitrectomy in Treatment of Rhegmatogenous Retinal Detachment

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Mohamed, Yasser Helmy; Ono, Kozue; Kinoshita, Hirofumi; Uematsu, Masafumi; Tsuiki, Eiko; Fujikawa, Azusa; Kitaoka, Takashi

2016-01-01

Aim. To investigate the anatomical success rates of pars plana vitrectomy (PPV) after primary rhegmatogenous retinal detachment (RRD). Methods. This retrospective study was conducted between December 2008 and October 2014 at Nagasaki University Hospital. The preoperative data recorded included the lens status, location of the retinal tear, whether a tear was visualized, presence of multiple tears, macula status, presence of peripheral lattice retinal degeneration, and best-corrected visual ac...

Efficacy of vitrectomy with triamcinolone assistance versus internal limiting membrane peeling for highly myopic macular hole retinal detachment.

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Wei, Yong; Wang, Ningli; Zu, Zhongqiao; Bi, Chuncao; Wang, Huaizhou; Chen, Fenghua; Yang, Xingguang

2013-06-01

To compare the outcomes of pars plana vitrectomy (PPV) with or without the adjuvant surgical procedures: triamcinolone acetonide (TA) assistance and/or internal limiting membrane (ILM) peeling for the treatment of highly myopic macular hole retinal detachment (MHRD). Case-control study. Pars plana vitrectomy combined with 2 kinds of adjuvant surgical procedures were used on 96 highly myopic eyes with MHRD. These eyes were assigned to 4 groups randomly: Group 1, non-TA-assisted PPV and without ILM peeling; Group 2, non-TA-assisted PPV with ILM peeling; Group 3, TA-assisted PPV and without ILM peeling; Group 4, TA-assisted PPV with ILM peeling. Anatomical reattachment of the retina, macular hole closure, and best-corrected visual acuity were measured. The rates of both retinal reattachment and macular hole closure were higher in Group 2 (84.0 and 44.0%) and Group 3 (80.8 and 46.2%) than Group 1 (73.9 and 17.4%); however, there were no differences between Group 2 and Group 3 (P > 0.05). The rates of macular hole closure were extremely low in Group 1 and also in eyes with extreme long axial lengths (≥29.0 mm), "severe" chorioretinal atrophy, and posterior staphyloma. Pars plana vitrectomy with either TA assistance or ILM peeling was effective for the treatment of highly myopic MHRD. If you peel the ILM, adding TA does not affect closure rates; and if TA is used to visualize the vitreous, ILM peeling may not be necessary in MHRD. There was a lower anatomical success rate in MHRD with extreme long axial lengths, severe chorioretinal atrophy, and posterior staphyloma.

Outcomes of 23-gauge pars plana vitrectomy and internal limiting membrane peeling with brilliant blue in macular hole

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Nohutcu A

2011-08-01

Full Text Available Huseyin Sanisoglu1, Mehmet Sahin Sevim1, Betul Aktas1, Semra Sevim2, Ahmet Nohutcu11Haydarpasa Numune Education and Research Hospital, Department of Ophthalmology, 2Uskudar State Hospital, Eye Clinic, Istanbul, TurkeyPurpose: The evaluation of anatomic and visual outcomes in macular hole cases treated with internal limiting membrane (ILM peeling, brilliant blue (BB, and 23-gauge pars plana vitrectomy (PPV.Materials and methods: Fifty eyes of 48 patients who presented between July 2007 and December 2009 with the diagnosis of stage 2, 3, or 4 macular holes according to Gass Classification who had undergone PPV and ILM peeling were included in this study. Pre- and postoperative macular examinations were assessed with spectral-domain optical coherence tomography. 23 G sutureless PPV and ILM peeling with BB was performed on all patients.Results: The mean age of patients was 63.34 ± 9.6 years. Stage 2 macular hole was determined in 17 eyes (34%, stage 3 in 24 eyes (48%, and stage 4 in 9 eyes (18%. The mean follow-up time was 13.6 ± 1.09 months. Anatomic closure was detected in 46/50 eyes (92%, whereas, in four cases, macular hole persisted and a second operation was not required due to subretinal fluid drainage. At follow-up after 2 months, persistant macular hole was detected in one case and it was closed with reoperation. At 12 months, an increase in visual acuity in 41 eyes was observed, while it remained at the same level in six eyes. In three eyes visual acuity decreased. There was a postoperative statistically significant increase in visual acuity in stage 2 and 3 cases (P < 0.05, however, no increase in visual acuity in stage 4 cases was observed.Conclusion: PPV and ILM peeling in stage 2, 3, and 4 macular hole cases provide successful anatomic outcomes, however, in delayed cases, due to photoreceptor loss, it has no effect on functional recovery. BB, used for clarity of ILM, may be beneficial due to its low retinal toxicity.Keywords: macular

Geometry, penetration force, and cutting profile of different 23-gauge trocars systems for pars plana vitrectomy.

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Meyer, Carsten H; Kaymak, Hakan; Liu, Zengping; Saxena, Sandeep; Rodrigues, Eduardo B

2014-11-01

To investigate the geometry, penetration force, and cutting profile of 23-gauge trocar systems for pars plana vitrectomy based on their grinding methods in a standardized laboratory setting. In this experimental study, Eleven different commercially available 23-gauge sclerotomy trocar systems were divided into 4 groups according to their needle grinding and deburring: "back" bevel, "spear" bevel, "lancet" bevel, and "spatula" bevel. The normative geometrical data of the trocar systems were systematically analyzed according to nomenclature ISO 7864 and ISO 9626. Force to penetrate a 0.4-mm thick polyurethane foil was measured by a Penetrometer, when the trocar needle was piercing, cutting, and sliding through the foil at different defined loading phases and plotted as a load-displacement diagram. Magnified images of the consecutive cut were taken under a microscope after the entire penetration through the foil. Three physicians used all trocar systems in a masked fashion on human sclera to evaluate the manual penetration force in 30° and 90°. The mean outer diameter of the trocar systems was 0.630 ± 0.009 mm, and the mean outer diameter of the trocars was 0.750 ± 0.013 mm. The mean point length was 3.11 ± 0.49 mm, and the mean length of the bevel was 1.46 ± 0.23 mm. The primary bevel angle was 10.75 ± 0.41°, and the secondary bevel angle was 65.9 ± 42.56°. The piercing forces of the back bevel and spear-pointed trocars/needles were at the same level (0.087 ± 0.028 N). The lancet-pointed needle had remarkable low piercing and cutting forces with 0.41 N (range, 0.35-0.47 N). The spatula bevel tip showed the highest penetration piercing force with 1.6 N (range, 1.59-1.73 N). The back bevel systems induced frequently triangular-shaped incisions, with two nearly rectangular cuts of short length. The spear bevels produced a regular characteristic linear cut. Especially, the lancet blade created straight cut with a linear wound apposition. Spatula trocar systems

Phacoaspiration with a Cionni ring versus pars plana lensectomy, vitrectomy and sutureless transscleral IOL fixation in pediatric patients with a subluxated lens.

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Thapa, Bikram Bahadur; Agarwal, Aniruddha; Singh, Ramandeep; Gupta, Parul Chawla; Ram, Jagat

2016-05-01

To compare outcomes of phacoaspiration (PA) with Cionni ring-assisted posterior-chamber intraocular lens implantation (PCIOL) versus pars plana lensectomy (PPL) with anterior vitrectomy (AV) and sutureless transscleral fixation of the IOL (TSFIOL) assisted with fibrin glue in the management of a subluxated lens. In this prospective and comparative interventional study, one eye of children with a bilateral subluxated lens was randomized to undergo PA with PCIOL using a Cionni ring (group A: n = 14 eyes), and the other eye underwent PPL + AV with glue-assisted TSFIOL (group B: n = 14 eyes). The outcome measures included best-corrected visual acuity (BCVA) in logMAR units and rates of complications at 12-month follow-up visits. 28 eyes of 14 children (age: 8.06 ± 4.49 years) were included in the study. BCVA improved from preoperative value of 1.21 to 0.4 (p = 0.001) in group A and from 1.53 to 0.31 (p = 0.001) in group B at month 12. There was no significant difference in the BCVA on comparing the two groups at month 12 (p > 0.411). Postoperative complications in group A included corneal edema (two eyes), Cionni hook capture (one eye), elevated IOP (one eye), and posterior capsular opacification (five eyes). In group B, corneal edema was seen in two eyes, hypotony in one eye, vitreous hemorrhage in one eye and pupillary optic capture in four eyes. Head-to-head comparison of the two techniques demonstrates no significant difference in the rates of complications at month 12. The decision to choose either technique may be based on the operating surgeon's skill, experience and preference.

Glaucoma de ángulo abierto posterior a la vitrectomía pars plana

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Kenia Galindo Reymond

Full Text Available Con este trabajo nos proponemos revisar las evidencias científicas relacionadas con la aparición del glaucoma de ángulo abierto posterior a la vitrectomía pars plana. Se revisaron las evidencias científicas relacionadas con la aparición del glaucoma de ángulo abierto posterior a la cirugía de vitrectomía pars plana. Para la investigación documental se examinaron los artículos de la temática indexados en las bases de datos Pubmed, Pubmed Central y Scielo, que correspondieron a los descriptores DeCs-MeSH: glaucoma de ángulo abierto y vitrectomía pars plana. En la búsqueda de avanzada se utilizó el booleano AND y la restricción de tiempo entre los años 2004 y 2014. De los 38 artículos identificados, se desecharon 16 por no tenerse acceso íntegro al documento. El tratamiento de los datos se realizó mediante el análisis de contenido de tipo directo. Los mecanismos patológicos que causan glaucoma de ángulo abierto posterior a la vitrectomía pars plana son múltiples y complejos. La hipótesis del daño por estrés oxidativo en las celdas de la malla trabecular y su repercusión en la salida del humor acuoso, tiene un sustento científico en su patogenia que la hace plausible. El tratamiento para controlar la hipertensión ocular en estos pacientes después de la vitrectomía es individualizado; puede transitar desde el tratamiento médico y hasta el uso de técnicas quirúrgicas simples o complejas en algunos casos. Aún no se han esclarecido los mecanismos fisiopatológicos del glaucoma de ángulo abierto posterior a la vitrectomía pars plana, por lo que son necesarias nuevas investigaciones sobre el tema.

Combined 23-gauge transconjunctival vitrectomy and scleral fixation of intraocular lens without conjunctival dissection in managing lens complications.

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Yeung, Ling; Wang, Nan-Kai; Wu, Wei-Chi; Chen, Kuan-Jen

2018-04-23

To evaluate the safety and efficacy of combined 23-gauge transconjunctival pars plana vitrectomy and scleral fixation of intraocular lens (IOL) without conjunctival dissection. A retrospective study in Chang Gung Memorial Hospital, Keelung and Taoyuan, Taiwan. Patients receiving combined 23-gauge transconjunctival pars plana vitrectomy and scleral fixation of IOL without conjunctival dissection were enrolled. The ocular findings, causes of lens complication, surgical procedures, type of IOL used, and complications were documented. We included 40 eyes from 39 patients (27 male, 12 female) with a mean age of 59.5 [standard deviation (±) 14.8] years old. The mean follow-up duration was 6.8 ± 5.4 months. The cause of lens complications was ocular trauma in 24 (60%) eyes, cataract surgery complications in 11 (28%) eyes, and spontaneous subluxation of crystalline lens in 5 (13%) eyes. The overall best corrected visual acuity (BCVA) (logMAR) improved from 1.359 ± 0.735 to 0.514 ± 0.582 (p IOL decentration was found in 3 (8%) eyes and 1 (3%) eye respectively. Combined 23-gauge transconjunctival vitrectomy and scleral fixation of IOL without conjunctival dissection is effective and safe in managing a wide variety of lens complications, with good postoperative comfort and visual recovery. Retrospective study, not applicable.

Small-Gauge Pars Plana Vitrectomy for the Management of Symptomatic Posterior Vitreous Detachment after Phacoemulsification and Multifocal Intraocular Lens Implantation: A Pilot Study from the Pan-American Collaborative Retina Study Group

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Navarro, Rodrigo M.; Machado, Leonardo M.; Maia, Ossires; Wu, Lihteh; Farah, Michel E.; Magalhaes, Octaviano; Arevalo, J. Fernando; Maia, Mauricio

2015-01-01

Purpose. To determine the efficacy of 23-gauge pars plana vitrectomy (PPV) for symptomatic posterior vitreous detachment (PVD) on visual acuity (VA) and quality after multifocal intraocular lenses (IOLs). Methods. In this prospective case series, patients who developed symptomatic PVD and were not satisfied with visual quality due to floaters and halos after multifocal IOL implantation underwent PPV. Examinations included LogMAR uncorrected visual acuity (UCVA), intraocular pressure, biomicroscopy, and indirect ophthalmoscopy at baseline and 1, 7, 30, and 180 days postoperatively. Ultrasonography and aberrometry were performed. The Visual Functioning Questionnaire 25 (VFQ-25) was administered preoperatively and at 30 days postoperatively. Both the postoperative UCVA and questionnaire results were compared to preoperative findings using the Wilcoxon test. Results. Sixteen eyes of 8 patients were included. VA significantly improved from 0.17 to 0.09 postoperatively (P = 0.017). All patients reported improvement of halos, glare, and floaters. VFQ-25 scores significantly improved in general vision (P = 0.023), near activities (P = 0.043), distance activities (P = 0.041), mental health (P = 0.011), role difficulties (P = 0.042), and driving (P = 0.016). Conclusion. PPV may increase UCVA and quality of vision in patients with bilateral multifocal IOLs and symptomatic PVD. Larger studies are advised. PMID:26504590

Outcome of 20-gauge transconjunctival cannulated sutureless vitrectomy using silicone oil or air tamponade

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Mohamed, Ahmed Abdel Alim; Abdrabbo, Mohamed

2013-01-01

Ahmed Abdel Alim Mohamed,1 Mohamed Abdrabbo21Ain Shams University, Faculty of Medicine, Ophthalmology Department, Cairo; 2Faculty of Medicine, Ophthalmology Department, Benha University, Benha, EgyptBackground: The purpose of this study was to assess the outcome of pars plana vitrectomy using a 20-gauge transconjunctival cannulated sutureless system with air or silicone oil tamponade in cases of retinal detachment of different etiologies.Methods: A prospective study was performed in 60 eyes f...

Role of avastin on the incidence of post-operative vitreous hemorrhage after vitrectomy in diabetic vitreous hemorrhage

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Ahmed, N.; Shaheer, M.; Tahir, M.Y.

2014-01-01

Diabetic retinopathy is one of the most common cause of legal blindness. Five to 10% of diabetic patients suffer from the proliferative diabetic retinopathy which includes the formation of new vessels on the retina and optic disc which can be complicated as vitreous hemorrhage and tractional retinal detachment. Pars plana vitrectomy along with laser photocoagulation is being used for the management of vitreous hemorrhage. In our study we used injection avastin one week before surgery to see its role on the incidence of rebleed after vitrectomy in diabetic vitreous hemorrhage. Materials and Methods; Fifty patients were divided into 2 equal groups on the basis of simple random sampling. 25 patients in Group I were operated with routine pars plana vitrectomy with endolaser photo- coagulation while in Group II all the 25 patients were given injection avastin intra-vitreally one week before surgery. Evaluation was done on the first post operative day, first follow up visit (one week) and after one month to see the incidence of re-bleed. Chi-square test was used for statistical analysis. Results: Fifty patients divided into two groups. In Group I, 3 patients had recurrent vitreous hemorrhage on first post-operative day, 3 patients had re-bleed on first follow up visit, and only 2 patients had re-bleed after one month. In Group II, none of the patients had recurrent vitreous hemorrhage on first post-operative day and on first follow-up visit (one week) while 2 patients had re-bleed after one month. Conclusion: Injection intravitreal Avastin (Bevaci- zumab) one week before surgery significantly reduces the risk of vitreous hemorrhage after vitrectomy in diabetic patients. (author)

Predictors of postoperative bleeding after vitrectomy for vitreous hemorrhage in patients with diabetic retinopathy.

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Motoda, Saori; Shiraki, Nobuhiko; Ishihara, Takuma; Sakaguchi, Hirokazu; Kabata, Daijiro; Takahara, Mitsuyoshi; Kimura, Takekazu; Kozawa, Junji; Imagawa, Akihisa; Nishida, Kohji; Shintani, Ayumi; Iwahashi, Hiromi; Shimomura, Iichiro

2017-12-19

To clarify the association between perioperative variables and postoperative bleeding in pars plana vitrectomy for vitreous hemorrhage in diabetic retinopathy. The present retrospective study enrolled 72 eyes of 64 patients who were admitted to Osaka University Hospital between April 2010 and March 2014, and underwent vitrectomy for vitreous hemorrhage as a result of diabetic retinopathy. Postoperative bleeding developed in 12 eyes. Using binomial logistic regression analysis, we found that the duration of operation was the only significant variable associated with postoperative bleeding within 12 weeks after vitrectomy. Furthermore, Poisson regression analysis identified fasting blood glucose just before vitrectomy, no treatment with antiplatelet drugs and treatment with antihypertensive drugs, as well as duration of operation, to be significantly associated with the frequency of bleeding within 52 weeks after vitrectomy. Long duration of operation can be used to predict bleeding within both 12 and 52 weeks after vitrectomy. In addition, fasting blood glucose just before vitrectomy, no treatment with antiplatelet drugs and treatment with antihypertensive drugs might be risk factors for postoperative bleeding up to 1 year after vitrectomy. © 2017 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

27-GAUGE VITRECTOMY WOUND INTEGRITY: A Randomized Pilot Study Comparing Angled Versus Straight Entry in Fluid-Filled Vitrectomized Eyes.

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Khan, M Ali; Durrani, Alia K; Hsu, Jason; Regillo, Carl D

2018-04-01

To compare clinical outcomes using angled versus straight trocar insertion during 27-gauge pars plana vitrectomy for epiretinal membrane. Pilot randomized controlled trial. Thirty eyes of 30 patients undergoing 27-gauge pars plana vitrectomy with membrane peeling for epiretinal membrane were randomized 1:1 to receive angled or straight trocar insertion. Intraocular pressure (IOP) and postoperative wound-related complications were compared. Fifteen eyes were randomized to each the angled and straight incision groups. No significant difference in phakic status (P = 0.71) or preoperative IOP (15.1 ± 3.4 vs. 14.6 ± 3.0 mmHg, P = 0.67) existed between groups. On postoperative Day 1, eyes in the straight group had lower IOP compared with the angled group (11.8 ± 3.9 vs. 15.3 ± 5.2 mmHg, P = 0.04) and a relative decrease in IOP compared with preoperative values (11.8 ± 3.9 vs. 15.1 ± 3.4 mmHg, P straight group) and serous choroidal detachment (1 eye, angled group). Eyes with straight incisions had transiently lower IOP on postoperative Day 1, possibly suggestive of subclinical wound leak in the very early postoperative period. Overall, rates of hypotony and sclerotomy-related complications were similarly low between wound construction strategies.

[Cost recovery for the treatment of retinal and vitreal diseases by pars plana vitrectomy under the German DRG system].

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Framme, C; Franz, D; Mrosek, S; Helbig, H

2007-10-01

Since 2004 inpatient health care in Germany is paid according to calculated DRGs. Only a few university hospitals participated in distinct cost calculations of clinical treatment. It was the aim of this study to check the cost recovery at a University Eye Hospital for the surgical treatment of retinal and vitreal diseases by pars plana vitrectomy (ppV), which are included in DRGs C03Z and C17Z. The performance data for both DRGs were collected for the years 2005 and 2006 using the E1 sheets according to section 21 KHEntG. The mean duration of all procedures was collected by data from the internal controlling. Costs for single operations were calculated from fixed and variable costs for the operation theatre and the ward including costs for personnel and material. In the 2-year period of 4,721 inpatient procedures 1,307 ppVs were performed. Each ppV had fixed surgical costs of 130.60 EUR; personnel costs varied between 575 EUR (C03Z; including cataract surgery; mean OP duration: 85 min) and 510 EUR (C17Z; no cataract surgery; mean OP duration: 73 min) at a proportion between general anaesthesia and local anaesthesia of 80/20. For a pure ppV material costs were 255 EUR. Additional adjuncts such as an encircling band, perfluorcarbon, ICG, tPA, gas and silicon oil or cataract surgery led to extra costs between 51 EUR and 250 EUR per adjunct und were used in 56% (C03Z) and 74.5% (C17Z) of all procedures. Costs for hospitalisation were about 1765 EUR at a mean residence time of 6.5 days. Thus, the overall costs of a pure basic ppV amounted to 2975 EUR (C03Z) and 2661 EUR (C17Z). In consideration of the current relative DRG weights of 1.08 and 0.957 and a current base rate of 2787.19 EUR in Bavaria, cost recovery is only given for basic ppV but not for complex ppVs having higher material and personnel costs. Additionally, the costs for multiple surgeries as occur in 5.9% of cases are not compensated by the DRG system. The reimbursement for inpatient ppVs in a University

Four-port bimanual 23-gauge vitrectomy for diabetic tractional retinal detachment.

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Wang, Zhao-Yang; Zhao, Ke-Ke; Li, Jia-Kai; Rossmiller, Brian; Zhao, Pei-Quan

2016-06-01

Four-port bimanual vitrectomy is a surgical technique that facilitates removal of epiretinal membranes in severe proliferative diabetic retinopathy (PDR). As the illumination is held by the assistant through the fourth scleral incision, fibrovascular membranes are removed by bimanual manipulation techniques. The objective of this study was to evaluate the safety and efficacy of four-port bimanual 23-gauge vitrectomy for patients with tractional retinal detachment (TRD) in severe PDR. Retrospective, comparative, consecutive, interventional case series. Sixty-six eyes of 58 consecutive patients who underwent primary vitrectomy for severe diabetic TRD. Thirty-six eyes of 31 cases that were treated with four-port 23-gauge vitrectomy were compared with 30 eyes of 27 cases that were treated with 23-gauge pars plana vitrectomy (PPV). Main outcome measures were best-corrected visual acuity (BCVA), retinal status, intraocular pressure, and incidence of intraoperative and postoperative complications with at least 6 months of follow-up. The primary and ultimate anatomic success rates (94.4% versus 93.3%, and 100% in both groups, respectively) and the mean BCVA changes did not differ significantly between groups. The whole surgical time and the membrane removal time were significantly (p four-port 23-gauge group than in the 23-gauge group. There was no difference in the incidence of intraoperative and postoperative complications in both groups. Four-port bimanual 23-gauge vitrectomy offers comparable anatomic success and shortens the surgical time compared with conventional 23-gauge PPV in patients with TRD resulting from severe PDR. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Pars Plana-Modified versus Conventional Ahmed Glaucoma Valve in Patients Undergoing Penetrating Keratoplasty: A Prospective Comparative Randomized Study.

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Parihar, Jitendra Kumar Singh; Jain, Vaibhav Kumar; Kaushik, Jaya; Mishra, Avinash

2017-03-01

To compare the outcome of pars-plana-modified Ahmed glaucoma valve (AGV) versus limbal-based conventional AGV into the anterior chamber, in patients undergoing penetrating keratoplasty (PK) for glaucoma with coexisting corneal diseases. In this prospective randomized clinical trial, 58 eyes of 58 patients with glaucoma and coexisting corneal disease were divided into two groups. Group 1 (29 eyes of 29 patients) included patients undergoing limbal-based conventional AGV into the anterior chamber (AC) along-with PK and group 2 (29 eyes of 29 patients) included those undergoing pars-plana-modified AGV along-with PK. Outcome measures included corneal graft clarity, intraocular pressure (IOP), number of antiglaucoma medications, and postoperative complications. Patients were followed up for a minimum period of 2 years. Out of 58 eyes (58 patients), 50 eyes (50 patients: 25 eyes of 25 patients each in group 1 and group 2) completed the study and were analyzed. Complete success rate for AGV (group 1: 76%; group 2: 72%; p = 0.842) and corneal graft clarity (group 1: 68%; group 2: 76%; p = 0.081) were comparable between the two groups at 2 years. Graft failure was more in conventional AGV (32%) as compared to pars plana-modified AGV (24%) but not statistically significant (p = 0.078) at 2 years. Though both procedures were comparable in various outcome measures, pars-plana-modified AGV is a viable option for patients undergoing PK, as it provides a relatively better corneal graft survival rate and lesser complications that were associated with conventional AGV.

Bacterial endogenous endophthalmitis in Vietnam: a randomized controlled trial comparing vitrectomy with silicone oil versus vitrectomy alone

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Do T

2014-08-01

Full Text Available Tan Do,1 Do N Hon,1 Tin Aung,2 Nguyen DTN Hien,1 Claude L Cowan Jr3 1Vietnam National Institute of Ophthalmology, Hanoi, Vietnam; 2Singapore National Eye Center, Singapore; 3Georgetown University Medical Center, Washington, DC, USA Background/aims: To compare treatment outcomes with and without silicone oil tamponade in patients undergoing pars plana vitrectomy (PPV for severe endogenous bacterial endophthalmitis (BEE. Methods: One hundred and eight consecutive patients with severe BEE (defined by the absence of pupil red reflex at presentation and/or dense vitreous opacity on ultrasound and no improvement after 24–36 hours of medical treatment were randomly assigned to two treatment groups: Group 1, standard PPV with intravitreal antibiotics; and Group 2, PPV with intravitreal antibiotics and silicone tamponade. Overall success was defined as: a visual acuity ≥ count fingers at 1 meter, with an attached retina, and no intraocular oil. Results: Fifty three patients were randomized to Group 1 and 55 patients to Group 2. The mean age of study subjects was 32 years and baseline clinical characteristics were similar in both groups. At the final follow-up visit at 9 months, the overall success rate of Group 2 (67.3% was significantly better than Group 1 (43.4%; P=0.01. There were also fewer devastating complications (such as inoperable retinal detachment, phthisis bulbi in Group 2 compared with Group 1 (21.8% versus 43.4%; P=0.01. Conclusion: The outcome at 9 months of patients with BEE treated by vitrectomy with silicone oil was better than those treated by vitrectomy alone. Keywords: bacterial endogenous endophthalmitis, vitrectomy, silicone oil endotamponade, randomized controlled trial

Contrast Sensitivity after Pars Plana Vitrectomy: Comparison between Macula-On and Macula-Off Rhegmatogenous Retinal Detachment.

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Kawamura, Hajime; Fujikawa, Masato; Sawada, Osamu; Sawada, Tomoko; Saishin, Yoshitsugu; Ohji, Masahito

2016-07-01

To evaluate the contrast sensitivity (CS) of eyes successfully repaired by vitrectomy for rhegmatogenous retinal detachment (RRD) with or without preoperative macular involvement. In this retrospective, consecutive, interventional case series, 109 eyes received primary vitrectomy for RRD, of which 36 with at least 12 months of follow-up and a best-corrected visual acuity (BCVA) ≥1 at 12 months postoperatively were investigated. The main outcome measurements were BCVA and CS at 12 months postoperatively. Patients with macula-on RRD preoperatively were included in the macula-on group, and patients with macula-off RRD preoperatively were included in the macula-off group. The between-group difference in CS under evening vision conditions was measured with a Takagi glare tester CGT-2000 at 6 visual angles and 13 contrast levels with and without glare. CS was significantly lower in the macula-off group for targets with visual angles of 1.6, 1.0, and 0.64° with glare (p macula-off RRD patients with good postoperative BCVA compared to macula-on RRD patients with good postoperative BCVA. © 2016 S. Karger AG, Basel.

Utility of Pars Plana Vitrectomy with Internal Limiting Membrane Dissection, in the Surgical Treatment of Macular Hole and Diabetic Macular Edema. Clinic-Pathological Correlation

OpenAIRE

Castro de Sousa, João Paulo

2006-01-01

ObjetivosEstudiar el papel de la extracción de la membrana limitante interna (MLI) durante la vitrectomía posterior por vía pars plana (VPP), en el tratamiento quirúrgico de lo agujero macular (AM) y de lo edema macular crónico diabético (EMCD). Hemos estudiado las tasas de éxito clínico de la extracción de la MLI durante la VPP. Además hemos analizado el procedimiento técnico de extracción de la MLI, el aporte de la extracción de la MLI en la resolución clínica del EMCD después de la VPP y e...

The Safety and Efficacy of Adjustable Postoperative Position after Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment

OpenAIRE

Lin, Zhong; Sun, Jin Tao; Wu, Rong Han; Moonasar, Nived; Zhou, Ye Hui

2017-01-01

Purpose. To report the safety and efficacy of adjustable postoperative position for rhegmatogenous retinal detachment (RRD). Methods. Retrospective review of 536 consecutive RRD eyes that underwent vitrectomy surgery for retina repair from year 2008 to 2014. The retinal breaks were divided into superior, lateral (nasal, temporal, and macular), and inferior locations, according to the clock of breaks. Patients with superior and lateral break location were allowed to have facedown position or l...

Midline sclerotomy approach for intraocular foreign body removal in phakic eyes using endoilluminator: A novel technique

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Ravani, Raghav; Chawla, Rohan; Azad, Shorya Vardhan; Gupta, Yogita; Kumar, Vinod; Kumar, Atul

2018-01-01

Purpose: The objective of this study is to describe the removal of retained intraocular foreign body (RIOFB) by bimanual pars plana vitrectomy through midline sclerotomy in phakic patients. Technique: Four eyes with RIOFB and clear lens underwent microincision vitrectomy surgery. A chandelier illumination was placed through one of the existing ports. The foreign body (FB) was localized by direct visualization (intravitreal) or indentation (pars plana), stabilized using an intraocular magnet/FB forceps introduced through a midline sclerotomy and freed of vitreous from all sides using a vitrectomy cutter through the other port bimanually, reoriented along their long axis and extracted through the midline sclerotomy. Results: All four FBs were removed successfully without slippage or damage to the clear lens. Conclusion: Chandelier illumination-assisted removal of FB through midline sclerotomy helps in easier localization, stabilization and removal, avoiding lens touch even in anteriorly located FBs such as at pars plana. PMID:29676316

Microvascular changes after vitrectomy with internal limiting membrane peeling: an optical coherence tomography angiography study.

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Mastropasqua, Leonardo; Borrelli, Enrico; Carpineto, Paolo; Toto, Lisa; Di Antonio, Luca; Mattei, Peter A; Mastropasqua, Rodolfo

2017-06-19

To evaluate superficial capillary plexus (SCP) changes occurring after internal limiting membrane (ILM) peeling for the treatment of idiopathic epiretinal membrane (ERM). A total of 15 eyes of 15 patients affected by idiopathic ERM (eight males and seven females; mean age 59.8 ± 9.6 years) were enrolled in the study. Patients were treated with pars plana vitrectomy followed by ERM and ILM peeling. Subjects were evaluated at baseline and at the week-1 and month-1 follow-up visits. At each visit, patients were evaluated with a complete ophthalmologic evaluation, which included imaging with optical coherence tomography angiography. Overall, the SCP vessel density was 43.0 ± 3.0% at baseline and was stable throughout the follow-up (40.0 ± 4.0% at week-1 and 41.0 ± 4.0% at month-1 follow-up visits; p = 0.087 and p = 0.426, respectively). Nevertheless, the SCP vessel density was reduced at week-1 visit in both the superior and inferior sectors. In these sectors, the superficial vessel density was still reduced at the month-1 follow-up visit. We observed a reduction in the SCP vessel density occurring after pars plana vitrectomy with ILM peeling. The reduction is referred to those areas where other changes (e.g., swelling of the arcuate nerve fiber layer) have been already described. In theory, superficial vessel density modifications may be due to the direct surgical trauma to the inner retina, where the superficial plexus is contained, during the ILM grasping.

Treatment of a dislocated lens by transcorneal vitrectomy and bimanual phacoemulsification

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Watanabe A

2014-08-01

Full Text Available Akira Watanabe, Tamaki Gekka, Hiroshi Tsuneoka Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan Background: As a method of treatment for a dropped lens nucleus, which occurred during cataract surgery, the dropped lens nucleus was removed through the corneal wound without using pars plana vitrectomy (PPV. After vitrectomy, the dropped lens nucleus was floated on the perfluorocarbon liquid (PFCL. The floating lens nucleus was then phacoemulsified and aspirated. During surgery, irrigation from the anterior chamber was performed. This method was very effective for treatment of a dropped hard nucleus.Case report: During cataract surgery on the left eye of an 80-year-old woman, a posterior capsule rupture occurred. As a result, the lens nucleus dropped into the vitreous cavity. Irrigation to the anterior chamber was performed, with an anterior chamber maintainer inserted through a newly created side port at the corneal limbus. A vitreous cutter and a light guide were inserted in order to perform vitrectomy through the corneal incisions that were created for the cataract surgery. After vitrectomy, the dropped lens nucleus was floated using PFCL. The floating lens nucleus was removed by a bimanual phacoemulsification technique, with the anterior chamber irrigation continuing. The separation of the irrigation port and the aspiration port allowed for effective treatment of the dropped nucleus that was floating on the PFCL, even using a ­phacoemulsification machine with a peristaltic pump system. Safe and effective vitrectomy, similar to a PPV, could be performed with this method using three corneal ports.Conclusion: This technique may allow safer and more effective treatment for a dropped lens nucleus compared with conventional PPV. With this technique, corneal distortion due to surgical manipulation can lead to reduced visibility of the posterior eye. Keywords: dislocated lens, transcorneal vitrectomy, bimanual

METAMORPHOPSIA AND OUTER RETINAL MORPHOLOGIC CHANGES AFTER SUCCESSFUL VITRECTOMY SURGERY FOR MACULA-OFF RHEGMATOGENOUS RETINAL DETACHMENT.

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Okuda, Tetsuhiko; Higashide, Tomomi; Sugiyama, Kazuhisa

2018-01-01

To evaluate the correlation between metamorphopsia and outer retinal morphologic changes after successful vitrectomy for rhegmatogenous retinal detachment (RRD). Forty eyes from 40 patients with macula-off (26 eyes) or macula-on (14 eyes) RRDs that underwent pars plana vitrectomy were included. Metamorphopsia was quantified with M-CHARTS. The relationship between the integrity of the outer retinal layers examined by spectral domain optical coherence tomography and metamorphopsia at 6 and 12 months postoperatively was evaluated. Metamorphopsia was significantly more frequent in eyes with macula-off RRD (88%) than in eyes with macula-on RRD (21%) at 6 months postoperatively (P macula-off RRD eyes from 6 months to 12 months (64%) postoperatively (P = 0.041). Horizontal metamorphopsia scores in eyes with continuous interdigitation zone and ellipsoid zone bands were significantly smaller than in eyes with a disrupted interdigitation zone band and a continuous ellipsoid zone band or in eyes with disrupted ellipsoid zone and interdigitation zone bands (P = 0.003 and P macula-off RRD.

Refractive changes after lens-sparing vitrectomy for macular hole and epiretinal membrane

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Muto T

2017-08-01

Full Text Available Tetsuya Muto,1 Tomoharu Nishimura,1 Takefumi Yamaguchi,2 Makoto Chikuda,1 Shigeki Machida1 1Department of Ophthalmology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan; 2Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Japan Purpose: Cataract progression after lens-sparing vitrectomy might differ according to original posterior segment diseases. Our objective was to analyze the refractive values after lens-sparing vitrectomy for macular hole (MH and epiretinal membrane (ERM. Materials and methods: We reviewed the medical records of 25 MH patients (25 eyes and 23 ERM patients (23 eyes who underwent lens-sparing vitrectomy. Refractive changes in both groups were compared. All patients underwent 20-gauge three-port pars plana vitrectomy. Fluid–air exchange was performed during vitrectomy only in the MH group. The results were analyzed using the unpaired t-test, chi-square test, or Fisher exact probability test, and multivariate analysis. Results: There were no significant differences in the patient’s age (P=0.45. The myopia progression rate (D/month was higher in the MH group after surgery than that in the ERM group (P=0.035. MH group had more females (P=0.043, longer surgical time (P<0.001, and higher frequencies of surgical adjuvants use (triamcinolone acetonide, P=0.019; brilliant blue G, P<0.001. The myopia progression rate in the MH group (R=0.568, P<0.001 correlated with female gender. However, no correlation was observed between longer surgical time and the use of surgical adjuvants. Conclusion: The rate of myopia progression was higher in the MH group. Fluid–air exchange and gender may affect the rate of myopia progression. Keywords: cataract, vitrectomy, macular hole, epiretinal membrane

Posterior subtenon triamcinolone acetonide in gas-filled eyes as an adjunctive treatment for complicated proliferative diabetic retinopathy.

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Lee, Yongeun; Kang, Seungbum; Park, Young-Hoon

2013-02-01

To evaluate the effect of adjunctive subtenon injection of triamcinolone acetonide (TA) in gas-filled eyes after vitrectomy for complicated proliferative diabetic retinopathy (PDR). This nonrandomized comparative study included 27 patients (27 eyes) who underwent pars plana vitrectomy and gas tamponade for treatment of PDR with tractional or combined tractional-rhegmatogenous retinal detachment and who received subtenon injection of TA (40 mg) at the end of surgery. The study group was compared with the control group (29 eyes), which was matched with the study group for preoperative and intraoperative parameters, but underwent pars plana vitrectomy and gas tamponade without a subtenon injection of TA. Retinal reattachments without reoperation were achieved in 25 eyes (92.6%) and 26 eyes (89.7%) at 6 months (p = 1.000) in the study and control groups, respectively. The study group and the control group did not differ significantly in the frequency of postoperative proliferative vitreoretinopathy, retinal redetachment rate, reoperation rate, macular pucker formation, postoperative vitreous hemorrhage, gain in visual acuity, intraocular pressure, and intraocular inflammation (p > 0.05). The clinical results of pars plana vitrectomy for complicated PDR are not improved significantly by an adjunctive subtenon TA injection in gas-filled eyes.

Effect of internal limiting membrane peeling on the development of epiretinal membrane after pars plana vitrectomy for primary rhegmatogenous retinal detachment.

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Nam, Ki Yup; Kim, Jung Yeul

2015-05-01

To investigate the difference in the occurrence of postoperative epiretinal membranes (ERMs) in vitrectomy for rhegmatogenous retinal detachment with and without peeling of the internal limiting membrane (ILM). The medical records of the 135 patients, who underwent vitrectomy for primary rhegmatogenous retinal detachment from November 2007 to August 2011, were analyzed retrospectively. Of the subjects, 70 patients underwent ILM peeling during the surgery and 65 did not. The best-corrected visual acuity, fundus photograph, and optical coherence tomography were collected 3, 6, and 12 months postoperatively. The relationship between ILM peeling and the preoperative findings of rhegmatogenous retinal detachment and development of a postoperative ERM was analyzed. No ERM occurred in the ILM peeling group, whereas an ERM occurred in 14 of 65 patients who underwent vitrectomy without ILM peeling (21.5%). This difference was significant (P peeling group and was significantly higher 12 months postoperatively (P = 0.03). Internal limiting membrane peeling seems to prevent the occurrence of a postoperative ERM in patients with primary rhegmatogenous retinal detachment.

Dellen formation as a complication of subconjunctival silicone oil following microincision vitrectomy

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Mahgoub MM

2017-12-01

Full Text Available Mohamed M Mahgoub,1,2 Maged M Roshdy,1,2 Sherine S Wahba1,2 1Ophthalmology Department, Ain Shams University, 2Ophthalmology Department, Al Watany Eye Hospital, Cairo, Egypt Purpose: To study the subconjunctival silicone oil (SCSO parameters associated with dellen formation following microincision vitrectomy (MIV.Patients and methods: This was a case–control study of 20 eyes with SCSO following MIV. Ten of them suffered postoperative dellen formation. Dellen occurrence, their sizes, number of loci, and distance between SCSO and the limbus were recorded. The outcome after silicone-oil removal was evaluated.Results: The SCSO was at 3.1±1.2 mm from the limbus. All cases with dellen had SCSO within 2 mm of the limbus (P<0.001. No other factors were found to be associated with dellen formation (age, P=0.414; sex, P=0.656; laterality, P=1; indication for pars plana vitrectomy, P=0.655; instrument gauge, P=0.211; circumference involved by SCSO, P=0.252. All the dellen healed after surgical evacuation of SCSO (P<0.001, leaving scars.Conclusion: Dellen can be associated with MIV secondary to SCSO near the limbus. Resolution with scarring occurred following SCSO evacuation. Therefore, SCSO should be evacuated as early as possible to avoid long-term peripheral corneal morbidity. Keywords: silicone oil-removal, subconjunctival silicone oil, dellen, vitrectomy

Two-Port Pars Plana Anterior and Central Core Vitrectomy (Lam Floaterectomy) in Combination With Phacoemulsification and Intraocular Lens Implantation Under Topical Anesthesia for Patients with Cataract and Significant Floaters: Results of the First 50 Consecutive Cases.

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Lam, Dennis S C; Leung, Hiu Ying; Liu, Shu; Radke, Nishant; Yuan, Ye; Lee, Vincent Y W

2017-01-01

To study the safety and efficacy of 2-port pars plana anterior and central core vitrectomy (Lam floaterectomy) in combination with phacoemulsification (phaco) and intraocular lens implantation (IOL) for patients with cataract and significant floaters under topical anesthesia. Retrospective review of the first 50 consecutive cases. A standardized treatment protocol was used for patients with cataract and significant (moderate to severe) floaters (duration > 3 months). Data analysis included intraoperative and postoperative complications, floater status, and patient satisfaction. There were 50 eyes (38 patients) with a male-to-female ratio of 1 to 2.3. Twelve patients had bilateral eye surgeries. Mean age was 58.10 ± 9.85 years (range, 39-83). All patients completed the 3-month follow-up. One eye had mild vitreous hemorrhage at the end of surgery arising from sclerotomy wound oozing. No other intraoperative compli-cations were encountered. Postoperatively, there was 1 case of transient hypotony and 1 case of congestion at sclerotomy wound. No cases of retinal break or detachment, or clinically significant macular edema, were reported. There were 5 cases (10%) of mild residual floaters and 1 case (2%) of floater recurrence. Total floater clearance rate was 88%. Patient satisfaction rates were 80%, 14%, 6%, and 0% for very satisfied, satis-fied, acceptable, and unsatisfied, respectively. The 3-month results in terms of safety and efficacy of the Lam floaterectomy in combination with phaco and IOLfor patients with cataract and significant floaters under topical anesthesia are encouraging. Further larger-scale, prospective, multicenter studies seem warranted. Copyright© 2017 Asia-Pacific Academy of Ophthalmology.

Clinical outcomes of pars plicata anterior vitrectomy: 2-year results

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Priya Narang

2015-01-01

Full Text Available Purpose: To demonstrate the safety and outcome of a surgical approach that uses pars plicata site for anterior vitrectomy during phacoemulsification procedure complicated by posterior capsule rupture and residual cortical matter. Design: Single center, retrospective, interventional, noncomparative study. Materials and Methods: Medical records of a consecutive series of 35 eyes of 35 patients who underwent pars plicata anterior vitrectomy (PPAV were reviewed. The main outcome measures were corrected and uncorrected distance visual acuity (CDVA, UDVA, early and late postoperative complications and intraocular pressure (IOP. Ultrasound biomicroscopic (UBM evaluation of sclerotomy site and spectral domain optical coherence tomography analysis for central macular thickness (CMT was performed. The final visual outcome at 2 years was evaluated. Results: At 2 years follow-up, the mean postoperative UDVA (logarithm of the minimum angle of resolution [logMAR] and CDVA (logMAR was 0.49 ± 0.26 and 0.19 ± 0.14, respectively. There was no significant change in the IOP (P = 0.061 and the mean CMT at 2 years was 192.5 ± 5.54 mm. The postoperative UBM image of the sclerotomy site at 8 weeks demonstrated a clear wound without any vitreous adhesion or incarceration. Intraoperative hyphema was seen in 1 (2.8% case and postoperative uveitis was seen in 2 (5.7% cases, which resolved with medications. No case of an iatrogenic retinal break or retinal detachment was reported. Conclusions: PPAV enables a closed chamber approach, allows thorough cleanup of vitreous in the pupillary plane and anterior chamber and affords better access to the subincisional and retropupillary cortical remnant with a significant visual outcome and an acceptable complication rate.

EFFECT OF INTERNAL LIMITING MEMBRANE PEELING DURING VITRECTOMY FOR DIABETIC MACULAR EDEMA: Systematic Review and Meta-analysis.

Science.gov (United States)

Nakajima, Takuya; Roggia, Murilo F; Noda, Yasuo; Ueta, Takashi

2015-09-01

To evaluate the effect of internal limiting membrane (ILM) peeling during vitrectomy for diabetic macular edema. MEDLINE, EMBASE, and CENTRAL were systematically reviewed. Eligible studies included randomized or nonrandomized studies that compared surgical outcomes of vitrectomy with or without ILM peeling for diabetic macular edema. The primary and secondary outcome measures were postoperative best-corrected visual acuity and central macular thickness. Meta-analysis on mean differences between vitrectomy with and without ILM peeling was performed using inverse variance method in random effects. Five studies (7 articles) with 741 patients were eligible for analysis. Superiority (95% confidence interval) in postoperative best-corrected visual acuity in ILM peeling group compared with nonpeeling group was 0.04 (-0.05 to 0.13) logMAR (equivalent to 2.0 ETDRS letters, P = 0.37), and superiority in best-corrected visual acuity change in ILM peeling group was 0.04 (-0.02 to 0.09) logMAR (equivalent to 2.0 ETDRS letters, P = 0.16). There was no significant difference in postoperative central macular thickness and central macular thickness reduction between the two groups. The visual acuity outcomes using pars plana vitrectomy with ILM peeling versus no ILM peeling were not significantly different. A larger randomized prospective study would be necessary to adequately address the effectiveness of ILM peeling on visual acuity outcomes.

Comparison of disposable sutureless silicone ring and traditional metal ring in 23-gauge vitrectomy combined with cataract surgery

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Li X-R

2011-06-01

Full Text Available Jian-Guo Wu, Rui-Hua Wei, Ai-Hua Liu, Xiao-Xu Zhou, Guo-Ling Sun, Xiao-Rong LiTianjin Medical University Eye Center, Tianjin, ChinaBackground: The purpose of this prospective, interventional, comparative case series was to evaluate the efficiency and feasibility of a disposable sutureless silicone lens ring for corneal contact lens stabilization during combined 23-gauge vitrectomy and cataract surgery.Methods: We developed a ring consisting of a single silicone component with three footplates along the ring margin to fit cannulae for holding conventional contact lenses. Thirty eyes from 30 patients with cataract and vitreoretinal disease were included, and divided into two matched groups according to disease type and ring used. In Group A, we used a 23-gauge transconjunctival vitrectomy system and a disposable sutureless silicone lens ring (n = 15. In Group B, we used a 23-gauge transconjunctival vitrectomy system and a conventional metal lens ring (n = 15. The main outcome measures were: time required for vitrectomy preparation, rate of intraoperative corneal limbus bleeding, and limbus scar rate at the final follow-up visit.Results: Thirty cases were successfully completed. The average vitrectomy preparation time was less in Group A than in Group B (P < 0.01, and the average preparation time saved was 3.94 minutes. None of the Group A patients had intraoperative bleeding or postoperative scarring, whereas all 15 Group B cases had bleeding and five had scarring. There was a statistically significant difference between Group A and Group B for these complications (P ≤ 0.05.Conclusion: This report demonstrates the advantages of using a sutureless silicone ring during combined 23-gauge vitrectomy and cataract surgery. Using this method could allow extra time for the surgeon to pay more attention to complex vitreoretinal procedures.Keywords: pars plana vitrectomy, contact lens, silicone ring, cataract surgery

A classification system of intraocular lens dislocation sites under operating microscopy, and the surgical techniques and outcomes of exchange surgery.

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Hayashi, Ken; Ogawa, Soichiro; Manabe, Shin-Ichi; Hirata, Akira; Yoshimura, Koichi

2016-03-01

The aim of this study was to examine the recent status of intraocular lens (IOL) dislocation according to a classification system based on vertical dislocation position, as well as the surgical techniques and outcomes of IOL exchange surgery. The medical records of 230 eyes from 214 consecutive patients who experienced IOL dislocation and underwent exchange surgery between 2006 and 2014 were reviewed. Vertical dislocation sites observed preoperatively under operating microscopy were examined, along with the surgical techniques and outcomes of IOL exchange. Dislocation sites included (1) the anterior chamber (12.2 %), (2) pseudophakodonesis (19.1 %), (3) the anterior vitreous cavity (47.4 %), (4) trap door-like dislocation (dangling in the peripheral vitreous cavity; 16.1 %), and (5) the retinal surface (5.2 %). The IOL retained in the anterior segment was moved onto the iris by pulling it up through the limbal side ports with an anterior vitrectomy (67.8 %), or by pushing it up from the pars plana with an anterior vitrectomy (26.5 %), while the IOL dropped on the retina was lifting it up from the retina after pars plana vitrectomy (5.7 %). Mean uncorrected and distance-corrected visual acuity significantly improved postoperatively (p system, approximately 95 % of dislocated IOLs were retained in the anterior segment, and these IOLs were exchanged using an anterior approach through limbal incisions with an anterior vitrectomy. Visual acuity improved significantly, and serious complications were uncommon, probably because the IOL exchange techniques were standardized and simplified without pars plana vitrectomy.

Late-Onset Inadvertent Bleb Formation following Pars Plana M3 Molteno Implant Tube Obstruction

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Anmar M. Abdul-Rahman

2017-01-01

Full Text Available Purpose: To report a case of inadvertent bleb formation presenting 18 months after pars plana M3 Molteno implant tube obstruction in a patient with mixed mechanism glaucoma. Materials and Methods: An 84-year-old Caucasian male with mixed mechanism glaucoma underwent slit-lamp examination, gonioscopy, colour anterior segment photography and anterior segment optical coherence tomography (AS-OCT. Results: An inadvertent bleb developed 18 months after pars plana implant tube re-positioning with a 6/0 Vicryl tie ligature. The bleb was located in the area anterior to the implant plate; it was characterised by a thin, transparent, avascular and multi-cystic wall, with a visible stoma at the posterior edge of the bleb. The bleb was functioning as demonstrated by an intraocular pressure of 6 mm Hg at presentation and a punctate fluorescein uptake pattern of the bleb wall. The bleb over the plate of the Molteno implant was non-functioning, likely secondary to tube obstruction by vitreous in the early postoperative period. AS-OCT showed a tract from the anterior chamber commencing at an entry wound through a corneal tunnel to the posterior stoma at the base of the inadvertent bleb. Conclusions: We hypothesise that the pathophysiologic factors resulting in an inadvertent bleb are a result of a combination of apoptosis, late-onset wound dehiscence and internal gaping of a centrally placed corneal wound. In addition, aqueous hydrodynamic factors may play a role.

Massive Silicone Oil Migration into the Subconjunctival Space: A Leakage Mechanism Dilemma

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Jesús Téllez

2018-05-01

Full Text Available Purpose: To report a case in which an early, massive silicone oil migration into the subconjunctival space occurred in a patient after sutureless vitrectomy with the presence of a previously implanted pars plana glaucoma drainage device. Case Report: An 80-year-old man presented with neovascular glaucoma secondary to a proliferative diabetic retinopathy in his left eye. After an intracamerular bevacizumab injection and panretinal photocoagulation, a 23-gauge pars plana vitrectomy (PPV combined with a superotemporal Ahmed pars plana glaucoma valve implantation was performed. Afterwards, the patient underwent a new 23-gauge PPV for a dense vitreous hemorrhage. Intravitreal 1,000 centistokes silicone oil was placed to prevent recurrent intraocular bleeding. No sutures were performed. In the first postoperative month, a massive migration of silicone oil into the 360° subconjunctival space was noted until no intraocular silicone oil was observed. Conclusions: We discuss the possible leakage mechanisms in this particular case.

Structural Changes of the Macula on Optical Coherence Tomography after Vitrectomy for Proliferative Diabetic Retinopathy.

Science.gov (United States)

Im, Jong Chan; Kim, Jong Ho; Park, Dong Ho; Shin, Jae Pil

2017-01-01

This study aimed to evaluate the relationship between macular structural changes and visual prognosis after pars plana vitrectomy (PPV) for proliferative diabetic retinopathy. The study included 60 eyes that had undergone PPV. Macular optical coherence tomography (OCT) findings were classified into 5 groups preoperatively and 10 groups postoperatively. Best-corrected visual acuity (BCVA) were analyzed according to pre- and postoperative OCT. From the preoperative OCT, normal fovea with/without traction, normal fovea with preretinal hemorrhage, and tractional retinal detachment involving fovea showed an increase in BCVA after PPV (all p 20/50). Subfoveal fibrosis, macular hole, loss of foveal depression, and serous foveal detachment showed poor visual prognosis (BCVA <20/100). Macular structural changes were various after PPV, and visual prognosis correlated with these changes. © 2017 S. Karger AG, Basel.

Partial-thickness macular hole in vitreomacular traction syndrome: a case report and review of the literature

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Al Sabti Khalid

2010-01-01

Full Text Available Abstract Introduction Vitreomacular traction syndrome has recently been recognized as a distinct clinical condition. It may lead to many complications, such as cystoid macular edema, macular pucker formation, tractional macular detachment, and full-thickness macular hole formation. Case presentation We report a case of vitreomacular traction syndrome with eccentric traction at the macula and a partial-thickness macular hole in a 63-year-old Pakistani Punjabi man. The patient was evaluated using optical coherence tomography, and he underwent a successful pars plana vitrectomy. After the operation, his foveal contour regained normal configuration, and his visual acuity improved from 20/60 to 20/30. Conclusions Pars plana vitrectomy prevents the progression of a partial thickness macular hole in vitreomacular traction syndrome. The relief of traction by vitrectomy restores foveal anatomy and visual acuity in this condition.

Tonic Pupil and Corneal Anesthesia after Vitrectomy and Encircling Band for Retinal Detachment in an Ex-Premature Child

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Xavier Valldeperas

2010-09-01

Full Text Available An 11-year-old boy presented with a total retinal detachment in his right eye. He had a bilateral 360° argon laser treatment for an active retinopathy of prematurity performed after his birth. He underwent an uneventful pars plana vitrectomy, encircling band, 810-nm diode endolaser and heavy silicone oil (Densiron® endotamponade. A tonic pupil and abolition of corneal sensitivity, with a large epithelial defect, were observed during the postoperative period. We discuss the possible etiopathogenic mechanisms of the long and short ciliary nerves damage, and the role that retinopathy of prematurity and retinal detachment laser treatment and the encircling band placement might have played in the development of the tonic pupil and the corneal anesthesia.

Anatomical and functional outcomes following vitrectomy for dense vitreous hemorrhage related to Terson syndrome in children.

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Sayman Muslubas, Isil; Karacorlu, Murat; Hocaoglu, Mumin; Ersoz, Mehmet Giray; Arf, Serra

2018-03-01

Our purpose was to assess anatomical and functional outcomes of vitrectomy in pediatric cases of Terson syndrome. A total of 11 eyes of seven children diagnosed with Terson syndrome secondary to traumatic brain injury and 17 eyes of 12 children diagnosed with Terson syndrome secondary to nontraumatic brain hemorrhage who had 20-gauge or 23-gauge pars plana or pars plicata vitrectomy were included in this retrospective study. The primary outcome was the change in visual acuity from the preoperative examination to postoperative final follow-up. Secondary outcomes were anatomic surgical success and postoperative complications. The mean time between diagnosis and surgery was 62 ± 35 days (range, 30-150), and the average age at the time of the surgery was 4.5 ± 6.4 years (range, 3 months to 17 years). The mean preoperative logarithm of the minimum angle of resolution (logMAR) (Snellen) best corrected visual acuity (BCVA) was 2.6 ± 0.7 (20/7260) (n = 9) and in the remaining 19 eyes it was recorded as noncentral, unsteady, nonmaintained fixation. The mean follow-up period was 50 ± 54 months (range, 12-192 months). At the last follow-up visit, the mean logMAR BCVA was 0.46 ± 0.6 (20/60) (n = 19) and in eight eyes it was recorded as fix-and-follow. One eye developed a retinal detachment 14 months after the first operation, and one eye developed an epiretinal membrane after 2 years. Anatomical success was recorded in all patients at the final visit. In children with massive vitreous hemorrhage secondary to Terson syndrome, vitrectomy is an effective procedure and offers a rapid visual improvement. Earlier surgical treatment prevents amblyopia and blood-related potential complications.

Primary 25-gauge transconjunctival sutureless vitrectomy in pseudophakic retinal detachment

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Horozoglu Fatih

2007-01-01

Full Text Available Aims: There are few reports on 25-gauge transconjunctival sutureless vitrectomy (TSV in cases of pseudophakic retinal detachment. We conducted this study to report the anatomic and functional outcomes of 25-gauge TSV in the treatment of primary pseudophakic retinal detachment (RD. Design: Prospective, interventional case series. Materials and Methods: Fifteen eyes of 15 patients with RD after cataract surgery with phacoemulsification were evaluated. Primary pseudophakic RDs with macular detachment and proliferative vitreoretinopathy Stage B or less were included in the study. Pars plana vitrectomy with the 25-gauge TSV system, perfluorocarbon liquid injection followed by air exchange, endolaser photocoagulation and sulfur hexafluoride gas (20% injection were applied to all eyes. Results: Mean follow-up time was 9.2 months (range, six to 12 months. Retinal reattachment with a single operation was achieved in 93% of eyes and with additional surgery, the retina was reattached in 100% of eyes. Preoperative visual acuity was less than 20/200 in all eyes (range, hand motions to 20/400. Postoperative visual acuity was 20/40 or better in eight eyes (53% and between 20/50 and 20/200 in seven eyes (47%. No severe hypotony was encountered and no sutures were required to close the scleral and conjunctival openings. Postoperative complications were macular pucker in one eye (7% and cystoid macular edema in another eye (7%. Conclusions: Primary 25-gauge TSV system appears to be an effective and safe procedure in the treatment of uncomplicated pseudophakic RD.

Anti-vascular endothelial growth factor for prevention of postoperative vitreous cavity haemorrhage after vitrectomy for proliferative diabetic retinopathy.

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Smith, Jonathan M; Steel, David H W

2015-08-07

surgery, the incidence of vitreous cavity washout or revision vitrectomy at six months, adverse effects of intervention (cataract, iris rubeosis and rubeotic glaucoma, retinal detachment, increased inflammation and systemic side effects), quality of life measures performed at least six months following vitrectomy, and density of POVCH. The current review included 12 RCTs that looked at the pre- or intraoperative use of intravitreal bevacizumab to prevent postoperative vitreous haemorrhage during pars plana vitrectomy for complications of PDR. The studies were conducted in a variety of countries (three from Iran, two from Italy, two from Egypt, and the remaining from South Korea, USA, Mexico, Pakistan, and Japan). The inclusion criteria for entry into the studies were standard complications of proliferative retinopathy: non-clearing vitreous haemorrhage, tractional retinal detachment involving the macula, or combined tractional rhegmatogenous detachment. The included studies randomised a total of 654 eyes. The average age of the participants was 54 years.We identified methodological issues in all included studies. Risk of bias was highest for masking of participants and investigators (four studies were an 'open label' design), and a number of studies were unclear when describing randomisation methods and sequence allocation.Participants receiving intravitreal bevacizumab in addition to pars plana vitrectomy were less likely to experience early POVCH (grade 2) compared to people undergoing pars plana vitrectomy alone (risk ratio (RR) 0.28, 95% confidence interval (CI) 0.08 to 0.96, 2 studies, 144 eyes, high-quality evidence). This corresponds to an absolute effect of 130 fewer people (95% CI 167 fewer to 7 fewer) with early POVCH per 1000 people when treated with intravitreal bevacizumab. We saw similar results for all grades of POVCH (RR 0.35, 95% CI 0.23 to 0.53, 9 studies, 512 eyes) and when excluding cases where assessment of outcome was impossible due to presence of

Evaluation of the macular architecture of patients operated on from macula-off rhegmatogenous retinal detachment using optical coherence tomography

International Nuclear Information System (INIS)

Ramos Lopez, Meisy; Obret Mendive, Isabel; Hernandez Silva, Juan Raul

2010-01-01

With the support of optical coherence tomography, to evaluate the macular condition of the patients operated on from rhegmatogenous retinal detachment, with detached macula, who underwent buckling surgery and pars plana vitrectomy

Study of modified two incisions silicone oil removal with a 23G transconjunctival sutureless vitrectomy system

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Hai-Jun Yang

2015-01-01

Full Text Available AIM:To evaluate the efficacy and safety of silicone oil removal with a 23G transconjunctival sutureless vitrectomy system linked disposable transfusion tube and self-made suction tip. METHODS: The suction tip was made with a 23G infusion tube be cut from the end of the 5mm. It was used to connect the disposable transfusion tube and 23G puncture cannula. The disposable transfusion tube which was cut from the end of the MaiFei's pipe was connected with the effusion box of the vitreous cutter. Intraocular silicone oil was proactive suction and removed through two incisions on pars plana ciliaris with the vitreous cutter suction system. RESULTS: Only 13 cases(9.8%need suture puncture ports in 132 cases in the operation. Operation time was 7-28min. The average operation time was 15.1± 6.2min. In early postoperative, there were 107 cases(81.1%appeared lower intraocular pressure(CONCLUSION: The surgery that silicone oil is removed through two incisions with a 23G transconjunctival sutureless vitrectomy system linked disposable transfusion tube and self-made suction tip has the advantages of safe, effective, fast, economic, and it is worthy of popularization and application in clinical.

COMPARATIVE ANALYSIS OF RETINAL REATTACHMENT SURGERY WITH OR WITHOUT INTERNAL LIMITING MEMBRANE PEELING TO PREVENT POSTOPERATIVE MACULAR PUCKER.

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Forlini, Matteo; Date, Purva; Ferrari, Luisa Micelli; Lorusso, Massimo; Lecce, Gabriella; Verdina, Tommaso; Neri, Giovanni; Benatti, Caterina; Rossini, Paolo; Bratu, Adriana; DʼEliseo, Domenico; Ferrari, Tommaso Micelli; Cavallini, Gian Maria

2017-07-18

To determine whether internal limiting membrane (ILM) peeling during pars plana vitrectomy for rhegmatogenous retinal detachment reduces the incidence of epiretinal membrane (ERM) formation. In this retrospective study, preoperative, intraoperative, and postoperative data from all eyes undergoing pars plana vitrectomy for rhegmatogenous retinal detachment between January 2007 and December 2013 was analyzed. All cases with at least 1-year of follow-up were included. Data collection included vision, intraoperative complications, occurrence of ERM, and spectral domain optical coherence tomography characteristics. The OCTs were retrieved for all eyes and were graded by a single masked grader. Out of 159 eyes recruited, ILM peeling was done in 78 eyes (49%). Overall occurrence of ERM was 20%. Seven eyes (9%) in ILM peeling group and 25 eyes in the non-ILM peeling group (31%) showed ERM (P = 0.001). Postoperative vision was significantly better in eyes that had ILM peeling (0.48 ± 0.4 logarithm of the minimum angle of resolution [20/63] vs. 0.77 ± 0.6 logarithm of the minimum angle of resolution [20/125], P = 0.003). In multivariable models adjusting for type of tamponade, ILM peeling reduced the likelihood of ERM formation by 75% (P = 0.01). Internal limiting membrane peeling during pars plana vitrectomy for rhegmatogenous retinal detachment significantly reduces ERM formation in the postoperative period and is associated with better visual and anatomical outcomes.

Considerations in Management of Rhegmatogenous Retinal ...

African Journals Online (AJOL)

buckling surgery but Patient B required pars plana vitrectomy with silicon oil tamponade. Best ... Both patients were discharged on topical steroids drops with two hourly .... used, fetal growth retardation monitoring may be considered.[3].

Intravitreal Angiostrongylus cantonensis: first case report in South America

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Gabriel Costa de Andrade

Full Text Available ABSTRACT This study reports the first case of intravitreal angiostrongyliasis in South America treated with posterior worm removal via pars plana vitrectomy. This was a retrospective, observational case study. Data from medical charts, wide-field digital imaging, ocular ultrasound, and visual evoked potential studies were reviewed. A 20-month-old boy presented with eosinophilic meningitis and right eye exotropia. Polymerase chain reaction analysis of the cerebrospinal fluid showed a positive result for Angiostrongylus cantonensis. Fundus examination revealed a pale optic disc, subretinal tracks, vitreous opacities, peripheral tractional retinal detachment, and a dead worm in the vitreous cavity. The patient underwent pars plana vitrectomy with worm removal. This case report illustrates the first case of intravitreal angiostrongyliasis in South America, possibly related to the uncontrolled spread of an exotic invasive species of snail.

Optical coherence tomography findings and retinal changes after vitrectomy for optic disc pit maculopathy

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Gaurav Sanghi

2014-01-01

Full Text Available Purpose : To study the optical coherence tomography (OCT patterns in optic disc pit maculopathy and retinal changes after vitreous surgery. Materials and Methods : Retrospective review of consecutive cases with optic disc pit maculopathy seen at two tertiary eye institutes from January 2005 to June 2009. Results : Twenty-four eyes of 23 patients are included. The presenting visual acuity ranged from 20/400 to 20/20 (median:20/80. The median age at presentation was 24 years (range, 6-57 years. Optical coherence tomography demonstrated a combination of retinoschisis and outer layer detachment (OLD in 19 (79.17% eyes, OLD only in 3 (12.5% eyes and retinoschisis only in 2 (8.33% eyes. An obvious communication (outer layer hole between the schisis and OLD was seen in 14 (73.68% of the 19 eyes with both features. Of the 21 eyes with retinoschisis, schisis was present in multiple layers in 15 (71.43% and single layer in 6 (28.57% eyes. Eleven eyes underwent pars plana vitrectomy including creation of posterior vitreous detachment (PVD, fluid-air exchange, low intensity laser photocoagulation at the temporal edge of the optic disc pit and non-expansile perfluoropropane gas (14% injection. Five (45.45% of 11 eyes undergoing vitrectomy had complete resolution and 4 (36.36% eyes had partial resolution of maculopathy. Visual acuity improved in 8 (72.72% of 11 eyes. Conclusion : Optical coherence tomography demonstrates multiple layer schisis and outer layer detachment as main features of optic disc pit maculopathy. Vitrectomy with PVD induction, laser photocoagulation and gas tamponade results in anatomical and visual improvement in most cases with optic disc pit maculopathy.

Multiple methods of surgical treatment combined with primary IOL implantation on traumatic lens subluxation/dislocation in patients with secondary glaucoma.

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Wang, Rui; Bi, Chun-Chao; Lei, Chun-Ling; Sun, Wen-Tao; Wang, Shan-Shan; Dong, Xiao-Juan

2014-01-01

To describe clinical findings and complications from cases of traumatic lens subluxation/dislocation in patients with secondary glaucoma, and discuss the multiple treating methods of operation combined with primary intraocular lens (IOL) implantation. Non-comparative retrospective observational case series. 30 cases (30 eyes) of lens subluxation/dislocation in patients with secondary glaucoma were investigated which accepted the surgical treatment by author in the Ophthalmology of Xi'an No.4 Hospital from 2007 to 2011. According to the different situations of lens subluxation/dislocation, various surgical procedures were performed such as crystalline lens phacoemulsification, crystalline lens phacoemulsification combined anterior vitrectomy, intracapsular cataract extraction combined anterior vitrectomy, lensectomy combined anterior vitrectomy though peripheral transparent cornea incision, pars plana lensectomy combined pars plana vitrectomy, and intravitreal cavity crystalline lens phacofragmentation combined pars plana vitrectomy. And whether to implement trabeculectomy depended on the different situations of secondary glaucoma. The posterior chamber intraocular lenses (PC-IOLs) were implanted in the capsular-bag or trassclerally sutured in the sulus decided by whether the capsular were present. visual acuity, intraocular pressure, the situation of intraocular lens and complications after the operations. The follow-up time was 11-36mo (21.4±7.13). Postoperative visual acuity of all eyes were improved; 28 cases maintained IOP below 21 mm Hg; 2 cases had slightly IOL subluxation, 4 cases had slightly tilted lens optical area; 1 case had postoperative choroidal detachment; 4 cases had postoperative corneal edema more than 1wk, but eventually recovered transparent; 2 cases had mild postoperative vitreous hemorrhage, and absorbed 4wk later. There was no postoperative retinal detachment, IOL dislocation, and endophthalmitis. To take early treatment of traumatic lens

Corneal endothelial cell loss and corneal biomechanical characteristics after two-step sequential or combined phaco-vitrectomy surgery for idiopathic epiretinal membrane

DEFF Research Database (Denmark)

Hamoudi, Hassan; Christensen, Ulrik Correll; La Cour, Morten

2017-01-01

with non-contact specular microscopy. Pachymetry [central cornea thickness (CCT)], keratometry and cornea volume (CV) were measured with Pentacam Scheimpflug camera. Primary outcome was change in CED after 12 months; secondary outcomes were changes in CCT and CV after 12 months. RESULTS: Sixty-two eyes......PURPOSE: To assess the impact of sequential and combined surgery [cataract surgery and 23-gauge pars plana vitrectomy (PPV) with peeling] on corneal endothelium cell density (CED) and corneal biomechanical characteristics. METHODS: Phakic eyes with epiretinal membrane (ERM) were prospectively...... allocated to (i) cataract surgery and subsequent PPV (CAT group), (ii) PPV and subsequent cataract surgery (VIT group) or (iii) phacovitrectomy (COMBI group). Eyes were examined at baseline, 1 month after each surgery, and at 3 and 12 months follow-up. Corneal endothelium cell density (CED) was assessed...

Comparison of microbiology and visual outcomes of patients undergoing small-gauge and 20-gauge vitrectomy for endophthalmitis

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Almeida DRP

2016-01-01

Full Text Available David RP Almeida,1 Eric K Chin,2,3 Shaival S Shah,3 Benjamin Bakall,3 Karen M Gehrs,3 H Culver Boldt,3 Stephen R Russell,3 James C Folk,3 Vinit B Mahajan3,41VitreoRetinal Surgery PA, Minneapolis, MN, 2Retina Consultants of Southern California, Riverside, CA, 3Vitreoretinal Service, Department of Ophthalmology and Visual Sciences, 4Omics Laboratory, University of Iowa, Iowa City, IA, USABackground: The role of pars plana vitrectomy (PPV for endophthalmitis has evolved over recent decades but the literature is lacking on comparisons between small-gauge and 20-gauge vitrectomy.Objective: To evaluate evolving etiological and microbiological trends in patients undergoing vitrectomy for endophthalmitis and to compare culture-positive rates and visual outcomes between small-gauge (23- and 25-gauge and 20-gauge instrumentation during vitrectomy for endophthalmitis.Methods: Ten-year retrospective comparative case series and prospective laboratory in vitro testing. Tertiary care academic referral center. Patients who underwent PPV for endophthalmitis between 2003 and 2013. Vitreous biopsies were obtained in all cases. The effect of vitrectomy gauge (20-, 23-, and 25-gauge and vitreous cutting rate (1,500 and 5,000 cuts per minute on the viability of bacterial culture was evaluated in an in vitro prospective laboratory investigation.Main outcome measures: Comparison of etiology, microbiology culture-positive rates, and visual outcomes between small-gauge and 20-gauge instrumentation in patients undergoing PPV for infectious endophthalmitis.Results: A total of 61 cases of vitrectomy for endophthalmitis were identified over a 10-year period; of these, 34 were treated with small-gauge (23- and 25-gauge vitrectomy and 27 were treated with 20-gauge vitrectomy. In the small-gauge group, 12 cases (35.3% yielded culture-positive results versus 20 cases (74.1% with culture positivity in the 20-gauge cohort (P=0.002. The most common cause of endophthalmitis was

Factors associated with pentosidine accumulation in the human vitreous

NARCIS (Netherlands)

Van Deemter, Marielle; Bank, Ruud A.; Vehof, Jelle; Hooymans, Johanna M. M.; Los, Leonoor I.

Purpose: To explore factors associated with pentosidine accumulation in the human vitreous. Methods: Vitreous samples were obtained during trans pars plana vitrectomy for macular hole or rhegmatogenous retinal detachment. Patient characteristics included age, gender, and diabetes mellitus. Ocular

EYE TRAUMA. OPEN GLOBE INJURY MANAGEMENT

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Mojca Globočnik Petrovič

2004-05-01

Full Text Available Background. Ocular trauma is important cause of blindness. Birmingham Eye Trauma Terminology allows us to use a standardized eye injury terminology which permits an unambigous interpretation. The Eye Injury Registry enables the analysis of medical, epidemyologic and social data.The most frequent ocular injury ocular contusion has a relatively good prognosis. An adequate primary ocular repair and correct timing of pars plana vitrectomy are very important in open globe injury management. There still exist some controversial issues concerning the role of posterior segment surgery in open globe injuries. These include timing of surgery, prophylactic scleral buckle placement and a proper use of systemic and intravitreal antibiotics.Conclusions. With adequate primary ocular repair, the use of systemic, intravitreal antibiotics, scleral buckling and proper timing for pars plana vitrectomy the prognosis for ocular trauma cases can be better.

Vitrectomy, lensectomy and silicone oil tamponade in the management of retinal detachment associated with choroidal detachment

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Jian-Di Liu

2013-06-01

Full Text Available AIM: To report the results of combined vitrectomy, lensectomy and silicone oil (SO tamponade in treating primary rhegmatogenous retinal detachment (RRD associated with choroidal detachment (CD.METHODS: A retrospective, consecutive and case series study of 21 subjects with concurrent RRD associated with CD was conducted. All subjects underwent a standard three-port 20G pars plana vitrectomy (PPV with lensectomy and silicone oil tamponade. Mean follow-up time was 8 months (rang from 4 to 19 months. The primary and final anatomic success rate, visual acuity and final intraocular pressure(IOP were recorded and analyzed.RESULTS: Of 21 subjects, 8 were women and 13 were men. Age at presentation ranged from 22 to 75 years (mean 57.4 years. The presenting vision ranged from light perception to 0.15. The initial IOP ranged from 3mmHg to 12mmHg (mean 6.2mmHg. All eyes were phakic except one pseudophakic. No intraocular lens was implanted during the primary surgical intervention. Fifteen of 21 (71.4% eyes had retina reattached after one operation. Six eyes had recurrent inferior retinal detachment due to proliferation. Five of them were successfully reattached after one or more additional operations. Mean IOP at final follow-up was 15.2mmHg (range from 8mmHg to 20mmHg. One case declined for further operation. The final reattachment rate was 95.2%. Visual acuity improved in 19 (90.5% eyes, was unchanged in 1 (4.8% eye and decreased in 1 (4.8% eye.CONCLUSION: Combination of vitrectomy, lensectomy and silicone tamponade is an effective method in treating RRD associated with CD, reducing the incidence of postoperative hypotony.

Visual Outcomes of Pars Plana Vitrectomy with Epiretinal Membrane Peeling in Patients with Asteroid Hyalosis: A Matched Cohort Study.

Science.gov (United States)

Mouna, Ali; Berrod, Jean-Paul; Conart, Jean-Baptiste

2017-01-01

The study aimed to evaluate outcomes of epiretinal membrane (ERM) peeling in patients with asteroid hyalosis (AH) and to compare them with those from controls without AH. This is a retrospective matched cohort study of 1,104 consecutive patients who underwent surgery for ERM between January 2004 and February 2014. Patients with AH were included in the study group and were matched for preoperative visual acuity, age, gender, date of surgery, and axial length with control patients without AH selected from the same cohort. The best-corrected visual acuity (BCVA) and central macular thickness (CMT) on optical coherence tomography were measured at baseline and postoperatively with a minimum follow-up period of 12 months. A total of 44 patients were included in the AH group and 44 in the control group. The mean initial BCVA was 0.53 ± 0.21 LogMAR for the AH group vs. 0.49 ± 0.20 LogMAR for the control group, and the mean initial CMT was 419 ± 74 vs. 423 ± 75 µm, respectively. During the follow-up, no significant difference was found regarding the final BCVA at 6 months (0.23 ± 0.14 vs. 0.24 ± 0.17) LogMAR (p = 0.87) and 12 months (0.16 ± 0.09 vs. 0.17 ± 0.12) LogMAR (p = 0.92), despite a tendency toward slower visual recovery for the AH group at 1 month, with a mean BCVA of 0.36 ± 0.12 vs. 0.28 ± 0.18 LogMAR (p = 0.08). No difference was found regarding the progression of CMT at 1.6 and 12 months with a mean CMT of 396 ± 47 vs. 378 ± 55 µm (p = 0.39), 356 ± 39 vs. 365 ± 41 µm (p = 0.48), and 349 ± 68 vs. 352 ± 53 µm (p = 0.87), respectively. Vitrectomy with ERM peeling in patients with AH was beneficial and showed similar functional and anatomical outcomes in both groups. AH does not seem to affect visual improvement or the complication rate after ERM peeling. Therefore, the indications for vitrectomy in case of ERM should not be prompted by the presence of AH. © 2017 S. Karger AG, Basel.

Epidemiologic characteristics of retinal detachment surgery at a specialized unit in Denmark

DEFF Research Database (Denmark)

Poulsen, Christina Doefler; Peto, Tunde; Grauslund, Jakob

2016-01-01

, pars plana vitrectomy (PPV), scleral buckling and combined operations were performed in 95.1% (n = 620), 4.6% (n = 30) and 0.3% (n = 2) respectively. Over time there was less use of silicone oil and greater use of gas tamponade (p =

Functional recovery following vitreoretinal surgery

NARCIS (Netherlands)

Scheerlinck, LME

2016-01-01

The general aim of this thesis was to evaluate functional outcome following vitreoretinal surgery for idiopathic epiretinal membranes (iERM) and rhegmatogenous retinal detachment (RRD). Idiopathic epiretinal membrane Pars plana vitrectomy with removal of the iERM is considered to be the standard

Pars-plana fluid aspiration for positive vitreous cavity pressure in anterior segment surgeries

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Thomas Kuriakose

2018-01-01

Full Text Available Positive vitreous pressure due to misdirection of aqueous or choroidal effusion leads to shallowing of the anterior chamber (AC before or during anterior segment surgeries. This shallow AC if not addressed makes surgery difficult and increases the risk of surgical complications. Methods to prevent and manage this condition described in literature are not without problems. We describe a minimally invasive technique of passing a 30G needle through the pars-plana to aspirate misdirected fluid from vitreous cavity either as a prophylaxis just before surgery or during it, thereby decreasing positive vitreous pressure. This technique, used in 12 eyes, seems to be effective in patients with angle-closure glaucoma, malignant glaucoma, and per-operative sudden increase in vitreous pressure during surgery. Small-incision surgeries are ideally suited for this procedure. This minimally invasive technique is simple to perform and complications are unlikely to be more than what is seen with intravitreal injections.

Clinically undetected retinal breaks causing retinal detachment: A review of options for management.

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Gupta, Deepak; Ching, Jared; Tornambe, Paul E

2017-08-12

The successful detection of retinal breaks is a critical step in rhegmatogenous retinal detachment surgery in order to prevent persistent/recurrent retinal detachments. Not all retinal breaks causing retinal detachments are obvious. Retinal breaks may be obscured by opacities that are either anterior segment related, lens related, or posterior segment related. Rules to identify breaks based on subretinal fluid configuration are more difficult to apply in pseudophakic, aphakic, and scleral buckle encircled eyes-and in eyes with repeat detachments and those with proliferative vitreoretinopathy. Exudative detachments exhibit characteristic features and must be ruled out. A thorough clinical examination preoperatively is important even if a vitrectomy is planned. We review the incidence and causes of undetected breaks, along with preoperative/clinical issues that may hinder break detection. We review the literature with respect to investigative approaches and techniques that are available to the vitreoretinal surgeon when primary breaks remain clinically undetected during the preoperative examination. We broadly divide the surgical approaches into ones where the surgeon utilizes techniques to pursue actively a search for breaks versus adopting a purely speculative approach. Advantages and disadvantages of various techniques are appraised. Intuitively one might argue that an encircling scleral buckle combined with vitrectomy would give higher single operation success than pars plana vitrectomy alone because "undetected" retinal breaks would be addressed by a 360° plombage. We could not confirm this concept. Newer techniques, such as pars plana vitrectomy augmented with dye extrusion or endoscopic-assisted pars plana vitrectomy, show encouraging results. Technological advances such as intraoperative optical coherence tomography will also help to broaden the vitreoretinal surgeon's armamentarium. At this time, there is no gold standard in terms of the recommended

Multiple methods of surgical treatment combined with primary IOL implantation on traumatic lens subluxation/dislocation in patients with secondary glaucoma

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Rui Wang

2014-04-01

Full Text Available AIM:To describe clinical findings and complications from cases of traumatic lens subluxation/dislocation in patients with secondary glaucoma, and discuss the multiple treating methods of operation combined with primary intraocular lens (IOL implantation.METHODS:Non-comparative retrospective observational case series. Participants:30 cases (30 eyes of lens subluxation/dislocation in patients with secondary glaucoma were investigated which accepted the surgical treatment by author in the Ophthalmology of Xi''an No.4 Hospital from 2007 to 2011. According to the different situations of lens subluxation/dislocation, various surgical procedures were performed such as crystalline lens phacoemulsification, crystalline lens phacoemulsification combined anterior vitrectomy, intracapsular cataract extraction combined anterior vitrectomy, lensectomy combined anterior vitrectomy though peripheral transparent cornea incision, pars plana lensectomy combined pars plana vitrectomy, and intravitreal cavity crystalline lens phacofragmentation combined pars plana vitrectomy. And whether to implement trabeculectomy depended on the different situations of secondary glaucoma. The posterior chamber intraocular lenses (PC-IOLs were implanted in the capsular-bag or trassclerally sutured in the sulus decided by whether the capsular were present. Main outcome measures:visual acuity, intraocular pressure, the situation of intraocular lens and complications after the operations.RESULTS: The follow-up time was 11-36mo (21.4±7.13. Postoperative visual acuity of all eyes were improved; 28 cases maintained IOP below 21 mm Hg; 2 cases had slightly IOL subluxation, 4 cases had slightly tilted lens optical area; 1 case had postoperative choroidal detachment; 4 cases had postoperative corneal edema more than 1wk, but eventually recovered transparent; 2 cases had mild postoperative vitreous hemorrhage, and absorbed 4wk later. There was no postoperative retinal detachment, IOL

NONSUPINE POSITIONING IN MACULAR HOLE SURGERY

DEFF Research Database (Denmark)

Alberti, Mark; la Cour, Morten

2016-01-01

underwent pars plana vitrectomy, internal limiting membrane peeling, and perfluoropropane gas tamponade and were randomly allocated to either FDP or NSP. The primary (noninferior) outcome was FTMH closure. The sample size was based on an estimated 95% closure rate and a -15% noninferiority margin...

Retinal detachment following endophthalmitis.

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Nelsen, P T; Marcus, D A; Bovino, J A

1985-08-01

Fifty-five consecutive patients with a clinical diagnosis of bacterial endophthalmitis were reviewed. All patients were treated with systemic, periocular, topical, and intravitreal antibiotics. In addition, 33 of the patients underwent a pars plana vitrectomy. Nine retinal detachments occurred within six months of initial diagnosis. The higher frequency of retinal detachment in the vitrectomy group (21%) as compared to those patients managed without vitrectomy (9%) may be explained by a combination of surgical complications and the increased severity of endophthalmitis in the vitrectomy group. The two patients who developed retinal detachment during vitrectomy surgery rapidly progressed to no light perception. Conversely, the repair of retinal detachments diagnosed postoperatively had a good prognosis.

Surgical management of retinal diseases: proliferative diabetic retinopathy and traction retinal detachment.

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Cruz-Iñigo, Yousef J; Acabá, Luis A; Berrocal, Maria H

2014-01-01

Current indications for pars plana vitrectomy in patients with proliferative diabetic retinopathy (PDR) include vitreous hemorrhage, tractional retinal detachment (TRD), combined tractional and rhegmatogenous retinal detachment (CTRRD), diabetic macular edema associated with posterior hyaloidal traction, and anterior segment neovascularization with media opacities. This chapter will review the indications, surgical objectives, adjunctive pharmacotherapy, microincision surgical techniques, and outcomes of diabetic vitrectomy for PDR, TRD, and CTRRD. With the availability of new microincision vitrectomy technology, wide-angle microscope viewing systems, and pharmacologic agents, vitrectomy can improve visual acuity and achieve long-term anatomic stability in eyes with severe complications from PDR. © 2014 S. Karger AG, Basel

Evaluation of pars plana sclera fixation of posterior chamber intraocular lens

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Fangju Han

2014-01-01

Full Text Available Purpose: The purpose of this study was to evaluate the clinical efficacy and safety of modified posterior chamber intraocular lens (PCIOL implantation with transscleral fixation. Design and Setting: This is a study, which is conducted at Department of Ophthalmology, Jinan Eye Hospital, Jinan Second People′s Hospital. Materials and Methods: A total of 82 patients who were scheduled for sutured PCIOL were divided randomly into modified and conventional groups. The former underwent PCIOL through pars plana fixation with knot buried and without scleral flap and the latter underwent transscleral fixation of PCIOL in the ciliary sulcus. The main outcome measures included operative time, postoperative visual acuity, and postoperative complications. Results: The mean operative time of the modified group was 39.95 ± 5.87 min, which was significantly less than that of the conventional group (45.77 ± 5.21 min; P < 0.05. No difference was found in postoperative visual acuity between the two groups. There were no significant postoperative complications, including knot exposure, endophthalmitis, and retinal detachment in either group. The optical clamping of PCIOL was prone to occur in the conventional group. Conclusion: Modified sutured PCIOL implantation is a safe, effective, and feasible technique for the correction of aphakia in eyes without adequate posterior capsular support.

Retinal changes detected by wide-field autofluorescence imaging of patients with primary rhegmatogenous retinal detachment

DEFF Research Database (Denmark)

Poulsen, Christina Døfler; Grauslund, Jakob; Peto, Tunde

2014-01-01

.2 million inhabitants. Methods: A clinical prospective study of 99 eyes in 99 patients undergoing surgery for primary RRD between 1st of January 2013 and 12th of July 2013. All patients underwent surgery with pars plana vitrectomy (PPV) and had either gas or silicone oil tamponade. Patients were examined...

Surgical Management of Traumatic Retinal Detachment with Primary Vitrectomy in Adult Patients

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Katarzyna Nowomiejska

2017-01-01

Full Text Available Purpose. To evaluate functional and anatomical results of pars plana vitrectomy (PPV in the retinal detachment (RD followed by severe eye trauma. Methods. Retrospective analysis of medical records of forty-one consecutive patients treated with 23-gauge PPV due to traumatic RD. Age, gender, timing of PPV, visual acuity, and presence of intraocular foreign body (IOFB and proliferative vitreoretinopathy (PVR were included in the analysis. Results. Mean age of patients was 47 years; the majority of patients were men (88%. Closed globe injury was present in 21 eyes and open globe injury in 20 eyes (IOFB in 13 eyes, penetration injury in 4 eyes, and eye rupture in 3 eyes. Mean follow-up period was 14 months; mean timing of PPV was 67 days. Twenty-seven (66% eyes had a functional success; 32 eyes (78% had anatomical success. As a tamponade silicone oil was used in 33 cases and SF6 gas in 8 cases. Conclusions. Severe eye injuries are potentially devastating for vision, but vitreoretinal surgery can improve anatomical and functional outcomes. Among analysed pre- and intra- and postoperative factors, absence of PVR, postoperative retinal attachment, and silicone oil as a tamponade were related to significantly improved visual acuity.

Success Rates of Vitrectomy in Treatment of Rhegmatogenous Retinal Detachment

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Yasser Helmy Mohamed

2016-01-01

Full Text Available Aim. To investigate the anatomical success rates of pars plana vitrectomy (PPV after primary rhegmatogenous retinal detachment (RRD. Methods. This retrospective study was conducted between December 2008 and October 2014 at Nagasaki University Hospital. The preoperative data recorded included the lens status, location of the retinal tear, whether a tear was visualized, presence of multiple tears, macula status, presence of peripheral lattice retinal degeneration, and best-corrected visual acuity (BCVA. The primary outcome measures were anatomical (primary and final and functional success (visual acuity better than 6/60. Results. This study evaluated 422 eyes of 411 patients with a mean age of 57.7±11.2 years. The single-operation reattachment rate (primary anatomical success was 89.8%. The final anatomical success rate was 100% after 2–6 operations (mean = 3.14±1.03. Functional success rate after the primary reattachment operation was 96.7%, while it was 97.2% at the end of the follow-up. Multiple logistic regression analysis of the possible risk factors for the primary anatomical failure showed a significant relation with the 25 G instruments (P=0.002 and the presence of multiple tears (P=0.01. Conclusion. The primary anatomical success of PPV for primary uncomplicated RRD was 89.8% and the final anatomical success rate was 100%.

Success Rates of Vitrectomy in Treatment of Rhegmatogenous Retinal Detachment.

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Mohamed, Yasser Helmy; Ono, Kozue; Kinoshita, Hirofumi; Uematsu, Masafumi; Tsuiki, Eiko; Fujikawa, Azusa; Kitaoka, Takashi

2016-01-01

Aim. To investigate the anatomical success rates of pars plana vitrectomy (PPV) after primary rhegmatogenous retinal detachment (RRD). Methods. This retrospective study was conducted between December 2008 and October 2014 at Nagasaki University Hospital. The preoperative data recorded included the lens status, location of the retinal tear, whether a tear was visualized, presence of multiple tears, macula status, presence of peripheral lattice retinal degeneration, and best-corrected visual acuity (BCVA). The primary outcome measures were anatomical (primary and final) and functional success (visual acuity better than 6/60). Results. This study evaluated 422 eyes of 411 patients with a mean age of 57.7 ± 11.2 years. The single-operation reattachment rate (primary anatomical success) was 89.8%. The final anatomical success rate was 100% after 2-6 operations (mean = 3.14 ± 1.03). Functional success rate after the primary reattachment operation was 96.7%, while it was 97.2% at the end of the follow-up. Multiple logistic regression analysis of the possible risk factors for the primary anatomical failure showed a significant relation with the 25 G instruments (P = 0.002) and the presence of multiple tears (P = 0.01). Conclusion. The primary anatomical success of PPV for primary uncomplicated RRD was 89.8% and the final anatomical success rate was 100%.

Comparison of the effects of 23-gauge and 25-gauge microincision vitrectomy blade designs on incision architecture

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Inoue M

2014-11-01

Full Text Available Makoto Inoue,1 Dina Joy K Abulon,2 Akito Hirakata1 1Kyorin Eye Center, School of Medicine, Kyorin University, Tokyo, Japan; 2Alcon Research, Ltd., Irvine, CA, USA Purpose: To compare the effects of different 23- and 25-gauge microincision vitrectomy trocar cannula entry systems on incision architecture.Methods: We tested one ridged microvitreoretinal (MVR, one non-ridged MVR, one pointed beveled, and one round-tipped beveled blade (n=10 per blade design per incision type. Each blade’s straight and oblique incision architecture was assessed in a silicone disc simulating the sclera. Wound leakage under pressure and endoscopic observations were conducted on sclerotomy sites of isolated porcine eyes (n=4 per blade design after simulated vitrectomy.Results: Differences in blade design created distinct incision architecture. Incisions were linear with the ridged MVR blade, flattened “M-shaped” with the non-ridged MVR blade, asymmetrical chevron-shaped with the pointed beveled blade, and curved with the round-tipped beveled blade. With the exception of oblique entry incision thickness, both MVR blade designs created thinner incisions than the beveled blades at entry and exit sites. Only the ridged MVR blade created incisions with no leakage. Vitreous incarceration was observed with all trocar cannula systems.Conclusion: Wound closure in porcine eyes was similar with all blades despite differences in incision architecture. Wound leakage occurred at low to moderate infusion pressures with most blades; no wound leakage was observed with ridged MVR blades. Keywords: entry system, incision closure, leakage, pars plana incision, sclerotomy, trocar blade 

SCLERAL BUCKLING VERSUS VITRECTOMY IN THE MANAGEMENT OF MACULA-OFF PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT: A COMPARISON OF VISUAL OUTCOMES.

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Wong, Chee Wai; Yeo, Ian Yew San; Loh, Boon Kwang; Wong, Edmund Yick Mun; Wong, Doric Wen Kuan; Ong, Sze Guan; Ang, Chong Lye; Lee, Shu Yen

2015-12-01

To compare visual outcomes between pars plana vitrectomy (PPV) with or without scleral buckling (SB) and SB alone in the management of uncomplicated macula-off primary rhegmatogenous retinal detachment. Case-control study of 723 patients with uncomplicated macula-off primary rhegmatogenous retinal detachment seen at the Singapore National Eye Centre from 2005 to 2011. The primary outcome measure was the proportion of eyes achieving functional success, defined as logMAR best-corrected visual acuity of ≤0.3 logMAR at 6 months postoperatively. Multivariable logistic regression analysis was performed adjusting for the following preoperative covariates: age, gender, race, lens status, number of tears found, presence of proliferative vitreoretinopathy, operative procedure, logMAR best-corrected visual acuity, and duration of symptoms. Three hundred and eight eyes underwent SB alone, and 415 eyes underwent PPV ± SB. In the SB group, 133 eyes (43.2%) achieved functional success compared with 116 eyes (28.0%) in the PPV ± SB group. This difference was statistically significant on both univariate (P macula-off primary rhegmatogenous retinal detachment.

Early surgical managment of penetrating ocular injuries involving the posterior segment.

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Michels, R G

1976-09-01

Pars plana vitrectomy technic can be used in the early management of certain penetrating ocular injuries involving the posterior segment, including selected intraocular foreign bodies. This study reports the results of ten consecutive cases of intraocular foreign bodies in the posterior segment treated by a combination of vitrectomy (including lensectomy when necessary) and foreign-body extraction with forceps. The foreign body was successfully removed in nine of ten eyes, and nine of ten eyes were salvaged. This favorable experience using early vitreous surgery suggests that the vitrectomy technic can be used in other penetrating injuries involving the posterior segment that are not associated with intraocular foreign bodies. Possible indications for early vitrectomy are presented, including cases with a poor prognosis when managed by conventional methods.

Effects of Vitrectomy on Recurrent Macular Edema due to Branch Retinal Vein Occlusion after Intravitreal Injection of Bevacizumab

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Tatsuya Yunoki

2013-01-01

Full Text Available Purpose. To evaluate the effects of pars plana vitrectomy (PPV on recurrent macular edema due to branch retinal vein occlusion (BRVO after intravitreal injections of bevacizumab (IVB. Methods. This retrospective study included 22 eyes of 22 patients who underwent single or multiple IVB injections for macular edema due to BRVO and showed a recurrence of macular edema. All patients then underwent PPV and were followed up for more than 6 months after the surgery with examinations of best corrected visual acuity (BCVA and optical coherence tomography (OCT. OCT parameters were central macular thickness (CMT and average retinal thickness in a 1-mm-diameter circular region at the fovea (MRT. Results. Mean BCVA, CRT, and MRT were significantly improved from the baseline after PPV. Greater improvement of BCVA, CRT, and MRT was obtained after 1 month of IVB than after 6 months of PPV. No eyes showed worsening of macular edema after the surgery. Conclusion. PPV improved BCVA and recurrent macular edema due to BRVO, but PPV that was less effective than IVB had been in the same patients. PPV may be one of the treatment options for recurrent macular edema due to BRVO after IVB.

Intravitreal Phacoemulsification Using Torsional Handpiece for Retained Lens Fragments

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Kumar, Vinod; Takkar, Brijesh

2016-01-01

Purpose: To evaluate the results of intravitreal phacoemulsification with torsional hand piece in eyes with posteriorly dislocated lens fragments. Methods: In this prospective, interventional case series, 15 eyes with retained lens fragments following phacoemulsification were included. All patients underwent standard three-port pars plana vitrectomy and intravitreal phacoemulsification using sleeveless, torsional hand piece (OZiL™, Alcon's Infiniti Vision System). Patients were followed up...

Modificaciones del endotelio corneal en cirugía de catarata simultánea con vitrectomía Changes of the corneal endothelium in cataract surgery combined with vitrectomy

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Zucell Ana Veitía Rovirosa

2012-12-01

Full Text Available Objetivo: determinar el comportamiento del endotelio corneal en pacientes sometidos a cirugías simultáneas de vítreo y catarata. Métodos: se realizó un estudio observacional, descriptivo y prospectivo. El universo lo constituyó 15 pacientes (15 ojos sometidos a cirugías de catarata y vítreo de forma simultánea. El estudio se efectúo en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer" de enero a noviembre de 2010. Resultados: la mayoría de los pacientes fueron hombres entre 53 y 67 años de edad. Las principales causas de indicación quirúrgica de vitrectomía pars plana fueron el desprendimiento de retina y la hemorragia vítrea. La densidad celular promedio antes de la cirugía y después de esta mostró una pérdida de 634 células (26,8 %. La ausencia de polimegatismo y sus formas leves predominaron en el preoperatorio, hubo un incremento hacia formas moderadas y severas en el posoperatorio. El pleomorfismo se comportó de forma similar al polimegatismo. Las complicaciones posquirúrgicas fueron hipertensión ocular, síndrome tóxico del segmento anterior y uveítis anterior. Conclusiones: valorar el estado del endotelio antes de la cirugía permite trazar una estrategia quirúrgica encaminada a proteger esta importante capa corneal y establecer un pronóstico visual del paciente. De esta forma permite evaluar su comportamiento en el posoperatorio.Objective: to determine the corneal endothelium behavior in the cataract surgery and vitrectomy performed simultaneously. Methods: a prospective, descriptive and observational research was carried out in “Ramón Pando Ferrer” Cuban Institute of Ophthalmology from January to November 2010. The sample was made up of 15 eyes from 15 patients, who had undergone cataract surgery and vitrectomy simultaneously. Results: most of the patients were men aged 53 to 67 years. The main causes to indicate the pars plana vitrectomy were retinal detachment and vitreous hemorrhage. Before

Scleral suspension pars-plana lensectomy for ectopia lentis followed by suture fixation of intraocular lens

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Mitra Sandip

2001-01-01

Full Text Available Purpose: To describe a simple technique of scleral suspension-pars plana lensectomy (SS-PPL in acquired and congenital ectopia lentis and scleral fixation of intraocular lens (IOL. Materials and Methods: Twenty eyes of 16 patients (12 unilateral and 4 bilateral cases of "essential familial lens subluxation" aged 10-40 years (mean 25 years underwent SS-PPL with implantation of scleral fixated IOL. Indications for surgery were best-corrected visual acuity <6/18, bisection of pupil by the lens, and lens-induced glaucoma. Prerequisites for SS-PPL were, visibility of part of the lens in the pupillary area and soft lens. Results: Postoperative visual acuity ranged from 6/6 - 6/36. Lens tilt in 3 cases(15% and small decentration in 2 cases(10% were seen; however these did not seriously compromise the visual result. Scant vitreous bleeding on the first postoperative day was seen in 3 cases (15%. Conclusion: The advantages of the scleral suspension of subluxated lens prior to lensectomy include stabilization; it allows proper viewing of the lens, avoids injury to the iris and cliary body during lensectomy and reduces the possibility of dislocation of the lens.

Bilateral spontaneous dislocation of posterior chamber intraocular lens in a patient with gyrate atrophy

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Michael Kinori

2012-01-01

Full Text Available We report a patient with gyrate atrophy, a rare metabolic disease, who had bilateral late spontaneous posterior dislocation of in-the-bag posterior chamber intraocular lens (PCIOL. He underwent pars plana vitrectomy, PCIOL retrieval and anterior chamber intraocular lens implantation in both eyes. This report may imply that patients with gyrate atrophy are at risk for spontaneous dislocation of intraocular lenses.

Ahmed Glaucoma Valve Implantation in Vitrectomized Eyes

OpenAIRE

Erçalık, Nimet Yeşim; İmamoğlu, Serhat

2018-01-01

Purpose. To evaluate the outcomes of Ahmed glaucoma valve (AGV) implantation in vitrectomized eyes. Materials and Methods. The medical records of 13 eyes that developed glaucoma due to emulsified silicon oil or neovascularization following pars plana vitrectomy and underwent AGV implantation were retrospectively reviewed. The main outcome measures were intraocular pressure (IOP), best-corrected visual acuity (BCVA), number of antiglaucoma medications, and postoperative complications. Surgical...

Short-Acting Gas Tamponade with Strict Face-Down Posturing for the Treatment of Idiopathic Macular Hole.

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Gotzaridis, Stratos; Liazos, Efstathios; Petrou, Petros; Georgalas, Ilias

2017-01-01

A retrospective consecutive case series to evaluate the safety and efficacy of 25 gauge pars plana vitrectomy, ILM peeling, 20% SF 6 gas tamponade and strict posturing for the treatment of idiopathic full-thickness macular holes. We report the results of 106 consecutive eyes that underwent standard 25-gauge pars plana vitrectomy, brilliant peel-assisted internal limiting membrane peel, fluid:gas exchange with 20% SF 6 and strict posturing for one week. All patients were followed up at one week, one month, three months, and nine months postoperatively. Biomicroscopy at day 1 and biomicroscopy and OCT at week 1, months 1, 3, and 9 were used to assess macular hole status postoperatively. Pre- and postoperative logMAR visual acuity was compared. The macular hole was closed in 102/106 eyes postoperatively (96.2%). Four eyes showed unclosed macular holes and underwent additional SF 6 intravitreal injection and strict posturing for 10 days. All macular holes were eventually closed without the need of a second surgical procedure. Mean visual acuity improved from 0.63 logMAR preoperatively to 0.39 logMAR postoperatively. One case of retinal toxicity was reported due to accidental intravitreal injection of antibiotic. 25-gauge vitrectomy, ILM peel, and short-acting gas tamponade are highly effective for the treatment of macular holes. Additional intravitreal gas injection followed by strict posturing seems to be a simple and effective treatment for unclosed holes.

A case involving an Ahmed™ glaucoma valve transferred from the vitreous into the anterior chamber of the eye with a silicone oil tamponade for the treatment of neovascular glaucoma

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Miki M

2013-02-01

Full Text Available Michiko Miki, Mari Ueki, Tetsuya Sugiyama, Shota Kojima, Tsunehiko IkedaDepartment of Ophthalmology, Osaka Medical College, Takatsuki, JapanPurpose: To report the short-term efficacy and safety of the transfer of an Ahmed™ glaucoma valve (AGV™ tube from the vitreous into the anterior chamber, in a patient with neovascular glaucoma who had undergone pars plana AGV™ implantation and ultimately needed a silicone oil tamponade.Case: A 41-year-old male with proliferative diabetic retinopathy in both eyes was referred to us for treatment in December 2009. Although the patient previously underwent several surgeries, he ultimately lost vision in his right eye. His left eye suffered from neovascular glaucoma after undergoing a pars plana vitrectomy for tractional retinal detachment. After several vitreous and glaucoma surgeries, the patient underwent implantation of a pars plana AGV™. Postoperatively, although his intraocular pressure was stabilized at approximately 10 mmHg, he had repeated vitreous hemorrhage and hyphema without improvement. He ultimately underwent PPV with a silicone oil tamponade and at the same time, the AGV™ tube was pulled out from the vitreous and inserted into the anterior chamber in order to avoid complications caused by the silicone oil.Results: At 19 months postoperative, the patient’s intraocular pressure had stabilized at 10 mmHg with no recurrence of vitreous hemorrhage and hyphema. Eventually, he lost vision in his left eye because of cerebral hemorrhage.Conclusion: The findings show that insertion of a pars plana AGV™ tube into the anterior chamber in a patient undergoing a silicone oil tamponade is both effective and safe in the short-term.Keyword: tube implantation, glaucoma surgery, tube transfer, pars plana, proliferative diabetic retinopathy, intraocular pressure

Analysis of clinical features and visual outcomes of pars planitis.

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Berker, Nilufer; Sen, Emine; Elgin, Ufuk; Atilgan, Cemile Ucgul; Dursun, Erdem; Yilmazbas, Pelin

2018-04-01

To evaluate the demographic characteristics, clinical features, treatment and outcomes of patients with pars planitis in a tertiary referral center in Turkey. Medical records of patients with pars planitis were retrospectively reviewed. The data including demographic and ocular features and treatment outcomes were recorded. The distribution of clinical findings and complications were evaluated according to age and gender groups. The changes in final BCVA compared to the initial BCVA were noted. Statistical analysis was performed using SPSS software (Version 18.0, SPSS Inc., Chicago, USA). Twenty-seven patients (54 eyes) were included in this study. 16 patients were male (59.3%), and 11 were female (40.7%). Mean age at diagnosis was 12.84 ± 8.26 (range 4-36) years. Mean follow-up period was 61.3 ± 52.15 (range 9-172) months. Mean BCVA was 0.58 ± 0.36 (range 0.03-1.00) (0.40 ± 0.45 logMAR) at presentation, and 0.81 ± 0.28 (range 0.10-1.00) (0.14 ± 0.27 logMAR) at final visit (P = 0.001). Vitreous inflammation (100%), vitreous haze (92.6%), snowballs (74.1%), snowbanks (66.7%), anterior chamber cells (66.7%) and peripheral retinal vascular sheathing (48.1%) were the most common presentations. Ocular complications included vitreous condensation (51.9%), cystoid macular edema (22.2%), cataract (18.5%), inferior peripheral retinal detachment (11.1%), glaucoma (5.6%) and vitreous hemorrhage (3.7%). Treatments included topical, periocular, intravitreal and systemic corticosteroids, immunosuppressives, peripheral laser photocoagulation and pars plana vitrectomy when needed. Pars planitis is an idiopathic chronic intermediate uveitis mostly affecting children and adolescents. In spite of its chronic nature with high potential of causing ocular complications, adequate treatment and close follow-up lead to favorable visual outcomes.

Bilateral proliferative retinopathy in B-cell acute lymphoblastic leukemia

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Devesh Kumawat

2018-01-01

Full Text Available A 4-year-old child with B-cell acute lymphoblastic leukemia presented with vitreous hemorrhage due to proliferative retinopathy in both eyes. Pars plana vitrectomy was performed in both eyes to clear nonresolving vitreous hemorrhage after systemic stabilization. Visual recovery was limited by the disc drag in the right eye and subfoveal exudation in the left eye. Etiopathogenesis and management of proliferative retinopathy in acute leukemias are discussed.

INTERNAL LIMITING MEMBRANE PEELING VERSUS INVERTED FLAP TECHNIQUE FOR TREATMENT OF FULL-THICKNESS MACULAR HOLES: A COMPARATIVE STUDY IN A LARGE SERIES OF PATIENTS.

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Rizzo, Stanislao; Tartaro, Ruggero; Barca, Francesco; Caporossi, Tomaso; Bacherini, Daniela; Giansanti, Fabrizio

2017-12-08

The inverted flap (IF) technique has recently been introduced in macular hole (MH) surgery. The IF technique has shown an increase of the success rate in the case of large MHs and in MHs associated with high myopia. This study reports the anatomical and functional results in a large series of patients affected by MH treated using pars plana vitrectomy and gas tamponade combined with internal limiting membrane (ILM) peeling or IF. This is a retrospective, consecutive, nonrandomized comparative study of patients affected by idiopathic or myopic MH treated using small-gauge pars plana vitrectomy (25- or 23-gauge) between January 2011 and May 2016. The patients were divided into two groups according to the ILM removal technique (complete removal vs. IF). A subgroup analysis was performed according to the MH diameter (MH peeling and 320 patients underwent pars plana vitrectomy and IF. Overall, 84.94% of the patients had complete anatomical success characterized by MH closure after the operation. In particular, among the patients who underwent only ILM peeling the closure rate was 78.75%; among the patients who underwent the IF technique, it was 91.93% (P = 0.001); and among the patients affected by full-thickness MH ≥400 µm, success was achieved in 95.6% of the cases in the IF group and in 78.6% in the ILM peeling group (P = 0.001); among the patients with an axial length ≥26 mm, success was achieved in 88.4% of the cases in the IF group and in 38.9% in the ILM peeling group (P = 0.001). Average preoperative best-corrected visual acuity was 0.77 (SD = 0.32) logarithm of the minimum angle of resolution (20/118 Snellen) in the peeling group and 0.74 (SD = 0.33) logarithm of the minimum angle of resolution (20/110 Snellen) in the IF group (P = 0.31). Mean postoperative best-corrected visual acuity was 0.52 (SD = 0.42) logarithm of the minimum angle of resolution (20/66 Snellen) in the peeling group and 0.43 (SD = 0.31) logarithm of the minimum angle of resolution (20

Intraoperative Macula Protection by Perfluorocarbon Liquid for the Metallic Intraocular Foreign Body Removal during 23-Gauge Vitrectomy

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Robert Rejdak

2017-01-01

Full Text Available Purpose. To evaluate visual and safety outcomes of 23-gauge (G pars plana vitrectomy (PPV with application of perfluorocarbon liquid (PFCL for intraoperative protection of the macula during intraocular foreign body (IOFB removal. Methods. Retrospective study of 42 patients who underwent 23 G PPV for IOFB removal from posterior segment with intraoperative PFCL application for the macula shielding. Collected data included corrected distance visual acuity (CDVA, size of IOFB, and complication rate. The mean follow-up period was 12 months. Results. The mean preoperative CDVA was 0.54 logMAR (SD 0.46, and the final mean CDVA was 0.68 logMAR (SD 0.66. All IOFBs were metallic with mean dimensions of 4.6 mm × 2.1 mm. Twenty-two IOFBs were removed through the corneal tunnel and 20 IOFBs through the sclerotomy. No intraoperative iatrogenic lesion of the macula was observed. As a tamponade, silicon oil was applied in 31 eyes, SF6 gas in 5 eyes, air in 4 eyes, and 2 eyes required no tamponade. Secondary retinal detachment was observed in 17% of cases, but at the end of the follow-up, all the retinas were attached. Conclusion. PFCL application during PPV is a safe method of protecting the macula from unexpected falling of the metallic IOFB during its removal.

Portable single port 23-gauge vitrectomy in postoperative endophthalmitis

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Höhn F

2015-08-01

Full Text Available Fabian Höhn,1,* Florian TA Kretz,2,* Saumil Sheth,3 S Natarajan,3 Pankaj Singh,4 Frank H Koch,4 Michael J Koss2,51Helios Klinikum Pforzheim, Pforzheim, Germany; 2Department of Ophthalmology, Hospital of the Ruprecht-Karls University, Heidelberg, Germany; 3Aditya Jyot Eye Hospital Pvt. Ltd, Mumbai, India; 4Department of Ophthalmology, Hospital of the Goethe University, Frankfurt am Main, Germany; 5Department of Ophthalmology, University of Southern California, Los Angeles, CA, USA*These authors contributed equally to this workAim: To evaluate the safety and effectiveness of the Intrector® for treating postoperative endophthalmitis.Materials and methods: In a retrospective multicenter study, patients who received a single port 23-gauge core pars plana vitrectomy and isovolumetric injection of vancomycin, ceftazidime, and dexamethasone/amphotericin B using the Intrector® for postoperative endophthalmitis of intermediate severity (grade II or III vitreous inflammation and best-corrected visual acuity between hand movements and 0.3 logMAR [logarithm of the minimum angle of resolution] were evaluated. Improvement in visual acuity, resolution of intraocular inflammation, the need for additional surgical procedures, and the development of complications were evaluated at a 1-month follow-up examination.Results: Fifteen patients (mean age 55.6±7.2 years underwent treatment with the Intrector®. The mean vitreous volume aspirated was 0.78±0.22 mL. The vitreous samples indicated positive microorganism culture results in six of the 15 cases, but the samples were positive when analyzed by real-time polymerase chain reaction in all cases (15/15. The mean best-corrected visual acuity improved significantly (P=0.01 from 0.88±0.29 (logMAR to 0.32±0.28. Each patient demonstrated at least three lines of visual improvement. No additional medical or surgical interventions were required, and the complete resolution of intraocular inflammation was noted in

Early postoperative endophthalmitis after pars plana Ahmed valve placement with persistent extraocular infection.

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Park, Susanna S; Rabowsky, Jeffrey

2007-01-01

This article presents a case of early postoperative endophthalmitis that occurred after vitrectomy and Ahmed Glaucoma Valve (New World Medical, Inc., Rancho Cucamonga, CA) placement and was treated with intravitreal antibiotics. Intravenous vancomycin was started after aqueous culture grew methicillin-resistant Staphylococcus aureus. The endophthalmitis improved, but new purulent discharge around the peritomy was noted 10 days after presentation, requiring removal of the valve.

Generalized seizures and transient contralateral hemiparesis following retrobulbar anesthesia: a case report.

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Dettoraki, Maria; Dimitropoulou, Chrisafoula; Nomikarios, Nikolaos; Moschos, Marilita M; Brοuzas, Dimitrios

2015-07-28

Retrobulbar block is a local anesthetic technique widely used for intraocular surgery. Although retrobulbar anesthesia is considered to be relatively safe, a number of serious adverse events have been reported. To our knowledge, immediate onset of generalized seizures with contralateral hemiparesis after retrobulbar anesthesia has not been reported. A 62-year-old Caucasian healthy male with a right eye retinal detachment was admitted for pars plana vitrectomy. During retrobulbar anesthesia with ropivacaine and before needle withdrawal, the patient developed twitching of the face which rapidly progressed to generalized tonic-clonic seizures. Arterial oxygen saturation decreased to 75 %. Chin lift was performed and 100 % oxygen was administrated via face mask, which increased saturation to 99 %. Midazolam 2 mg was administrated intravenously to control seizures. After cessation of seizures, left-sided hemiparesis was evident. Brain computed tomography and electroencephalogram were normal 3 h later. The patient underwent pars plana vitrectomy under general anesthesia 4 days later. Serious complications of local anesthesia for ophthalmic surgery are uncommon. We present a case in which generalized tonic-clonic seizures developed during retrobulbar anesthesia, followed by transient contralateral hemiparesis. The early onset of seizures indicated intra-arterial injection of the anesthetic. Our case suggested the need for close monitoring during the performance of retrobulbar anesthesia and the presence of well-trained personnel for early recognition and immediate management of the complications.

Rhegmatogenous retinal detachments associated to Stickler syndrome in a tertiary eye care center in Saudi Arabia

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Alshahrani ST

2015-12-01

Full Text Available Saeed T Alshahrani,1 Nicola G Ghazi,2 Saba Al-Rashaed2 1Ophthalmology Department, King Fahad Specialist Hospital, Dammam, 2Vitreoretinal Department, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia Purpose: To investigate the clinical findings and outcomes of rhegmatogenous retinal detachment (RRD in Stickler syndrome on affected and fellow eyes that underwent prophylactic retinopexy.Patients and methods: Chart review of 70 eyes (62 patients. Incidence of RRD, postoperative visual acuity, and risk factors were evaluated.Results: Twenty-two patients (35% had RRD in the fellow eye, 37% of the eyes had cataract, 93% had macular detachment, 50% had proliferative vitreoretinopathy, and 41% had posterior vitreous detachment. Success rates were: 60% of patients after scleral buckling; 57.1% after pars plana vitrectomy; and 75% after combined scleral buckling and pars plana vitrectomy. Sixty-one (93.8% of patients had successful surgery (including second surgery. Silicone oil tamponade was significantly associated with final anatomic outcome, with a protective odds ratio of 0.11 (P=0.027. Visual acuity improved in 54% of eyes and decreased in 5%. Statistically significant associations were present for eyes with final visual acuity ≥20/200, and total retinal detachment (P<0.001; preoperative cataract (P=0.023; and proliferative vitreoretinopathy (P<0.001. RRD developed in 16/44 eyes despite laser prophylaxis.Conclusion: Prophylactic retinopexy was not beneficial for Stickler syndrome patients. Success of primary surgery for RRD remains low. The primary surgery should be vitrectomy combined with scleral buckling and silicone oil tamponade. Keywords: Stickler syndrome, retinopexy, Gulf States, Saudi Arabia, ocular genetics, arthro-ophthalmopathy, collagen disorder

Retinal detachment in paediatric patients

International Nuclear Information System (INIS)

Zafar, S. N.; Qureshi, N.; Azad, N.; Khan, A.

2013-01-01

Objective: To assess the causes of retinal detachment in children and the various operative procedures requiring vitreoretinal surgical intervention for the same. Study Design: Case series. Place and Duration of Study: Department of Ophthalmology, Al-Shifa Trust Eye Hospital, Rawalpindi, from January 2006 to May 2009. Methodology: A total of 281 eyes of 258 patients, (aged 0 - 18 years) who underwent vitreo-retinal surgical intervention for retinal detachment were included. Surgical log was searched for the type of retinal detachment and its causes. Frequencies of various interventions done in these patients viz. vitrectomy, scleral buckle, use of tamponading agents, laser photocoagulation and cryotherapy were noted. Results were described as descriptive statistics. Results: Myopia was the cause in 62 (22.1%) and trauma in 51 (18.1%) of the eyes. Total retinal detachment (RD) was treated in 94 (33.5%) eyes, sub total RD in 36 (12.8%), recurrent RD in 32 (11.4%), giant retinal tear in 28 (10%), tractional RD in 15 (5.3%) and exudative RD in 2 (0.7%). Prophylactic laser or cryotherapy was applied in 74 (26.3%) of the eyes. Pars plana vitrectomy (PPV) was carried out in 159 (56.6%) eyes while scleral buckle procedure was done in 129 (45.9%) eyes. Silicon oil was used in 149 (53%), perfluorocarbon liquid in 32 (11.4%) and gas tamponade in 20 (7.1%) eyes. Conclusion: The most common cause of retinal detachment in paediatric patients was myopia, followed by trauma. Total RD was more common as compared to the other types. The most common procedure adopted was pars plana vitrectomy followed by scleral buckle procedure. (author)

Linguatula serrata in the anterior chamber of the eye

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Muna Bhende

2014-01-01

Full Text Available We report a case of intraocular Linguatula in healthy young female who presented with a history of trivial trauma, dislocated lens, inflammation and secondary glaucoma. A mobile worm was seen in the anterior chamber. Pars plana lensectomy and vitrectomy was planned to remove both the cataractous lens and the parasite during which the worm disappeared from view but was later recovered from the cassette fluid. It was identified as the nymphal form of Linguatula serrata (tongue worm.

Functional and Morphological Correlations before and after Video-Documented 23-Gauge Pars Plana Vitrectomy with Membrane and ILM Peeling in Patients with Macular Pucker.

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Mayer, Wolfgang J; Fazekas, Clara; Schumann, Ricarda; Wolf, Armin; Compera, Denise; Kampik, Anselm; Haritoglou, Christos

2015-01-01

Purpose. To assess functional and morphological alterations following video-documented surgery for epiretinal membranes. Methods. Forty-two patients underwent video-documented 23-gauge vitrectomy with peeling of epiretinal (ERM) and inner limiting membrane (ILM). Patient assessment was performed before and 3 and 6 months including best corrected visual acuity (BCVA), slit lamp biomicroscopy, SD-OCT, and central 2° and 18° microperimetry. In addition, all video-documented areas of peeling on the retinal surface were evaluated postoperatively using an additional focal 2° microperimetry. Retinal sensitivity and BCVA were correlated with morphological changes (EZ and ELM) in the foveal region and in regions of membrane peeling. Results. Overall, BCVA increased from 0.6 (±0.2) to 0.2 (±0.2) logMAR after 6 months with an increase in retinal sensitivity (17.9 ± 2.7 dB to 26.8 ± 3.1 dB, p peeling areas (p peeling and overall retinal sensitivity regarding visual acuity gain could be observed after 6 months (p > 0.05). In contrast, overall postoperative retinal sensitivity was significantly decreased in patients with a visual acuity gain lower than 2 lines (p peeling due to the use of intraocular forceps may affect the outer retinal structure. Nevertheless, these changes seem to have no significant impact on postoperative functional outcome.

[Internal limiting membrane peeling as prophylaxis of epimacular membrane formation in eyes undergoing vitrectomy for rhegmatogenous retinal detachement].

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Hejsek, L; Dusová, J; Stepanov, A; Rozsíval, P

2014-06-01

Rhegmatogenous retinal detachment is a serious condition that can significantly impair visual function, even after a successful surgery. One of the complications that can significantly impair visual acuity in the postoperative period is a development of the epimacular membrane (ERM). The aim of this work is to monitor the effect of peeling of the internal limiting membrane (ILM) in the macula at the anatomical and functional results in the postoperative period, especially with regard to the development of ERM. Prospective study of 21 eyes, which underwent peeling of ILM during pars plana vitrectomy for rhegmatogenous retinal detachment (on detached macula). The ILM peeling was done without using decalin during this procedure. We tested best corrected visual acuity (BCVA) and followed fundus biomicroscopic findings. Proliferative vitreoretinopathy (PVR) was evaluated according to the recommendations of the Retina Society Terminology Committee. To exclude the development of ERM in the macula optical coherence tomography (OCT) was performed at the end of the 18-month follow-up period. In total, the results of 21 eyes of 21 patients who underwent PPV for rhegmatogenous retinal detachment were evaluated. In all of them was during PPV performed ILM peeling on detached macula, these are followed prospectively. ILM peeling without using decalin was sufficient in all eyes. All eyes with ILM peeling did not develop ERM at the end of the follow-up period. ILM peeling during PPV for rhegmatogenous retinal detachment reduces the risk of developing secondary ERM.

Vitrectomia transconjuntival: dados preliminares com o sistema Millennium TSV-25 Transconjunctival vitrectomy: preliminary data using the TSV-25 Millennium System

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Flávio Rezende Filho

2005-12-01

Full Text Available OBJETIVO: Relatar os resultados cirúrgicos preliminares de vitrectomia via pars plana com técnica transconjuntival com o sistema Millennium-TSV-25. MÉTODOS: Vinte pacientes (20 olhos, obtidos seqüencialmente, submetidos à vitrectomia transconjuntival com o sistema Millennium-TSV-25, entre julho de 2003 e janeiro de 2004, foram avaliados prospectivamente por um período mínimo de um mês pós-operatório. Olhos com buraco macular, membrana epi-retiniana, edema macular, descolamento regmatogênico da retina, endoftalmite e hemorragia vítrea com ou sem descolamento tracional da retina foram incluídos. Complicações e dificuldades intra e pós-operatórias foram computadas. RESULTADOS: Os 20 pacientes completaram pelo menos um mês de acompanhamento pós-operatório. Foram 4 buracos maculares, 2 membranas epi-retinianas, 2 edemas maculares cistóides pós-facectomia, 1 edema macular diabético, 5 descolamentos regmatogênicos da retina, 5 hemorragias vítreas (2 associadas a descolamento tracional da retina e 1 endoftalmite. A média da pressão intra-ocular no primeiro dia pós-operatório foi de 15,7 mmHg (6 - 46 mmHg e no primeiro mês de 14,2 mmHg (8 - 22 mmHg. Não houve nenhum caso de complicação, como rotura relacionada às esclerotomias, endoftalmite ou hipotonia ocular pós-operatória. Três dos 5 olhos (60% com descolamento de retina necessitaram de nova intervenção cirúrgica (todos pseudofácicos e 4 dos 5 olhos (80% com hemorragia vítrea tiveram hemorragia vítrea residual pós-operatória. Todos os casos com alterações maculares e os olhos fácicos com descolamento de retina foram bem sucedidos. CONCLUSÕES: Esta técnica de vitrectomia transconjuntival demonstrou, como principais benefícios, a baixa incidência de roturas relacionadas às esclerotomias e hipertensão ocular pós-operatória. Parece ser imprescindível a adequada seleção dos casos.PURPOSE: To report the preliminary surgical results of pars plana

Valsalva Retinopathy Associated with Sexual Activity

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Khalid Al Rubaie

2014-01-01

Full Text Available A 54-year-old healthy male presented complaining of sudden loss of vision in the right eye. Initial visual acuity was counting fingers. The patient’s acute vision loss developed after sexual activity. Color fundus photos and fluorescein angiography were performed showing a large subinternal limiting membrane hemorrhage in the macular area. A 23-gauge sutureless pars plana vitrectomy with brilliant blue assisted internal limiting membrane peeling was performed with best-corrected visual acuity recovery to 20/50 at 6 months of followup.

Macular hole-associated retinal detachment in Best vitelliform dystrophy: Series of two cases and literature review

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Tewari, Ruchir; Kumar, Vinod; Ravani, Raghav; Dubey, Devashish; Chandra, Parijat; Kumar, Atul

2018-01-01

Two eyes of 2 patients with macular hole-associated retinal detachment in clinically diagnosed vitelliruptive stage of Best vitelliform dystrophy were surgically managed by 25-gauge sutureless pars plana vitrectomy, internal limiting membrane (ILM) peeling with inverted ILM flap, and short-acting (SF6) gas tamponade. The patients were assessed with respect to best-corrected visual acuity, color fundus photographs, shortwave fundus autofluorescence, and swept source optical coherence tomography. Surgical intervention led to Type 1 closure of macular hole, resolution of retinal detachment, and improvement in vision in both patients. PMID:29676326

Macular hole-associated retinal detachment in Best vitelliform dystrophy: Series of two cases and literature review

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Ruchir Tewari

2018-01-01

Full Text Available Two eyes of 2 patients with macular hole-associated retinal detachment in clinically diagnosed vitelliruptive stage of Best vitelliform dystrophy were surgically managed by 25-gauge sutureless pars plana vitrectomy, internal limiting membrane (ILM peeling with inverted ILM flap, and short-acting (SF6 gas tamponade. The patients were assessed with respect to best-corrected visual acuity, color fundus photographs, shortwave fundus autofluorescence, and swept source optical coherence tomography. Surgical intervention led to Type 1 closure of macular hole, resolution of retinal detachment, and improvement in vision in both patients.

Bilateral Simultaneous Rhegmatogenous Retinal Detachment following Laser in situ Keratomileusis

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Erhan Yumusak

2016-06-01

Full Text Available A 21-year-old woman developed simultaneous rhegmatogenous retinal detachment after laser in situ keratomileusis (LASIK in both eyes. She underwent pars plana vitrectomy surgery combined with endolaser photocoagulation and silicone oil tamponade in the right eye. A week later, pneumatic retinopexy was done in the left eye. As the retinal tear did not seal, 360° scleral buckling surgery was performed and retina was attached. Bilateral simultaneous rhegmatogenous retinal detachment after LASIK for correction of myopia can be a serious complication. Patients should be informed about the possibility of this complication.

Excellent outcome of Aspergillous endophthalmitis in a case of allergic bronchopulmonary aspergillosis

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Balbir Khan

2014-01-01

Full Text Available While invasive aspergillosis occurs typically in severely immunocompromised patients, cases of surgical site infections have been reported in immunocompetent individuals. The purpose is to report an eye with post-operative Aspergillus endophthalmitis, which achieved a good visual outcome following early and aggressive treatment. A young patient, known case of allergic bronchopulmonary aspergillosis presented to us with post-cataract surgery endophthalmitis. He was treated with pars plana vitrectomy and intravitreal voriconazole and systemic itraconazole. The patient regained a vision of 20/30 with follow up of 2 years.

Small gauge vitrectomy: Recent update

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Sumeet Khanduja

2013-01-01

Full Text Available Small gauge vitrectomy, also known as minimally invasive vitreous surgery (MIVS, is a classic example of progress in biomedical engineering. Disparity in conjunctival and scleral wound location and reduction in wound diameter are its core principles. Fluidic changes include increased pressure head loss with consequent reduction in infusional flow rate and use of higher aspiration vacuum at the cutter port. Increase An increase in port open/port closed time maintains an adequate rate of vitreous removal. High Intensity Discharge (HID lamps maintain adequate illumination in spite of a decrease in the number of fiberoptic fibers. The advantages of MIVS are, a shorter surgical time, minimal conjunctival damage, and early postoperative recovery. Most complications are centered on wound stability and risk of postoperative hypotony, endophthalmitis, and port site retinal break formation. MIVS is suited in most cases, however, it can cause dehiscence of recent cataract wounds. Retraction of the infusion cannula in the suprachoroidal space may occur in eyes with scleral thinning. As a lot has been published and discussed about sutureless vitrectomy a review of this subject is necessary. A PubMed search was performed in December 2011 with terms small gauge vitrectomy, 23-gauge vitrectomy, 25-gauge vitrectomy, and 27 gauge vitrectomy, which were revised in August 2012. There were no restrictions on the date of publication but it was restricted to articles in English or other languages, if there abstracts were available in English.

Vitrectomy and internal limiting membrane peeling for macular folds secondary to hypotony in myopes

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Nadal J

2015-05-01

Full Text Available Jeroni Nadal,1–3 Elisa Carreras,2,3 Maria Isabel Canut,1–3 Rafael I Barraquer1–3 1Centro de Oftalmologia Barraquer, 2Universitat Autònoma de Barcelona, 3Instituto Barraquer, Barcelona, Spain Background: Hypotony maculopathy (HM changes may persist, and visual acuity remains poor, despite normalization of intraocular pressure (IOP. The aim of this study was to evaluate the visual and anatomical results of pars plana vitrectomy (PPV, internal limiting membrane (ILM peeling, and 20% SF6 gas tamponade in five myopic patients with HM.Methods: This retrospective interventional study was conducted at the Barraquer Center of Ophthalmology, a tertiary care center in Barcelona, Spain, and included five eyes from five consecutive patients (aged 55.4±13.1 years with HM caused by different conditions. All the patients were treated with 23-gauge PPV, ILM peeling, and 20% SF6 gas tamponade. Preoperative and postoperative evaluation was performed using anterior and posterior biomicroscopy and best corrected visual acuity (BCVA by logMAR charts.Results: Before surgery, median spherical equivalent was -13.1 (range -7, -19 diopters of myopia. Preoperatively, four cases presented IOP <6.5 mmHg for 3 (range 2–8 weeks. In three of these four cases, IOP >6.5 mmHg was achieved over 16 (range 16–28 weeks, without resolution of HM; increased IOP was not achieved in the remaining case treated 2 weeks after diagnosis of HM. One case presented IOP >6.5 mmHg with HM for 28 weeks before surgery. Preoperative BCVA was 0.7 (range 0.26–2.3 logMAR, and 0.6 (range 0.3–0.7 logMAR and 0.5 (range 0.2–1 logMAR, respectively, at 4 and 12 months after surgery. There was no statistically significant difference between preoperative and postoperative BCVA. Hyperpigmentation lines in the macular area were observed in three cases with hypotony. These lines progressed after surgery despite resolution of the retinal folds in the three cases, and BCVA decreased in parallel

Vitrectomy with and without scleral buckling for retinal detachment Vitrectomia com e sem "scleral buckling" para descolamento da retina

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Rubens Camargo Siqueira

2007-03-01

Full Text Available PURPOSE: To compare the surgical results of vitrectomy with and without scleral buckling for rhegmatogenous retinal detachment (RD. METHODS: Fifty-one patients with rhegmatogenous retinal detachment with proliferative vitreoretinopathy (PVR at different stages were submitted to pars plana vitrectomy as the primary surgery, 23 patients (45.09% with scleral buckle (group I and 28 (54.90% without scleral buckle (group II. Visual acuity, anterior segment complications, intraocular pressure, strabismus and retina reattachment rate were evaluated in both groups. RESULTS: The anatomical success and postoperative complications were similar in both groups. Retinal reattachment was achieved in 20 of 23 eyes (87% of group I and in 24 of 28 eyes (85.7% of group II after the initial surgery (p=1.000. Elevated intraocular pressure was noted in 2 eyes (8.7% of group I and 1 eye (3.6% of group II (p=0.583. Corneal abnormalities were seen in 3 eyes (13% of group I and 2 eyes (7.19% of the group II (p=0.647. Visual acuity improved from a preoperative median of 20/200 to a median of 20/100 in group 1 and from 20/400 to 20/100 in group 2; the difference between the two groups was statistically significant (pOBJETIVOS: Comparar os resultados cirúrgicos da vitrectomia com e sem "buckle" escleral para descolamento da retina regmatogênico (DR. MÉTODOS: Cinqüenta e um pacientes com descolamento da retina regmatogênico com proliferação vitreorretiniana (PVR em diferentes estádios foram submetidos a vitrectomia pars plana como cirurgia primária; 23 pacientes (45,09% com buckle escleral (grupo 1 e 28 pacientes (54,90% sem "buckle" escleral (grupo 2. Acuidade visual, complicações do segmento anterior, pressão intra-ocular, estrabismo e razão do redescolamento da retina foram avaliados em ambos os grupos. RESULTADOS: O sucesso anatômico e complicações pós-operatórias foram semelhantes em ambos os grupos. A reaplicação da retina foi obtida em 20 dos 23

Vitrectomy with internal limiting membrane peeling for macular hole in high myopia eyes

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Chun-Mei Deng

2015-08-01

Full Text Available AIM: To compare the clinical effects between pars plana vitrectomy(PPVand PPV with internal limiting membrane peeling(ILMPfor macular hole in high myopia eyes. METHODS:The clinical data of 33 high myopia with macular hole patients(36 eyeswith or without retinal detachment caused by macular hole were retrospectively analyzed. The patients were divided into two groups according to different operation methods: 15 eyes in groupⅠhad undergone PPV; 21 eyes in groupⅡhad undergone PPV with ILMPP peeling. According to different conditions of patients,different auxiliary methods were accepted, such as silicone oil tamponade, C3F8 tamponade, photocoagulation, condensation, etc. The follow-up period was 3～12mo. Best corrected visual acuity(BCVA, macular hole closure rate and retinal reattachment rate were continuous checked after operation. Then we evaluated the outcome in the two groups by statistical analysis.RESULTS: The postoperative mean BCVA increased by 0.167 in group Ⅰand 0.456 in group Ⅱ than preoperative, the difference was significant(t=2.46,6.753; P=0.027,0.000. And the difference of BCVA improvement was significant between those two groups(t=-2.943, P=0.006. The macular hole closed in 7 eyes(46.67%in group Ⅰ,and 18 eyes(85.71%in group Ⅱ; The difference was significant between those two groups(χ2=6.287,P=0.025.Retinal reattachment was found in 11 eyes(91.67%in group Ⅰ and 19 eyes(94.73%in group Ⅱ. The difference was not significant between the two groups(χ2=0.856, P=0.418. CONCLUSION: PPV with ILMPP peeling for macular hole in high myopia eyes can obviously improve closure of macular hole and postoperative visual acuity. But the difference of retinal reattachment rate was not significant between peeling and unpeeling of ILMP.

ILM peeling in nontractional diabetic macular edema: review and metanalysis.

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Rinaldi, M; dell'Omo, R; Morescalchi, F; Semeraro, F; Gambicorti, E; Cacciatore, F; Chiosi, F; Costagliola, C

2017-10-31

To evaluate the effect of internal limiting membrane (ILM) peeling during vitrectomy for nontractional diabetic macular edema. PUBMED, MEDLINE and CENTRAL were reviewed using the following terms (or combination of terms): diabetic macular edema, nontractional diabetic macular edema, internal limiting membrane peeling, vitrectomy, Müller cells. Randomized and nonrandomized studies were included. The eligible studies compared anatomical and functional outcomes of vitrectomy with or without ILM peeling for tractional and nontractional diabetic macular edema. Postoperative best-corrected visual acuity and central macular thickness were considered, respectively, the primary and secondary outcomes. Meta-analysis on mean differences between vitrectomy with and without ILM peeling was performed using inverse variance method in random effects. Four studies with 672 patients were eligible for analysis. No significant difference was found between postoperative best-corrected visual acuity or best-corrected visual acuity change of ILM peeling group compared with nonpeeling group. There was no significant difference in postoperative central macular thickness and central macular thickness reduction between the two groups. The visual acuity outcomes in patients affected by nontractional diabetic macular edema using pars plana vitrectomy with ILM peeling versus no ILM peeling were not significantly different. A larger prospective and randomized study would be necessary.

Ocular coherence tomographic examination of postoperative foveal architecture after scleral buckling vs vitrectomy for macular off retinal detachment.

LENUS (Irish Health Repository)

Gibran, S K

2012-02-03

AIMS: This pilot study uses Optical Coherence Tomography (OCT) imaging to compare the difference in foveal architecture after successful retinal detachment (RD) surgery by scleral buckling or pars plana vitrectomy (PPV). METHODS: Prospective recruitment of patients with macular off RDs. Detachment surgery was undertaken by scleral buckling, external drainage, and air injection (group 1) or by PPV (group 2). Postoperatively patients had clinical examinations and OCT at 1, 3, 6, and 12 months. If abnormalities persisted, a further OCT was obtained at 18 months. RESULTS: Retinal reattachment, including clinical macular reattachment, was achieved in all cases within 24 h postoperatively. In group 1 (n=22), postoperative OCT showed persistent foveal detachment in 63% of cases (n=14) at 1 and 3 months. At 6 and 12 months, 36% (n=8) and 9% (n=2) had a persistent foveal detachment, respectively, and at 18 months, foveal detachment eventually. In group 2 (n=21), postoperative OCT showed an attached fovea in all cases; however, foveal thickening suggesting intraretinal oedema was present in all cases. The oedematous appearance of retina on OCT settled in 1-3 months. No foveal abnormality was seen at 6 and 12 months postoperatively. CONCLUSIONS: A high proportion of patients with successful retinal reattachment surgery by scleral buckling had foveal detachments postoperatively. No cases who had PPV had foveal detachments; however, transient retinal oedema was evident in all cases. The aetiology of these changes is unknown and warrants further investigation, as there is the potential of a long-term effect on vision.

A meta-analysis of vitrectomy with or without internal limiting membrane peeling for macular hole retinal detachment in the highly myopic eyes.

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Gao, Xinxiao; Guo, Jia; Meng, Xin; Wang, Jun; Peng, Xiaoyan; Ikuno, Yasushi

2016-06-13

To evaluate the anatomical and visual outcomes by par plana vitrectomy with or without internal limiting membrane (ILM) peeling in highly myopic eyes with macular hole retinal detachment (MHRD). MEDLINE (Ovid, PubMed) and EMBASE were used for data collection up to September 30, 2015. The parameters of anatomical success, macular hole closure and improved best corrected visual acuity (BCVA) at or beyond 6 months after operation were assessed as the primary outcome measurement. The meta-analysis was performed with the fixed-effects model. Seven comparative analyses involving a total of 373 patients were included in the present meta-analysis. Statistically the pooled data showed significant relative risk (RR) in terms of primary reattachment between ILM peeling and non-peeling groups (RR, 1.19; 95 % CI, 1.04 to 1.36; P = 0.012). An effect favoring ILM peeling with regard to macular hole closure was also detected (RR, 1.71; 95 % CI, 1.20 to 2.43; P = 0.003). However, no statistically significant difference was found in the improved BCVA (logarithm of the minimum angle of resolution) at 6 months or more (95 % CI, -0.31 to 0.44; P = 0.738). There is no proved benefit of postoperative visual improvement. However, the available evidences from this study suggested a superiority of ILM peeling over no peeling for myopic patients with MHRD.

Calcification of Hydrophilic Acrylic Intraocular Lenses With a Hydrophobic Surface: Laboratory Analysis of 6 Cases.

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Gartaganis, Sotirios P; Prahs, Philipp; Lazari, Eftichia D; Gartaganis, Panos S; Helbig, Horst; Koutsoukos, Petros G

2016-08-01

To investigate the nature and characteristic features of deposits causing opacification of intraocular lenses (IOLs) based on the examination of clinical findings using scanning electron microscopy (SEM) and energy-dispersive x-ray spectroscopy (EDX) analysis. Retrospective, observational case series. This is a multicenter study of 6 hydrophilic acrylic IOLs (Lentis LS-502-1; Oculentis GmbH, Berlin, Germany) with a hydrophobic surface that were explanted from 5 patients because of opacification. Three patients had an uncomplicated phacoemulsification. One patient underwent combined phacoemulsification and pars plana vitrectomy for retinal detachment and later silicone oil endotamponade owing to redetachment. The last patient had a pars plana vitrectomy and silicone oil instillation combined with phacoemulsification for tractive retinal detachment and diabetic retinopathy. The explanted lenses were submitted to our laboratory and were examined by SEM and EDX in order to identify the morphologic features and the composition of the deposits. SEM and EDX analyses confirmed the presence of calcific deposits in the interior of the opacified hydrophilic IOLs, with a pattern showing the formation of lumps on the surface. The lumps were due to subsurface formation of calcium phosphate crystalline deposits. The crystallite clusters seemed to diffuse from the IOL interior to the surface. We demonstrated the calcification pattern of the hydrophilic IOL (Lentis LS-502-1) with a hydrophobic surface. Although hydrophilic acrylic lenses have a hydrophobic surface, the development of calcification is a possible threat initiating from the hydrophilic subsurface of the IOLs. Copyright © 2016 Elsevier Inc. All rights reserved.

Impact of duration of macula-off retinal detachment on visual outcome: a systematic review and meta-analysis of literature.

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van Bussel, Erik M; van der Valk, Rikkert; Bijlsma, Ward R; La Heij, Ellen C

2014-10-01

To systematically review the influence of the lag time between macula-off retinal detachment and surgical intervention on postoperative visual acuity as main outcome measure. Systematic review and meta-analysis of articles published from 1995 to October 2013 of patients with macula-off retinal detachment and treated with scleral buckling or pars plana vitrectomy. Eligible data were pooled in a meta-analysis, analyzing the odds ratio between different durations of ≤ 3, ≤ 4, ≤ 7, and ≤ 10 days, comparing a final visual acuity of ≤ 0.4 logMAR with >0.4 logMAR, using a random-effects model. Last, the number needed to treat was calculated. Fourteen articles were eligible, of which 9 studies contained data that were suitable for meta-analysis. Patients who were operated with scleral buckling (n = 602) within 3 days since macular detachment had a statistically significant better chance of reaching a final visual acuity of 0.4 logMAR or better compared with a longer duration of macular detachment, with an odds ratio for ≤ 3 days versus 4 days to 7 days of 2.86 (95% confidence interval, 1.37-5.99) and an odds ratio for ≤ 3 days versus >3 days of 3.09 (95% confidence interval, 1.56-6.12), and with a number needed to treat of 4. For pars plana vitrectomy, the limited amount of data precluded a meta-analysis with substantial results. This meta-analysis suggests that scleral buckling for macular detachment must preferably be performed within 3 days to optimize visual outcome.

Visualizing Macular Structures During Membrane Peeling Surgery With an Intraoperative Spectral-Domain Optical Coherence Tomography Device.

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Leisser, Christoph; Hackl, Christoph; Hirnschall, Nino; Luft, Nikolaus; Döller, Birgit; Draschl, Petra; Rigal, Karl; Findl, Oliver

2016-04-01

The aim of this study was to examine the quality of intraoperative visualization of the posterior hyaloid, epiretinal membrane (ERM), inner limiting membrane (ILM), and hyporeflective subfoveal zone with a commercially available, microscope-integrated spectral-domain OCT setup (mi-SD-OCT) (Rescan 700; Carl Zeiss Meditec AG, Germany). Twenty patients prospectively scheduled for pars plana vitrectomy with membrane peeling due to an idiopathic ERM were included. Standard 23-gauge, three-port pars plana vitrectomy with membrane peeling and staining of the ERM with a trypan blue-based chromovitrectomy dye was performed in all cases. Intraoperative SD-OCT was performed before and after peeling and visualization of the posterior hyaloid, ERM, ILM, and presence of subfoveal hyporeflective zones were examined. OCT follow-ups were performed 2 days and 3 months after surgery. The study was approved by the local ethics committee of the city of Vienna. Successful intraoperative visualization of ERM by mi-SD-OCT was possible in all cases. The posterior hyaloid and ILM could not be seen in the mi-SD-OCT scans, whereas an intraoperative subfoveal hyporeflective zone presented in 35% of cases. In 12.5% an independent subfoveal hyporeflective zone presented postoperatively. Visual acuity improved in 93.8% of patients after surgery. mi-SD-OCT appears to be a valuable tool for intraoperative visualization of the ERM and offers immediate visualization of retinal anatomy during peeling. Therefore, it adds to the understanding of intraoperative traumatic changes due to the peeling procedure. Copyright 2016, SLACK Incorporated.

Outcomes in bullous retinal detachment

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Sarah P. Read

2017-06-01

Conclusions and importance: GRTs are an uncommon cause of retinal detachment. While pars plana vitrectomy with tamponade is standard in GRT management, there is variability in the use of scleral buckling and PFO in these cases. This is in contrast to retinal dialysis where scleral buckle alone can yield favorable results. Though a baseball ocular trauma is common, retinal involvement is rare compared to other sports injuries such as those occurring with tennis, soccer and golf. Sports trauma remains an important cause of retinal injury and patients should be counseled on the need for eye protection.

Vitrectomy for proliferative diabetic retinopathy

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Chao Peng

2013-10-01

Full Text Available AIM:To observe the clinical effect of vitrectomy for proliferative diabetic retinopathy(PDR.METHODS: The clinical data of 55 cases(65 eyes, underwent vitrectomy, membrane peeling, endolaser photocoagulation and silicone oil or C3F8 injection, were retrospectively studied. During 6 months to 1 year follow-up period, visual acuity, intraocular pressure, retinal conditions and complications were observed.RESULTS: All 65 eyes received vitrectomy, of which silicone oil was tamponaded in 32 eyes, C3F8 was injected in 8 eyes, BBS was filled in 25 eyes. Visual improvement achieved in 42 eyes. Two eyes were manually vision, form count fingers to 0.05 in 18 eyes, >0.05-0.1 in 28 eyes, >0.1-0.3 in 12 eyes and >0.3 in 5 eyes. Retinal hole was occurred in 7 eyes, limitations fibrosis membrane remained in 8 eyes, retinal detachment appeared in 5 eyes, IOP increased in 18 eyes, vitreous hemorrhage relapsed in 12 eyes, 36 eyes received supplemental photocoagulation treatment 1-3 times after operation.CONCLUSION:Vitrectomy combined endophotocoagulation is an effective treatment for PDR. Silicone oil tamponade can limit the hemorrhage.

Suspected bacterial endophthalmitis following sustained-release dexamethasone intravitreal implant: a case report.

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Arıkan Yorgun, Mücella; Mutlu, Melek; Toklu, Yasin; Cakmak, Hasan Basri; Cağıl, Nurullah

2014-06-01

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.

Dislocation of polyfocal full-optics accommodative intraocular lens after neodymium-doped yttrium aluminum garnet capsulotomy in vitrectomized eye

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Kyung Tae Kang

2013-01-01

Full Text Available We report a case of dislocation of WIOL-CF® polyfocal full-optics intraocular lens (IOL after neodymium-doped yttrium aluminum garnet (Nd: YAG laser capsulotomy in the vitrectomized eye. At 22 months before the dislocation of the IOL, a 55-year-old male patient underwent phacoemulsification with WIOL-CF® IOL implantation in a local clinic and 10 months after the cataract surgery the patient underwent pars plana vitrectomy, endolaser photocoagulation and 14% C 3 F 8 gas tamponade for the treatment of rhegmatogenous retinal detachment. At 9 months after the vitrectomy, the patient visited our clinic for a sudden decrease of vision after Nd: YAG capsulotomy in the local clinic. On fundus examination, the dislocated IOL was identified and the Nd: YAG capsulotomy site and the larger break, which is suspected to have been a route of the dislocation were observed in the posterior capsule.

Anatomical and functional outcomes of retinectomies in retinal detachments complicated by proliferative vitreoretinopathy

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Mohammad Idrees Adhi

2017-10-01

Full Text Available Purpose: To study anatomical and functional outcomes of retinectomies in rhegmatogenous retinal detachments complicated by proliferative vitreoretinopathy. Methods: This is a retrospective interventional consecutive case series of eyes with rhegmatogenous retinal detachments complicated by advanced proliferative vitreoretinopathy and managed by relaxing retinectomy over a period of seventeen years. Three-port pars plana vitrectomy included core vitrectomy and removal of all epi-retinal membranes. On failure to flatten, retina was cut and excised. Basal vitrectomy and removal of anterior flap of retina then followed. Silicone oil was used as temponade in majority of cases. The dependent variables were anatomical and functional outcomes. The statistical analysis was performed on SPSS 21. Results: Series included 370 eyes of 337 patients. Mean follow up was 39 months. Scleral explant was used in 90(24.39% cases. Two hundred and nine (56.49% eyes were operated with trans conjunctival sutureless vitrectomy technique. Procedure was bilateral in 33 patients (09.79%. Retina attached in 311(84.05% eyes after initial surgery. Final re-attachment after one or more surgeries was achieved in 344(92.97% eyes. Two hundred and eleven (57.02% cases achieved visual acuity of 6/60 or better. Conclusion: Relaxing retinectomies have good and encouraging anatomical and functional outcomes. This surgery can be effectively carried out with trans conjunctival sutureless vitrectomy technique. Keywords: Retinotomy and retinectomy, Proliferative vitreoretinopathy, Trans conjunctival sutureless vitrectomy, Silicone oil

[Experimental results of erbium:YAG laser vitrectomy].

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Mrochen, M; Petersen, H; Wüllner, C; Seiler, T

1998-01-01

Vitrectomy performed by conventional guillotine devices includes the risk of mechanical damage to retina as well as other ocular structures. The present study aims to investigate the efficacy of the Er:YAG laser for vitreous liquefaction. Vitreous liquefaction by means of Er:YAG laser pulses was performed using a special handpiece. The output of an Er:YAG laser operating at 2.94 microns was coupled into a ZrF optical fibre (length 2 m) which ended inside a cavity located at the quartz tip (diameter 320 microns) of the handpiece where tissue ablation took place. The viscosity of the liquefied vitreous was determined by rotation viscosimetry and compared to liquefied vitreous obtained by mechanical vitrectomy. In addition, the aspiration flow (ml/min) was correlated to the repetition/cutting rate of the laser and the cutter. The temperature rise at the handpiece was recorded with a micro thermocouple. The cutting threshold was determined to 5 mJ +/- 3 mJ at a pulse duration of 200 microseconds. The viscosity of the vitreous liquefied with the Er:YAG laser was 31 +/- 10 mPa s which is similar to the results of mechanical vitrectomy (42 +/- 19 mPa s) but significant less than that of normal vitreous (880 +/- 280 mPa s). The aspiration of the laser handpiece in dependence to the repetition rate increases linear up to 2.6 ml/min at 30 Hz. The temperature increase at the handpiece was < 1 K under vitrectomy conditions (aspiration and irrigation) with an averaged laser power of 0.3 W (10 mJ at 30 Hz). The decreased vacuum forces used by the laser vitrectomy system may result in less mechanical stress to the retina as well as intravitreal structures which may be attached to it. An Er:YAG laser vitrectomy system may offer the potential of fewer complications during vitrectomy.

Transconjunctival drainage of serous and hemorrhagic choroidal detachment.

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Rezende, Flávio A; Kickinger, Mônica C; Li, Gisèle; Prado, Renata F; Regis, Luiz Gustavo T

2012-02-01

To describe a novel surgical technique for drainage of bullous serous and hemorrhagic choroidal detachments. A prospective, consecutive case series of 6 eyes with serous and/or hemorrhagic choroidal detachments secondary to intraocular surgery was documented to evaluate the feasibility of using the 25-gauge and 20-gauge transconjunctival trocar/cannula systems to drain choroidal detachments. Two eyes had expulsive hemorrhagic choroidal detachments and 4 eyes had serous choroidal detachments after glaucoma surgeries. A 25-gauge infusion line was placed in the anterior chamber. A 20-gauge (in eyes with hemorrhagic choroidal detachments) or a 25-gauge (in eyes with serous detachments) trocar/cannula system was inserted into the suprachoroidal space 7.0 mm from limbus. After drainage, the cannulas were removed and no sutures were placed. Pars plana vitrectomy was performed only in eyes with concomitant pathology that demanded the additional procedure. The primary outcome measure was presence of choroidal detachment at 1 week, 2 weeks, and 1 month postoperatively. Secondary outcome measures were visual acuity at 6 months and intraocular pressure at 1 week and 1, 3, and 6 months postoperatively. Drainage of hemorrhagic choroidal detachments resulted in resolution of the detachments by 1 month postoperatively. In eyes with serous detachments, resolution was achieved by 1 week postdrainage. In both groups, intraocular pressure increased to at least 10 mmHg by postoperative Week 1. The visual acuity improved in all eyes. No complications related to the transconjunctival technique were noted. Transconjunctival drainage of serous and hemorrhagic choroidal detachments seems to be a feasible and simple surgical option with minimal scleral and conjunctival damage. Pars plana vitrectomy may not be necessary when draining choroidal detachments in this manner.

Application and experience of anterior vitrectomy in phacoemulsification

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Xiao-Bo Zeng

2016-02-01

Full Text Available AIM: To observe and discuss the clinical application and effect of anterior vitrectomy in phacoemulsification for the treatment of vitreous prolapse caused by posterior capsular rupture or suspensory ligament transection.METHODS:Retrospective analysis of 28 cases(35 eyeswith cataract in whom vitreous prolapse caused by posterior capsular rupture or suspensory ligament transection occurred in phacoemulsification and intraocular lens implantation and anterior vitrectomy were performed was conducted. RESULTS:Anterior vitrectomy for timely and accurate treatment for vitreous prolapse caused by posterior capsular rupture or suspensory ligament transection occurred in phacoemulsification was satisfied. CONCLUSION: Anterior vitrectomy has good curative effect for vitreous prolapse caused by posterior capsular rupture or suspensory ligament transection occurred in phacoemulsification and is effective with less severe complications.

Diabetic Macular Edema.

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Gundogan, Fatih C; Yolcu, Umit; Akay, Fahrettin; Ilhan, Abdullah; Ozge, Gokhan; Uzun, Salih

2016-01-01

Diabetic macular edema (DME), one the most prevalent causes of visual loss in industrialized countries, may be diagnosed at any stage of diabetic retinopathy. The diagnosis, treatment, and follow up of DME have become straightforward with recent developments in fundus imaging, such as optical coherence tomography. Laser photocoagulation, intravitreal injections, and pars plana vitrectomy surgery are the current treatment modalities; however, the positive effects of currently available intravitreally injected agents are temporary. At this point, further treatment choices are needed for a permanent effect. The articles published between 1985-2015 years on major databases were searched and most appropriate 40 papers were used to write this review article.

Percutaneous cardiopulmonary support to treat suspected venous air embolism with cardiac arrest during open eye surgery: a case report.

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Shin, Seokyung; Nam, Bokyung; Soh, Sarah; Koo, Bon-Nyeo

2014-11-01

We report a case of possible venous air embolism (VAE) during trans pars plana vitrectomy with air-fluid exchange of the vitreous cavity. Shortly after initiation of air-fluid exchange, decreases in end-tidal CO2, oxygen saturation, and blood pressure were observed. The patient rapidly progressed to cardiac arrest unresponsive to cardiopulmonary resuscitation, and recovered after the application of percutaneous cardiopulmonary support. Prompt termination of air infusion is needed when VAE is suspected during air-fluid exchange, and extracorporeal life support should be considered in fatal cases. Although the incidence is rare the possibility of VAE during ophthalmic surgery clearly exists, and therefore awareness and vigilant monitoring seem critical.

Outcomes Associated With Concurrent Iris-Sutured Intraocular Lens Placement and Subluxated Crystalline Lens Extraction.

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McClellan, Scott F; Soiberman, Uri; Gehlbach, Peter L; Murakami, Peter N; Stark, Walter J

2015-08-01

We have developed a novel surgical technique, to our knowledge, for the management of subluxated crystalline lenses involving preplacement of an iris-sutured posterior chamber intraocular lens (PCIOL) before pars plana vitrectomy and lensectomy. To investigate the outcomes of eyes with subluxated crystalline lenses, predominantly a result of Marfan syndrome (14 eyes [58%]) or trauma (5 eyes [21%]), that underwent pars plana vitrectomy and lensectomy with placement of an iris-sutured PCIOL. We performed a retrospective, noncomparative case series of 24 eyes from 17 consecutive adult patients with surgically treated subluxated crystalline lenses presenting to the Wilmer Eye Institute at Johns Hopkins Hospital from October 6, 2006, through May 1, 2013. The mean (SD) postoperative follow-up was 24.4 (20.5) months for eyes with at least 6 months of follow-up (last date, October 13, 2014). We performed the analysis from January 21, 2014, through January 3, 2015. Improvement in best-corrected visual acuity using an automated Snellen chart and induction of astigmatism for eyes with at least 6 months of follow-up (n = 18) and IOL stability during follow-up for all eyes (n = 24). The mean (SD) age at surgery was 49.4 (10.7 [range, 29-67]) years. We found an improvement in mean (SD [95% CI]) best-corrected visual acuity from 0.66 (0.71 [0.30-1.02]) logMAR preoperatively (Snellen equivalent, approximately 20/90; range, 20/30 to hand motions) to 0.07 (0.11 [95% CI, 0.01-0.12]) logMAR postoperatively (Snellen equivalent, approximately 20/23; range, 20/15 to 20/50). We found little change in astigmatism postoperatively (mean change, -0.1 [95% CI, -0.5 to 0.13] diopters). Postoperative complications included retinal detachment (1 eye [4%]), retained cortical fragment (1 [4%]), cystoid macular edema (2 [8%]), and IOL subluxation (3 [13%]) owing to haptic slippage within 3 months of the procedure. The overall probability of successfully achieving placement of a centered iris

Value of optical coherence tomography in the detection of macular pathology before the removal of silicone oil

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Rashad MA

2016-01-01

Full Text Available Mohammad Ahmad Rashad, Ahmed Abdel Aliem Mohamed, Asmaa Ismail Ahmed Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt Purpose: To assess the pathological macular changes with optical coherence tomography (OCT before the removal of silicone oil (SiO in eyes that had undergone pars plana vitrectomy for complicated forms of retinal detachment (RD.Patients and methods: Subjects included 48 patients (51 eyes with complicated RD including proliferative vitreoretinopathy, proliferative diabetic retinopathy, recurrent RD, penetrating trauma, uveitis, giant retinal tears, and macular holes. All the eyes had undergone SiO injection. Furthermore, all eyes had been planned for the removal of SiO 6–12 months after the primary surgery. Finally, all eyes had a fundus examination and OCT examination before the silicone oil removal.Results: OCT findings indicated epiretinal membrane in 41% of the eyes, macular edema in 17%, macular detachment in 13.5%, macular thinning in 13.5%, macular holes in 10%, and subretinal membranes in 2%. Preoperative OCT was normal in only 12% of the eyes, while a clinical fundus examination was normal in 43% (P<0.001. Eyes with normal OCT had significantly better mean logMAR (0.35 than eyes with pathological changes detected through OCT (1.28; P<0.001. Surgical modifications were made during the removal of SiO in 74.5% of the eyes.Conclusion: OCT detected significantly more pathological changes than a clinical fundus examination. This had an impact on both surgical step modification during the removal of SiO and predictability of visual outcome after the removal of SiO. Keywords: optical coherence tomography, silicone oil, pars plana vitrectomy, proliferative vitreoretinopathy, proliferative diabetic retinopathy

Recent Advances and History of Vitreous Surgery

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Tatsuya Mimura

2011-01-01

Full Text Available There have been tremendous advances in the small-gauge pars plana vitrectomy (PPV systems. This review provides an overview of the recent advances and state of the art of vitreous surgery. The two most innovative advancements that have been developed in this area are the small-gauge cutter and the new illuminating systems. Compared to the traditional 20-gauge PPV, transconjunctival sutureless small-gauge PPV is a safe and effective strategy to treat a variety of vitreoretinal diseases. Chandelier illumination allows better visualisation of vitreous for bimanual surgery. The small-gauge PPV provides benefits in terms of less inflammation, less patient discomfort, and faster recovery of the visual acuity.

Branch retinal artery occlusion post-penetrating globe injury with intraocular foreign body.

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Nagpal, Manish; Chaudhary, Pranita; Jain, Ashish

2018-01-01

Intraocular foreign body (IOFB) in cases of penetrating eye injury accounts for an important indication of vitreoretinal intervention following ocular trauma. Vascular occlusion as a complication of IOFB is rare. Here we present a case of a 34-year-old male with post-traumatic cataract and an intraocular metallic foreign body (IOFB) lodged in the superficial layers of the retina inferotemporal to the disc, causing an inferotemporal branch retinal artery occlusion. The case was managed by lensectomy with pars plana vitrectomy and IOFB removal followed by a second procedure of secondary IOL implantation. Final best-corrected visual acuity improved to 6/24. This case highlights an unusual sequelae following penetrating ocular trauma.

Branch retinal artery occlusion post-penetrating globe injury with intraocular foreign body

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Manish Nagpal

2018-01-01

Full Text Available Intraocular foreign body (IOFB in cases of penetrating eye injury accounts for an important indication of vitreoretinal intervention following ocular trauma. Vascular occlusion as a complication of IOFB is rare. Here we present a case of a 34-year-old male with post-traumatic cataract and an intraocular metallic foreign body (IOFB lodged in the superficial layers of the retina inferotemporal to the disc, causing an inferotemporal branch retinal artery occlusion. The case was managed by lensectomy with pars plana vitrectomy and IOFB removal followed by a second procedure of secondary IOL implantation. Final best-corrected visual acuity improved to 6/24. This case highlights an unusual sequelae following penetrating ocular trauma.

Delayed-onset streptococcus pyogenes endophthalmitis following Ahmed glaucoma valve implantation.

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Bayraktar, Zerrin; Kapran, Ziya; Bayraktar, Sükrü; Acar, Nur; Unver, Yaprak Banu; Gök, Kemran

2005-01-01

To report a case of delayed-onset Streptococcus pyogenes endophthalmitis following implantation of an Ahmed glaucoma valve. A 10-year-old patient presented with acute endophthalmitis 1 year after Ahmed glaucoma valve implantation. The conjunctiva and Tenon's capsule over the valve plate had been penetrated by one of the polypropylene fixation sutures. The valve was removed, and pars plana vitrectomy was performed. Vitreous specimens and removal of the discharge over the plate revealed Streptococcus pyogenes. This is the first documented case of Streptococcus pyogenes endophthalmitis following Ahmed glaucoma valve implantation. We think the conjunctival buttonhole caused by the polypropylene suture provided an entry site for the infection. (c) Japanese Ophthalmological Society 2005.

Microplastics effects in Scrobicularia plana.

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Ribeiro, Francisca; Garcia, Ana R; Pereira, Beatriz P; Fonseca, Maria; Mestre, Nélia C; Fonseca, Tainá G; Ilharco, Laura M; Bebianno, Maria João

2017-09-15

One of the most common plastics in the marine environment is polystyrene (PS) that can be broken down to micro sized particles. Marine organisms are vulnerable to the exposure to microplastics. This study assesses the effects of PS microplastics in tissues of the clam Scrobicularia plana. Clams were exposed to 1mgL -1 (20μm) for 14days, followed by 7days of depuration. A qualitative analysis by infrared spectroscopy in diffuse reflectance mode period detected the presence of microplastics in clam tissues upon exposure, which were not eliminated after depuration. The effects of microplastics were assessed by a battery of biomarkers and results revealed that microplastics induce effects on antioxidant capacity, DNA damage, neurotoxicity and oxidative damage. S. plana is a significant target to assess the environmental risk of PS microplastics. Copyright © 2017 Elsevier Ltd. All rights reserved.

Outcomes of vitrectomy for advanced diabetic retinopathy at Groote ...

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Background. Present limitations in primary and secondary prevention of diabetic retinopathy mean that many patients with diabetes present with advanced retinal complications, often requiring surgery (vitrectomy). Objectives. To determine the outcomes of vitrectomy for advanced diabetic retinopathy and to examine ...

Scleral Buckling Versus Primary Vitrectomy in the Management of Retinal Detachment Associated with Mild Vitreous Hemorrhage

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Tansu Erakgün

2014-03-01

Full Text Available Objectives: The aim of this study was to compare the surgical impact of scleral buckling (SB and pars plana vitrectomy (PPV on the anatomic results and visual recovery in cases of rhegmatogenous retinal detachment with mild vitreous hemorrhage. Materials and Methods: In this study, we included 78 eyes of 78 phakic patients who underwent primary surgery for rhegmatogenous retinal detachment complicated by mild vitreous hemorrhage (38 eyes by SB,40 eyes by PPV;all patients had been followed for longer than 6 months after surgery. The surgical outcome and the rate of complications were retrospectively compared. Mann-Whitney U-test and chi-square test were used for the statistical analysis. Results: The reattachment rate after the first surgery was 78.9% (30/38 in the SB group and 95% (38/40 in the PPV group. The difference between the groups was statistically significant (p=0.035. Unseen retinal breaks in 4 eyes, malpositioned buckle in 2 eyes and insufficient closure of the break in 2 eyes of SB cases, as well as reopening of the original break in 2 eyes of PPV cases were the causes of failure. Visual improvement in the PPV group was significantly better than in the SB group in the third and sixth postoperative months (p<0.001 and p=0.026, respectively. Peroperative and postoperative complications were as follows: in the SB group-subretinal hemorrhage (5.2%, PVR of grade B or worse (10.5%, macular pucker (7.8%, and postoperative cataract (13%; in the PPV groupiatrogenic breaks (10%, lens damage (5%, PVR of grade B or worse (5%,macular pucker (5%, and postoperative cataract (35%. Conclusion: Even though the high incidence of peroperative complications such as iatrogenic breaks or postoperative complications such as cataract formation was the major drawback, the results indicate that PPV performed to alleviate peripheral vitreoretinal tractions and clear vitreous hemorrhage offers better anatomic and functional results than SB in the management of

A STUDY OF CASE SERIES OF INTRAOCULAR FOREIGN BODIES IN A TERTIARY CARE CENTER IN SOUTH INDIA

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Shilpa Y. D

2017-09-01

Full Text Available BACKGROUND Intraocular foreign bodies can cause vision threatening complication in cases of penetrating ocular injuries. Ocular injuries can occur anywhere at work place, at home, due to road traffic accidents, etc. Accidental eye injuries are common in males in work place. Awareness about using protective eye wear is required at work places where injuries are common. The aim of the study is to study the demographic profile, visual and anatomical outcome in patients presenting with posterior segment Intraocular Foreign Bodies (IOFB undergoing vitrectomy. MATERIALS AND METHODS Retrospective analysis was done on patients who underwent pars plana vitrectomy for posterior segment IOFB from March 2014 to April 2017. Complete ocular examination, B scan ultrasonography and x-ray orbit were done in all cases and retained posterior segment intraocular foreign body confirmed. Intraoperative difficulties, anatomical and visual outcome and postoperative complications were studied. RESULTS Cases with posterior segment intraocular foreign body and endophthalmitis had poor visual and anatomical outcome. Patients who underwent complete vitrectomy with 240 encirclage band with or without tamponade had better visual outcome. CONCLUSION Imaging in the injured eye is important to identify the presence of intraocular foreign body. Planning of the surgical procedure depending on the ocular condition plays a vital role in visual outcome.

Optical coherence tomography imaging of chorioretinal folds associated with hypotony maculopathy following pars plana vitrectomy

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Williams Jr BK

2015-09-01

Full Text Available Basil K Williams Jr, Jonathan S Chang, Harry W Flynn Jr Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA Abstract: Chorioretinal folds may occur as a consequence of hypotony and can be a cause of vision loss when associated with macular involvement. In this report, the spectral domain ocular coherence tomography imaging of three patients with chorioretinal folds before and after management are presented. The cases had unique presentations and each underwent different management approaches, but the results included improved visual acuities and lessened chorioretinal folds. Keywords: hypotony, chorioretinal folds, ocular coherence tomography

Treatment of malignant glaucoma with minimal invasive vitrectomy surgery

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Li Meng

2015-09-01

Full Text Available AIM:To evaluate the efficacy of 25G vitrectomy surgery for malignant glaucoma. METHODS: Thirteen eyes of 11 patients with malignant glaucoma who had a history of primary angle-closure glaucoma were analyzed retrospectively from September 2012 to October 2013 in our hospital. All patients had undergone a prior surgery of trebeculectomy combined with iridectomy. The pre-operative mean best corrected visual acuity(BCVAin LogMAR was 0.70±0.13 and the mean intraocular pressure(IOPwas 41.3±12.7mmHg. Corneal edema, ciliary body edema and very shallow anterior chamber with a mean value of 0.69±0.17mm were showed by ultrasound biomicroscopy(UBM. Anterior vitrectomy and posterior capsulotomy were performed with 25G vitrectomy system in all eyes. Seven phakic eyes underwent phacoimulsification combined IOL implantation surgery during vitrectomy.RESULTS: The patients were followed up for 6～18mo with an average of 11.7±5.4mo. BCVA at the last follow-up improved to 0.29±0.08 and the mean IOP was 18.6±3.9mmHg. UBM results showed that ciliary body edema was eliminated, the iris was flattened and the anterior chamber was deepened with a mean depth of 2.48±0.31mm at 1mo after surgery. Postoperative complications included corneal edma, Descemet membrane folds, anterior chamber inflammation, fibrotic exudation, local iris posterior synechia and hypotony(IOP≤5mmHg. One eye had high IOP of 26.4mmHg and required long-term topical antiglaucoma medication to control the IOP≤21mmHg. No complications such as corneal endothelium decompensation, IOL capture, intraocular hemorrhage, infection and uncontrolled IOP were observed. CONCLUSION: 25G vitrectomy is safe and effective for treating malignant glaucoma, controls IOP and reduces complications associated with traditional vitrectomy. Combined vitrectomy with phacoemulsification may improve the success rate and visual function.

Proliferative diabetic retinopathy after vitrectomy early factors affect IOP

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Shi-Bo Liu

2013-05-01

Full Text Available AIM:To explore possible causes of early postoperative elevated intraocular pressure caused by proliferative diabetic retinopathy(PDRvitrectomy. METHODS:Totally 72 cases(100 eyeswhich have performed vitrectomy for proliferative diabetic retinopathy were retrospectively analyzed to observe the incidence of postoperative ocular hypertension, and the relevant factors that caused postoperative high intraocular pressure were statistically analyzed. Early postoperative ocular hypertension diagnostic criteria: any time after 2 weeks of non-contact tonometer measured IOP> 25mmHg(1mmHg=0.133kPa. RESULTS:High intraocular pressure after vitrectomy occurred in 27 eyes(27%, the incidence of male and female were 27.27%, 26.79%, the difference was not statistically significant(P>0.05. Eyes filled with balanced liquid filling incidence rate of 30.95%, 6.25%, and the difference was statistically significant(P0.05. Incidences of intraoperative panretinal photocoagulation and additional retinal photocoagulation group were 41%, 20%, and the difference was statistically significant(P<0.05. Preoperative retinopathy of four, five, six groups of incidence were 9.52%, 23.81%, 40.56%, and the groups were statistically significant(P<0.05. Unconsolidated preoperative retinal detachment and retinal detachment incidence rate of 19%, 41%, and the difference was statistically significant(P<0.05. Surgery in the united lens resection with intraoperative unfederated lens the resection group's incidence rate of 34%, 15%, the difference was statistically significant(P<0.05. Logistic regression analysis showed that retinal detachment preoperative and intraoperative intraocular filling were independent risk factors that caused early postoperative ocular hypertension after vitrectomy. CONCLUSION:Post-operative ocular hypertension after PDR vitrectomy is related to preoperative retinal detachment, intraoperative lensectomy, intraoperative intraocular filling, and intraoperative

A new approach for sutureless 20-G vitrectomy

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Dikran G Hovaghimian

2015-01-01

The new approach of 20-G sutureless vitrectomy utilizing N-butyl-2-cyanoacrylate is a safe and effective technique for the surgical treatment of a variety of vitreoretinal pathologies. Conversion to this technique is very simple. A very short learning curve is required, with no need for new expensive instrumentation. It combines all the advantages of 20-G vitrectomy, adding to it the sutureless advantage of the technique.

Effect of vitrectomy combined medication hyperplastic on patients with diabetic retinopathy

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Xue-Qun Yu; Guo-Ping Cao; Ming-Xia Tang

2015-01-01

AIM: To observe the comparison of vitrectomy combined drug therapy(Ranibizumab injection)and single vitrectomy for proliferatived diabetic retinopathy(PDR)and the influence of the curative effect and prognosis of patients. METHODS: In this study, 112 cases(125 eyes)with PDR were selected and randomly divided into experimental group and control group(n=56). Fifty-six cases(61 eyes)in experimental group were injected by drug therapy of 0.5mg ranibizumab and received vitrectomy; In control group...

Usefulness of Discarded Vitreous Samples from Routine Vitrectomy

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Natàlia Vilà

2016-01-01

Full Text Available Purpose. To describe the histopathological features of vitreous samples obtained after vitrectomy surgery from diabetic and nondiabetic patients. Methods. Vitreous specimens from 137 patients who underwent vitrectomy for different clinical conditions were analysed. All samples were centrifuged and each resulting pellet was fixed and processed as part of routine paraffin section histopathology. The histopathological features were categorized in a semiquantitative fashion. The samples from diabetic and nondiabetic patients were compared. Results. The 125 included patients (58 diabetic, 60% males were aged 64.2±13.9 years. The presence of hemorrhage, inflammatory cells, and histiocytes was significantly higher in the diabetic group (P<0.001, P=0.028, and P=0.016, resp., showing more vessels (P<0.001 and ghost vessels (P=0.049. The presence of inflammatory cells was the feature with the highest sensitivity for detecting diabetes mellitus (98% and also the highest negative predictive value (89%. In the multivariate analysis, three variables emerged as independent significant predictors of diabetes in vitrectomy samples: hemorrhage, endothelial-lined vessels, and age (P<0.001, P<0.001, and P=0.019, resp.. Conclusions. Different histopathological features can be found in vitreous samples from diabetic patients. Analysis of vitrectomy samples may serve as a tool for diabetes management.

Hybrid wide-angle viewing-endoscopic vitrectomy using a 3D visualization system

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Kita M

2018-02-01

Full Text Available Mihori Kita, Yuki Mori, Sachiyo Hama Department of Ophthalmology, National Organization Kyoto Medical Center, Kyoto, Japan Purpose: To introduce a hybrid wide-angle viewing-endoscopic vitrectomy, which we have reported, using a 3D visualization system developed recently. Subjects and methods: We report a single center, retrospective, consecutive surgical case series of 113 eyes that underwent 25 G vitrectomy (rhegmatogenous retinal detachment or proliferative vitreoretinopathy, 49 eyes; epiretinal membrane, 18 eyes; proliferative diabetic retinopathy, 17 eyes; vitreous opacity or vitreous hemorrhage, 11 eyes; macular hole, 11 eyes; vitreomacular traction syndrome, 4 eyes; and luxation of intraocular lens, 3 eyes. Results: This system was successfully used to perform hybrid vitrectomy in the difficult cases, such as proliferative vitreoretinopathy and proliferative diabetic retinopathy. Conclusion: Hybrid wide-angle viewing-endoscopic vitrectomy using a 3D visualization system appears to be a valuable and promising method for managing various types of vitreoretinal disease. Keywords: 25 G vitrectomy, endoscope, wide-angle viewing system, 3D visualization system, hybrid

Early vitrectomy effective for Norrie disease.

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Walsh, Mark K; Drenser, Kimberly A; Capone, Antonio; Trese, Michael T

2010-04-01

To review our experience with Norrie disease to determine if early vitrectomy abrogates the natural history of this rare disease; namely, bilateral no light perception visual acuity and phthisis bulbi. We retrospectively reviewed the medical records of all patients seen in our tertiary care pediatric retinal clinical practice from 1988 through 2008 with a potential diagnosis of Norrie disease. Inclusion required not only clinical findings consistent with Norrie disease but also genetics and/or a family history consistent with Norrie disease. Medical record review revealed 14 boys with clinically diagnosed Norrie disease and either Norrie disease gene (NDP) mutations noted on genetic testing (13 patients) and/or a clear family history consistent with Norrie disease (4 patients). All 14 boys with definite Norrie disease had vitrectomy with or without lensectomy in at least 1 eye prior to 12 months of age. Of the 14 boys with definite Norrie disease, 7 maintained at least light perception visual acuity in 1 eye and 3 had no light perception visual acuity bilaterally; visual acuity data were not available for 4 patients. Only 2 of 24 (8%) eyes became phthisical. Historically, no treatment has been offered to mitigate the dismal natural history of Norrie disease. We recommend consideration of early vitrectomy in Norrie disease.

Diabetic vitrectomy in a large type 1 diabetes patient population

DEFF Research Database (Denmark)

Ostri, Christoffer; la Cour, Morten; Lund-Andersen, Henrik

2014-01-01

1996 and 2010. Surgical history was obtained from The Danish National Patient Register. RESULTS: The population consisted of 3980 patients with type 1 diabetes. Median follow-up was 10.0 years. In total, 106 patients underwent diabetic vitrectomy in the observation period. Surgery indications were...... nonclearing vitreous haemorrhage (43%) or tractional retinal detachment (57%). The cumulative incidence rates of diabetic vitrectomy were 1.6% after 5 years and 2.9% after 10 years. When excluding patients with no or mild diabetic retinopathy, the corresponding rates were higher; 3.7% and 6.4%, respectively...... (p diabetic vitrectomy increased in patients experiencing glycosylated haemoglobin A1c > 75 mmol/mol in the observation period (p

Vitrectomy in patients over 90 years of age

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Muto T

2016-01-01

Full Text Available Tetsuya Muto, Tomoyuki Ide, Makoto Chikuda, Shigeki Machida Department of Ophthalmology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan Purpose: The aim of this study was to evaluate vitrectomy procedures performed in patients over 90 years of age at the Dokkyo Medical University Koshigaya Hospital (Koshigaya, Japan.Patients and methods: Vitrectomies were performed in nine eyes of nine patients who were over 90 years of age between May 2010 and March 2015. Factors such as the underlying vitreoretinal disease, preoperative and postoperative best-corrected visual acuity (BCVA, surgical time, postoperative body position, need for a second surgery, systemic disease, and intraoperative changes in systemic conditions have been evaluated.Results: The most common cause of the underlying vitreoretinal disease was vitreous hemorrhage derived from age-related macular degeneration and posterior dislocation of the lens secondary to a posterior capsular rupture (two cases each. The mean values for the logarithm of the minimum angle of resolution BCVA were 2.15 preoperatively and 1.46 postoperatively (P=0.020, Wilcoxon signed-rank test. The mean surgical time was 109 minutes. Prone position was needed in two cases, and no second surgeries were needed. The most common cause of systemic disease was hypertension, which was found in six cases. Transient hypertension was found in two cases during surgery, and these patients were treated using intravenous calcium blocker injections.Conclusion: Patients over 90 years of age who underwent vitrectomy procedures did not have serious problems, except transient hypertension during surgery. The BCVA significantly improved. These results indicated that vitrectomies could be performed successfully in patients over 90 years of age. Keywords: vitrectomy, underlying vitreoretinal disease, transient hypertension

Comparison of lens oxidative damage induced by vitrectomy and/or hyperoxia in rabbits

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Hong Yan

2017-02-01

Full Text Available AIM: To compare of lens oxidative damage induced by vitrectomy and/or hyperoxia in rabbit. METHODS: Sixteen New Zealand rabbits (2.4-2.5 kg were randomly divided into two groups (Group A, n=12; Group B, n=4. In Group A, the right eyes were treated with vitrectomy and systemic hyperoxia (oxygen concentration: 80%-85%, 1 ATA, 4h/d (Group A-right, and the left eyes were treated with hyperoxia without vitrectomy surgery (Group A-left. Four rabbits in group B (eight eyes were untreated as the controls. Lens transparency was monitored with a slit lamp and recorded before and after vitrectomy. After hyperoxic treatment for 6mo, the eyeballs were removed and the lens cortices (containing the capsules and nuclei were separated for further morphological and biochemical evaluation. RESULTS: Six months after treatments, there were no significant morphological changes in the lenses in any experimental group when observed with a slit lamp. However, the levels of water-soluble proteins and ascorbate, and the activities of catalase and Na+-K+-ATPase were significantly reduced, whereas the levels of malondialdehyde and transforming growth factor β2 (TGF-β2 were significantly elevated, in both the cortices and nuclei of eyes treated with vitrectomy and hyperoxia. The increase in protein-glutathione mixed disulfides and the reduction in water-soluble proteins were more obvious in the lens nuclei. The levels of ascorbate in the vitreous fluid were also reduced after vitrectomy, whereas TGF-β2 increased after vitrectomy and hyperoxia. Systemic hyperoxia exposure increased these effects. CONCLUSION: Removal of the intact vitreous gel with vitrectomy and exposing the lens to increased oxygen from the retina induce lens oxidation and aggregation. Thus, an intact vitreous gel structure may protect the lens from oxidative insult and maintain lens transparency.

Clinical and cost-effectiveness of internal limiting membrane peeling for patients with idiopathic full thickness macular hole. Protocol for a Randomised Controlled Trial: FILMS (Full-thickness macular hole and Internal Limiting Membrane peeling Study

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Cook Jonathan

2008-11-01

Full Text Available Abstract Background A full-thickness macular hole (FTMH is a common retinal condition associated with impaired vision. Randomised controlled trials (RCTs have demonstrated that surgery, by means of pars plana vitrectomy and post-operative intraocular tamponade with gas, is effective for stage 2, 3 and 4 FTMH. Internal limiting membrane (ILM peeling has been introduced as an additional surgical manoeuvre to increase the success of the surgery; i.e. increase rates of hole closure and visual improvement. However, little robust evidence exists supporting the superiority of ILM peeling compared with no-peeling techniques. The purpose of FILMS (Full-thickness macular hole and Internal Limiting Membrane peeling Study is to determine whether ILM peeling improves the visual function, the anatomical closure of FTMH, and the quality of life of patients affected by this disorder, and the cost-effectiveness of the surgery. Methods/Design Patients with stage 2–3 idiopathic FTMH of less or equal than 18 months duration (based on symptoms reported by the participant and with a visual acuity ≤ 20/40 in the study eye will be enrolled in this FILMS from eight sites across the UK and Ireland. Participants will be randomised to receive combined cataract surgery (phacoemulsification and intraocular lens implantation and pars plana vitrectomy with postoperative intraocular tamponade with gas, with or without ILM peeling. The primary outcome is distance visual acuity at 6 months. Secondary outcomes include distance visual acuity at 3 and 24 months, near visual acuity at 3, 6, and 24 months, contrast sensitivity at 6 months, reading speed at 6 months, anatomical closure of the macular hole at each time point (1, 3, 6, and 24 months, health related quality of life (HRQOL at six months, costs to the health service and the participant, incremental costs per quality adjusted life year (QALY and adverse events. Discussion FILMS will provide high quality evidence on the

Intravitreal methotrexate infusion for proliferative vitreoretinopathy

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Sadaka A

2016-09-01

Full Text Available Ama Sadaka,1 Robert A Sisk,1–3 James M Osher,1,3 Okan Toygar,4 Melinda K Duncan,5 Christopher D Riemann1,3 1Department of Ophthalmology, University of Cincinnati College of Medicine, 2Department of Opthalmology, Cincinnati Children’s Hospital Medical Center, 3Cincinnati Eye Institute, Cincinnati, OH, USA; 4Department of Ophthalmology, Bahcesehir University Medical Faculty, Istanbul, Turkey; 5Department of Biological Sciences, University of Delaware, Newark, DE, USA Purpose: The purpose of this study was to evaluate intravitreal methotrexate infusion (IMI during pars plana vitrectomy (PPV for retinal detachment in patients with high risk for the development of proliferative vitreoretinopathy (PVR.Methods: Patients presenting with severe recurrent PVR with tractional retinal detachment and/or a history of severe ocular inflammation were treated with IMI. Clinical outcomes were determined from a retrospective medical chart review.Results: Twenty-nine eyes presenting with either tractional retinal detachment and recurrent PVR (n=22 or a history of severe inflammation associated with high PVR risk (n=7 received IMI during PPV. Best-corrected visual acuity at 6 months was ≥20/200 in 19 of 29 eyes (66% and remained stable or improved compared with initial presentation in 24 of 29 eyes (83%. At the last follow-up examination, the retinas of 26 of 29 eyes (90% remained attached after IMI while three eyes required another reattachment procedure. Three additional eyes (10% developed recurrent limited PVR without recurrent RD and were observed. No complications attributable to IMI occurred during a mean follow-up of 27 months.Conclusion: Eyes at high risk for PVR development due to a history of prior PVR or intraocular inflammation had a low incidence of PVR following IMI at the time of PPV for RD repair. No significant safety issues from IMI were observed in this series. Keywords: tractional retinal detachment, recurrent retinal detachment, pars

Surgical and visual outcomes of retinal detachment surgery in eyes with chorio-retinal coloboma

International Nuclear Information System (INIS)

Zafar, S.A.; Qureshi, N.A.; Pathan, A.H.K.

2016-01-01

Objective: To evaluate the anatomical and visual outcome of surgical management of retinal detachment associated with chorio-retinal coloboma. Study Design: Prospective interventional case series Place and Duration of Study: This study was conducted at Al-Shifa Trust Eye Hospital Rawalpindi from Jan 2012 to Dec 2013. Material and Methods: Twenty one eyes (21 patients) that underwent surgery for retinal detachment associated with chorio-retinal colobomas were selected. Evaluation was done on the basis of type of intervention, final visual acuity and anatomical outcome and complications. Out of 21, 19(90.47 percent) eyes underwent pars plana vitrectomy with silicone oil (SO) and 2(9.52 percent) underwent primary scleral buckling surgery. SO was removed in 9 (47.36 percent) eyes at final follow up. Encircling band was placed in 12 (63.15 percent) eyes based on peroperative judgment of surgeon. Intra-operative lensectomy was performed in 6 (28.57 percent) eyes. The main outcome measures were retinal re-attachment and visual recovery. Statistical analysis was performed using IBM statistical package for social sciences (SPSS) Statistics (version 17.0, Chicago, Illinois, USA). Qualitative variables were described using percentage; quantitative data were defined using mean +- standard deviation. The pre op and post op frequency of best corrected visual acuity (BVA) was compared using Wilcoxan Signed Ranks Test. Confidence interval was 95 percent (level of significance p<0.05). Results: The mean number of operations per eye were 1.57+- 0.74; mean follow-up was 13.1 months (range 12-18). The retina remained attached in 18 eyes (85.71 percent) at final follow-up. The post op BCVA improved significantly as compared to pre op BCVA (p< 0.01). Mean pre op BCVA was counting fingers (CF) and mean post op value of BCVA was 3/60. Conclusion: Pars plana vitrectomy along with silicon oil tamponade for retinal detachment related to choroiretinal coloboma improves the long

Factors affecting visual outcomes after treatment of infectious endophthalmitis in northeastern Thailand

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Yospaiboon Y

2018-04-01

Full Text Available Yosanan Yospaiboon, Anocha Intarapanich, Wipada Laovirojjanakul, Tanapat Ratanapakorn, Suthasinee Sinawat, Thuss Sanguansak, Chavakij Bhoomibunchoo KKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand Objective: To determine factors affecting visual outcomes after treatment of infectious endophthalmitis during 2012–2016 at a large referral eye center in northeastern Thailand. Patients and methods: Medical charts of patients with a diagnosis of infectious endophthalmitis including demographic data, types of endophthalmitis, causative organisms, methods of treatment, anatomical, and functional outcomes were retrospectively reviewed. Factors associated with improved visual outcomes were analyzed.Results: Four hundred and eleven patients (417 eyes were recruited for the study. The three most common types were post-traumatic (44.53%, post-operative (31.87%, and endogenous endophthalmitis (17.52%. Vitreous cultures revealed causative organisms in 41.25%. Most common Gram-positive organisms were coagulase-negative Staphylococcus 30% (36/120, Bacillus spp. 20% (24/120, and Streptococcus pneumoniae 18.33% (20/120. Most common Gram-negatives were Pseudomonas spp. 24.32% (9/37, Klebsiella spp. 24.32% (9/37, and Enterobacter spp. 16.21% (6/37. Methods of treatment were medical treatment (18.71% and surgical treatment (81.29%, including pars plana vitrectomy with or without silicone oil tamponade (62.59% and destructive surgery (18.71%. After treatment, visual improvement was noted in 44.6%, stable vision in 18.47%, and worse vision in 36.93%. Factors associated with improved visual outcomes were post-operative endophthalmitis (P<0.001, coagulase-negative Staphylococcus (P=0.003, and initial visual acuity before treatment of hand motion or better (P=0.017.Conclusion: Most infectious endophthalmitis patients were post-traumatic, post-operative, and endogenous. The most common method of treatment was

Clinical study of secondary glaucoma after silicone oil tamponade

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Xiao-Chun Chen

2013-12-01

Full Text Available AIM: To evaluate the related risk factors and treatment method of secondary glaucoma after pars plana vitrectomy and silicone oil tamponade.METHODS: The retrospective study analyzed 114 patients(118 eyeswho were treated with pars plana vitrectomy combined with silicone oil tamponade. Lenses were reserved in 78 eyes and were taken away in 40 eyes among which intraocular lens were implanted in 17 eyes. There were 39 eyes in which the filling time of silicone was no more than 6 months while 79 eyes in which the filling time was more than 6 months. The follow-up time was(16.2±4.9months. Primary and secondary glaucoma were excluded before the vitrectomy. Silicone oil glaucoma(SOGwas diagnosed when intraocular pressure(IOPwas measured higher than 21mmHg(1mmHg=0.133kPathree times in succession at least 1 month after silicone oil tamponade and inflammation and neovascular glaucoma should be excluded. Anti-glaucoma drugs were administrated once SOG was diagnosed. If the IOP was not controlled after 2 weeks, the silicone oil was taken away. If the IOP was still high, the anti-glaucoma surgery was operated. The data was analyzed by the SPSS 16.0 software using a binary logistic regression analysis. RESULTS: Among the 32 eyes of SOG, lenses were removed in 16 eyes(50%. The filling time of silicone oil was more than 6 months in 27 eyes(84.4%and silicone oil emulsion happened in 20 eyes(62.5%. IOP returned normal in 17 eyes after administrating anti-glaucoma medication within 2 weeks. Silicone oils were taken away in 15 eyes. However, 4 eyes still had high IOP after surgery; one of them was given anti-glaucoma drugs once more; two of them underwent trabeculectomy and one of them underwent cyclophotocoagulation. The lens conditions(whether it was taken away or not, P=0.024, the silicone oil filling time(whether the time was more than 6 months, P=0.014, and the status of the silicone oil(whether emulsification occurred or not, P=0.000were all found to be

Long-Term Outcomes of Total Exudative Retinal Detachments in Stage 3B Coats Disease.

Science.gov (United States)

Li, Albert S; Capone, Antonio; Trese, Michael T; Sears, Jonathan E; Kychenthal, Andres; De la Huerta, Irina; Ferrone, Philip J

2018-06-01

To evaluate the long-term outcomes of treatment of total exudative retinal detachments (ERDs) secondary to Coats disease (stage 3B) and the role of vitrectomy. Retrospective, observational case series. A total of 16 eyes in 16 patients undergoing treatment for total ERDs secondary to Coats disease with at least 5 years of follow-up. We reviewed the records of patients with stage 3B Coats disease. The interventions, including the timing of vitrectomy if used, and clinical course were recorded. The primary outcome measures were visual acuity at the most recent appointment, whether there was progression to neovascular glaucoma (NVG) or phthisis bulbi, and need for enucleation. All patients received ablative treatment (photocoagulation or cryotherapy), with 8 having scleral buckling (SB) and 6 having external drainage of subretinal fluid (XD). Of the 12 patients who had pars plana vitrectomy (PPV), 8 had early PPV (EV) in the first year after presenting, and 4 of 8 in the expectant management group had late PPV (late vitrectomy) at a mean of 4.3 years post-presentation for treatment of significant traction retinal detachment (TRD). The other 4 patients of 8 in the expectant management group did not require vitrectomy. Mean follow-up overall was 9 1/2 years. At the date of last follow-up, 50% had no light perception or light perception vision, which was consistent across the subgroups that underwent EV (4/8), late vitrectomy (2/4), or no PPV (2/4). A total of 4 of 16 patients had progression to NVG or phthisis, 1 of whom required enucleation. In this retrospective series of patients with Stage 3B Coats disease, ablative therapy with a combination of PPV, XD, or SB was effective in preventing progression to NVG or phthisis in the majority of patients, thus preserving the globe. Half of the patients (4/8) in this series who did not undergo PPV in the early vitrectomy group developed late-onset TRD, suggesting a possible role for early prophylactic vitrectomy with possible

Osteo-odonto-keratoprosthesis for end-stage cornea blindness.

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Wong, H S; Then, K Y; Ramli, R

2011-10-01

We report the first case of Osteo-odonto-keratoprosthesis (OOKP) who successfully underwent surgery in Malaysia following a grade 4 (severe) chemical injury in both eyes in 2006. The patient's left eye was eviscerated and his right eye underwent penetrating keratoplasty. However, the corneal graft failed and became opaque. His right eye could only perceive light. The OOKP was offered to him hoping to recover some functional vision. He underwent a 2-stage surgery to implant the OOKP into his right eye. However, 2 months post-operation, he developed vitreous haemorrhage. A successful pars plana vitrectomy (PPV) was performed via the limited view through the lens. He attained a final visual acuity of 6/60 (N36). He was able to mobilize more independently, feed, dress himself and read large print.

Early Decomposition of Retained Heavy Silicone Oil Droplets

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Touka Banaee

2012-01-01

Full Text Available Purpose: To report a case of early decomposition of retained heavy silicone oil droplets. Case Report: The single highly myopic eye of a 16-year-old boy with history of scleral buckling and buckle revision developed redetachment due to inferior retinal dialysis. The patient underwent pars plana vitrectomy and injection of heavy silicone oil. Early emulsification of the silicone oil was observed following surgery, which was removed 4 weeks later in another operation. Retained heavy silicone droplets lost their heavier- than-water specific gravity within 2 months together with extensive iris depigmentation, and release of pigment granules into the anterior chamber and vitreous cavity. Conclusion: This case report demonstrates that heavy silicone oil droplets can undergo in vivo chemical decomposition with possible toxic effects on ocular tissues.

Vasoproliferative retinal tumor. Report of two cases

International Nuclear Information System (INIS)

Arencibia Gonzalez, Danaides; Eguia Martinez, Frank; Santana Alas, Eva

2010-01-01

Vasoproliferative retinal tumor is a rare and benign condition that presents as an exudative lesion in the peripheral retina. The lesion can be classified in primary (idiopathic) or secondary to other ocular processes. Therapeutic options include observation, cryotherapy, laser photocoagulation, surgical removal by pars plana vitrectomy, photodynamic therapy and epiescleral brachytheraphy with radio-active isotopes associated or not to the use of anti-angiogenic or anti-inflammatory drugs. The selection of a particular management modality depends on the type of case. Two female patients affected with this condition were presented; the most important characteristics in their clinical pictures, as well as the results of other tests as retinography, fluorescent and ICG angiography and echography were described. The management and the therapeutical and evolutive course of both patients were also discussed

Delayed inflammation associated with retained perfluorocarbon liquid

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S Pradeep

2011-01-01

Full Text Available A 55-year-old woman, with history of cataract surgery 1 year back, presented with features of ocular inflammation for last 3 months. She had no history of any other intraocular surgery. On examination, anterior segment showed frothy material in the inferior angle with moderate anterior chamber reaction (cells+/flare+ and sulcus intraocular lens with large posterior capsule rent. Fundoscopy showed multiple, small to medium-sized transparent bubbles of perfluorocarbon liquid (PFCL with membranes in the vitreous cavity. Ultrasonography confirmed the presence of PFCL in the vitreous cavity. Pars plana vitrectomy with anterior chamber wash was done which led to good visual recovery. To conclude, retained PFCL can cause late onset fibrinous inflammation after a quiescent period but surgical intervention may lead to good visual outcome.

Vitreous occlusion of tube implant in a phakic patient with traumatic glaucoma

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Suneeta Dubey

2014-01-01

Full Text Available Tube implants or glaucoma drainage devices have become an important method of intraocular pressure reduction when treating complex cases of traumatic glaucoma. However, it is not uncommon to have complications associated with tube implants. The optimal treatment of patients who have undergone glaucoma implant surgery complicated by vitreous incarceration is uncertain. If vitreous is present or is able to prolapse into anterior chamber, as in aphakic or pseudophakic patient without an intact posterior capsule, a concurrent anterior vitrectomy is usually performed. In such cases, pars plana vitrectomy has been found to be more effective in several studies. However, there are no set guidelines for management of such a case in a phakic eye and the management can be more challenging especially when there is no obvious deficiency in posterior capsule, zonular dialysis, or loose vitreous gel in the anterior chamber prior to or during tube implantation. We describe a case of 14-year-old phakic patient with traumatic glaucoma without vitreous gel in anterior chamber whose tube implant became occluded by vitreous resulting in increased intra ocular pressure. This is the first documented report of vitreous incarceration in a phakic patient and its successful management.

Retinal thinning after internal limiting membrane peeling for idiopathic macular hole.

Science.gov (United States)

Imamura, Yutaka; Ishida, Masahiro

2018-03-01

To determine the changes in retinal thickness and whether they correlate with the size of the macular hole (MH) after vitrectomy with internal limiting membrane peeling. Retrospective, interventional case series METHODS: Consecutive patients with an MH and undergoing pars plana vitrectomy with internal limiting membrane peeling were studied. The retinal thicknesses in the inner 4 sectors as defined by the Early Treatment of Diabetic Retinopathy Study were measured using spectral-domain optical coherence tomography (SD-OCT) before and at 2 weeks and 1, 3, 6, and 12 months after the surgery. The basal and minimum diameters of the MHs were measured. The correlations between the retinal thicknesses and the size of the MH were determined. Thirty-three eyes of 32 consecutive patients (18 women; mean age, 64.2 ± 8.8 years) with an MH were studied. Thirteen eyes had a stage-2 MH; 12 eyes, a stage-3 MH; and 8 eyes, a stage-4 MH. The mean retinal thickness in the temporal sector was 362.8 ± 29.9 µm preoperatively, 337.9 ± 20.6 µm at 2 weeks postoperatively, and 307.6 ± 20.2 µm at 12 months postoperatively (P peeling.

Negozio baten marketin plana: Getxoko Hurbilekojalea

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Gantxegi Infiesta, Enara

2018-01-01

Gradu Amaierako Lan (GAL) honen helburua Getxoko Hurbilekojalea negozioaren inguruko Marketin Plan bat egitea da. Horretarako, sektorearen eta negozioaren azterketa sakona egingo da, negozioak aurrean dituen aukera eta mehatxuak identifikatuz, alde batetik, eta baita berezko dituen indar-gune eta ahuleziak ere. Ondoren, marketin helburuak, estrategiak eta ekintza-plana zehaztuko dira, negozioari onura ekarriko diotelakoan.

Clinical analysis of vitrectomy in treatment of 48 eyes with metallic foreign bodies

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Dong Yuan

2014-08-01

Full Text Available AIM: To investigate the effect of vitrectomy in treatment of metal intraocular foreign bodies and the factors affecting visual prognosis.METHODS:Fourty seven cases(48 eyeswith foreign bodies from January 2010 to June 2013 in our hospital underwent vitrectomy combined with intraocular foreign body removal were retrospectively analyzed. The changes of visual acuity, the size of foreign body, the complications of preoperative, and the relationship between treatment time and visual acuity were recorded. RESULTS: Totally 46 eyes were successfully removed the complete foreign body, 2 eyes of orbital foreign bodies had not been removed. After 6mo of followed-up, the best corrected visual acuity were all improved in varying degrees(PPCONCLUSION:Vitrectomy has obvious advantages in the treatment of metal intraocular foreign bodies. Timely and appropriate vitrectomy is very important to the recovery of visual function.

Evolving trends in primary retinal detachment repair: microincisional vitrectomy and the role of OCT.

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Williams, Patrick D; Hariprasad, Seenu M

2014-01-01

Retinal detachment repair continues to evolve toward less invasive techniques that can safely, efficiently, and consistently provide optimal outcomes. In fact, 53% of U.S. respondents to the American Society of Retinal Specialists 2013 Preferences and Trends Survey said they would perform a vitrectomy without scleral buckle to treat a retinal detachment with a superior tear, while 25% would perform pneumatic retinopexy, and 21% would use a scleral buckle with or without vitrectomy.11 Compared to in 2005, many more surgeons prefer vitrectomy-only repair, whereas fewer prefer scleral buckle. Interestingly, preferences toward pneumatic retinopexy have slightly declined, which may reflect increased confidence in vitrectomy surgery to repair a detached retina safely and efficiently as an alternative. Even complex detachments can be treated in a minimally invasive fashion with the improvements in instrumentation, trocars, and oil infusion. While trends will likely continue toward minimal invasiveness, some form of scleral buckle, vitrectomy, and pneumatic retinopexy will all persist as treatment options. OCT advancements may allow for individualized discussions of visual prognosis and surgical decision making without the need for any invasive testing.

Análisis geotécnico de anclas planas para plataformas marinas

OpenAIRE

Arto Cuesta, Javier

2017-01-01

RESUMEN: El presente Trabajo de Fin de Grado es un estudio englobado en el campo de la geotecnia offshore sobre el comportamiento de anclas planas para aerogeneradores dispuestas en suelos puramente cohesivos (arcilla) y puramente friccionales (arena). Para elaborar el análisis, se ha realizado un modelado numérico, mediante un software comercial basado en el empleo de elementos finitos, de un ancla plana dispuesta a diferentes profundidades, sobre la cual se aplica un desplazamien...

Coordination Skills during Vitrectomy in Treatment of Proliferative Diabetic Retinopathy

Institute of Scientific and Technical Information of China (English)

Xuehong Chen; Shanshan Luo; Yanchan Liu

2014-01-01

Purpose:.To discuss effective nursing and coordination skills for vitrectomy in the treatment of diabetic retinopathy. Methods: Fifty patients (51 eyes) with diabetic retinopathy required vitrectomy were enrolled in this study..Individual nursing service was delivered by strengthening preoperative preparation, providing psychological nursing, and intraopera-tive observation of the severity of diseases by circulating nurses;meticulous nursing was given postoperatively. Results:All 50 patients underwent surgery successfully..Intra-operatively,.patients had stable physical signs..Five patients had postoperative visual acuity0.3..No complicated infection was seen. Conclusion: For patients diagnosed with proliferative diabetic retinopathy requiring vitrectomy,.full preparations should be made and psychological nursing should be delivered preopera-tively, the severity of diseases and clinical reactions should be closely observed intraoperatively,.and proper processing and nursing measures should be taken postoperatively,.which col-lectively enhance surgical success rate,.decrease surgical com-plications,.and attain favorable treatment efficacy.(Eye Science 2014; 29:55-58).

Intravitreal injection of perfluoropropane for the treatment of vitreomacular traction

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Xiao-Ping Wan

2013-07-01

Full Text Available AIM: To study the efficacy of a single intravitreal injection of perfluoropropane(C3F8in releasing vitreomacular traction. METHODS: Twelve eyes of 12 consecutive patients with vitreomacular traction received a single intravitreal injection of 0.3mL 100%(C3F8were retrospectively analyzed. The best corrected vision acuity and the neural epithelium thickness of central macular were observed. RESULTS: One month following treatment, vitreomacular traction was released in 5 eyes(42%, mean final visual acuity(VAimproved 0.04 and mean central foveal thickness decreased by 69μm. The vision acuity before and after treatment were 0.20±0.07, 0.25±0.04 respectively.CONCLUSION: Intravitreal C3F8 injection could offer a minimally invasive alternative to pars plana vitrectomy in patients with vitreomacular traction.

Vitreoretinal surgery in advanced coats disease.

Science.gov (United States)

Ozdamar, Yasemin; Berker, Nilufer; Batman, Cosar; Zilelioglu, Orhan

2009-01-01

To report the outcomes of vitreoretinal surgery for a patient with total retinal detachment and a subretinal nodule associated with Coats disease (CD). A 20-year-old woman stage 3B CD underwent vitreoretinal surgery with triamcinolone acetonide-assisted pars plana vitrectomy, limited retinotomy, removal of the subretinal nodule and membrane, endolaser photocoagulation, and silicone oil tamponade. The surgical outcomes were observed. Retinal attachment was achieved after vitreoretinal surgery, removal of the subretinal membrane, and endoresection of the subretinal fibrous nodule. No intraoperative or postoperative complications occurred due to the surgical technique. The retina remained attached during the postoperative follow-up period of 6 months. Vitreoretinal surgery is an effective surgical technique that provides successful reattachment of the retina and enables endoresection of the subretinal fibrous nodule in eyes with advanced CD. It also prevents the devastating intraocular complications leading to enucleation.

Effects of vitrectomy combined with cataract surgery on the corneal endothelial cells in diabetic retinopathy

OpenAIRE

Lei Zhan; Si-Ying Xiong; Meng-Xin Gan; Li-Hui Wen

2017-01-01

AIM: To investigate the effects of vitrectomy combined with cataract surgery on the corneal endothelial cells in diabetic retinopathy. METHODS: A retrospective study was designed. 160 patients(160 eyes)with diabetic retinopathy from Jan 2015 to Feb 2017 were divided into two groups according to cataract. 74 patients(74 eyes)were operated on vitrectomy, and 86 patients(86 eyes)on vitrectomy combined with phacoemulsification cataract surgery and capsular bag implantation of foldable intraocular...

Seed longevity of Eragrostis plana Nees buried in natural grassland soil

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Renato Borges de Medeiros

2014-11-01

Full Text Available The objective of this research was to evaluate the seed longevity of Eragrostis plana Nees buried at different soil depths, in a natural-grassland area in the Pampa biome (46 m altitude, 30º05´S and 51º40´W of Rio Grande do Sul State, Brazil. The experimental design was a split-plot type in complete blocks with two factors: seeds buried at five different depth levels (soil surface and 2.5, 5, 10 and 20 cm and seven exhumation dates. The blocks were allocated in natural grassland grazed by cattle, allocated in a 12-m-long transection. Fifty-four permeable nylon bags filled with 100 seeds in each division, with five vertical divisions, were buried in each row. Seven exhumation dates were used: the first on October 14, 2003 and the last on January 14, 2006. The percentage of viable seeds of E. plana, collected at seven exhumation times and set at different depths in the soil horizon, were described by simple negative exponential equations. Based on the model, the percentage of viable seeds collected at the five depths, (soil surface and 2.5, 5, 10, and 20 cm, after 2.5 years of burial, were 0.1, 0.5, 1.0, 7.4 and 22.1%, respectively. Increase in depth is directly associated with physical and physiological seed integrity of E. plana. Negative simple exponential equations can be used to predict seed longevity of E. plana buried in nylon bags. This invader species accumulates soil seed-bank of high longevity.

Contact-free trans-pars-planar illumination enables snapshot fundus camera for nonmydriatic wide field photography.

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Wang, Benquan; Toslak, Devrim; Alam, Minhaj Nur; Chan, R V Paul; Yao, Xincheng

2018-06-08

In conventional fundus photography, trans-pupillary illumination delivers illuminating light to the interior of the eye through the peripheral area of the pupil, and only the central part of the pupil can be used for collecting imaging light. Therefore, the field of view of conventional fundus cameras is limited, and pupil dilation is required for evaluating the retinal periphery which is frequently affected by diabetic retinopathy (DR), retinopathy of prematurity (ROP), and other chorioretinal conditions. We report here a nonmydriatic wide field fundus camera employing trans-pars-planar illumination which delivers illuminating light through the pars plana, an area outside of the pupil. Trans-pars-planar illumination frees the entire pupil for imaging purpose only, and thus wide field fundus photography can be readily achieved with less pupil dilation. For proof-of-concept testing, using all off-the-shelf components a prototype instrument that can achieve 90° fundus view coverage in single-shot fundus images, without the need of pharmacologic pupil dilation was demonstrated.

Analysis of 23G and 25G+vitrectomy for retinal detachment

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Ying-Li Lu

2016-06-01

Full Text Available AIM: To compare the clinical effect of 23G and 25G+ vitrectomy for retinal detachment. METHODS: Forty seven patients with retinal detachment were treated with 23G vitrectomy(27 eyes in 27 cases as group Aand 25G+ vitrectomy(20 eyes in 20 cases as group B. The operation time and the incidence of intraoperative complications were recorded. The occurrence of retinal reposition, visual acuity, intraocular pressure(IOPand complications were observed. Postoperative follow-up time of the two groups were 3d, 1wk, 3mo.The relevant records were statistically analyzed and compared. RESULTS: The operation time of 23G group and 25G+ group were 50.21+4.52min, 49.15+5.14min,respectively and there was no significant difference between the two groups(P>0.05. The main complications were retinal hemorrhage and iatrogenic retinal hole. There were 3 eyes with retinal hemorrhage, 2 eyes with iatrogenic retinal hole in 23G group, and 1 eye with retinal hemorrhage, 1 eye with iatrogenic retinal hole in the 25G+ group, and the difference was statistically significant(PP>0.05. The number of eyes with hypotonia in 23G and 25G+ group were 3 and 1 eyes respectively, the difference was statistically significant(PP>0.05. At the last follow-up, the results showed that 26 eyes(96%with retinal reposition in 23G group, 19 eyes(95%in 25G+ group, the difference was not statistically significant(P>0.05. CONCLUSION: The clinical effect of 23G and 25G+ vitrectomy for retinal detachment is similar, but 25G+ vitrectomy can reduce incidence of complications and early postoperative low IOP.

Clinical outcomes of endoscope-assisted vitrectomy for treatment of rhegmatogenous retinal detachment

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Yokoyama S

2017-11-01

Full Text Available Sho Yokoyama,1 Takashi Kojima,2 Toshio Mori,3 Taisuke Matsuda,1 Hiroyuki Sato,3 Norihiko Yoshida,4 Tatsushi Kaga,1 R Theodore Smith,5 Kazuo Ichikawa6 1Department of Ophthalmology, Japan Community Healthcare Organization Chukyo Hospital, Nagoya, Japan; 2Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan; 3Department of Ophthalmology, Iida Municipal Hospital, Iida, Japan; 4Department of Ophthalmology, Japanese Red Cross Gifu Hospital, Gifu, Japan; 5Department of Ophthalmology, New York University School of Medicine, New York, NY, USA; 6Chukyo Eye Clinic, Nagoya, Japan Summary: We evaluated the clinical outcomes for ophthalmic endoscope-assisted vitrectomy in consecutive patients with uncomplicated rhegmatogenous retinal detachment (RRD. The primary success rate was 98.4% (125/127 without performing a posterior drainage retinotomy or using perfluorocarbon liquids (PFCL for subretinal fluid drainage.Purpose: To investigate the clinical outcomes of endoscope-assisted vitrectomy in patients with uncomplicated RRD.Methods: We examined 127 eyes from consecutive patients who underwent repair of RRD by 23- or 25-gauge endoscope-assisted vitrectomy, with a minimum follow-up of 3 months. Eyes with the following criteria were excluded: Giant retinal tears, grade C proliferative vitreoretinopathy, dense vitreous hemorrhage, retinal detachment secondary to other ocular diseases, and prior retinal or vitreous surgery. All cases underwent subretinal fluid drainage, endolaser photocoagulation and fundus inspection were performed under ophthalmic endoscopic observation. Success rate, visual acuity, surgery time and complications were evaluated.Results: Primary and final success rate was 98.4% (125/127 and 100% (127/127, respectively, Surgery time was 59.6±26.3 minutes. The best-corrected visual acuity significantly improved from 20/100 to 20/20 (P<0.0001. There were 2 cases (1.6% of creation of a peripheral drainage retinotomy and 4

IN VITRO FLOW ANALYSIS OF NOVEL DOUBLE-CUTTING, OPEN-PORT, ULTRAHIGH-SPEED VITRECTOMY SYSTEMS.

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Zehetner, Claus; Moelgg, Marion; Bechrakis, Emmanouil; Linhart, Caroline; Bechrakis, Nikolaos E

2017-10-09

To analyze the performance and flow characteristics of novel double-cutting, open-port, 23-, 25-, and 27-gauge ultrahigh-speed vitrectomy systems. In vitro fluidic measurements were performed to assess the volumetric aspiration profiles of several vitrectomy systems in basic salt solution and egg white. Double-cutting open-port vitrectomy probes delivered stable aspiration flow rates that were less prone to flow variation affected by the cutting speed. Increase in cutting frequency to the maximum level resulted in flow reduction of less than 10% (0.0%-9.5%). Commercially available 23-, 25-, and 27-G double-cutting probes exhibited higher egg-white and basic salt solution flow rates at all evaluated cut rates, with aspirational efficiencies being 1.1 to 2.9 times the flow rates of standard single-blade vitrectomy probes of the same caliber at the maximum preset vacuum. The highest relative differences were observed at faster cut rates. The newly introduced double-cutting open-port vitrectomy probes delivered stable aspiration flow rates that were less prone to flow variation affected by the cutting speed. The fluidic principle of constant flow even at the highest cut rates and low vacuum levels might impact surgical strategies, especially when performing manipulations close to the retina.

[Drusen characteristics after internal limiting membrane peeling].

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Lehmann, F; Jenisch, T; Helbig, H; Gamulescu, M A

2015-05-01

There are some reports showing isolated cases of drusen regression after pars plana vitrectomy (ppV) with peeling of the internal limiting membrane (iLM). Drusen characteristics after iLM peeling was investigated in this study. The data of 527 patients who had received iLM peeling between 2004 and 2012 were retrospectively collected and those patients with retinal drusen were selected for the study. Fundus photographs before and after vitrectomy due to a macular hole or epiretinal gliosis were compared and drusen arrangement in the peeling site was analyzed. The aim of the study was to show whether there was drusen regression 2-5 months after surgery. Out of the 527 patients 11 showed central macular drusen, 4 with confluent large drusen (> 63 µm diameter) and 7 with small hard drusen (≤ 63 µm diameter). One patient showed drusen regression after iLM peeling without any changes in the other eye and all other patients showed no differences in the drusen findings (n = 6) or even some additional drusen (n = 4) without drusen alterations in the other eye. The results of this study could not confirm some reports showing drusen regression after iLM peeling in the peeling site in general and there was only one single case of central drusen regression.

Macular detachment associated with an optic pit: optical coherence tomography patterns and surgical outcomes.

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Skaat, Alon; Moroz, Iris; Moisseiev, Joseph

2013-01-01

To describe the different optical coherence tomography (OCT) patterns in macular detachment associated with an optic disc pit and their long-term evolution following vitrectomy.
 The data of 5 patients (9-43 years of age) with unilateral macular detachment associated with an optic disc pit, who had at least 1 year of follow-up, were compiled. Pars plana vitrectomy combined with gas tamponade was performed as the primary procedure in all patients. The OCT scans, best-corrected visual acuity (BCVA), and anatomic outcomes were documented.
 Two main OCT patterns were identified: a multilayer schisis pattern and a serous detachment pattern. Patients with multilayer schisis pattern were older and demonstrated worse mean preoperative (20/160) and postoperative (20/50) BCVA compared to serous detachment pattern patients (20/30 and 20/20, respectively). An average of 2.3 procedures per patient was needed in the multilayer schisis pattern compared to just one procedure in the serous detachment pattern. In 3 patients, additional pneumatic retinopexy was performed with full resolution of the subretinal fluid achieved.
 Two distinct OCT patterns were observed in eyes with macular detachments with an optic pit, with different clinical features and prognoses. Excellent final visual acuity was obtained in all eyes, including those that required several surgical procedures.

Changes in Matrix Metalloproteinases in Diabetes Patients' Tears After Vitrectomy and the Relationship With Corneal Epithelial Disorder.

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Matsumura, Takehiro; Takamura, Yoshihiro; Tomomatsu, Takeshi; Arimura, Shogo; Gozawa, Makoto; Takihara, Yuji; Inatani, Masaru

2015-06-01

Previous studies indicate involvement of matrix metalloproteinases (MMPs) in the pathogenesis of diabetic keratopathy. To evaluate MMP levels in the tears of patients with diabetes, we investigated changes in MMP levels during perioperative periods and clarify the relationship with corneal epithelial disorders following vitrectomy. Matrix metalloproteinase levels in tears were measured by multiplex bead array in patients with or without diabetes who were scheduled for vitrectomy. Twenty-two patients with diabetes and proliferative diabetic retinopathy, and 20 patients with epiretinal membrane or macular hole (control group), were recruited. Changes in MMP levels during perioperative periods and the relationship with corneal epithelial disorders after vitrectomy were analyzed. The levels of MMP-2, -9, and -10 at 1 day after surgery in the diabetic group were significantly higher than in the control group. At 1 week after surgery, MMP-10 levels in the diabetic group were significantly higher than in the control group. After vitrectomy, corneal epithelial disorders occurred in six patients in the diabetic group but not in the control group. In the diabetic group, MMP-10 levels in tears of patients with corneal epithelial disorders were significantly higher than those in patients without corneal epithelial disorders. The MMP concentration in tears of patients with diabetes was higher than in nondiabetic patients after vitrectomy. High MMP-10 levels were observed in patients with diabetes and corneal epithelial disorders after vitrectomy. Aberrant levels of MMP-10 may cause corneal epithelial disorder after vitrectomy.

Retinal Layers Measurements following Silicone Oil Tamponade for Retinal Detachment Surgery.

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Jurišić, Darija; Geber, Mia Zorić; Ćavar, Ivan; Utrobičić, Dobrila Karlica

2017-12-19

This study aimed to investigate the influence of silicone oil on the retinal nerve fiber layer (RNFL) thickness in patients with primary rhegmatogenous retinal detachment who underwent vitreoretinal surgery. The study included 47 patients (eyes), who underwent a pars plana vitrectomy with the silicone oil tamponade. The control group included unoperated eye of all participants. Spectral-domain optical coherence tomography (SD-OCT) was used for the measurements of peripapilar and macular RNFL thickness. The average peripapillary RNFL thickness was significantly higher in the silicone oil filled eyes during endotamponade and after its removal. The eyes with elevated IOP had less thickening of the RNFL in comparison to the eyes with normal IOP. Central macular thickness and macular volume were decreased in the silicone oil filled eyes in comparison to the control eyes. In conclusion, silicone oil caused peripapilar RNFL thickening in the vitrectomized eyes during endotamponade and after silicone oil removal.

A 9 year-old girl with herpes simplex virus type 2 acute retinal necrosis treated with intravitreal foscarnet.

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King, John; Chung, Mina; DiLoreto, David A

2007-01-01

A 9-year-old girl presented with a 2-week history of redness in the left eye. Examination revealed vitritis, retinal whitening, vasculitis, and optic nerve head edema. Polymerase chain reaction testing of the aqueous fluid revealed herpes simplex virus type 2. The retinitis was controlled with intravenous acyclovir and intravitreal foscarnet. The clinical course was complicated by retinal neovascularization and vitreous hemorrhage, which was treated by pars plana vitrectomy and endolaser. While there are few case reports of herpes simplex virus type 2 retinitis in children, this one is unique for the following reasons: it is the first reported case of herpes simplex virus type 2 retinitis in a child less than 10 years old without a previous history of neonatal infection or central nervous system involvement; no other children have been reported to have been treated with intravitreal foscarnet; and retinal neovascularization complicated the recovery.

Vitreous haemorrhage in massive hemorrhagic polypoidal choroidal vasculopathy: clinical characteristics and surgical outcomes: Vitreous hemorrhage in PCV.

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Narayanan, Raja; Mithal, Kopal; Jalali, Subhadra; Chhablani, Jay Kumar; Mathai, Annie; Ali, Md Hasnat

2015-01-01

To report the outcomes of vitreous hemorrhage (VH) associated with hemorrhagic polypoidal choroidal vasculopathy (PCV). A retrospective study of 28 eyes of 27 consecutive patients of hemorrhagic PCV with VH, which were managed surgically between January 2003 and December 2011, was performed. All patients underwent pars plana vitrectomy for VH associated with PCV. The main outcome measure was best-corrected visual acuity (BCVA) at baseline, at 1, 3 and 6 months post operatively and at last follow up. The visual acuity measured on early treatment diabetic retinopathy study (ETDRS) chart improved in 16 eyes (57.1 %) by two or more lines, remained unchanged in nine eyes (32.1 %) and decreased in three (10.7 %) after surgery when compared to baseline VA. The mean baseline VA was 2.69 ± 0.57 logMAR units (hemorrhagic PCV have sustained improvement in visual acuity following surgery.

CASE REPORT OF SEVERE PROLIFERATIVE RETINOPATHY IN A PATIENT WITH CONGENITAL LIPODYSTROPHY.

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Rosin, Boris; Jaouni, Tareq

2017-08-21

A case report of a patient with severe proliferative retinopathy due to congenital lipodystrophy. We reviewed the medical history, imaging, and surgical procedures of a 25-year-old woman with a history of congenital lipodystrophy, presenting with bilateral combined tractional and exudative retinal detachment, poorly controlled diabetes mellitus, and extreme dislipidemia. The patient underwent retinal detachment repair surgery both eyes. On the last follow-up, both retinae were flat, and visual acuity had improved in the right eye to J3 for near and finger counting 3 m for distance. Surgery combining pars plana vitrectomy and scleral bucking successfully flattened both retinae and significantly improved visual acuity in one eye in this case of bilateral retinal detachment with combined tractional and exudative components in a patient with congenital lipodystrophy. Surgical control of retinal complications is thus possible, provided there is adequate control of the underlying risk factors.

Effects of vitrectomy combined with cataract surgery on the corneal endothelial cells in diabetic retinopathy

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Lei Zhan

2017-08-01

Full Text Available AIM: To investigate the effects of vitrectomy combined with cataract surgery on the corneal endothelial cells in diabetic retinopathy. METHODS: A retrospective study was designed. 160 patients(160 eyeswith diabetic retinopathy from Jan 2015 to Feb 2017 were divided into two groups according to cataract. 74 patients(74 eyeswere operated on vitrectomy, and 86 patients(86 eyeson vitrectomy combined with phacoemulsification cataract surgery and capsular bag implantation of foldable intraocular lens. To record the change of corneal endothelial cells density, average cellular area, coefficient of variation and percentage of hexagonal endothelial cell before and after treatment with Topcon corneal specular microscope. RESULTS: Before and after surgery, the results of corneal endothelial cells density, average cellular area, coefficient of variation and percentage of hexagonal endothelial cell in simple vitrectomy group were no significant difference(P>0.05; After treatment corneal endothelial cells density and percentage of hexagonal endothelial cell were changed with statistical difference as the same as average cellular area and coefficient of variation(PPCONCLUSION: It has certain influence on the corned endothelial cells when using vitrectomy combined with cataract surgery in diabetic retinopathy. For patients with indications, it should be paid attention to protecting the corneal endothelial cells.

25G compared with 20G vitrectomy under Resight non-contact wide-angle lenses for Terson syndrome.

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Mao, Xinbang; You, Zhipeng

2017-08-01

The aim of the present study was to compare the effectiveness of 25G vitrectomy to standard 20G vitrectomy for treatment of Terson syndrome under Resight non-contact wide-angle lenses. This was a case-control study of 20 patients with Terson syndrome (study group) that underwent 25G vitrectomy under Resight non-contact wide-angle lenses, with those of 20 matched patients that underwent 20G vitrectomy (control group). Medical records were reviewed from between July 2011 and October 2013. Data included results of the Early Treatment Diabetic Retinopathy Study examination, ophthalmology B-scan ultrasonography and fundus photography. The mean age, follow-up time, the preoperative visual acuity of LogMAR and the preoperative intraocular pressure (IOP) were all comparable in the two groups (all P>0.05). There were statistically significant differences in postoperative visual acuity of LogMAR compared with preoperative visual acuity (Pcontact wide-angle lenses can achieve a significantly shorter operative time and lower post-operative IOP compared with 20G Vitrectomy.

The generalized Abel-Plana formula. Applications to Bessel functions and Casimir effect

International Nuclear Information System (INIS)

Saharian, A.A.; Institute of Applied Problems in Physics NAS RA, Yerevan; Abdus Salam International Centre for Theoretical Physics, Trieste

2000-02-01

One of the most efficient methods to obtain the vacuum expectation values for the physical observables in the Casimir effect is based on using the Abel-Plana summation formula. This allows us to derive the regularized quantities in a manifestly cutoff independent way and present them in the form of strongly convergent integrals. However, the application of Abel-Plana formula, in its usual form, is restricted by simple geometries when the eigenmodes have a simple dependence on quantum numbers. The author generalized the Abel-Plana formula which essentially enlarges its application range. Based on this generalization, formulae have been obtained for various types of series over the zeros of some combinations of Bessel functions and for integrals involving these functions. It has been shown that these results generalize the special cases existing in literature. Further, the derived summation formulae have been used to summarize series arising in the mode summation approach to the Casimir effect for spherically and cylindrically symmetric boundaries. This allows us to extract the divergent parts from the vacuum expectation values for the local physical observables in a manifestly cutoff independent way. The present paper reviews these results. Some new considerations are also added. (author)

Postoperative eccentric macular holes after vitrectomy and internal limiting membrane peeling.

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Brouzas, Dimitrios; Dettoraki, Maria; Lavaris, Anastasios; Kourvetaris, Dimitrios; Nomikarios, Nikolaos; Moschos, Marilita M

2017-06-01

The purpose of this study was to describe the incidence, clinical characteristics, and outcome of eccentric macular holes presenting after vitrectomy and internal limiting membrane (ILM) peeling for the treatment of macular pathology and discuss the pathogenesis of holes formation. A retrospective, noncomparative, interventional case-series study of five patients who developed eccentric macular holes postoperatively following vitrectomy in 198 consecutive patients who underwent ILM peeling for idiopathic macular hole and epiretinal membrane formation between 2008 and 2015. Five patients (2.5 %) developed full-thickness eccentric macular holes postoperatively. Three patients presented with a single eccentric macular hole, one patient had an eccentric hole after a failed idiopathic macular hole surgery and one patient developed four eccentric macular holes. The mean diameter of the holes was 584 μm (range 206-1317 μm) and the average time of holes formation after vitrectomy was 27.7 weeks (range 1-140 weeks). Postoperative best-corrected visual acuity ranged from "counting fingers" to 20/25. The eyes with the holes distant from the fovea had the best final visual acuity. No further intervention was attempted and no complications occurred. The mean follow-up time was 26.8 months. The postoperative macular holes after vitrectomy and ILM peeling were variable in number, size, and time of appearance but remained stable and were not associated with any complications. The pathogenesis of macular holes is most consistent with contraction of the residual ILM or secondary epimacular proliferation probably stimulated by ILM peeling.

Two-Dimensional Cutting (TDC Vitrectome: In Vitro Flow Assessment and Prospective Clinical Study Evaluating Core Vitrectomy Efficiency versus Standard Vitrectome

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Mitrofanis Pavlidis

2016-01-01

Full Text Available Purpose. To evaluate comparative aspiration flow performance and also vitrectomy operating time efficiency using a double-cutting open port vitreous cutting system incorporated in a two-dimensional cutting (TDC, DORC International vitrectome design versus standard vitreous cutter. Methods. In vitro investigations compared aspiration flow rates in artificial vitreous humor at varying cutter speeds and vacuum levels using a TDC vitrectome and a standard vitrectome across different aspiration pump systems. A prospective single-centre clinical study evaluated duration of core vitrectomy in 80 patients with macular pucker undergoing 25-gauge or 27-gauge vitrectomy using either a TDC vitrectome at 16,000 cuts per minute (cpm or standard single-cut vitrectome, combined with a Valve Timing intelligence (VTi pump system (EVA, DORC International. Results. Aspiration flow rates remained constant independent of TDC vitrectome cut rate, while flow rates decreased linearly at higher cutter speeds using a classic single-blade vitrectome. Mean duration of core vitrectomy surgeries using a TDC vitreous cutter system was significantly (p<0.001 shorter than the mean duration of core vitrectomy procedures using a single-cut vitrectome of the same diameter (reduction range, 34%–50%. Conclusion. Vitrectomy surgery performed using a TDC vitrectome was faster than core vitrectomy utilizing a standard single-action vitrectome at similar cut speeds.

Comparison of clinical outcome between 23-G and 25-G vitrectomy in diabetic patients.

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Taleb, Eman Abo; Nagpal, Manish P; Mehrotra, Navneet S; Bhatt, Kalyani; Goswami, Sangeeta; Babalola, Yewande O; Noman, Abdulrahman

2017-01-01

To compare the clinical outcomes and complications between 23-G and 25-G vitrectomy in patients with diabetic vitreous hemorrhage (VH). A retrospective comparative study comprising 69 eyes (36 eyes in 23-G group and 33 eyes in 25-G group) of 65 patients who underwent vitrectomy with air tamponade for diabetic vitreous hemorrhage (VH) with at least 6 months of follow-up was conducted. There were no significant differences between the two groups in age, gender, bilaterality, type of diabetes, presence of hypertension, lens status, and previous argon laser photocoagulation state ( P > 0.05). Best-corrected visual acuity (BCVA) of both groups at postoperative 1 month logarithm of the minimum angle of resolution (logMAR) (1.06 ± 0.99, 0.90 ± 0.96), 3 months logMAR (1.07 ± 0.93, 0.83 ± 0.85), and 6 months logMAR (1.03 ± 0.89, 0.83 ± 0.85) significantly improved from the preoperative BCVA logMAR (2.03 ± 0.83, 2.15 ± 0.99) for 23-G group, 25-G group, respectively ( P 0.05). 25-G vitrectomy is as effective for PDR as 23-G vitrectomy.

Changes in Retinal Thickness after Vitrectomy for Epiretinal Membrane with and without Internal Limiting Membrane Peeling.

Science.gov (United States)

Obata, Shumpei; Fujikawa, Masato; Iwasaki, Keisuke; Kakinoki, Masashi; Sawada, Osamu; Saishin, Yoshitsugu; Kawamura, Hajime; Ohji, Masahito

2017-01-01

To investigate anatomic changes in retinal thickness (RT) and functional changes after vitrectomy for idiopathic epiretinal membranes (ERMs) with and without internal limiting membrane (ILM) peeling. The medical records of 100 eyes of 96 patients with ERM who underwent vitrectomy and ERM removal were reviewed retrospectively. The RT was measured by optical coherence tomography, and the area was divided into 9 sections. The best-corrected visual acuity (BCVA), 9 RT areas, and incidence rates of recurrent ERM were compared between the groups with and without ILM peeling before the operation and 12 months postoperatively. Thirty-nine eyes that underwent vitrectomy with ILM peeling and 61 eyes that underwent vitrectomy without ILM peeling met the inclusion criteria. There were no significant differences between the groups in the BCVA and any of the RTs before the operation and 12 months postoperatively. The ERMs recurred in 8 (20.5%) of 39 eyes and 26 (42.6%) of 61 eyes in the groups with and without ILM peeling, respectively, with a difference that reached significance (p = 0.02) 12 months postoperatively. Vitrectomy for ERM affects the BCVA or the RTs 12 months postoperatively. Additional ILM peeling does not affect them, but it might reduce the ERM recurrence rate. © 2016 S. Karger AG, Basel.

Treatment of acute infectious endophthalmitis by vitrectomy surgery with silicon oil tamponade

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Xiao-Dong Han

2015-09-01

Full Text Available AIM: To observe theclinical effect of acute infectious endophthalmitis by vitrectomy surgery with silicon oil tamponade.METHODS:The clinical data of 23 patients(23 eyesdiagnosed with acute endophthalmitis in our hospital from January, 2008 to February, 2013 were retrospectively analyzed, excluding the patients with intraocular foreign body. All the patients were undergone routine closed three-channel vitrectomy with silicon oil, including 6 eyes(complicated with traumatic cataractwith Ⅰ lensectomy and Ⅰ intraocular lens(IOLimplantation, 3 eyes(complicated with traumatic cataractwith Ⅰ lensectomy and Ⅱ IOL implantation, 4 eyes(complicated with cataract during silicon oil tamponadewith Ⅱ lensectomy and Ⅱ IOL implantation, 5 eyes(4 eyes with traumatic endophthalmitis and 1 eye with entophthalmia caused by glaucoma filtering bleb leakingreserved lens, 1 eye(post-cataract surgery entophthalmiawith Ⅰ IOL explantation and Ⅱ IOL implantation, and 4 eyes(post-cataract surgery entophthalmiareserved lens. RESULTS:Within follow-up 6～24mo, inflammation after vitrectomy surgery with silicon oil tamponade was controlled in all the 23 patients(23 eyes. Final visual acuity was improved in 21 eyes(91%. The intraocular pressure(IOPof 2 eyes were over 30mmHg. IOP of 1 eye was controlled after silicon oil removed, and IOP of the other eye after silcon oil extraction was still high and needed to be controlled by IOP lowering drugs. CONCLUSION: The patients of acuteinfectious endophthalmitis should undergo vitrectomy with silicon oil tamponade as early as possible, which can effectively controli endophthalmitis and improve visual acuity.

Effect of early vitrectomy combined with silicone oil tamponade for severe infectious traumatized endophthalmitis

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Xiao Zheng

2013-08-01

Full Text Available AIM: To explore the relations of clinical efficacy and surgical timing of vitrectomy combined with silicone oil tamponade for severe infectious traumatized endophthalmitis.METHODS: Totally 59 patients(59 eyeswith severe infectious traumatized endophthalmitis accepted vitrectomy combined with silicone oil tamponade. Patients were divided into two groups by different surgical timing. Group A accepted operation in 24 hours. Group B accepted operation 24 hours after injury. Retina status during operation, clinical efficacy and best-corrected visual acuity were observed and recorded. RESULTS: The cases of early operation group got lesser retina injury and higher efficacy and better best-corrected visual acuity. CONCLUSION:Vitrectomy combined with silicone oil tamponade is an effective way to cure severe infected traumatized endophthalmitis. Early surgical treatment is the key to achieve better effect.

Vitrectomy with or without internal limiting membrane peeling for idiopathic epiretinal membrane: A meta-analysis.

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Chang, Wei-Cheng; Lin, Chin; Lee, Cho-Hao; Sung, Tzu-Ling; Tung, Tao-Hsin; Liu, Jorn-Hon

2017-01-01

Studies on vitrectomy with and without internal limiting membrane (ILM) peeling for idiopathic epiretinal membrane (ERM) have yielded uncertain results regarding clinical outcomes and recurrence rates. To compare the clinical outcomes of vitrectomy with and without ILM peeling for idiopathic ERM. Databases, including PubMed, Embase, Cochrane, Web of Science, Google Scholar, CNKI databases, FDA.gov, and ClinicalTrials.gov, published until July 2016, were searched to identify studies comparing the clinical outcomes following vitrectomy with ERM and ILM peeling and with only ERM peeling, for treating idiopathic ERM. Studies with sufficient data were selected. Pooled results were expressed as mean differences (MDs) and risk ratios (RRs) with corresponding 95% confidence intervals (CI) for vitrectomy with and without ILM peeling with regard to postoperative best corrected visual acuity (BCVA), central retinal thickness (CRT), and ERM recurrence rate. Eleven retrospective studies and one randomized controlled trial involving 756 eyes were identified. This demonstrated that the postoperative BCVA within 12 months was significantly better in the non-ILM peeling group (MD = 0.04, 95% CI: 0.00 to 0.08; P = 0.0460), but that the patients in the ILM peeling group had significantly better postoperative BCVA after 18 months (MD = -0.13, 95% CI: -0.23 to -0.04; P = 0.0049) than did those in the non-ILM peeling group. The non-ILM peeling group exhibited a higher reduction in postoperative CRT (MD = 51.55, 95% CI:-84.23 to -18.88; P = 0.0020) and a higher recurrence rate of ERM (RR = 0.34, 95% CI:0.16 to 0.72; P = 0.0048) than did the ILM peeling group. However, the improvement rates of BCVA (RR = 1.03, 95% CI:0.72 to 1.47; P = 0.8802) and postoperative CRTs (MD = 18.15, 95% CI:-2.29 to 38.60; P = 0.0818) were similar between the two groups. Vitrectomy with ILM peeling results in better visual improvement in long-term follow-ups and lower ERM recurrence rates, and vitrectomy with

Early Vitrectomy for Vitreous Hemorrhage Associated With Retinal Tears

NARCIS (Netherlands)

Tan, H. Stevie; Mura, Marco; Bijl, Heico M.

2010-01-01

PURPOSE: To evaluate outcome of early surgery in vitreous hemorrhage, presumably associated with retinal tears. DESIGN: Retrospective, noncomparative interventional case series. METHODS: We included 40 consecutive cases in 39 patients treated with early vitrectomy for vitreous hemorrhage. Main

Internal Limiting Membrane Peeling to Prevent Post-vitrectomy Epiretinal Membrane Development in Retinal Detachment.

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Akiyama, Kunihiko; Fujinami, Kaoru; Watanabe, Ken; Tsunoda, Kazushige; Noda, Toru

2016-11-01

To determine the efficacy of internal limiting membrane (ILM) peeling during vitrectomy for rhegmatogenous retinal detachment (RRD) regarding post-vitrectomy epiretinal membrane (ERM) development and visual outcomes. Retrospective, interventional, comparative case series. Setting: Institutional. One hundred and two consecutive eyes with RRD treated with vitrectomy and followed for at least 6 months. ILM was peeled without using dye such as indocyanine green (ICG). Observational Procedures: Patients were divided into 2 groups based on postoperative ERM development: Group 1, 81 eyes without ERM formation; Group 2, 21 eyes with ERM development. Patients also were divided into 2 subgroups: those with and without ILM peeling (58 and 44 eyes, respectively). Statistical analyses were performed between the 2 groups with/without ERM formation and between the 2 subgroups with/without ILM peeling for 5 preoperative factors including foveal involvement of the RRD, 4 intraoperative factors including ILM peeling, baseline best-corrected visual acuity (BCVA), and final BCVA. An association of ILM peeling with ERM prevention and the influence of ILM peeling on visual outcomes. ILM peeling was significantly (P peeling. ILM peeling without ICG staining during the initial vitrectomy for RRDs may prevent postoperative ERM formation with favorable visual outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Serratia marcescens endophthalmitis after pterygium surgery: a case report.

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Yi, Myeong Yeon; Chung, Jin Kwon; Choi, Kyung Seek

2017-11-02

To report a case of Serratia marcescens endophthalmitis after pterygium surgery using the bare sclera technique with mitomycin C (MMC). A 69-year-old male patient underwent pterygium excision surgery using the bare sclera technique and 0.02% MMC. The patient presented with decreased visual acuity and pain from the day after the operation. Trans pars plana vitrectomy was performed and intravitreal antibiotics were administered. Cultures from the aqueous humor and intraocular lens were all positive for S. marcescens, which was sensitive to an empiric antibiotic regimen. The best corrected distant visual acuity, 1 month after treatment, was a finger count/50 cm, but the retinal layer structure and the vasculature were relatively well preserved. This is the first reported case of S. marcescens endophthalmitis after pterygium surgery. Endophthalmitis caused by S. marcescens has a devastating visual prognosis and may show a high clinical risk-benefit ratio for the application of MMC in pterygium surgery.

Isolated endogenous Fusarium endophthalmitis in an immunocompetent adult after a thorn prick to the hand.

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Milligan, Alice L; Gruener, Anna M; Milligan, Iain D; O'Hara, Geraldine A; Stanford, Miles R

2017-06-01

To report the case of an immunocompetent adult presenting with endogenous Fusarium endophthalmitis. A woman in her thirties presented with symptoms and signs of a unilateral anterior uveitis. After initial improvement with topical corticosteroids, she continued to develop a panuveitis with an associated drop in vision to counting fingers. A vitreous biopsy confirmed Fusarium solani by 18S rRNA fungal gene detection and PCR sequencing. Despite treatment with pars plana vitrectomy, intravitreal amphotericin B and systemic voriconazole her visual outcome was poor. Detailed review of her antecedent history revealed the route of acquisition to be a thorn prick to the hand two weeks prior to presentation. This patient's endophthalmitis most likely resulted from cutaneous inoculation of Fusarium solani with subsequent hematogenous spread. Endogenous Fusarium endophthalmitis is well recognized in the immunocompromised but is very rarely seen in the immunocompetent. This case highlights the importance of thorough history-taking and consideration of fungal endophthalmitis in the differential diagnosis of a treatment-refractory uveitis.

A unique case of phaeohyphomycosis subretinal abscess in a patient with arthropathy and lung pathology.

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Matthews, Bryan J; Partridge, David; Sheard, Richard M; Rennie, Ian G; Mudhar, Hardeep Singh

2013-12-01

A 67-year-old former gold miner with rheumatoid arthritis, treated with steroids and methotrexate, presented to eye casualty with a painful right eye. Examination revealed an anterior uveitis and despite an initial response to topical steroids, the intraocular inflammation worsened with anterior and posterior uveitis development. Re-examination showed a white mass in the peripheral nasal retina initially suspected of being active Toxoplasmosis infection and anti-toxoplasmosis treatment commenced. After improvement and tapering of this treatment, the intraocular inflammation reoccurred. Cytopathological examination of a pars plana vitrectomy obtained vitreous sample that showed a non-diagnostic non-infectious chronic vitritis. The vitreoretinal surgeons elected to do a direct biopsy of the white subretinal mass in the peripheral nasal area. This revealed, quite unexpectedly, an abscess containing pigmented phaeohyphomycosis fungi. This case report documents the multidisciplinary approach that assisted in clinching a final diagnosis and the role of sub-retinal biopsy in this unprecedented scenario.

Management of pseudophakic cystoid macular edema.

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Guo, Suqin; Patel, Shriji; Baumrind, Ben; Johnson, Keegan; Levinsohn, Daniel; Marcus, Edward; Tannen, Brad; Roy, Monique; Bhagat, Neelakshi; Zarbin, Marco

2015-01-01

Pseudophakic cystoid macular edema (PCME) is a common complication following cataract surgery. Acute PCME may resolve spontaneously, but some patients will develop chronic macular edema that affects vision and is difficult to treat. This disease was described more than 50 years ago, and there are multiple options for clinical management. We discuss mechanisms, clinical efficacy, and adverse effects of these treatment modalities. Topical non-steroidal anti-inflammatory agents and corticosteroids are widely used and, when combined, may have a synergistic effect. Intravitreal corticosteroids and anti-vascular endothelial growth factor (anti-VEGF) agents have shown promise when topical medications either fail or have had limited effects. Randomized clinical studies evaluating anti-VEGF agents are needed to fully evaluate benefits and risks. When PCME is either refractory to medical therapy or is associated with significant vitreous involvement, pars plana vitrectomy has been shown to improve outcomes, though it is associated with additional risks. Copyright © 2015 Elsevier Inc. All rights reserved.

Progressive atrophy of retinal pigment epithelium after trypan-blue-assisted ILM peeling for macular hole surgery

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Sachin Jain

2013-01-01

Full Text Available We report a case of progressive atrophy of the retinal pigment epithelium (RPE after trypan-blue-assisted peeling of internal limiting membrane (ILM for macular hole surgery. A 68-year-old Caucasian female underwent a 20-g pars plana vitrectomy for a chronic stage-3 macular hole. The ILM was stained with 0.06% trypan blue (VisionBlue™, DORC Netherlands for 2 min after fluid air exchange. Dye was reapplied for another 2 min due to poor staining. The ILM was completely removed around the macular hole with forceps. RPE atrophy was noticed at the edge of the hole 1 month after surgery. It progressively increased in intensity and enlarged over 2 years. Her final visual acuity was counting fingers, significantly worse compared to her presenting visual acuity of 20/200. Progressive atrophy of RPE in our patient was most likely due to the toxicity of trypan blue. Reapplication of the dye may increase the likelihood of toxicity.

IOP measurement in silicone oil tamponade eyes by Corvis ST tonometer, Goldmann applanation tonometry and non-contact tonometry.

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Zhang, Yang; Zheng, Lin; Bian, Ailing; Zhou, Qi

2018-04-01

To compare the postoperative intraocular pressure (IOP) of eyes following pars plana vitrectomy (PPV) combined with intravitreal silicone oil (SO) tamponade by Corneal Visualization Scheimpflug Technology (CST), Goldmann applanation tonometry (GAT) and non-contact tonometry (NCT). Thirty-eight participants who had undergone PPV combined with SO tamponade to treat vitreoretinal diseases were enrolled. Postoperative IOP measurements were obtained using CST, NCT and GAT. Inter-device agreement was assessed by Bland-Altman analysis. The correlation coefficient was used to describe the potential postoperative factors affecting the postoperative IOP differences between each device. Bland-Altman analysis revealed the bias between CST and GAT, between CST and NCT, and between GAT and NCT to be -0.2, 2.1 and 2.4 mmHg, respectively. CST and GAT correlated well with each other. NCT values were lower than those of GAT and CST (all p contact method for measuring postoperative IOP in SO tamponade eyes.

Intravitreal Phacoemulsification Using Torsional Handpiece for Retained Lens Fragments.

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Kumar, Vinod; Takkar, Brijesh

2016-01-01

To evaluate the results of intravitreal phacoemulsification with torsional hand piece in eyes with posteriorly dislocated lens fragments. In this prospective, interventional case series, 15 eyes with retained lens fragments following phacoemulsification were included. All patients underwent standard three-port pars plana vitrectomy and intravitreal phacoemulsification using sleeveless, torsional hand piece (OZiL™, Alcon's Infiniti Vision System). Patients were followed up for a minimum of six months to evaluate the visual outcomes and complications. The preoperative best-corrected visual acuity (BCVA) ranged from light perception to 0.3. No complications such as thermal burns of the scleral wound, retinal damage due to flying lens fragments, or difficult lens aspiration occurred during intravitreal phacoemulsification. Mean post-operative BCVA at the final follow-up was 0.5. Two eyes developed cystoid macular edema, which was managed medically. No retinal detachment was noted. Intravitreal phacoemulsification using torsional hand piece is a safe and effective alternative to conventional longitudinal phacofragmentation.

Intravitreal Phacoemulsification Using Torsional Handpiece for Retained Lens Fragments

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Kumar, Vinod; Takkar, Brijesh

2016-01-01

Purpose: To evaluate the results of intravitreal phacoemulsification with torsional hand piece in eyes with posteriorly dislocated lens fragments. Methods: In this prospective, interventional case series, 15 eyes with retained lens fragments following phacoemulsification were included. All patients underwent standard three-port pars plana vitrectomy and intravitreal phacoemulsification using sleeveless, torsional hand piece (OZiL™, Alcon's Infiniti Vision System). Patients were followed up for a minimum of six months to evaluate the visual outcomes and complications. Results: The preoperative best-corrected visual acuity (BCVA) ranged from light perception to 0.3. No complications such as thermal burns of the scleral wound, retinal damage due to flying lens fragments, or difficult lens aspiration occurred during intravitreal phacoemulsification. Mean post-operative BCVA at the final follow-up was 0.5. Two eyes developed cystoid macular edema, which was managed medically. No retinal detachment was noted. Conclusion: Intravitreal phacoemulsification using torsional hand piece is a safe and effective alternative to conventional longitudinal phacofragmentation. PMID:27621783

Preserved scleral patch graft for unexpected extreme scleral thinning found at the scleral buckling procedure: A case report

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Spela Stunf

2011-01-01

Full Text Available Pre-existing scleral pathology is an important risk factor for globe rupture during scleral buckling procedures. We report here, the surgical management of an unexpected scleral pathology found at the scleral buckling procedure in a retinal detachment patient. A 77-year-old white female with retinal detachment underwent a scleral buckling procedure. The surgery was converted into a scleral graft procedure, as extreme scleral thinning was found intraoperatively. An alcohol-preserved donor sclera graft was used. The second surgery for definitive retinal alignment was performed two weeks later. The presented case of an unexpected scleral pathology in a retinal detachment patient was managed with a combination of scleral grafting and pars plana vitrectomy, without any major complications. The anatomical outcome was excellent and the scleral rupture was prevented; the visual outcome was satisfactory. A conversion of the scleral buckling procedure into a scleral graft procedure has proved to be safe and effective for unexpected scleral pathology.

Effect of intravitreal injection of Conbercept before PPV on complications and visual recovery in patients with PDR

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Shao-Bing Lin

2018-05-01

Full Text Available AIM: To analyze the effect of intravitreal injection of Conbercept before pars plana vitrectomy(PPVon complications and visual recovery in patients with proliferative diabetic retinopathy(PDR. METHODS: Totally 94 patients with PDR(monocular onsetwere randomly divided into the experimental group(n=47and the control group(n=47. All patients were treated by PPV. The experimental group was treated with intravitreal injection of conbercept at 5-7d before PPV while the control group was not given the intervention. The surgical time, surgical procedures, complications and visual recovery in the two groups were observed and statistically analyzed. RESULTS: The operating time of PPV for the experimental group was significantly shorter than that for the control group(72.33±15.71min vs 91.06±19.29min, PPPPCONCLUSION: The intravitreal injection of conbercept before PPV has a positive effect on reducing the incidence of intraoperative complications and promoting postoperative visual recovery in patients with PDR.

Surgical repair of large cyclodialysis clefts.

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Gross, Jacob B; Davis, Garvin H; Bell, Nicholas P; Feldman, Robert M; Blieden, Lauren S

2017-05-11

To describe a new surgical technique to effectively close large (>180 degrees) cyclodialysis clefts. Our method involves the use of procedures commonly associated with repair of retinal detachment and complex cataract extraction: phacoemulsification with placement of a capsular tension ring followed by pars plana vitrectomy and gas tamponade with light cryotherapy. We also used anterior segment optical coherence tomography (OCT) as a noninvasive mechanism to determine the extent of the clefts and compared those results with ultrasound biomicroscopy (UBM) and gonioscopy. This technique was used to repair large cyclodialysis clefts in 4 eyes. All 4 eyes had resolution of hypotony and improvement of visual acuity. One patient had an intraocular pressure spike requiring further surgical intervention. Anterior segment OCT imaging in all 4 patients showed a more extensive cleft than UBM or gonioscopy. This technique is effective in repairing large cyclodialysis clefts. Anterior segment OCT more accurately predicted the extent of each cleft, while UBM and gonioscopy both underestimated the size of the cleft.

A unique case of phaeohyphomycosis subretinal abscess in a patient with arthropathy and lung pathology

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Bryan J Matthews

2013-01-01

Full Text Available A 67-year-old former gold miner with rheumatoid arthritis, treated with steroids and methotrexate, presented to eye casualty with a painful right eye. Examination revealed an anterior uveitis and despite an initial response to topical steroids, the intraocular inflammation worsened with anterior and posterior uveitis development. Re-examination showed a white mass in the peripheral nasal retina initially suspected of being active Toxoplasmosis infection and anti-toxoplasmosis treatment commenced. After improvement and tapering of this treatment, the intraocular inflammation reoccurred. Cytopathological examination of a pars plana vitrectomy obtained vitreous sample that showed a non-diagnostic non-infectious chronic vitritis. The vitreoretinal surgeons elected to do a direct biopsy of the white subretinal mass in the peripheral nasal area. This revealed, quite unexpectedly, an abscess containing pigmented phaeohyphomycosis fungi. This case report documents the multidisciplinary approach that assisted in clinching a final diagnosis and the role of sub-retinal biopsy in this unprecedented scenario.

Intraocular lens dislocation after whole-body vibration.

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Vela, José I; Andreu, David; Díaz-Cascajosa, Jesús; Buil, José A

2010-10-01

We present 2 cases of intraocular lens (IOL) dislocation that appeared shortly after the patients exercised on a vibration platform. The first patient was a 71-year-old woman who presented with lens subluxation in her right eye and a complete posterior IOL dislocation in her left eye. The second case was a 62-year-old woman who presented with unilateral IOL dislocation within the capsular bag in her right eye. Timing from IOL implantation to dislocation was approximately 6 years and 4 years, respectively. Pars plana vitrectomy with removal of the dislocated IOL was performed in both patients. Whole-body vibration training has become increasingly popular as a form of exercise training. It reportedly may provide benefits in physical function and in some diseases, especially in older people. However, evidence-based protocols ensuring safety and efficacy in this population are lacking. We discuss vibration as a cause of late IOL dislocation. Copyright © 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Anterior vitrectomy and partial capsulectomy via anterior approach to treat chronic postoperative endophthalmitis

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Mete Güler

2013-02-01

Full Text Available AIM:To describe the results of vitrectomy and partial capsulectomy via anterior approach surgical technique in treatment of chronic postoperative endophthalmitis (CPE.METHODS:Clinical records of 9 patients treated for CPE between 2006 and 2010 were reviewed retrospectively. All of these patients were treated with vitrectomy and partial capsulectomy via anterior approach.RESULTS:Six of 9 patients were male. The average patients’ age was (60±8.1 years. The average period between cataract extraction and onset of signs and symptoms was (3.6±1.3 weeks. The average presenting visual acuity was 0.3±0.1 and the average final post operative visual acuity was 0.7±0.2. The mean follow-up period was (28.1±8.9 weeks. In all patients, the inflammation subsided after surgery.CONCLUSION:Our results suggest that anterior vitrectomy and partial capsulectomy via anterior approach may be considered as potentially useful and relatively less invasive technique to treat CPE.

Macular retinoschisis in eyes with glaucomatous optic neuropathy: Vitrectomy and natural course.

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Yoshikawa, Tadanobu; Yamanaka, Chihiro; Kinoshita, Takamasa; Morikawa, Shohei; Ogata, Nahoko

2018-02-01

Our purpose was to determine the effectiveness of vitrectomy in resolving the macular retinoschisis in an eye with glaucomatous optic neuropathy and also to determine the natural course of macular retinoschisis. This was a retrospective case series of patients who were diagnosed with macular retinoschisis and glaucomatous optic neuropathy. Fourteen eyes of 13 patients were studied. Patients with high myopia, vitreomacular traction syndrome, and the pit macular syndrome were excluded. There were three men and ten women, and 12 had unilateral and one had bilateral macular retinoschisis. Vitrectomy was performed for a serous retinal detachment, macular hole, or severe visual loss in five eyes. The mean follow-up time was 68.8 months in these five eyes, and the macular retinoschisis was resolved and the best-corrected visual acuity (BCVA) at the final visit was significantly improved in all eyes (P = 0.007). However, two of these fiv e eyes developed a macular hole and required a second vitrectomy. Of the nine eyes without treatment with a mean follow-up time of 29.0 months, the BCVA at the final visit remained unchanged from the baseline BCVA in all eyes. The macular retinoschisis was resolved or reduced in three eyes without treatment. Vitrectomy was effective for the resolution of macular retinoschisis in eyes with glaucomatous optic neuropathy and serous retinal detachment or macular hole or severe reduction of the BCVA. Macular retinoschisis can be resolved without a reduction of the BCVA in some cases without treatment.

Vitreolensectomy in Marfan's syndrome.

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Hubbard, A D; Charteris, D G; Cooling, R J

1998-01-01

To evaluate the effectiveness of pars plana vitreolensectomy in the management of subluxed lenses associated with Marfan's syndrome and to assess the need for intraoperative retinal photocoagulation to prevent post-operative retinal detachment. A retrospective review was carried out of 40 eyes of patients with Marfan's syndrome who underwent pars plana vitreolensectomy for subluxed lenses. All patients demonstrated stable or improved visual acuity following surgery with a low incidence of complications. Pars plana vitreolensectomy is a safe and effective treatment for subluxed lenses in patients with Marfan's syndrome. It appears that intraoperative prophylactic laser treatment need only be applied to areas of lattice degeneration to limit the incidence of post-operative retinal detachment.

Effects of lens extirpation with anterior vitrectomy on vitreous three-dimensional mesh structure

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Yan Zhao

2017-06-01

Full Text Available AIM: To investigate the changes in vitreous gel structure after lens extirpation combined with anterior vitrectomy in rabbit eyes. METHODS: Twenty-eight chinchilla rabbits were divided into three groups. The control group (Group I included 16 eyes from eight rabbits who did not receive any treatment. Group II included 20 eyes from 10 rabbits that underwent lens aspiration only. Group III included 20 eyes from 10 rabbits that underwent lens aspiration combined with posterior capsulotomy and anterior vitrectomy. Eyes were harvested on the 30th and 60th day postoperatively, respectively. Changes in vitreous gel stretch length due to gravity and the rate of vitreous liquefaction were observed. The collagen content in the vitreous body was examined using the L-hydroxyproline test. Electronic microscopic images were obtained from each eyeball. RESULTS: On both the 30th and 60th day postoperatively, the vitreous gel length of group III was significantly shorter than group I and group II (P<0.05, while the rate of liquefaction of the vitreous body in group III was significantly higher than group I and group II (P<0.05. The collagen content in group III was also higher than that in group I and group II (P<0.05. CONCLUSION: Loss of vitreous gel mass is more likely to occur in the eyes of rabbits receiving anterior vitrectomy. Lensectomy combined with anterior vitrectomy may damage the stable three-dimensional mesh structure of collagen, which could aggravate vitreous gel liquefaction.

Clinical efficacy and safety of vitrectomy combined with cyclophotocoagulation in treatment of traumatic glaucoma

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Guo-Ning Ye

2018-02-01

Full Text Available AIM: To analyze the clinical efficacy and safety of vitrectomy combined with cyclophotocoagulation in the treatment of traumatic glaucoma, and to provide an effective treatment for improving the quality of life of patients with traumatic glaucoma.METHODS: Totally 90 patients(90 eyeswith traumatic glaucoma admitted in our hospital from January 2011 to July 2016 were divided into two groups(45 patients in each groupaccording to different treatment methods. The patients in the observation group underwent vitrectomy combined with cyclophotocoagulation under direct vision; the control group underwent vitrectomy combined with trans-scleral cyclophotocoagulation. We observed the effect of different treatment on visual acuity, intraocular pressure and complication of the two groups. RESULTS: The visual acuity of the observation group was significantly better than that of the control group after treatment(Z=-5.689, PP>0.05. The change of decreased intraocular pressure in the observation group was less than that in the contral group after operation(PP>0.05. The complications of the two groups after treatment were vitreous hemorrhage, choroidal detachment, low intraocular pressure, increased intraocular pressure and other complications, but the complication rate of two groups were no different(χ2=1.553, P=0.213. CONCLUSION: Vitrectomy combined with cyclophotocoagulation under direct vision brings patients better visual acuity than that combined with trans-scleral cyclophotocoagulation.

Comparison of disposable sutureless silicone ring and traditional metal ring in 23-gauge vitrectomy combined with cataract surgery.

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Wu, Jian-Guo; Wei, Rui-Hua; Liu, Ai-Hua; Zhou, Xiao-Xu; Sun, Guo-Ling; Li, Xiao-Rong

2011-01-01

The purpose of this prospective, interventional, comparative case series was to evaluate the efficiency and feasibility of a disposable sutureless silicone lens ring for corneal contact lens stabilization during combined 23-gauge vitrectomy and cataract surgery. We developed a ring consisting of a single silicone component with three footplates along the ring margin to fit cannulae for holding conventional contact lenses. Thirty eyes from 30 patients with cataract and vitreoretinal disease were included, and divided into two matched groups according to disease type and ring used. In Group A, we used a 23-gauge transconjunctival vitrectomy system and a disposable sutureless silicone lens ring (n = 15). In Group B, we used a 23-gauge transconjunctival vitrectomy system and a conventional metal lens ring (n = 15). The main outcome measures were: time required for vitrectomy preparation, rate of intraoperative corneal limbus bleeding, and limbus scar rate at the final follow-up visit. Thirty cases were successfully completed. The average vitrectomy preparation time was less in Group A than in Group B (P < 0.01), and the average preparation time saved was 3.94 minutes. None of the Group A patients had intraoperative bleeding or postoperative scarring, whereas all 15 Group B cases had bleeding and five had scarring. There was a statistically significant difference between Group A and Group B for these complications (P ≤ 0.05). This report demonstrates the advantages of using a sutureless silicone ring during combined 23-gauge vitrectomy and cataract surgery. Using this method could allow extra time for the surgeon to pay more attention to complex vitreoretinal procedures.

Corrigendum - Intraocular pressure changes following the use of silicone oil or Densiron 68 as endotamponade in pars plana vitrectomy

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Romano MR

2010-12-01

Full Text Available Romano MR, Angi M, Romano V, et alA word was omitted from the conclusion of the Abstract. The correct version is as follows:Conclusion: Overall, the use of Densiron 68 was not associated with significantly higher IOP values as compared with SSO.

Comparison of Optic Nerve Head Blood Flow Autoregulation among Quadrants Induced by Decreased Ocular Perfusion Pressure during Vitrectomy

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Ryuya Hashimoto

2017-01-01

Full Text Available Purpose. The present study aimed to examine changes in optic nerve head (ONH blood flow autoregulation in 4 quadrants (superior, nasal, inferior, and temporal with decreased ocular perfusion pressure (OPP during vitrectomy in order to determine whether there is a significant difference of autoregulatory capacity in response to OPP decrease at each ONH quadrant. Methods. This study included 24 eyes with an epiretinal membrane or macular hole that underwent vitrectomy at Toho University Sakura Medical Center. Following vitrectomy, the tissue mean blur rate (MBR, which reflects ONH blood flow, was measured. Mean tissue MBRs in the four quadrants were generated automatically in the software analysis report. Measurements were conducted before and 5 and 10 min after intraocular pressure (IOP elevation of approximately 15 mmHg in the subjects without systemic disorders. Results. The baseline tissue MBR of the temporal quadrant was significantly lower than that of the other 3 quadrants (all P<0.05. However, the time courses of tissue MBR in response to OPP decrease were not significantly different among the four quadrants during vitrectomy (P=0.23. Conclusions. There is no significant difference in the autoregulatory capacity of the four ONH quadrants in patients without systemic disorders during vitrectomy.

Vitrectomy with internal limiting membrane peeling vs no peeling for Macular Hole-induced Retinal Detachment (MHRD): a meta-analysis.

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Su, Jing; Liu, Xinquan; Zheng, Lijun; Cui, Hongping

2015-06-20

we conducted our meta-analysis of published studies to assess existing evidence about the efficacy and safety of vitrectomy with ILM peeling vs. that of vitrectomy with no ILM peeling for Macular hole-induced retinal detachment. Databases, including Pubmed, Cochrane Library, Ovid, Web of Science, Wanfang and CNKI, were searched to identify studies comparing outcomes following vitrectomy with ILM peeling and that with no ILM peeling for macular hole-induced retinal detachment. The meta-analysis was performed by RevMan 5.1. Six comparative studies comprising 180 eyes were identified. It was indicated that the rate of retinal reattachment (Odds ratio (OR) = 3.03, 95 % Confidence interval (CI):1.35 to 6.78; P = 0.007) and macular hole closure (OR = 6.74, 95 % CI:3.26 to 13.93; P peeling than that in the group of vitrectomy with no ILM peeling. However, the improved BCVA (Weighted mean difference (WMD) = 0.14, 95 % CI: -0.20 to 0.47; P = 0.42) and the rate of postoperative complications were similar between the two groups. Vitrectomy with internal limiting membrane peeling is an efficient and safe procedure for macular hole-induced retinal detachment.

Perfluoroctano líquido como tamponante vitreorretiniano de curta duração no pós-operatório de portadores de descolamento de retina por ruptura gigante Perfluoroctane liquid as a short-term vitreous-retinal tamponade in the postoperative period in patients with retinal detachment due to giant tears

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Marcelo Carvalho Ventura

2007-06-01

Full Text Available OBJETIVOS: Relatar os resultados de vitrectomia via pars plana com utilização de perfluocarbono líquido (Perfluoroctano-Ophtalmos®, como tamponante vítreo-retiniano de curta duração, no pós-operatório de portadores de descolamento de retina, por ruptura gigante. MÉTODOS: Estudaram-se dez desses pacientes. Todos os casos eram complicados por vitreorretinopatia proliferativa grau B ou pior com rupturas que variavam em extensão de 90º a 210º. O perfluorocarbono líquido foi introduzido, por via pars plana, com o volume necessário para ultrapassar o limite posterior da ruptura, permanecendo no pós-operatório por cinco dias, estando os pacientes em decúbito dorsal. Após esse período submetiam-se a segunda intervenção para troca do perfluorocarbono líquido para gás ou óleo de silicone. RESULTADOS: Após período de acompanhamento médio de 16,2 ± 12,4 meses (2 a 43 meses, 80% das retinas estavam aplicadas, sendo necessária a repetição desta técnica em 1 caso (10% caso e em 2 casos (20% não houve reaplicação da retina por vitreorretinopatia avançada. Houve melhora da acuidade visual em 5 casos (50%. CONCLUSÃO: Observaram-se bons resultados quanto à aplicação da retina (80% e melhora da acuidade visual (50% quando do uso do perfluorocarbono líquido como tamponante vitreorretiniano de curta duração no pós-operatório de cirurgias de descolamento de retina por rupturas gigantes.PURPOSE: To report pars plana vitrectomy results of intravitreous use of liquid perfluorocarbon as a short-term postoperative tamponade in retinal detachment due to giant tears in a series of patients. METHODS: Ten of those patients, all of them complicated by proliferative vitreoretinopathy grade B or worse, with tear extension varying from 90º to 210º were studied. Perfluorocarbon liquid was injected via pars plana until the posterior tear limit, remaining in the postoperative period during five days, with the patients in supine position

Perfluorocarbon-perfused 23 gauge three-dimensional vitrectomy for complicated diabetic tractional retinal detachment

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Velez-Montoya, Raul; Guerrero-Naranjo, Jose Luis; Garcia-Aguirre, Gerardo; Morales-Cantón, Virgilio; Fromow-Guerra, Jans; Quiroz-Mercado, Hugo

2011-01-01

Background Perfluorocarbon liquid (PCL)-perfused vitrectomy has been shown in previous studies to be feasible, safe, and to have advantages in managing complicated cases of tractional retinal detachment. The present study had the objectives of describing the anatomical results and measuring surgical time and PCL consumption when combining PCL-perfused techniques with modern vitrectomy equipment. Methods A prospective, interventional consecutive case series was investigated. We enrolled patients with diabetic tractional retinal detachment, complicated by proliferative vitreoretinopathy and poor vision. A 23 gauge PCL-perfused vitrectomy was done with three-dimensional settings. During the procedure, we assessed the degree of surgical bleeding, visualization quality, and difficulty of membrane dissections. Visual acuity, intraocular pressure, and anatomical success were assessed at one and 3 months of follow-up. Results Twelve patients were enrolled in this study. There were no statistical significant changes in intraocular pressure and visual acuity throughout the follow-up period. Surgery was performed in a hemorrhage-free environment in almost all cases, with good visualization and low technical difficulty. The mean complete surgical time was 94.92 ± 25.03 minutes. The mean effective vitrectomy time was 22.50 ± 19.04 minutes and the mean PCL consumption was 25.08 ± 9.76 mL, with a speed of 1.11 mL/minute. Anatomical success was 67% at 3 months. Conclusion Although the technique proved to have some advantages in managing complicated cases of diabetic tractional retinal detachment, there was a high consumption of PCL. A redesign of the entire system is needed in order to decrease the amount of PCL needed for the technique. PMID:22267907

Combined Phacoemulsification, Vitrectomy and Endolaser Photocoagulation in Patients with Diabetic Retinopathy and Cataract

International Nuclear Information System (INIS)

Wahab, S; Hargun, L. D.

2014-01-01

Objective: To determine the outcomes of early vitrectomy and endolaser photocoagulation effects during phacoemulsification in cataractous eyes with diabetic retinopathy. Study Design: Descriptive study. Place and Duration of Study: Ophthalmology Department Unit-II, DUHS, Civil Hospital, Karachi, and Al-Noor Eye Clinic, Karachi, from February 2009 to December 2010. Methodology: Consecutive 54 patients with 7 - 15 years duration of type II diabetes with severe non-proliferative diabetic retinopathy (NPDR) and early proliferative diabetic retinopathy (PDR) who had cataract grade I and II underwent vitrectomy, endolaser photocoagulation and phacoemulsification with IOL implantation. Best corrected visual acuity was main outcomes measure assessed till 6 months follow-up. Results: Out of 54 eyes, 32 patients were females and 22 were males. Majority 47 (87%) eyes gained significant (p < 0.001) improvement of best corrected visual acuity of four lines or better while 5 (9.3%) eyes retained stable visual acuity. In only 2 eyes, vision declined to 3/60 or less. Conclusion: Early vitrectomy with phacoemulsification in severe NPDR and early PDR patients, if assisted or augmented with endolaser photocoagulation, maximizes, early visual rehabilitation with less morbidity and may retard progression of retinopathy. (author)

Sympathetic ophthalmia after 23-gauge transconjunctival sutureless vitrectomy

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Masatoshi Haruta

2010-11-01

Full Text Available Masatoshi Haruta1, Hirokazu Mukuno2, Kazuaki Nishijima3, Hitoshi Takagi4, Mihori Kita51Department of Ophthalmology, Kurume University School of Medicine, Kurume, Fukuoka, Japan; 2Department of Ophthalmology, Konan Hospital, Kobe, Hyogo, Japan; 3Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Kyoto, Japan; 4Department of Ophthalmology, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan; 5Department of Ophthalmology, Hyogo Prefectural Amagasaki Hospital, Amagasaki, Hyogo, JapanPurpose: We report a case of a sympathetic ophthalmia that occurred after 23-gauge transconjunctival sutureless vitrectomy for a retinal detachment.Case report: A 41-year-old Japanese woman underwent combined phacoemulsification with intraocular lens implantation and 23-gauge transconjunctival sutureless vitrectomy for a rhegmatogenous retinal detachment in the right eye. Endolaser photocoagulation and silicone oil tamponade were used to manage inferior retinal holes. Four weeks after the surgery, she returned with a 5-day history of reduced vision and metamorphopsia in her left eye. Slit-lamp examination showed a shallow anterior chamber in the right eye and moderate anterior uveitis bilaterally. Silicone oil bubbles and pigment dispersion were observed in the subconjunctival space adjacent to the right eye’s superonasal sclerotomy site. Fundus examination showed multifocal serous retinal detachments in both eyes. A diagnosis of sympathetic ophthalmia was made and the patient was treated with intensive topical and systemic steroids. The subretinal fluid cleared in both eyes following treatment. Twelve months after the onset of inflammation, the patient’s condition was stable on a combination of oral cyclosporine and topical steroids. Sunset glow retinal changes remain, but there has been no evidence of recurrent inflammation.Conclusion: Sympathetic ophthalmia can develop after 23-gauge

Sulfur Hexafluoride 20% versus Lactated Ringer′s solution for Prevention of Early Postoperative Vitreous Hemorrhage after Diabetic Vitrectomy

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Fereydoun Farrahi

2010-01-01

Full Text Available Purpose: To compare the hemostatic effect of sulfur hexafluoride 20% (SF6 20% with lactated Ringer′s solution for prevention of early postoperative vitreous hemorrhage following diabetic vitrectomy. Methods: In a prospective randomized clinical trial, 50 eyes undergoing diabetic vitrectomy were divided into two groups. At the conclusion of surgery, in one group the vitreous cavity was filled with SF6 20% while in the other group lactated Ringer′s solution was retained in the vitreous cavity. The two groups were compared for the rate of early postoperative vitreous hemorrhage. Results: The incidence of vitreous hemorrhage was lower in the SF6 group than the Ringer′s group 4 days (20% vs 68%, P=0.001, 7 days (24% vs 60%, P=0.01 and 4 weeks (16% vs 40%, P=0.059 after vitrectomy. Conclusion: In comparison with lactated Ringer′s solution, SF6 20% had a significant hemostatic effect especially in the early postoperative period after diabetic vitrectomy and reduced the incidence of vitreous hemorrhage.

Efficacy of non-fovea-sparing ILM peeling for symptomatic myopic foveoschisis with and without macular hole.

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Al-Badawi, Amer Hamad; Abdelhakim, Mohamad Amr Salah Eddin; Macky, Tamer Ahmed; Mortada, Hassan Aly

2018-04-30

To study anatomical and visual outcomes of pars plana vitrectomy (PPV) with non-fovea-sparing (entire) internal limiting membrane (ILM) peeling in eyes with myopic foveoschisis (MF). Prospective interventional case series of eyes undergoing PPV with entire ILM peeling for symptomatic MF. Preoperative spectral domain optical coherence tomography (SD - OCT) epiretinal membrane, anomalous posterior vitreous detachment, vitreoschisis and postoperative changes in SD-OCT central foveal thickness (CFT), ellipsoid zone defect, foveal detachment (FD), macular hole (MH) diameter (if present) and best-corrected visual acuity (BCVA) in logarithm of the minimum angle of resolution (logMAR). This study included 21 eyes (21 patients) with mean age 60.4±13.1, 15 females (71.4%). All patients achieved complete postoperative reattachment by SD-OCT (no FD) 6 months post vitrectomy, with no iatrogenic intraoperative or postoperative MH, and with significant improvement in final BCVA from 1.6±0.30 to1.0±0.2 logMAR, and in CFT from 918.2±311.4 to182.3±33.1 µm. Patients were subdivided into subgroup A: 11 eyes without MH; and subgroup B: 10 eyes with MH, the latter had significant improvement in MH diameter (p=0.005). Preoperative BCVA was a significant risk factor for visual gain, while preoperative FD and CFT were significant for CFT change. Vitrectomy with non-fovea-sparing (entire) ILM peeling resulted in a significant functional and anatomical improvement in eyes with MF with/without MH with no reported complications. Results are comparable to fovea-sparing ILM peeling. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The Effect of Altitude on Intraocular Pressure in Vitrectomized Eyes with Sulfur Hexafluoride Tamponade by the Friedenwald Method: Rabbit Animal Model

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Jans Fromow-Guerra

2016-01-01

Full Text Available The aim of this study is to assess the change in intraocular pressure after a road trip, in eyes with different levels of filling with gas tamponade. Five rabbit eyes were subject to pars plana vitrectomy and gas tamponade (filling percentage: 25%, 50%, and 100% of nonexpansile SF6, 100% saline solution, and 100% room air. A sixth eye was injected with 0.35 cc of undiluted SF6 without vitrectomy. Guided by global positioning system, they were driven to the highest point of the highway connecting Mexico City with Puebla city and back, stopping every 300 m to assess intraocular pressure. The rabbit’s scleral rigidity and estimation for human eyes were done by using the Friedenwald nomogram. Maximum altitude was 3209 m (Δ949 m. There were significant differences in intraocular pressure on the rabbit eyes filled with SF6 at 100%, 50%, 25%, and 100% room air. Per every 100 m of altitude rise, the intraocular pressure increased by 1.53, 1.0046, 0.971, and 0.97 mmHg, respectively. Using the human Friedenwald rigidity coefficient, the human eye estimate for intraocular pressure change was 2.1, 1.8, 1.4, and 1.1 mmHg per every 100 m of attitude rise. Altitude changes have a significant impact on intraocular pressure. The final effect depends on the percentage of vitreous cavity fill and scleral rigidity.

Risk factors for postoperative intraretinal cystoid changes after peeling of idiopathic epiretinal membranes among patients randomized for balanced salt solution and air-tamponade.

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Leisser, Christoph; Hirnschall, Nino; Hackl, Christoph; Döller, Birgit; Varsits, Ralph; Ullrich, Marlies; Kefer, Katharina; Karl, Rigal; Findl, Oliver

2018-02-20

Epiretinal membranes (ERM) are macular disorders leading to loss of vision and metamorphopsia. Vitrectomy with membrane peeling displays the gold standard of care. Aim of this study was to assess risk factors for postoperative intraretinal cystoid changes in a study population randomized for balanced salt solution and air-tamponade at the end of surgery. A prospective randomized study, including 69 eyes with idiopathic ERM. Standard 23-gauge three-port pars plana vitrectomy with membrane peeling, using intraoperative optical coherence tomography (OCT), was performed. Randomization for BSS and air-tamponade was performed prior to surgery. Best-corrected visual acuity improved from 32.9 letters to 45.1 letters 3 months after surgery. Presence of preoperative intraretinal cystoid changes was found to be the only risk factor for presence of postoperative intraretinal cystoid changes 3 months after surgery (p = 0.01; odds ratio: 8.0). Other possible risk factors such as combined phacoemulsification with 23G-ppv and membrane peeling (p = 0.16; odds ratio: 2.4), intraoperative subfoveal hyporeflective zones (p = 0.23; odds ratio: 2.6), age over 70 years (p = 0.29; odds ratio: 0.5) and air-tamponade (p = 0.59; odds ratio: 1.5) were not found to be significant. There is strong evidence that preoperative intraretinal cystoid changes lead to smaller benefit from surgery. © 2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Management of macular epiretinal membrane by vitrectomy and intravitreal triamcinolone.

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Shukla, Dhananjay

2014-04-01

A patient underwent successful vitrectomy for macular epiretinal membrane with anatomical and functional improvement. 10 weeks later, there was a recurrence of macular edema with corresponding visual decline. An intravitreal injection of triamcinolone acetonide not only restored the macular anatomy but also improved the visual outcome beyond that achieved after surgery.

Full Thickness Macular Hole Closure after Exchanging Silicone-Oil Tamponade with C3F8 without Posturing

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Tina Xirou

2011-05-01

Full Text Available Purpose: To report a case of macular hole closure after the exchange of a silicone-oil tamponade with gas C3F8 14%. Method: A 64-year-old female patient with a stage IV macular hole underwent a three-port pars-plana vitrectomy and internal limiting membrane peeling. Due to the patient’s chronic illness (respiratory problems, a silicone-oil tamponade was preferred. However, the macula hole was still flat opened four months postoperatively. Therefore, the patient underwent an exchange of silicone oil with gas C3F8 14%. No face-down position was advised postoperatively due to her health problems. Results: Macular hole closure was confirmed with optical coherence tomography six weeks after exchanging the silicone oil with gas. Conclusions: Macular hole surgery using a silicone-oil tamponade has been proposed as treatment of choice for patients unable to posture. In our case, the use of a long-acting gas (C3F8 14%, even without posturing, proved to be more effective.

Acute Central Retinal Artery Occlusion Associated with Intraocular Silicone Oil Tamponade

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Mehmet Yasin Teke

2012-05-01

Full Text Available Many systemic and ocular factors may cause acute central retinal artery occlusion (CRAO. Herein, we aimed to describe a case of CRAO due to intraocular silicone oil (SO tamponade. To the best of our knowledge, a case like our has not been reported previously. A 58-yearold male patient had undergone combined pars plana vitrectomy-lensectomy and intraocular SO for lens luxation and vitreus hemorrhage associated with a blunt ocular trauma in his right eye. Two weeks after the surgery, he presented with acute vision loss in the same eye. He was diagnosed with acute CRAO and it should be related with mechanical press or raised intraocular pressure (IOP associated with SO. He was treated by partial removal of SO immediately. In spite of the regression of retina edema, his visual acuity did not improve due to optic atrophy. SO may cause CRAO due to raised IOP and/or its mechanical pressure and this complication must be kept in mind. (Turk J Oph thal mol 2012; 42: 238-40

Macular Buckling Surgery for Retinal Detachment Associated with Macular Hole in High Myopia Eye

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Kenan Sönmez

2017-12-01

Full Text Available A 68-year-old woman presented to our clinic with a 1-month history of central scotoma and visual loss in her right eye. The best corrected visual acuity (BCVA was hand motion in her right eye. Fundus examination showed myopic chorioretinal degeneration in association with posterior staphyloma and the retina was slightly elevated throughout the macula. Optical coherence tomography (OCT revealed retinal detachment involving the posterior pole with a macular hole and staphyloma. The patient underwent pars plana vitrectomy, internal limiting membrane peeling, macular buckling, and perfluoropropane gas tamponade. At 3-month follow-up, her BCVA was improved to counting fingers at 1 meter and flattened retina with closed macular hole was observed by OCT. Myopic macular hole with retinal detachment associated with posterior staphyloma represent a challenge regarding their management and several surgical techniques have been described. Although satisfactory anatomical improvement is achieved in these eyes after surgery, the visual acuity outcomes may be poorer than expected due to the chorioretinal atrophy at the posterior pole.

Correlation between Interleukin-6 and Thrombin-Antithrombin III Complex Levels in Retinal Diseases.

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Ehrlich, Rita; Zahavi, Alon; Axer-Siegel, Ruth; Budnik, Ivan; Dreznik, Ayelet; Dahbash, Mor; Nisgav, Yael; Megiddo, Elinor; Kenet, Gili; Weinberger, Dov; Livnat, Tami

2017-09-01

This study aims to evaluate and correlate the levels of interleukin-6 (IL-6) and thrombin-antithrombin III complex (TAT) in the vitreous of patients with different vitreoretinal pathologies. Vitreous samples were collected from 78 patients scheduled for pars plana vitrectomy at a tertiary medical center. Patients were divided by the underlying vitreoretinal pathophysiology, as follows: macular hole (MH)/epiretinal membrane (ERM) (n = 26); rhegmatogenous retinal detachment (RRD) (n = 32); and proliferative diabetic retinopathy (PDR) (n = 20). Levels of IL-6 and TAT were measured by enzyme-linked immunosorbent assay and compared among the groups. A significant difference was found in the vitreal IL-6 and TAT levels between the MH/ERM group and both the PDR and RRD groups (P Diabetes was associated with higher IL-6 levels in the RRD group. Different relationships between the IL-6 and TAT levels were revealed in patients with different ocular pathologies. Our results imply that variations in vitreal TAT level may be attributable not only to an inflammatory reaction or blood-retinal barrier breakdown, but also to intraocular tissue-dependent regulation of thrombin.

Ab interno management of blocked Ahmed valve in the posterior segment.

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Odrich, Steven; Wald, Kenneth; Sperber, Laurence

2013-01-01

To report a case of late failure of a posterior segment placed Ahmed valve in a uveitic eye with a corneal graft and a minimally invasive, ab interno approach in restoring valve function, pressure control, and preservation of vision. Case report. A 25 gauge trans-conjunctival 3-port pars plana vitrectomy was performed to inspect and clean the ostium of the Ahmed valve of any vitreous debris. The Ahmed valve was not disturbed externally and conjunctival dissection was not performed. A 27-gauge blunt cannula was introduced through the vitrector site and used to cannulate the tube and flush it with balanced salt solution. A bleb was immediately re-established and all instruments were removed requiring no sutures. Intraocular pressure returned to target levels and a filtration bleb was re-established. Corneal graft clarity was restored with resolution of preoperative microcystic edema. Postoperative inflammation was minimal and vision was restored. A nonfunctioning tube shunt residing in the vitreous cavity may be revised ab interno without disturbing the shunt placement or the conjunctiva under which it resides to re-establish filtration.

Macular Hole Surgery with Internal Limiting Membrane Peeling Facilitated by Membrane-Blue® versus Membrane-Blue-Dual®: A Retrospective Comparative Study

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Uri Soiberman

2016-01-01

Full Text Available Background. This study aims to compare the outcome of macular hole (MH surgery with internal limiting membrane (ILM peeling facilitated by two different vital dyes. Methods. This was a retrospective chart review. The group designated “group-MB” underwent pars plana vitrectomy with ILM peeling facilitated by Membrane-Blue (MB, whereas in “group-MBD,” the vital dye used was Membrane-Blue-Dual (MBD. Results. Seventy-four eyes comprised the study population: 53 in group-MB and 21 in group-MBD. There was no difference in the rate of macular hole closure in group-MB or group-MBD: 71.2% closed MHs compared to 66.7%, respectively (p=0.7. Postoperative visual improvement was of a higher magnitude in the MBD group compared to the MB group: −0.34±0.81 logMAR versus 0.01±0.06 logMAR, respectively (p=0.003. Conclusions. In this study, MBD led to better visual results that may be related to better staining characteristics or lesser toxicity compared to MB.

Delayed diagnosis of homocystinuria presenting as bilateral congenital lens subluxation

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Jelić-Vuković Marija

2017-01-01

Full Text Available Introduction. Homocystinuria is an autosomal recessively inherited defect leading to hyperhomocysteinemia and associated with ocular manifestations, mainly myopia and ectopia lentis. Case outline. A 26-year-old male with secondary glaucoma due to bilateral lens subluxation was admitted to the Department of vitreoretinal surgery. Horizontal nystagmus, bilateral lens subluxation, and bilateral amblyopia were first discovered at the age of three years. Preoperative laboratory workup revealed elevated levels of homocysteine. Bilateral pars plana lensectomy and vitrectomy followed by a sulcus fixation of the intraocular lens (ALCON MA60 Acrysof IOL were performed. The patient was prescribed folic acid, methionine, and pyridoxine, and was urged to maintain a methionine-low diet. After a bilateral lensectomy and sulcus fixation of the intraocular lens and a methionine restriction therapy combined with vitamin B6, B9, and B12 supplementation, his condition improved greatly. Conclusion. In this report of a rare case we emphasize the importance of examining differential diagnoses of lens subluxation, since early intervention can prevent serious complications.

An open, comparative clinical study on the efficacy and safety of 10% trichloroacetic acid, 25% trichloroacetic acid and cryotherapy for verruca plana.

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Cengiz, Fatma Pelin; Emiroglu, Nazan

2015-01-01

Although there are several methods to treat Verruca plana, warts do not respond well to the common therapeutic options. In this study, we compared the safety and efficacy of 10% trichloroacetic acid, 25% trichloroacetic acid, and cryotherapy for the treatment of warts caused by Verruca plana. Ten percent and 25% trichloroacetic acid were applied to warts weekly until all lesions cleared. Cryotherapy was performed by liquid nitrogen spray for 5-10 seconds for each lesion per week until the lesions cleared. The number of Verruca plana lesions and adverse effects were evaluated five times during the treatment (the initial visit, week 2, week 4, week 6, and week 8). The number of lesions decreased through week 8 for all three treatments, and the reductions in the mean numbers of lesions were statistically similar (p > 0.05). Those in the cryotherapy group exhibited more erythema, pain, erosions, bullae, and hyperpigmentation (p cryotherapy group (p cryotherapy are effective methods to treat Verruca plana. 10% trichloroacetic acid offers a safer and easier treatment than either 25% trichloroacetic acid or cryotherapy.

Improved outcome after primary vitrectomy in diabetic patients treated with statins.

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Tuuminen, Raimo; Sahanne, Sari; Haukka, Jari; Loukovaara, Sirpa

2016-01-01

To evaluate the effect of preoperative statin treatment on the outcome of primary vitrectomy in type 1 and 2 diabetic patients. In this open, observational institutional study, a total of 192 eyes of 171 type 1 and 2 adult diabetic patients admitted for primary vitrectomy for management of sight-threatening forms of diabetic retinopathy were divided according to the use of lipid-lowering therapy: those with statin treatment (79 eyes of 73 patients) and those taking no statin medication (113 eyes of 98 patients). One-month best-corrected visual acuity (BCVA) gain and cumulative 12-month revitrectomy frequency were analyzed. In multivariate linear regression, diabetic patients with statin treatment had a better 1-month BCVA improvement than did those without statin treatment (absolute difference 0.26, 95% confidence interval [CI] 0.02-0.50, p = 0.028). Subgroup analysis revealed that diabetic patients on statin had better postoperative BCVA improvement when preoperative status included partial or panretinal laser photocoagulation (p = 0.042 and p = 0.049) and anti-vascular endothelial growth factor therapy (p = 0.011). Moreover, diabetic patients with preoperative macular edema (p = 0.009), vitreous hemorrhage (p<0.001), proliferative retinopathy (p<0.001), or tractional retinal detachment (p = 0.010) had better BCVA recovery if receiving statin. In Cox proportional hazards regression model, revitrectomies in our 12-month follow-up were less frequent in diabetic patients on statin treatment (hazard ratio 0.28, 95% CI 0.08-0.93, p = 0.037). These data provide novel insight into the potential clinical benefit for patients with sight-threatening diabetic retinopathy undergoing vitrectomy treated with statin.

Clinical study of foldable intraocular lens secondary implantation after lens-vitrectomy in residual capsular with traumatic eyes

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Ru-Fa Meng

2015-07-01

Full Text Available AIM: To investigate the operation methods and clinical effects of foldable intraocular lens secondary implantation after lens-vitrectomy in residual capsular with traumatic eyes.METHODS: During January 2012 to January 2014, foldable intraocular lens was implanted on 47 cases following lens-vitrectomy in residual capsular with traumatic eyes 3～6mo. Follow-up period was 6～12mo, averaged(8.21±2.63mo. RESULTS:All of 47 eyes had successful operation at one time, and position deviation was not appeared. The naked vision of the last postoperative follow-up was(0.44±0.19. Compared with best corrected visual acuity(0.41±0.23, and There was no significant difference between visual acuity of preoperative and last follow-up period(t=0.879, P=0.342. No severe complication was found. CONCLUSION: Secondary implantation of foldable intraocular lens is a safe and reliable method for correcting ametropia after lens-vitrectomy in residual capsular with traumatic eyes.

The generalized Abel-Plana formula with applications to Bessel functions and casimir effect

International Nuclear Information System (INIS)

Saharian, Aram A.

2007-08-01

One of the most efficient methods for the evaluation of the vacuum expectation values for physical observables in the Casimir effect is based on using the Abel-Plana summation formula. This enables to derive the renormalized quantities in a manifestly cutoff independent way and to present them in the form of strongly convergent integrals. However, applications of the Abel- Plana formula, in its usual form, are restricted by simple geometries when the eigenmodes have a simple dependence on quantum numbers. The author generalized the Abel-Plana formula which essentially enlarges its application range. Based on this generalization, formulae have been obtained for various types of series over the zeros of combinations of Bessel functions and for integrals involving these functions. It has been shown that these results generalize the special cases existing in literature. Further, the derived summation formulae have been used to summarize series arising in the direct mode summation approach to the Casimir effect for spherically and cylindrically symmetric boundaries, for boundaries moving with uniform proper acceleration, and in various braneworld scenarios. This allows to extract from the vacuum expectation values of local physical observables the parts corresponding to the geometry without boundaries and to present the boundary-induced parts in terms of integrals strongly convergent for the points away from the boundaries. As a result, the renormalization procedure for these observables is reduced to the corresponding procedure for bulks without boundaries. The present paper reviews these results. We also aim to collect the results on vacuum expectation values for local physical observables such as the field square and the energy-momentum tensor in manifolds with boundaries for various bulk and boundary geometries. (author)

RECURRENT MACULAR HOLES IN THE ERA OF SMALL-GAUGE VITRECTOMY: A Review of Incidence, Risk Factors, and Outcomes.

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Abbey, Ashkan M; Van Laere, Lily; Shah, Ankoor R; Hassan, Tarek S

2017-05-01

To evaluate the preoperative features, intraoperative management, and postoperative outcomes of recurrent macular holes that developed after initial successful repair with small-gauge vitrectomy techniques. We retrospectively reviewed 392 eyes with idiopathic macular holes successfully treated with small-gauge vitrectomy. Thirteen of these eyes underwent reoperation after macular hole reopening. We assessed patient demographics, visual acuity, postoperative anatomical success, potential precipitating clinical factors of hole reopening, and details of the surgical repairs of these eyes. Macular hole reopening occurred in 13 (3.3%) of 392 eyes in a mean of 28 months (range, 1-120 months) after initial repair. All 13 recurrent holes closed after a second vitrectomy, but 4 (31%) holes reopened again and had vitrectomy. Of these, 2 reopened a third time. Ultimately, 11 (85%) holes were closed at the most recent follow-up. The mean best-corrected visual acuity was 20/81 before initial repair, 20/148 after the first reopening, 20/115 after repair of the first reopening, and 20/55 after repair of >1 reopening. Ten of 13 (77%) patients had, or later developed, macular holes in the other eye during follow-up. Reoperation successfully achieved hole closure and ultimate visual improvement in most eyes with recurrent macular holes. Most patients with recurrent holes previously had, or later developed, full-thickness macular holes in the other eye.

A case report of intraocular lens luxation with the capsular bag after vitrectomy.

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Kawai, Kenji; Bando, Masayasu; Suzuki, Takahiro; Hayakawa, Kenji

2004-04-01

We experienced a case of intraocular lens (IOL) luxation with the capsular bag after vitrectomy. The case was a 66-year-old female in whom an IOL was implanted one year after surgery for giant tear retinal detachment using silicone oil. Four years after the implantation surgery, the patient suffered subluxation of the IOL with the capsular bag. Examinations of the luxated IOL with the capsular bag using a stereoscopic microscope confirmed the presence of silicone oil droplets between the capsule and the IOL. Adhesion of vitreous body residues was observed in the capsule. Luxation of the IOL was thought to be connected with chronic inflammation resulting from the use of silicone oil and repeated vitrectomy. In addition to examining pathological findings of luxated IOL, it would also be important in the future to identify the pathology of the capsular bag.

Efficacy of Insecticide and Bioinsecticide Ground Sprays to Control Metisa plana Walker (Lepidoptera: Psychidae) in Oil Palm Plantations, Malaysia.

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Salim, Hasber; Rawi, Che Salmah Md; Ahmad, Abu Hassan; Al-Shami, Salman Abdo

2015-12-01

The effectiveness of the synthetic insecticides trichlorfon, lambda-cyhalothrin, cypermethrin emulsion concentrated (EC) and cypermethrin emulsion water based (EW) and a bio-insecticide, Bacillus thuringiensis subsp. kurstaki (Btk), was evaluated at 3, 7, 14 and 30 days after treatment (DAT) for the control of Metisa plana larvae in an oil palm (Elaeis guineensis) plantation in Malaysia. Although all synthetic insecticides effectively reduced the larval population of M. plana, trichlorfon, lambda-cyhalothrin and cypermethrin EC were the fastest-acting. The larval population dropped below the economic threshold level (ETL) 30 days after a single application of the synthetic insecticides. Application of Btk, however, gave poor results, with the larval population remaining above the ETL post treatment. In terms of operational productivity, ground spraying using power spray equipment was time-consuming and resulted in poor coverage. Power spraying may not be appropriate for controlling M. plana infestations in large fields. Using a power sprayer, one man could cover 2-3 ha per day. Hence, power spraying is recommended during outbreaks of infestation in areas smaller than 50 ha.

Feasibility study on retinal vascular bypass surgery in isolated arterially perfused caprine eye model

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Chen, Y; Wu, W; Zhang, X; Fan, W; Shen, L

2011-01-01

Purpose To investigate the feasibility of bypassing occluded segments of retinal venous main vessels in isolated, arterially perfused caprine eyes via the closed-sky vitrectomy approach using keratoprosthesis. Methods Isolated caprine eyes were used in this study. For each eye, the retinal vessel was perfused by Krebs solution via ophthalmic artery, and pars plana vitrectomy was performed using temporary keratoprosthesis. All retinal micro-vascular maneuvers were performed in a closed-sky eyeball. The main retinal vein was blocked by endodiathermy at the site of the vessel's first branching. Two openings, several millimeters apart, were created by vascular punctures in both the main vein and its branch vein wall straddling the induced occluded segment. Catheterization was achieved using a flexible polyimide tube, with each end inserted into the vessel wall opening. A sealed connection between the vessel and the tube was obtained by endodiathermy. Bypass of the occluded retinal vein segment was thus achieved, and the patency of this vascular bypass was confirmed by intravascular staining. Results Puncturing, catheterization, and endodiathermy were viable by closed-sky approach using keratoprosthesis. Bypassing of the occluded retinal main vein segment was accomplished with the combination of these maneuvers. Good results were obtained in 23 of 38 (60%) caprine eyes. Conclusions This study demonstrated that bypassing the occluded segment of retinal main vein can be successfully performed in a closed-sky eyeball model of isolated, arterially perfused caprine eye. This early work indicated that the more advanced retinal vascular bypass surgery in in vivo eye may be feasible in the future. PMID:21921946

Glaucoma associated with the management of rhegmatogenous retinal detachment

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Mangouritsas G

2013-04-01

Full Text Available George Mangouritsas, Spyridon Mourtzoukos, Dimitra M Portaliou, Vassilios I Georgopoulos, Anastasia Dimopoulou, Elias Feretis Eye Clinic, General Hospital "Hellenic Red Cross", Athens, Greece Abstract: Transient or permanent elevation of intraocular pressure (IOP is a common complication following vitreoretinal surgery. Usually secondary glaucoma, which develops after scleral buckling procedures, or pars plana vitrectomy for repair of rhegmatogenous retinal detachment, is of multifactorial origin. It is essential, for appropriate management, to detect the cause of outflow obstruction. An exacerbation of preexisting open-angle glaucoma or a steroid-induced elevation of IOP should also be considered. Scleral buckling may be complicated by congestion and anterior rotation of the ciliary body resulting in secondary angle closure, which can usually resolve with medical therapy. The use of intravitreal gases may also induce secondary angle-closure with or without pupillary block. Aspiration of a quantity of the intraocular gas may be indicated. Secondary glaucoma can also develop after intravitreal injection of silicone oil due to pupillary block, inflammation, synechial angle closure, or migration of emulsified silicone oil in the anterior chamber and obstruction of the aqueous outflow pathway. In most eyes medical therapy is successful in controlling IOP; however, silicone oil removal with or without concurrent glaucoma surgery may also be required. Diode laser transscleral cyclophotocoagulation and glaucoma drainage devices constitute useful treatment modalities for long-term IOP control. Cooperation between vitreoretinal and glaucoma specialists is necessary to achieve successful management. Keywords: retinal detachment, intraocular pressure elevation, glaucoma, vitrectomy, intravitreal gas, silicone oil

Comparison of endoscopic-assisted and temporary keratoprosthesis-assisted vitrectomy in combat ocular trauma: experience at a tertiary eye center in Turkey.

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Ayyildiz, Onder; Hakan Durukan, Ali

2018-01-01

Objective This study was performed to compare the functional and anatomical results of endoscopic-assisted and temporary keratoprosthesis (TKP)-assisted vitrectomy in patients with combat ocular trauma (COT). Methods The medical records of 14 severely injured eyes of 12 patients who underwent endoscopy or TKP implantation in combination with vitreoretinal surgery from 2007 to 2015 were retrospectively evaluated. The patients' ocular history and functional and anatomic anterior and posterior segment results were analyzed. Results Eight eyes (57%) underwent TKP-assisted vitrectomy and six eyes (43%) underwent endoscopic vitrectomy. The most common cause of COT was detonation of improvised explosive devices (72%), and the most common type of injury was an intraocular foreign body (50%). The median time from trauma to surgery and the median surgical time were significantly shorter in the endoscopy than TKP group. The postoperative functional and anatomical results were not significantly different between the two groups. Conclusions TKP-assisted vitrectomy should be performed in eyes requiring extensive bimanual surgery. In such cases, a corneal graft must be preserved for the TKP at the end of the surgery. Endoscopy shortens the surgical time and can reduce the complication rate.

Biometria de una población de Homalaspis plana (Milne Edwards, 1834 en Punta Maule (Coronel, Chile

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Marco A Retamal

1980-12-01

Full Text Available This work deals with the bionomy of the population of Homalaspis plana (Milne Edwards, 1834 sampled in Coronel, Chile. Homalaspis plana share his biotope with: Paraxanthus barbiger (Poeppig, 1836 and Gaudichaudia gaudichaudi (Milne Edwards, 1834. A marked sexual dimorphism is apparent, the males are larger and heavier than the females; moreover, the volumes of the chelae of the first are also larger. The percentaje of the female population was significantly larger than the males population. The spawning extends from June to December. Each class of the ovigerous females, gives a different contribution, the maxima is done by the 5,74 cm class with 29,21%. The minimum size of ovigerous females is 49,3 mm L.C

Cadmium sulfide quantum dots induce oxidative stress and behavioral impairments in the marine clam Scrobicularia plana.

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Buffet, Pierre-Emmanuel; Zalouk-Vergnoux, Aurore; Poirier, Laurence; Lopes, Christelle; Risso-de-Faverney, Christine; Guibbolini, Marielle; Gilliland, Douglas; Perrein-Ettajani, Hanane; Valsami-Jones, Eugenia; Mouneyrac, Catherine

2015-07-01

Cadmium sulfide (CdS) quantum dots have a number of current applications in electronics and solar cells and significant future potential in medicine. The aim of the present study was to examine the toxic effects of CdS quantum dots on the marine clam Scrobicularia plana exposed for 14 d to these nanomaterials (10 µg Cd L(-1) ) in natural seawater and to compare them with soluble Cd. Measurement of labile Cd released from CdS quantum dots showed that 52% of CdS quantum dots remained in the nanoparticulate form. Clams accumulated the same levels of Cd regardless of the form in which it was delivered (soluble Cd vs CdS quantum dots). However, significant changes in biochemical responses were observed in clams exposed to CdS quantum dots compared with soluble Cd. Increased activities of catalase and glutathione-S-transferase were significantly higher in clams exposed in seawater to Cd as the nanoparticulate versus the soluble form, suggesting a specific nano effect. The behavior of S. plana in sediment showed impairments of foot movements only in the case of exposure to CdS quantum dots. The results show that oxidative stress and behavior biomarkers are sensitive predictors of CdS quantum dots toxicity in S. plana. Such responses, appearing well before changes might occur at the population level, demonstrate the usefulness of this model species and type of biomarker in the assessment of nanoparticle contamination in estuarine ecosystems. © 2015 SETAC.

[Long-term outcome of vitrectomy combined with internal limiting membrane peeling for idiopathic macular holes].

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Yamamoto, Kaori; Hori, Sadao

2011-01-01

To elucidate the long-term outcome of internal limiting membrane (ILM) peeling on visual function during vitrectomy for idiopathic macular holes using scanning laser ophthalmoscope (SLO) microperimetry. Prospective uncontrolled study. We studied 31 eyes (29 patients) with idiopathic macular holes. All patients underwent vitrectomy with ILM peeling. The SLO microperimetry was performed preoperatively, and once a year for 3 years postoperatively to detect scotomas in and around the macular holes, and both within and in close vicinity to the areas of ILM peeling. Closure of macular holes after one surgery was confirmed in all cases except for 2 with second surgery. The visual acuity by logarithmic minimum angle of resolution (logMAR) averaged 0.71 +/- 0.36 before surgery, 0.23 +/- 0.31 one year, 0.14 +/- 0.27 two years and 0.12 +/- 0.26 three years after surgery. There was significant improvement up to 2 years after the surgery. All scotomas detected before surgery in the holes, and 77.4% of those detected around the holes decreased gradually. No scotomas were detected in or around the area of ILM peeling either before or after surgery. ILM peeling in vitrectomy for idiopathic macular holes successfully improved visual acuity and did not influence retinal sensitivity in and around the area of ILM peeling. The scotomas detected in and around the holes before surgery gradually reduced or disappeared.

Comparing the Effect of Intravenous and Inhalational Anesthtics on Hemodynamic Changes in Deep Vitrectomy Surgery

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Khosro Naghibi

2016-05-01

Full Text Available Abstract Background: Due to high prevalence of vitrectomy surgery, and the importance of anesthetic technique in conducting an uncomplicated surgery, we decided to do this study. Materials and Methods: This prospective randomized study was conducted on 80 patients 40-80 years old candidating deep vitrectomy sugery under general anesthesia that were categorized into II and III Class by American Society of Anesthesiologist (ASA. Patients were randomly allocated to two groups of 40 members. Anesthesia was induced in both groups in the same manner. For maintaining anesthesia, patients from I group receiVed 1.2% isofluran with 50% O2 in air at 4L/min and infusion of remifentanil (0.1 mg.kg-1.min-1. But in the P group, we used propofol up to 10mg/kg /hr with infusion of remifentanyl. Propofol and isoflurane in fusion was discontinued with the last surgical stitches, but remifentanil infusion continued in both groups until the eye was covered with shield. Hemodynamic variables were recorded just before the induction of anesthesia and in different time intervals till discharging of the patients from the recovery room. Then, data were compared. Results: Results showed that there is a significant change in propofol group compared to isofluran in deep vitrectomy surgery operations. Conclusion: Hemodynamic changes are more significant in maintaining propofol anesthesia when compared with isoflurane.

Vitrectomy for optic disk pit with macular schisis and outer retinal dehiscence.

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Shukla, Dhananjay; Kalliath, Jay; Tandon, Manish; Vijayakumar, Balakrishnan

2012-07-01

To describe the outcomes of vitrectomy for optic disc pit-related maculopathy with central outer retinal dehiscence. This prospective interventional case series included seven patients with optic disc pit with macular schisis and central outer retinal dehiscence who underwent vitrectomy with internal limiting membrane peeling, barrage laser photocoagulation, and gas tamponade and were followed for at least 6 months. The surgical outcomes in terms of restoration of macular anatomy and visual improvement were recorded at each visit by fundus photography and optical coherence tomography. The mean age of the patients was 21.3 ± 8.6 years (range, 10-35 years), and the mean duration of defective vision was 6.7 ± 8.5 months (range, 1-24 months). Preoperatively, the median best-corrected visual acuity (BCVA) was 20/60 (range, 20/40 to 20/120). Full-thickness macular holes were noticed in 4 patients 1 month postoperatively. Gas tamponade was repeated in two patients with large macular holes. By the final follow-up, macular holes had closed and BCVA improved in all patients except one. Final mean central macular thickness was 176.83 ± 55.74 μ, the range being 109 μ to 256 μ. The median postoperative BCVA was 20/30 (range, 20/20 to 20/80). Six of 7 patients (85.7%) had improvement in BCVA postoperatively (mean, +2 lines; range, 1-4 lines). Five patients (71%) achieved a postoperative BCVA of ≥20/30. Best-corrected visual acuity dropped by one line in the patient with persistent macular hole. Vitrectomy with internal limiting membrane peeling can achieve excellent final surgical outcomes in optic pit maculopathy with outer retinal dehiscence despite the potential for macular hole formation.

Vitrectomy with Internal Limiting Membrane Peeling versus No Peeling for Idiopathic Full-Thickness Macular Hole

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Spiteri Cornish, Kurt; Lois, Noemi; Scott, Neil W

2014-01-01

OBJECTIVE: To determine whether internal limiting membrane (ILM) peeling improves anatomic and functional outcomes of full-thickness macular hole (FTMH) surgery when compared with the no-peeling technique. DESIGN: Systematic review and individual participant data (IPD) meta-analysis undertaken...... under the auspices of the Cochrane Eyes and Vision Group. Only randomized controlled trials (RCTs) were included. PARTICIPANTS AND CONTROLS: Patients with idiopathic stage 2, 3, and 4 FTMH undergoing vitrectomy with or without ILM peeling. INTERVENTION: Macular hole surgery, including vitrectomy and gas...... endotamponade with or without ILM peeling. MAIN OUTCOME MEASURES: Primary outcome was best-corrected distance visual acuity (BCdVA) at 6 months postoperatively. Secondary outcomes were BCdVA at 3 and 12 months; best-corrected near visual acuity (BCnVA) at 3, 6, and 12 months; primary (after a single surgery...

Optical Coherence Tomography for Retinal Surgery: Perioperative Analysis to Real-Time Four-Dimensional Image-Guided Surgery.

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Carrasco-Zevallos, Oscar M; Keller, Brenton; Viehland, Christian; Shen, Liangbo; Seider, Michael I; Izatt, Joseph A; Toth, Cynthia A

2016-07-01

Magnification of the surgical field using the operating microscope facilitated profound innovations in retinal surgery in the 1970s, such as pars plana vitrectomy. Although surgical instrumentation and illumination techniques are continually developing, the operating microscope for vitreoretinal procedures has remained essentially unchanged and currently limits the surgeon's depth perception and assessment of subtle microanatomy. Optical coherence tomography (OCT) has revolutionized clinical management of retinal pathology, and its introduction into the operating suite may have a similar impact on surgical visualization and treatment. In this article, we review the evolution of OCT for retinal surgery, from perioperative analysis to live volumetric (four-dimensional, 4D) image-guided surgery. We begin by briefly addressing the benefits and limitations of the operating microscope, the progression of OCT technology, and OCT applications in clinical/perioperative retinal imaging. Next, we review intraoperative OCT (iOCT) applications using handheld probes during surgical pauses, two-dimensional (2D) microscope-integrated OCT (MIOCT) of live surgery, and volumetric MIOCT of live surgery. The iOCT discussion focuses on technological advancements, applications during human retinal surgery, translational difficulties and limitations, and future directions.

Effect of scleral buckle removal on strabismus surgery outcomes after retinal detachment repair

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Chang, Jee Ho; Hutchinson, Amy; Zhang, Monica; Lambert, Scott R.

2015-01-01

Background/Aims To investigate the effect of scleral buckle removal on the outcomes of strabismus surgery in patients with a prior history of retinal detachment surgery. Methods We reviewed the medical records of 18 patients who underwent strabismus surgery following a scleral buckling procedure at one institution. We investigated the effect of multiple variables on outcome, including: gender, age, surgeon, number of strabismus surgeries, adjustable suture use, previous pars plana vitrectomy, preoperative best-corrected visual acuity and time of surgery. Outcomes were considered successful if there was ≤ 10 prism diopter (PD) residual horizontal and/or ≤ 4 PD residual vertical deviation. Outcomes were analyzed statistically using Fisher's exact test and Mann-Whitney test. Results Strabismus surgery coupled with scleral buckle removal was associated with a higher rate of success (success with buckle removal, 62.5%; success without buckle removal, 10.0%; p=0.04). There were no significant difference in preoperative findings between the scleral buckle removal and non- removal groups. No retinal redetachments occurred after scleral buckle removal. Conclusion In our series, scleral buckle removal was associated with improved surgical outcome in patients with strabismus following a scleral buckling procedure. PMID:24299332

Lawn mower injuries as a cause of serious visual acuity impairment - Case reports.

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Jasielska, Monika; Winiarczyk, Mateusz; Bieliński, Paweł; Mackiewicz, Jerzy

2017-05-11

[b]Abstract Objective.[/b] The aim of the study is to present four cases of lawn mowers injuries as a cause of serious visual acuity impairment. [b]Materials and Method[/b]. A retrospective study of four patients admitted in 2013-2015 to the Department of Vitreoretinal Surgery in Lublin with severe open or closed globe injury, one with an intraocular foreign body (IOFB). The presence of eye protective equipment was assessed, as well as visual acuity, eye tissue condition before and after treatment, and applied therapy. In all cases an improvement was achieved in local conditions. The intraocular foreign body was removed, wounds sutured and damaged tissues placed in position. All eyeballs were saved. In three cases, visual acuity was improved to a usable level. Three patients underwent pars plana vitrectomy, one with IOFB removal from the vitreous cavity. [b]Conclusions[/b]. Lawn mower induced eye injuries are a significant cause of serious visual acuity impairment or blindness. The presented study shows that lawn mower eye injuries are still a therapeutic, social and economic problem, yet are very preventable with proper eye protection and patients' education. Current prevention strategies are inadequate, and therefore should be updated.

An evidence-based meta-analysis of vascular endothelial growth factor inhibition in pediatric retinal diseases: part 1. Retinopathy of prematurity.

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Mititelu, Mihai; Chaudhary, Khurram M; Lieberman, Ronni M

2012-01-01

Recently there has been interest in the novel, off-label use of anti-vascular endothelial growth factor (anti-VEGF) agents for various stages of retinopathy of prematurity (ROP). The authors report on the quality and depth of new evidence published from 2009 to 2011 concerning the treatment of retinopathy of prematurity (ROP) with bevacizumab (Avastin; Genentech Inc., South San Francisco, CA) as either primary or adjunctive treatment for ROP. There is significant variability in the evidence, quality, and design of the studies available in the literature. There has been a trend in the scientific literature of the past 2 years toward larger, multi-center, randomized studies investigating the role of bevacizumab in the treatment of ROP. More recent evidence suggests that monotherapy with intravitreal bevacizumab may be a viable first-line treatment for select cases of zone I ROP and possibly for posterior zone II disease. Adjunctive treatment with bevacizumab may enhance outcomes in patients treated with laser photocoagulation or pars plana vitrectomy. However, there are significant concerns regarding its long-term safety profile. Further prospective studies are warranted to more fully determine the role of anti-VEGF therapy in this disease. Copyright 2012, SLACK Incorporated.

INTRASURGICAL MICROSCOPE-INTEGRATED SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY-ASSISTED MEMBRANE PEELING.

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Falkner-Radler, Christiane I; Glittenberg, Carl; Gabriel, Max; Binder, Susanne

2015-10-01

To evaluate microscope-integrated intrasurgical spectral domain optical coherence tomography during macular surgery in a prospective monocenter study. Before pars plana vitrectomy and before, during, and after membrane peeling, 512 × 128 macular cube scans were performed using a Carl Zeiss Meditec Cirrus high-definition OCT system adapted to the optical pathway of a Zeiss OPMI VISU 200 surgical microscope and compared with retinal staining. The study included 51 patients with epiretinal membranes, with 8 of those having additional lamellar macular holes, 11 patients with vitreomacular traction, and 8 patients with full-thickness macular holes. Intraoperative spectral domain optical coherence tomography allowed performing membrane peeling without using retinal dyes in 40% of cases (28 of 70 patients). No residual membranes were found in 94.3% of patients (66 of 70 patients) in intrasurgical spectral domain optical coherence tomography and subsequent (re)staining. In patients with vitreomacular traction, intrasurgical spectral domain optical coherence tomography scans facilitated decisions on the need for an intraocular tamponade after membrane peeling. Intraoperative spectral domain optical coherence tomography was comparable with retinal dyes in confirming success after membrane peeling. However, the visualization of flat membranes was better after staining.

Progress in clinical research of asteroid hyalosis

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Xiao-Xue Liu

2017-08-01

Full Text Available Asteroid Hyalosis(AHis a common clinical disease, which has been considered a benign disorder as it rarely impairs visual acuity. It was often discovered when the patient was treated for other eye diseases. The mechanism was unclear. Its characteristic B-ultrasound property makes the B-ultrasound a very helpful diagnostic technique. In the case of the patients with other fundus diseases associated with AH, optical coherence tomography(OCTand fluorescein angiography(FAmay be used to reduce the interference from asteroid bodies, therefore improve the fundus visibility. Recent studies have shown that AH can incorporate with many other eye diseases. For example, in patients with cataracts, asteroid hyalosis can cause surface calcification of silicone plate intraocular lenses, which in most cases may lead to the need for explantation of the calcified intraocular lenses. The efficacy of pars plana vitrectomy(PPV, the removal of some, or all, of the eye's vitreous humor for AH remains controversial. In this paper, we provide a review of the recent literature on AH disease: the etiology, diagnosis and treatment. We hope to thus improve the awareness and outcomes of AH disease.

Displacement of foveal area toward optic disc after macular hole surgery with internal limiting membrane peeling.

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Kawano, K; Ito, Y; Kondo, M; Ishikawa, K; Kachi, S; Ueno, S; Iguchi, Y; Terasaki, H

2013-07-01

To determine whether there is a displacement of the fovea toward the optic disc after successful macular hole (MH) surgery with internal limiting membrane (ILM) peeling. The medical records of 54 eyes of 53 patients that had undergone pars plana vitrectomy with ILM peeling and gas or air tamponade for an idiopathic MH were evaluated. Spectral-domain optical coherence tomography (OCT) had been performed before and >6 months after the surgery. The preoperative distances between the center of the MH and the optic disc (MH-OD), center of the MH and the bifurcation or crossing of retinal vessels (MH-RV) were measured in the OCT images. In addition, the postoperative distance between the center of the fovea and optic disc (F-OD) and the center of the fovea and the same bifurcation or crossing of retinal vessels (F-RV) were measured in the OCT images. The F-OD was 2.67±0.33 disc diameters (DD), which was significantly shorter than that of the MH-OD of 2.77±0.33 DD (Pdisplacement of the center of the macula toward the optic disc.

Familial Exudative Vitreoretinopathy.

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Sızmaz, Selçuk; Yonekawa, Yoshihiro; T Trese, Michael

2015-08-01

Familial exudative vitreoretinopathy (FEVR) is a hereditary disease associated with visual loss, particularly in the pediatric group. Mutations in the NDP, FZD4, LRP5, and TSPAN12 genes have been shown to contribute to FEVR. FEVR has been reported to have X-linked recessive, autosomal dominant, and autosomal recessive inheritances. However, both the genotypic and phenotypic features are variable. Novel mutations contributing to the disease have been reported. The earliest and the most prominent finding of the disease is avascularity in the peripheral retina. As the disease progresses, retinal neovascularization, subretinal exudation, partial and total retinal detachment may occur, which may be associated with certain mutations. With early diagnosis and prompt management visual loss can be prevented with laser photocoagulation and anti-VEGF injections. In case of retinal detachment, pars plana vitrectomy alone or combined with scleral buckling should be considered. Identifying asymptomatic family members with various degrees of insidious findings is of certain importance. Wide-field imaging with fluorescein angiography is crucial in the management of this disease. The differential diagnosis includes other pediatric vitreoretinopathies such as Norrie disease, retinopathy of prematurity, and Coats' disease.

Recurrent Vitreous Hemorrhage from an Optic Nerve Retinal Arterial Macroaneurysm

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Jessica F. Yang

2017-10-01

Full Text Available Objective: To report a case of recurrent vitreous hemorrhage from an optic nerve retinal arterial macroaneurysm (ONRAM successfully treated with intraoperative endolaser. Patient and Methods: A 92-year-old woman on oral aspirin and warfarin anticoagulation for atrial fibrillation developed three episodes of dense vitreous hemorrhage from an ONRAM. Due to failure of the vitreous hemorrhage to clear spontaneously, a total of three pars plana vitrectomy (PPV procedures were performed along with a 1.25-mg intravitreal bevacizumab injection after the third episode of hemorrhage. During the third PPV procedure, a 25-gauge 532-nm green diode laser endoprobe was used to deliver low-power (100 mW and long-duration (500 ms laser spots directly on the ONRAM to induce intraoperative shrinkage of the ONRAM. Results: After the endolaser treatment, the macroaneurysm showed involution due to fibrosis without any adverse effects on retinal circulation or visual field defect. No recurrence of vitreous hemorrhage was noted after 2 years of follow-up. Conclusion: Oral anticoagulant use may have been responsible for the atypical clinical course in our patient. Laser photocoagulation, including intraoperative endolaser photocoagulation, may be considered in selected cases of symptomatic ONRAMs.

Anatomical success in patients after retinectomy for complex retinal detachment

International Nuclear Information System (INIS)

Mukhtar, A.; Ishaq, M.; Islam, Q.U.

2015-01-01

To evaluate the efficacy of primary and redo retinectomy in eyes with complex retinal detachment. Study Design: Quasi-experimental study. Place and Duration of Study: Armed Forces Institute of Ophthalmology Rawalpindi from Jan 2012 to June 2013. Patients and Methods: Fifty eight eyes (patients) underwent relaxing retinectomies for complex retinal detachment with proliferative vitreoretinopathy or intrinsic retinal shortening. Operative technique included pars plana vitrectomy, proliferative vitreoretinopathy management, use of intraoperative perfluorocarbon liquid, retinectomy, endolaser and intraocular temponade. The main outcome was anatomic success, defined as complete retinal reattachment at four months follow up. Eighteen eyes out of the same primary group underwent second retinectomy because of anatomical failure. Results: Mean age of study population was 53.78 ± 15.11 years, 56.9% of patients were male(s). Anatomic success rate after 1st retinectomy was achieved in 68.96% (40 eyes out of 58). In eighteen eyes that underwent 2nd retinectomy, anatomic success rate was 72.22% (13 eyes out of 18). Overall success rate was 91.3% (53 eyes out of 58) in our study. Conclusions: Relaxing retinectomies for retinal shortening can improve the anatomical success rate in patients with complex RD. (author)

Outcomes of microscope-integrated intraoperative optical coherence tomography-guided center-sparing internal limiting membrane peeling for myopic traction maculopathy: a novel technique.

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Kumar, Atul; Ravani, Raghav; Mehta, Aditi; Simakurthy, Sriram; Dhull, Chirakshi

2017-07-04

To evaluate the outcomes of pars plana vitrectomy (PPV) with microscope-integrated intraoperative optical coherence tomography (I-OCT)-guided traction removal and center-sparing internal limiting membrane (cs-ILM) peeling. Nine eyes with myopic traction maculopathy as diagnosed on SD-OCT underwent PPV with I-OCT-guided cs-ILM peeling and were evaluated prospectively for resolution of central macular thickness (CMT) and improvement in best-corrected visual acuity (BCVA), and complications, if any, were noted. All patients were followed up for more than 9 months. Resolution of the macular retinoschisis was seen in all nine eyes on SD-OCT. At 36 weeks, there was a significant improvement in mean BCVA from the preoperative BCVA (P = 0.0089) along with a reduction in the CMT from 569.77 ± 263.19 to 166.0 ± 43.91 um (P = 0.0039). None of the eyes showed worsening of BCVA or development of full-thickness macular hole in the intraoperative or follow-up period. PPV with I-OCT-guided cs-ILM peeling helps in complete removal of traction, resolution of retinoschisis and good functional recovery with low intraoperative and postoperative complications.

Multiple extrafoveal macular holes following internal limiting membrane peeling.

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Hussain, Nazimul; Mitra, Sandip

2018-01-01

Internal limiting membrane (ILM) peeling has been the standard of treatment for macular holes. Besides, causing retinal nerve fiber layer surface abnormality, postoperative extrafoveal multiple retinal holes is a rare phenomenon following ILM peeling. We report an unusual complication of eight extrafoveal macular holes occurring following ILM peeling. A 60-year-old male presented with complaints of decreased and distorted vision in the right eye. He was diagnosed as having epiretinal membrane with lamellar macular hole. He underwent 23G pars plana vitrectomy, brilliant blue assisted ILM peeling and fluid gas exchange. Intraoperatively, ILM was found to be adherent to the underlying neurosensory retina. One month after cataract surgery, he underwent YAG capsulotomy in the right eye. He complained of visual distortion. His fundus evaluation in the right eye showed multiple (eight) extrafoveal retinal holes temporal to the macula clustered together. This case demonstrated that peeling of ILM, especially when it is adherent to the underlying neurosensory retina, may cause unwanted mechanical trauma to the inner retina. Glial apoptosis and neuronal degeneration may presumably play a role in delayed appearance of multiple (eight) extrafoveal macular holes, which has not been reported earlier.

Tomographic Structural Changes of Retinal Layers after Internal Limiting Membrane Peeling for Macular Hole Surgery.

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Faria, Mun Yueh; Ferreira, Nuno P; Cristóvao, Diana M; Mano, Sofia; Sousa, David Cordeiro; Monteiro-Grillo, Manuel

2018-01-01

To highlight tomographic structural changes of retinal layers after internal limiting membrane (ILM) peeling in macular hole surgery. Nonrandomized prospective, interventional study in 38 eyes (34 patients) subjected to pars plana vitrectomy and ILM peeling for idiopathic macular hole. Retinal layers were assessed in nasal and temporal regions before and 6 months after surgery using spectral domain optical coherence tomography. Total retinal thickness increased in the nasal region and decreased in the temporal region. The retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), and inner plexiform layer (IPL) showed thinning on both nasal and temporal sides of the fovea. The thickness of the outer plexiform layer (OPL) increased. The outer nuclear layer (ONL) and outer retinal layers (ORL) increased in thickness after surgery in both nasal and temporal regions. ILM peeling is associated with important alterations in the inner retinal layer architecture, with thinning of the RNFL-GCL-IPL complex and thickening of OPL, ONL, and ORL. These structural alterations can help explain functional outcome and could give indications regarding the extent of ILM peeling, even though peeling seems important for higher rate of hole closure. © 2017 S. Karger AG, Basel.

Inner retinal thinning after Brilliant Blue G-assisted internal limiting membrane peeling for vitreoretinal interface disorders.

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Ambiya, Vikas; Goud, Abhilash; Khodani, Mitali; Chhablani, Jay

2017-04-01

The aim of this study was to evaluate ganglion cell layer and nerve fiber layer thickness after Brilliant Blue G (BBG)-assisted internal limiting membrane (ILM) peeling for vitreomacular disorders. Retrospective analysis of spectral domain optical coherence tomography (SD-OCT) of 42 eyes of 42 patients, who underwent pars plana vitrectomy with BBG-assisted ILM peeling, was performed. Inclusion criteria were idiopathic macular hole, idiopathic vitreomacular traction, and idiopathic epiretinal membrane. Key exclusion criteria were vitreoretinal interface abnormalities secondary to any other diseases, follow-up period of less than 3 months, and any other associated retinal pathology. Average, minimum, and sectoral ganglion cell, and inner plexiform layers (GCIPL) and retinal nerve fiber layer (RNFL) parameters were collected. Changes in these parameters from baseline to 3- and 6-month visits after surgery were analyzed. At 3 months after surgery, we found a statistically significant reduction in the average GCIPL thickness (P = 0.031) and also in the superior sectors (P peeling for vitreomacular interface disorders leads to thinning of the inner retina including GCIPL and RNFL. These structural changes should be correlated with retinal function tests to explore the pros and cons of this surgical step.

INTERNAL LIMITING MEMBRANE PEELING IN MACULAR HOLE SURGERY; WHY, WHEN, AND HOW?

Science.gov (United States)

Chatziralli, Irini P; Theodossiadis, Panagiotis G; Steel, David H W

2018-05-01

To review the current rationale for internal limiting membrane (ILM) peeling in macular hole (MH) surgery and to discuss the evidence base behind why, when, and how surgeons peel the ILM. Review of the current literature. Pars plana vitrectomy is an effective treatment for idiopathic MH, and peeling of the ILM has been shown to improve closure rates and to prevent postoperative reopening. However, some authors argue against ILM peeling because it results in a number of changes in retinal structure and function and may not be necessary in all cases. Furthermore, the extent of ILM peeling optimally performed and the most favorable techniques to remove the ILM are uncertain. Several technique variations including ILM flaps, ILM scraping, and foveal sparing ILM peeling have been described as alternatives to conventional peeling in specific clinical scenarios. Internal limiting membrane peeling improves MH closure rates but can have several consequences on retinal structure and function. Adjuvants to aid peeling, instrumentation, technique, and experience may all alter the outcome. Hole size and other variables are important in assessing the requirement for peeling and potentially its extent. A variety of evolving alternatives to conventional peeling may improve outcomes and need further study.

Familial Exudative Vitreoretinopathy

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Selçuk Sızmaz

2015-08-01

Full Text Available Familial exudative vitreoretinopathy (FEVR is a hereditary disease associated with visual loss, particularly in the pediatric group. Mutations in the NDP, FZD4, LRP5, and TSPAN12 genes have been shown to contribute to FEVR. FEVR has been reported to have X-linked recessive, autosomal dominant, and autosomal recessive inheritances. However, both the genotypic and phenotypic features are variable. Novel mutations contributing to the disease have been reported. The earliest and the most prominent finding of the disease is avascularity in the peripheral retina. As the disease progresses, retinal neovascularization, subretinal exudation, partial and total retinal detachment may occur, which may be associated with certain mutations. With early diagnosis and prompt management visual loss can be prevented with laser photocoagulation and anti-VEGF injections. In case of retinal detachment, pars plana vitrectomy alone or combined with scleral buckling should be considered. Identifying asymptomatic family members with various degrees of insidious findings is of certain importance. Wide-field imaging with fluorescein angiography is crucial in the management of this disease. The differential diagnosis includes other pediatric vitreoretinopathies such as Norrie disease, retinopathy of prematurity, and Coats’ disease. (Turk J Ophthalmol 2015; 45: 164-168

Endophthalmitis after descemet stripping endothelial keratoplasty with concave-oriented dislocation on slit-lamp optical coherence topography.

Science.gov (United States)

Kaiura, Terry L; Ritterband, David C; Koplin, Richard S; Shih, Carolyn; Palmierto, Pat M; Seedor, John A

2010-02-01

To present the first reported case of Descemet membrane stripping endothelial keratoplasty (DSEK)-associated endophthalmitis with concave dislocation on slit-lamp optical coherence topography (SL-OCT). An 86-year-old man underwent DSEK for corneal decompensation secondary to prior surgery. On all postoperative visits, a slit-lamp examination and SL-OCT were performed. On the first postoperative day, the lenticle was dislocated in a concave configuration as imaged with the SL-OCT. On the second postoperative day, the patient had eye pain, nausea, and increased intraocular pressure. On SL-OCT imaging, the concave configuration and fibrin stranding were imaged. With intraocular pressure lowering, the patient's pain subsided, and he was scheduled for a lenticle refloat the following day. The next day, endophthalmitis was diagnosed secondary to exuberant purulent inflammation. At surgery, the lenticle was removed, cultures were obtained, and pars plana vitrectomy and intravitreal injections were administered. Intraoperative cultures were positive for heavy growth of Streptococcus pneumoniae. Endophthalmitis is a potential complication for any intraocular procedure including DSEK. SL-OCT imaging postoperatively may reveal concave lenticle configuration and subtle anterior chamber fibrin stranding may be early sign of endophthalmitis.

Size dependent bioaccumulation and ecotoxicity of gold nanoparticles in an endobenthic invertebrate: The Tellinid clam Scrobicularia plana

International Nuclear Information System (INIS)

Pan Jinfen; Buffet, Pierre-Emmanuel; Poirier, Laurence; Amiard-Triquet, Claude; Gilliland, Douglas; Joubert, Yolaine; Pilet, Paul; Guibbolini, Marielle; Risso de Faverney, Christine; Roméo, Michèle; Valsami-Jones, Eugenia; Mouneyrac, Catherine

2012-01-01

Gold nanoparticles (AuNPs) have important technological applications resulting in an increased potential for release to the environment, and a greater possibility of toxicological effects. The marine bivalve Scrobicularia plana was exposed to AuNPs of size 5, 15 and 40 nm during a 16 d laboratory exposure at 100 μg Au L −1 . After exposure to AuNPs forming aggregates (>700 nm), the clams accumulated Au in their soft tissues. Biochemical (biomarkers) and behavioral (burrowing and feeding) responses were investigated. Au NPs were responsible of metallothionein induction (5, 40 nm), increased activities of catalase (15, 40 nm) and superoxide dismutase (40 nm) and of glutathione S-transferase by the three sizes of AuNPs indicating defense against oxidative stress. Exposure to AuNPs impaired burrowing behavior. However, it must be underlined that these effects were observed at a dose much higher than expected in the environment. - Highlights: ► AuNPs were aggregated to a maximum distribution peak at 0.6 μm in seawater. ► Scrobicularia plana accumulated Au with higher accumulation for bigger NPs. ► Induction of MT, CAT, SOD and GST showed oxidative stress in clams. ► TBARS levels advocated no significant oxidative damage in clams. ► Gold is an inert metal, ecotoxic effects are probably due to the nanoparticle form. - AuNPs were aggregated in seawater, Scrobicularia plana accumulated Au with higher accumulation for bigger NPs and increased activities of biomarkers showed oxidative stress.

Rearranjo estrutural de PET durante compressão plana

OpenAIRE

Elton Luis Gasparotto Denardin

2004-01-01

As características da tensão – deformação do Poli(tereftalato de etileno) (PET) durante o processo de deformação por compressão plana tem sido estudadas. Amostras de PET com e sem tratamento térmico obtidas por injeção foram deformadas a diferentes temperaturas de deformação, abaixo e acima da temperatura de transição vítrea (Tg) utilizando diferentes taxas de deformação e tensões finais aplicadas. O comportamento mecânico foi analisado através das curvas de tensão – deformação obtidas por de...

A Simple Method for Removal of Particles from the Retinal Surface during Vitrectomy

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Touka Banaee

2014-01-01

Full Text Available Removal of particulate materials from the retinal surface is somewhat difficult during small gauge vitrectomy. Simple injection of balanced salt solution into the vitreous cavity in a controlled manner using a connector tubing between the syringe and needle can produce enough turbulence to float the deposited material and remove it.

Surgical challenges and outcomes of rhegmatogenous retinal detachment in albinism.

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Sinha, M K; Chhablani, J; Shah, B S; Narayanan, R; Jalali, S

2016-03-01

To report the outcomes and surgical difficulties during rhegmatogenous retinal detachment (RRD) repair in patients with albinism. Retrospective analysis of 10 eyes of 9 patients with albinism that underwent RRD repair was performed. Collected data included demographic details, preoperative examination details, surgical procedure, surgical difficulties, anatomical, and visual outcomes. Outcome measures were retinal reattachment and visual acuity at the last follow-up. Mean preoperative best-corrected visual acuity (BCVA) was logMAR (Logarithm of the Minimum Angle of Resolution) 2.15 (range 0.9-3.0) with preoperative localization of causative break in six eyes. One eye had proliferative vitreoretinopathy grade C1 preoperatively. Four eyes underwent scleral buckling (SB) and six underwent 20G pars plana vitrectomy (PPV) with silicone oil injection. Intraoperative complication as iatrogenic retinal break occurred in four eyes. For retinopexy during vitrectomy, endolaser delivery was possible in three out of six eyes, whereas three eyes had cryopexy. The mean follow-up was 12 months in SB group (range 1-12; median 12 months) and 5.33 months (range 1-12; median 3 months) in PPV group. Among vitrectomized eye, two eyes had recurrence at 3 months with oil in situ. Rest of the eyes had attached retina at last follow-up. Mean BCVA at last follow-up was logMAR -1.46 (range 0.7-2.0) with mean improvement of -0.57 logMAR. Identification of break, induction of posterior vitreous detachment, and endolaser delivery may be difficult during RRD repair in patients with albinism. The incidence of PVR appeared less in these eyes. Both SB and PPV were efficacious and appear to be good surgical techniques for use in this patient population.

Single night postoperative prone posturing in idiopathic macular hole surgery.

LENUS (Irish Health Repository)

2012-02-01

Purpose. To evaluate the role of postoperative prone posturing for a single night in the outcome of trans pars plana vitrectomy (TPPV) with internal limiting membrane (ILM) peel and 20% perfluoroethane (C2F6) internal tamponade for idiopathic macular hole. Methods. This prospective trial enrolled 14 eyes in 14 consecutive patients with idiopathic macular hole. All eyes underwent TPPV with vision blue assisted ILM peeling with and without phacoemulsification and intraocular lens (IOL) for macular hole. Intraocular gas tamponade (20% C2F6) was used in all cases with postoperative face-down posturing overnight and without specific posturing afterwards. LogMAR visual acuity, appearance by slit-lamp biomicroscopy, and ocular coherence tomography (OCT) scans were compared preoperatively and postoperatively to assess outcome. Results. Among 14 eyes recruited, all eyes were phakic; 50% of patients underwent concurrent phacoemulsification with IOL. The macular holes were categorized preoperatively by OCT appearance, 4 (28.57%) were stage 2, 7 (50%) were stage 3, and 3 (21.43%) were stage 4. Mean macular hole size was 0.35 disk diameters. Symptoms of macular hole had been present for an average of 6.5 months. All holes (100%) were closed 3 and 6 months postoperatively. Mean visual acuity (logMAR) was improved to 0.61 at 3 months and was stable at 6 months after the surgery. None of the eyes had worse vision postoperatively. Conclusions. Vitrectomy with ILM peeling and 20% C2F6 gas with a brief postoperative 1 night prone posturing regimen is a reasonable approach to achieve anatomic closure in idiopathic macular hole. Concurrent cataract extraction did not alter outcomes and was not associated with any additional complications.

Long-term results, prognostic factors and cataract surgery after diabetic vitrectomy

DEFF Research Database (Denmark)

Ostri, Christoffer; Lux, Anja; Lund-Andersen, Henrik

2014-01-01

haemorrhage patients. For tractional retinal detachment patients, use of silicone oil was associated with low vision (visual acuity4 and p-values ≤ 0.03, logistic regression). Of the 134 patients who were phakic after surgery, 43% and 29% were phakic......-term predictor of low vision after surgery is use of silicone oil for endotamponade. About 2/3 of phakic patients will subsequently have cataract surgery the first 10 years after diabetic vitrectomy....

Clinical effect of neovascular glaucoma treated by vitrectomy and cyclophotocoagulation

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Yi-Xuan Jin

2014-07-01

Full Text Available AIM: To observe the postoperative intraocular pressure(IOPand operation safety in the eyes of the neovascular glaucoma pateints treated by intraocular cyclophotocoagulation which needed vitrectomy at the same time. METHODS: A total of 12 neovascular glaucoma cases(14 eyessecondary to diabetic retinopathy, retinal detachment surgery and trauma were reviewed in our study. This procedure mainly used intraocular photocoagulation catheter to highlight the ciliary processes until the ciliary became white atrophy or plosion after vitreous surgery treatment. The intraocular photocoagulation catheter was performed at a power of 300-500mW, for a duration of 0.1-0.2ms. Postoperative follow-up was at least for 6mo. The observation of 14 postoperative neovascular glaucoma was performed at 1wk, 1, 6mo observing the IOP and complications. RESULTS: IOP of the 11 eyes was significantly declined and controlled in normal. After cyclophotocoagulation, average IOP at 1wk was 16.7±14.4mmHg, 15.7±8.8mmHg at 1mo and 12.9±4.5mmHg at 6mo, which compared with untreatment(39.6 ±10.0mmHgwas statistically significant different(PCONCLUSION: The intraocular cyclophotocoagulation and vitrectomy simultaneously can deal with the primary disease and secondary neovascular glaucoma. The operation can be accurately performed under direct cyclophotocoagulation and it is a safe and effective way for neovascular glaucoma which needs vitreous surgery.

APPROACHES TO THE CONSTRUCTION OF THE VITRECTOMY RISK MANAGEMENT SYSTEM IN PATIENTS WITH PROLIFERATIVE DIABETIC RETINOPATHY

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A. M. Ruban

2016-08-01

Full Text Available The article presents the some approaches to create a system support of making decision during vitrectomy in patients with diabetic proliferative retinopathy, promotes objective assessment of individual risk-management for patient and allows optimize ophthalmological care for them.

Biodynamic modelling of the bioaccumulation of trace metals (Ag, As and Zn) by an infaunal estuarine invertebrate, the clam Scrobicularia plana

International Nuclear Information System (INIS)

Kalman, J.; Smith, B.D.; Bury, N.R.; Rainbow, P.S.

2014-01-01

Highlights: • Biodynamic modelling is used to predict accumulation of Ag, As and Zn in S. plana. • Dissolved and sediment-associated metals contribute to total metal bioaccumulation. • Relative importance varies with water and sediment concentrations and geochemistries. - Abstract: Biodynamic modelling was used to investigate the uptake and accumulation of three trace metals (Ag, As, Zn) by the deposit feeding estuarine bivalve mollusc Scrobicularia plana. Radioactive labelling techniques were used to quantify the rates of trace metal uptake (and subsequent elimination) from water and sediment diet. The uptake rate constant from solution (±SE) was greatest for Ag (3.954 ± 0.375 l g −1 d −1 ) followed by As (0.807 ± 0.129 l g −1 d −1 ) and Zn (0.103 ± 0.016 l g −1 d −1 ). Assimilation efficiencies from ingested sediment were 40.2 ± 1.3% (Ag), 31.7 ± 1.0% (Zn) and 25.3 ± 0.9% (As). Efflux rate constants after exposure to metals in the solution or sediment fell in the range of 0.014–0.060 d −1 . By incorporating these physiological parameters into biodynamic models, our results showed that dissolved metal is the predominant source of accumulated Ag, As and Zn in S. plana, accounting for 66–99%, 50–97% and 52–98% of total accumulation of Ag, As and Zn, respectively, under different field exposure conditions. In general, model-predicted steady state concentrations of Ag, As and Zn matched well with those observed in clams collected in SW England estuaries. Our findings highlight the potential of biodynamic modelling to predict Ag, As and Zn accumulation in S. plana, taking into account specific dissolved and sediment concentrations of the metals at a particular field site, together with local water and sediment geochemistries

COMPLETE RESOLUTION OF LARGE RETINAL FOLD AFTER TRANSECTION OF RETROLENTAL MEMBRANE DURING LENS-SPARING VITRECTOMY FOR RETINOPATHY OF PREMATURITY: A 15-YEAR FOLLOW-UP.

Science.gov (United States)

Thomas, Benjamin J; Yonekawa, Yoshihiro; Trese, Michael T

2016-01-01

To describe the long-term anatomical and visual outcomes of a patient with retinopathy of prematurity characterized by a prominent retinal fold adherent to the posterior lens capsule, treated by lens-sparing vitrectomy with surgical transection of the retrolental membrane. A premature infant was born at a gestational age of 25 weeks and birthweight of 636 g. She developed threshold retinopathy of prematurity bilaterally and was subsequently treated with laser ablative therapy. The left eye responded favorably, with regression of neovascularization; however, the right eye progressed to Stage 4A with a prominent retinal fold adherent to the posterior lens capsule. The patient underwent lens-sparing vitrectomy with dissection of the retrolental membrane at postmenstrual age of 44 weeks. At 15-year follow-up, the patient has maintained a best-corrected visual acuity of 20/60 and, of note, demonstrated complete resolution of the previous retinal fold. Surgical treatment for retinopathy of prematurity was considerably advanced by the introduction of lens-sparing vitrectomy techniques; however, cases developing retrolental membranes often persisted with poor visual outcomes, and lensectomy is conventionally performed. However, in select cases of Stage 4A retinopathy of prematurity, careful transection of retrolental membranes during lens-sparing vitrectomy using the appropriate technique may provide very good anatomical and visual outcomes.

Tissue plasminogen activator-assisted vitrectomy for submacular hemorrhage due to age-related macular degeneration

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Mustafa Gok

2017-01-01

Full Text Available Purpose: The purpose of this study was to evaluate the treatment efficacy of vitrectomy combined with subretinal recombinant tissue plasminogen activator (r-tPA and factors affecting visual improvement in patients with submacular hemorrhage (SMH due to neovascular age-related macular degeneration (nAMD. Materials and Methods: Medical records of 17 consecutive patients diagnosed with SMH secondary to nAMD were retrospectively reviewed. The initial surgical procedure involved a 23-gauge transconjunctival vitrectomy, subretinal r-tPA application through a self-sealing inferior retinotomy, and sulfur hexafluoride gas for tamponade in all patients. The duration, size, and thickness of the hemorrhage and the pre- and post-operative visual acuity (VA using a Snellen chart were recorded. VA was converted to logMAR for statistical analysis. Results: The average duration and size of the SMH were 12.8 ± 18.2 days and 8.6 ± 5.3 disc areas, respectively. The mean follow-up time was 16.9 ± 4.7 months. A statistically significant visual improvement was found when comparing initial VA with postoperative best-corrected VA (BCVA and final BCVA (Wilcoxon rank test, P ≤ 0.01. There was no significant correlation between the size of the hemorrhage and postoperative BCVA and final BCVA (Spearman's rho test. There was no statistically significant correlation between the initial VA and postoperative BCVA and final BCVA (Spearman's rho test. There was no significant correlation between the duration of hemorrhage and postoperative BCVA and final BCVA (Spearman's rho test. The preoperative thickness of hemorrhage (747.5 ± 30 μm was not correlated with postoperative BCVA or final BCVA (Pearson's test. Conclusions: Vitrectomy combined with subretinal r-tPA injection and gas tamponade is an effective surgical intervention to preserve VA in selected patients with apparent SMH.

INCOMPLETE REPAIR OF RETINAL STRUCTURE AFTER VITRECTOMY WITH INTERNAL LIMITING MEMBRANE PEELING.

Science.gov (United States)

Hisatomi, Toshio; Tachibana, Takashi; Notomi, Shoji; Nakatake, Shunji; Fujiwara, Kohta; Murakami, Yusuke; Ikeda, Yasuhiro; Yoshida, Shigeo; Enaida, Hiroshi; Murata, Toshinori; Sakamoto, Taiji; Sonoda, Koh-Hei; Ishibashi, Tatsuro

2017-08-01

To examine retinal changes after vitrectomy with internal limiting membrane (ILM) peeling, we used a cynomolgus monkey model and focused on surgical damages of ILM peeling for long observational period of 3 years. Vitrectomy was performed followed by ILM peeling similar to clinical settings in humans. Ultrastructural changes of the retina were investigated by light, transmission, and scanning electron microscopy at 3 months and 3 years after ILM peeling. Ultrastructural study showed that the ILM peeled area was still clearly recognized after 3 years. The Müller cell processes covered most of the retina; however, the nerve fiber layer was partly uncovered and exposed to the vitreous space. The arcuate linear nerve fiber bundles were observed as comparable with dissociated optic nerve fiber layer appearance. Small round retinal surface defects were also observed around macula, resembling the dimple sign. Forceps-related retinal thinning was also found on the edge of ILM peeling, where we started peeling with fine forceps. The ultrastructural studies showed that most of ILM peeling area was covered with glial cells during wound healing processes. Retinal changes were found comparable with dissociated optic nerve fiber layer appearance or dimple sign, which were clinically observed with optical coherence tomography.

Case report: a novel KERA mutation associated with cornea plana and its predicted effect on protein function

DEFF Research Database (Denmark)

Roos, Laura; Bertelsen, Birgitte; Harris, Pernille

2015-01-01

of the keratocan gene (KERA) on chromosome 12q22. To date, only nine different disease-associated KERA mutations, including four missense mutations, have been described. Case presentation: In this report, we present clinical data from a Turkish family with autosomal recessive cornea plana. In some of the affected...

Clinical clues for differential diagnosis between verruca plana and verruca plana-like seborrheic keratosis.

Science.gov (United States)

Kim, Won-Jeong; Lee, Won-Ku; Song, Margaret; Kim, Hoon-Soo; Ko, Hyun-Chang; Kim, Byung-Soo; Kim, Moon-Bum

2015-04-01

Sometimes the clinical differentiation between verruca plana (VP) and VP-like seborrheic keratosis (SK) could be challenged. However, there have been no studies on this issue to date. The aim of this study was to elucidate clinical and dermoscopic differences between these two diseases, and also to suggest a diagnostic algorithm of VP and VP-like SK without skin biopsy. The patients who had lesions clinically considered as VP or VP-like SK were the target of our study. We took clinical and dermoscopic photos with informed consent and conducted a questionnaire. All patients had their diagnoses confirmed by biopsy. Thirty-three patients were enrolled in our study. Seventeen patients were finally diagnosed with VP (51.5%) and 16 patients with VP-like SK (48.5%). In clinical findings, VP-like SK showed significantly more scattered distribution than VP (P = 0.039), which exhibited more clustered or grouped distribution (P = 0.039). In dermoscopic findings, brain-like appearance was more commonly observed in VP-like SK (P = 0.003) whereas VP showed more red dots or globular vessels (P = 0.017) and even-colored light brown to yellow patch (P 0.05). Based on our results, we suggest a diagnostic algorithm using Koebner's phenomenon, dermoscopic findings, distribution of each lesion and biopsy for multiple VP-like lesions in adults, and we think it will be a very useful diagnostic tool in daily clinical dermatological practice. © 2015 Japanese Dermatological Association.

GIANT CELL TUMOR OF THE VERTEBRA SIMULATING VERTEBRA PLANA

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B. Aalami-Harandi

1981-07-01

Full Text Available A case of g iant cell tumor of t he vertebra simulat ing vert ebra plana was reported . t he d i agnos i s o f t he vertebra plana should not be confirmed by t he history of the patient and radiologica l manifestation alone . it can onlybe confirmed by biopsy ."nBone l esions of the spine i s one of the most di fficul t problems t o diagnosis and t r eat . Spinal tumors a r e either primary or metastatic . Ilos t bone tumors of the spine i n t he first two decade of l i f e are primary and benign;where as a majority of the bone lesions in old people ar e me tast at1,c and rna I 1' 9n ant . 5- 11 The rnaI1' 9~ant Lee Ss 1i 0ns 0f t h e Sp1' - ne can wi t hout very great risk be excl uded f r om diagnostic considerati on in chi ldren and adoles cence (She r r a r d . 1969 12 . From 34 casps of bone l esions of the spine and the pelvis i n the f irst two decade of l i f e, reported by Thommes on and 1 3 , Paulsen (1967 ni ne were histiochtosis X, two anevr ysma l bone cyst,nine Ewi ng sar coma , two reticul um cell sar c ~ma. None were g i ant cel l tumor ."nGiant cell tumor of the spine is r a re; mo s t of t he report ed cases were in t he sacrum. J affe (1958 17repor t ed only two c ases of giant cell t umo r, one of which o c c ur r e d in the por t e d s a c r um.Of the 218 cases of the g i an t ce l l tumor re6 by Goldenbe rg and Carnpbell( 1970 there were 13 cases of g i ant c e l l tumor o f the ver t ebra , one in the cervical r e g i o n , o ne in the l umbar spi ne , and e l e ven in t he sacrum. Of '08 giant ce l l t umors studied by Coley( 19604 ,one was i n the lumba r ver t ebra and one in the s a c rum. al In a r e view of 413 tumors i nc l uding t he spine(Cohen et 3 1964 tr.ere were sixteen cases o f g i ant c e l l tumor ,one  n the c e r vica l spine , one in the l umbar r e gion and f ourte61 n the sacrum. I n thi s a r t i c l e we are going to report a case of giant cel l t umor of the s i xth thor a ci

Prospective Retinal and Optic Nerve Vitrectomy Evaluation (PROVE study: findings at 3 months

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Reddy RK

2013-09-01

Full Text Available Rahul K Reddy,1 Maziar Lalezary,1 Stephen J Kim,1 Jeffrey A Kammer,1 Rachel W Kuchtey,1 Edward F Cherney,1 Franco M Recchia,2 Karen M Joos,1 Anita Agarwal,1 Janice C Law11Department of Ophthalmology, Vanderbilt University School of Medicine, Nashville, TN, USA; 2Tennessee Retina, PC, Nashville, TN, USABackground: The purpose of this paper is to report the 3-month findings of the Prospective Retinal and Optic Nerve Vitrectomy Evaluation (PROVE study.Methods: Eighty eyes of 40 participants undergoing vitrectomy were enrolled. Participants underwent baseline evaluation of the study (surgical and fellow (control eye that included: intraocular pressure, central corneal thickness, gonioscopy, cup-to-disc ratio measurement, color fundus and optic disc photography, automated perimetry, and optical coherence tomography of the macula and optic nerve. Evaluation was repeated at 3 months. Main outcome measures were changes in macula and retinal nerve fiber layer (RNFL thickness and intraocular pressure.Results: All participants completed follow-up. Mean cup-to-disc ratio of study and fellow eyes at baseline was 0.43 ± 0.2 and 0.46 ± 0.2, respectively, and 13% of participants had undiagnosed narrow angles. There was no significant change in intraocular pressure, cup-to-disc ratio, or pattern standard deviation in study eyes compared with baseline or fellow eyes at 3 months. Vision improved in all study eyes at 3 months compared with baseline (P = 0.013, but remained significantly worse than fellow eyes (P < 0.001. Central subfield and temporal peripapillary RNFL thickness were significantly greater in eyes with epiretinal membrane (P < 0.05, and resolution after surgery correlated with visual improvement (P < 0.05.Conclusion: The 3-month results do not indicate any increased risk for open-angle glaucoma but suggest that a relatively high percentage of eyes may be at risk of angle closure glaucoma. Temporal RNFL thickness and central subfield were increased

The loss of 60Co by Scrobicularia plana and Carcinus maenas as influenced by the way of contamination

International Nuclear Information System (INIS)

Amiard-Triquet, C.; Amiard, J.-C.

1976-01-01

The elimination of 60 Co by Scrobicularia plana and Carcinus maenas depends upon the way of contamination: the loss of cobalt by both species is relatively fast after a single intake of contaminated food. It is slower after chronic ingestion of radioactive food [fr

Blindness and Frequency of Vitrectomy in Young Danish Type 1 Diabetic Patients. A 15-year follow-up

DEFF Research Database (Denmark)

Broe, Rebecca; Olsen, Birthe Susanne; Grauslund, Jakob

of patients who had undergone vitrectomy and the date of their first surgery. Results were correlated to age, gender, diabetes duration and HbA1c. Results: Of the 324 patients examined in 1995, 6 have been registered as blind (4 males and 2 females), 5 were between 21 and 29 years old at registration......Design of study: Cohort study. Purpose: To investigate the prevalence of blindness and frequency of vitrectomy in a nationwide Danish cohort of young type 1 diabetic patients. Methods: In 1986-89 a cohort of 80% of all Danish type 1 diabetic patients below the age of 18 (n=720) was identified.......8 %, ptype 1 diabetic patients. The mean age at the time of surgery was less than 30 years. Our results indicate that high levels of HbA1c in childhood and adolescence, as well...

A Comparison of Topical or Retrobulbar Anesthesia for 23-Gauge Posterior Vitrectomy

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Hande Celiker

2014-01-01

Full Text Available Background. To compare the efficacy and safety of topical anesthesia versus retrobulbar anesthesia in 23-gauge vitreoretinal surgery. Materials and Methods. A total of 63 patients scheduled for 23 G posterior vitrectomy without scleral buckling procedures were included in the study. The patients were randomly assigned to receive either topical (Group 1, n=31 or retrobulbar anesthesia (Group 2, n=32. Postoperatively, patients were shown a visual analogue pain scale (VAPS from 1 (no pain or discomfort to 4 (severe pain or discomfort to rate the levels of pain. Results. There was more discomfort in patients in Group 2 while anesthetic was administered (Group 1:  1.0±0, Group 2: 2.3±0.7, P=0.0001. Between the two groups the level of pain during surgery (Group 1: 1.4±0.5, Group 2: 1.5±0.5; P=0.85 was noted. There was also no significant difference between two groups postoperatively (Group 1: 1.2±0.4, Group 2: 1.3±0.4; P=0.28. There were no complications in either group related to the anesthetic technique. No patient needed sedation or anesthesia supplement during the surgery or postoperative period. Conclusion. Topical anesthesia in posterior vitrectomy procedures is an effective and safe method that is alternative to retrobulbar anesthesia.

Clinical Efficacy of Simulated Vitreoretinal Surgery to Prepare Surgeons for the Upcoming Intervention in the Operating Room.

Science.gov (United States)

Deuchler, Svenja; Wagner, Clemens; Singh, Pankaj; Müller, Michael; Al-Dwairi, Rami; Benjilali, Rachid; Schill, Markus; Ackermann, Hanns; Bon, Dimitra; Kohnen, Thomas; Schoene, Benjamin; Koss, Michael; Koch, Frank

2016-01-01

To evaluate the efficacy of the virtual reality training simulator Eyesi to prepare surgeons for performing pars plana vitrectomies and its potential to predict the surgeons' performance. In a preparation phase, four participating vitreoretinal surgeons performed repeated simulator training with predefined tasks. If a surgeon was assigned to perform a vitrectomy for the management of complex retinal detachment after a surgical break of at least 60 hours it was randomly decided whether a warmup training on the simulator was required (n = 9) or not (n = 12). Performance at the simulator was measured using the built-in scoring metrics. The surgical performance was determined by two blinded observers who analyzed the video-recorded interventions. One of them repeated the analysis to check for intra-observer consistency. The surgical performance of the interventions with and without simulator training was compared. In addition, for the surgeries with simulator training, the simulator performance was compared to the performance in the operating room. Comparing each surgeon's performance with and without warmup trainingshowed a significant effect of warmup training onto the final outcome in the operating room. For the surgeries that were preceeded by the warmup procedure, the performance at the simulator was compared with the operating room performance. We found that there is a significant relation. The governing factor of low scores in the simulator were iatrogenic retinal holes, bleedings and lens damage. Surgeons who caused minor damage in the simulation also performed well in the operating room. Despite the large variation of conditions, the effect of a warmup training as well as a relation between the performance at the simulator and in the operating room was found with statistical significance. Simulator training is able to serve as a warmup to increase the average performance.

Clinical Efficacy of Simulated Vitreoretinal Surgery to Prepare Surgeons for the Upcoming Intervention in the Operating Room.

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Svenja Deuchler

Full Text Available To evaluate the efficacy of the virtual reality training simulator Eyesi to prepare surgeons for performing pars plana vitrectomies and its potential to predict the surgeons' performance.In a preparation phase, four participating vitreoretinal surgeons performed repeated simulator training with predefined tasks. If a surgeon was assigned to perform a vitrectomy for the management of complex retinal detachment after a surgical break of at least 60 hours it was randomly decided whether a warmup training on the simulator was required (n = 9 or not (n = 12. Performance at the simulator was measured using the built-in scoring metrics. The surgical performance was determined by two blinded observers who analyzed the video-recorded interventions. One of them repeated the analysis to check for intra-observer consistency. The surgical performance of the interventions with and without simulator training was compared. In addition, for the surgeries with simulator training, the simulator performance was compared to the performance in the operating room.Comparing each surgeon's performance with and without warmup trainingshowed a significant effect of warmup training onto the final outcome in the operating room. For the surgeries that were preceeded by the warmup procedure, the performance at the simulator was compared with the operating room performance. We found that there is a significant relation. The governing factor of low scores in the simulator were iatrogenic retinal holes, bleedings and lens damage. Surgeons who caused minor damage in the simulation also performed well in the operating room.Despite the large variation of conditions, the effect of a warmup training as well as a relation between the performance at the simulator and in the operating room was found with statistical significance. Simulator training is able to serve as a warmup to increase the average performance.

Stereoscopic three-dimensional images of an anatomical dissection of the eyeball and orbit for educational purposes.

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Matsuo, Toshihiko; Takeda, Yoshimasa; Ohtsuka, Aiji

2013-01-01

The purpose of this study was to develop a series of stereoscopic anatomical images of the eye and orbit for use in the curricula of medical schools and residency programs in ophthalmology and other specialties. Layer-by-layer dissection of the eyelid, eyeball, and orbit of a cadaver was performed by an ophthalmologist. A stereoscopic camera system was used to capture a series of anatomical views that were scanned in a panoramic three-dimensional manner around the center of the lid fissure. The images could be rotated 360 degrees in the frontal plane and the angle of views could be tilted up to 90 degrees along the anteroposterior axis perpendicular to the frontal plane around the 360 degrees. The skin, orbicularis oculi muscle, and upper and lower tarsus were sequentially observed. The upper and lower eyelids were removed to expose the bulbar conjunctiva and to insert three 25-gauge trocars for vitrectomy at the location of the pars plana. The cornea was cut at the limbus, and the lens with mature cataract was dislocated. The sclera was cut to observe the trocars from inside the eyeball. The sclera was further cut to visualize the superior oblique muscle with the trochlea and the inferior oblique muscle. The eyeball was dissected completely to observe the optic nerve and the ophthalmic artery. The thin bones of the medial and inferior orbital wall were cracked with a forceps to expose the ethmoid and maxillary sinus, respectively. In conclusion, the serial dissection images visualized aspects of the local anatomy specific to various procedures, including the levator muscle and tarsus for blepharoptosis surgery, 25-gauge trocars as viewed from inside the eye globe for vitrectomy, the oblique muscles for strabismus surgery, and the thin medial and inferior orbital bony walls for orbital bone fractures.

Clinical and histological evaluation of large macular hole surgery using the inverted internal limiting membrane flap technique

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Kase S

2016-12-01

Full Text Available Satoru Kase, Wataru Saito, Shohei Mori, Michiyuki Saito, Ryo Ando, Zhenyu Dong, Tomohiro Suzuki, Kousuke Noda, Susumu Ishida Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan Purpose: The aims of this study were to analyze optical coherence tomography (OCT imaging of large macular holes (MHs treated with inverted internal limiting membrane (ILM flap technique and to perform a histological examination of an ILM-like membrane tissue obtained during vitrectomy.Patients and methods: This is a retrospective observational case study. Nine patients, comprising of five males and four females, showing large and myopic MHs, underwent pars plana vitrectomy (PPV with inverted ILM flap technique assisted by brilliant blue G (BBG staining. Ophthalmological findings including visual acuity and OCT were investigated based on medical records. Formalin-fixed paraffin-embedded tissue section of an ILM-like membrane was submitted for immunohistochemistry with glial fibrillary acidic protein (GFAP.Results: ILM was clearly stained with BBG in eight patients, whereas the ILM in one case revealed no staining with BBG during PPV. Visual acuities improved to >0.2 LogMAR in six patients. The complete closure of MH following PPV with inverted ILM technique was eventually achieved in all patients determined by OCT imaging (100%. Only one patient showed recovery of ellipsoid zone and interdigitation zone following the surgery. Elongation of outer nuclear layer was noted in three eyes. The ILM-like membrane not stained with BBG histologically revealed an amorphous structure admixed with GFAP-positive mononuclear cell infiltration.Conclusion: PPV with inverted ILM flap technique achieved 100% closure rates with favorable configuration at an initial surgery in large MHs. Our histopathological data also suggest that even BBG staining-negative membrane may be a useful material for autologous transplantation to the hole. Keywords

Reverse pupillary block after implantation of a scleral-sutured posterior chamber intraocular lens: a retrospective, open study.

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Bang, Seung Pil; Joo, Choun-Ki; Jun, Jong Hwa

2017-03-29

To report the clinical features of patients with reverse pupillary block (RPB) after scleral-sutured posterior chamber intraocular lens (PC IOL) implantation and biometric changes after laser peripheral iridotomy (LPI). Eight patients attending our hospital's ophthalmology outpatient clinic, who developed RPB after implantation of a scleral-sutured PC IOL due to subluxation of the crystalline lens or IOL, were investigated in this retrospective, observational study. Preoperative evaluations showed angle pigmentation in all cases and iridodonesis in 2 cases. Two subjects had used an α 1A -adrenoceptor antagonist for benign prostatic hyperplasia. Pars plana or anterior partial vitrectomy was performed in all cases. All eyes showed an extremely deep anterior chamber, a concave iris configuration, and contact between the IOL optic and the iris at the pupillary margin. Pupil capture was detected in 2 cases. The mean (± SD) anterior chamber angle (ACA) was 89.91 ± 10.06°, and the anterior chamber depth (ACD) was 4.42 ± 0.16 mm before LPI. After LPI, the iris immediately became flat with a decreased ACA (51.70 ± 2.59°; P = 0.018) and ACD (4.14 ± 0.15 mm; P = 0.012). After LPI, the intraocular pressure decreased from 19.75 ± 3.77 mmHg to 15.63 ± 4.30 mmHg (P = 0.011), and the spherical equivalent decreased from -0.643 ± 0.385 D to - 0.875 ± 0.505 D (P = 0.016). Concomitant vitrectomy, angle pigmentation, and iridodonesis may be risk factors for RPB after scleral-sutured PC IOL implantation. LPI is effective for relieving the RPB.

Wide-Field Landers Temporary Keratoprosthesis in Severe Ocular Trauma: Functional and Anatomical Results after One Year

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Katarzyna Nowomiejska

2015-01-01

Full Text Available Purpose. To evaluate longitudinal functional and anatomical results after combined pars plana vitrectomy (PPV and penetrating keratoplasty (PKP using a wide-field Landers intraoperative temporary keratoprosthesis (TKP in patients with vitreoretinal pathology and corneal opacity due to severe ocular trauma. Material and Methods. Medical records of 12 patients who had undergone PPV/PKP/KP due to severe eye trauma were analyzed. Functional (best-corrected visual acuity and anatomic outcomes (clarity of the corneal graft, retinal attachment, and intraocular pressure were assessed during the follow-up (mean 16 months. Results. Final visual acuities varied from NLP to CF to 2 m. Visual acuity improved in 7 cases, was unchanged in 4 eyes, and worsened in 1 eye. The corneal graft was transparent during the follow-up in 3 cases and graft failure was observed in 9 eyes. Silicone oil was used as a tamponade in all cases and retina was reattached in 92% of cases. Conclusions. Combined PPV and PKP with the use of wide-field Landers TKP allowed for surgical intervention in patients with vitreoretinal pathology coexisting with corneal wound. Although retina was attached in most of the cases, corneal graft survived only in one-fourth of patients and final visual acuities were poor.

Nitric oxide levels in the anterior chamber of vitrectomized eyes with silicon oil

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Paulo Escarião

2013-10-01

Full Text Available PURPOSE: To investigate the nitric oxide levels in the anterior chamber of eyes who underwent pars plana vitrectomy (PPV with silicone oil. METHODS: Patients who underwent PPV with silicon oil injection, from february 2005 to august 2007, were selected. Nine patients (nine eyes participated in the study (five women and four men. Nitric oxide concentration was quantified after the aspiration of aqueous humor samples during the procedure of silicon oil removal. Data such as: oil emulsification; presence of oil in the anterior chamber; intraocular pressure and time with silicone oil were evaluated. Values of p <0.05 were considered to be statistically significant. RESULTS: A positive correlation between nitric oxide concentration and time with silicon oil in the vitreous cavity (r=0.799 was observed. The nitric oxide concentration was significantly higher (p=0.02 in patients with silicon oil more than 24 months (0.90µmol/ml ± 0.59, n=3 in the vitreous cavity comparing to patients with less than 24 months (0.19µmol/ml ± 0.10, n=6. CONCLUSION: A positive correlation linking silicone oil time in the vitreous cavity with the nitric oxide concentration in the anterior chamber was observed.

Radial optic neurotomy for ischaemic central vein occlusion

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Martínez-Jardón, C S; Meza-de Regil, A; Dalma-Weiszhausz, J; Leizaola-Fernández, C; Morales-Cantón, V; Guerrero-Naranjo, J L; Quiroz-Mercado, H

2005-01-01

Background/aims: Ischaemic central retinal vein occlusion (CRVO) accounts for 20–50% of all CRVO. No treatment has been proved to be effective. The efficacy of radial optic neurotomy (RON) was evaluated in eyes with ischaemic CRVO. Methods: 10 patients with ischaemic CRVO underwent RON. After pars plana vitrectomy, a microvitreoretinal blade was used to incise the scleral ring, cribriform plate, and adjacent sclera at the nasal edge of the optic disc. Best corrected visual acuity (BCVA), intraocular pressure (IOP), fluorescein angiography (FA), multifocal electroretinography (mfERG), and optical coherence tomography (OCT) were measured preoperatively and at 1, 3, and 6 months postoperatively. Results: No visual improvement was noted in the eyes that underwent RON. FA and mfERG showed no increase in retinal perfusion or retinal function postoperatively. Mean macular central thickness changed from 841 (SD 170) μm preoperatively to 162 (SD 34) μm at the sixth postoperative month. One patient had retinal central artery perforation intraoperatively. One patient developed neovascular glaucoma. Conclusion: RON in ischaemic CRVO did not improve visual function (by mfERG) or visual acuity although macular thickness did improve. This technique may be associated with potential risks. Randomised studies are needed to corroborate these results. PMID:15834084

Delayed-Onset Post-Keratoplasty Endophthalmitis Caused by Vancomycin-Resistant Enterococcus faecium

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Julio C. Hernandez-Camarena

2012-10-01

Full Text Available Background: Vancomycin-resistant Enterococcus (VRE endophthalmitis after penetrating keratoplasty (PKP is very rare, the management is a challenge due to both the pattern of antibiotic resistance and the aggressive nature of the infectious process. We report the first delayed-onset case of VRE endophthalmitis after PKP. Materials and Methods: Case report of a 51-year-old female with a 7-week history of PKP who arrived at the emergency room with signs and symptoms of endophthalmitis. Initial visual acuity was light perception, and a posterior pole exam was not possible due to the intense vitreous reaction. Mode B ultrasound was used to assess the posterior pole. The patient underwent pars plana vitrectomy and received intravitreous antibiotics. Results: Vitreous stains and cultures were positive for Enterococcus faecium resistant to vancomycin. Donor rim cultures and viral PCR were negative. Treatment was carried out by repeated intravitreal antibiotics and systemic linezolid. Clinical improvement was seen after the second dose of intravitreous antibiotics and systemic linezolid, but visual acuity remained at light perception consistent with the ischemic changes observed in the posterior pole. Conclusion: VRE endophthalmitis might be associated with positive donor rim cultures. Prompt use of systemic linezolid in addition to intravitreous antibiotics is recommendable, but even with prompt treatment, visual prognosis is guarded.

Acute retinal necrosis results in low vision in a young patient with a history of herpes simplex virus encephalitis.

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Shahi, Sanjeet K

2017-05-01

Acute retinal necrosis (ARN), secondary to herpes simplex encephalitis, is a rare syndrome that can present in healthy individuals, as well as immuno-compromised patients. Most cases are caused by a secondary infection from the herpes virus family, with varicella zoster virus being the leading cause of this syndrome. Potential symptoms include blurry vision, floaters, ocular pain and photophobia. Ocular findings may consist of severe uveitis, retinal vasculitis, retinal necrosis, papillitis and retinal detachment. Clinical manifestations of this disease may include increased intraocular pressure, optic disc oedema, optic neuropathy and sheathed retinal arterioles. A complete work up is essential to rule out cytomegalovirus retinitis, herpes simplex encephalitis, herpes virus, syphilis, posterior uveitis and other conditions. Depending on the severity of the disease, the treatment options consist of anticoagulation therapy, cycloplegia, intravenous acyclovir, systemic steroids, prophylactic laser photocoagulation and pars plana vitrectomy with silicon oil for retinal detachment. An extensive history and clinical examination is crucial in making the correct diagnosis. Also, it is very important to be aware of low vision needs and refer the patients, if expressing any sort of functional issues with completing daily living skills, especially reading. In this article, we report one case of unilateral ARN 20 years after herpetic encephalitis. © 2016 Optometry Australia.

Early rhegmatogenous retinal detachment following laser in situ keratomileusis for high myopia.

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Farah, M E; Höfling-Lima, A L; Nascimento, E

2000-01-01

Four eyes had early rhegmatogenous retinal detachment within 3 months of laser in situ keratomileusis (LASIK) for correction of high myopia using the microkeratome, Clear Corneal Molder. In two eyes, retinal detachment resulted from horseshoe tears, one occurring in an otherwise normal region of the retina and the other at the margin of an area of lattice degeneration detected during preoperative examination. The first eye was treated with retinopexy using a 287 encircling scleral exoplant, drainage of subretinal fluid, and laser photocoagulation by indirect ophthalmoscopy. The other eye was treated with pneumatic retinopexy and cryotherapy. In the other eyes, retinal detachment was the result of giant tears with no evidence of prior retinal degeneration. These eyes were treated with pars plana vitrectomy, fluid-gas exchange with 15% perfluoropropane (C3F8), endolaser photocoagulation, and a 42 encircling scleral exoplant. After treatment, the first two eyes achieved spectacle-corrected visual acuity of 20/40. In the last two eyes, final spectacle-corrected visual acuity was 20/400 in one eye and light perception in the other. Although no cause-effect relationship between LASIK and retinal detachment can be stated, these cases suggest that LASIK may be associated with retinal detachment, particularly in highly myopic eyes. Further studies are necessary to determine high-risk patient characteristics.

Submacular hemorrhage in neovascular age-related macular degeneration: A synthesis of the literature.

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Stanescu-Segall, Dinu; Balta, Florian; Jackson, Timothy L

2016-01-01

Large submacular hemorrhage, an uncommon manifestation of neovascular age-related macular degeneration, may also occur with idiopathic polypoidal choroidal vasculopathy. Submacular hemorrhage damages photoreceptors owing to iron toxicity, fibrin meshwork contraction, and reduced nutrient flux, with subsequent macular scarring. Clinical and experimental studies support prompt treatment, as tissue damage can occur within 24 hours. Without treatment the natural history is poor, with a mean final visual acuity (VA) of 20/1600. Reported treatments include retinal pigment epithelial patch, macular translocation, pneumatic displacement, intravitreal or subretinal tissue plasminogen activator, intravitreal anti-vascular endothelial growth factor (VEGF) drugs, and combinations thereof. In the absence of comparative studies, we combined eligible studies to assess the VA change before and after each treatment option. The greatest improvement occurred after combined pars plana vitrectomy, subretinal tissue plasminogen activator, intravitreal gas, and anti-vascular endothelial growth factor treatment, with VA improving from 20/1000 to 20/400. The best final VA occurred using combined intravitreal tissue plasminogen activator, gas, and anti-vascular endothelial growth factor therapy, with VA improving from 20/200 to 20/100. Both treatments had an acceptable safety profile, but most studies were small, and larger randomized controlled trials are needed to determine both safety and efficacy. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

Surgical approach and optic coherence tomographic evaluation of optic disc anomaly in association with serous macular detachment.

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Güven, Dilek; Balcıoğlu, Nihal; Türker, Cağrı; Baydar, Yasemin; Sendül, Yekta

2013-12-01

Serous macular detachment (SMD) may accompany optic disc pit (ODP) and cause visual loss if untreated. We want to present different therapeutic approaches and interesting optical coherence tomography (OCT) findings in three consecutive cases. In this case series, two patients with SMD and one patient with partial macular detachment and inferior retinal detachment accompanying ODP were evaluated before and after surgical intervention clinically and by spectral-domain OCT. The patients were 44 (case 1), 22 (case 2) and 24 (case 3) years old. Pars plana vitrectomy (PPV) + silicone oil + laser, PPV + sulfur hexafluoride gas (SF6) + laser and pneumatic retinopexy were applied, respectively. The patients were followed for 18, 15 and 14 months. Preoperative best-corrected visual acuities (BCVAs) were 5/100, 7/10 and counting fingers at 1 m. Vision improved in all cases with resolution of subretinal fluid. Final BCVAs were 3/10, 10/10 and 1/10, respectively. OCT images revealed optic disc anomaly details and changes after surgical intervention, photoreceptor outer segment alterations at the detached area and macular surface changes. Surgical intervention should be tailored individually in cases with SMD. OCT is efficient for in vivo evaluation of this pathological condition and anatomical outcomes of surgery.

20 g PPV with indocyanine green-assisted ILM peeling versus 23 g PPV with brilliant blue G-assisted ILM peeling for epiretinal membrane.

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Manousaridis, Kleanthis; Peter, Silvia; Mennel, Stefan

2016-06-01

To compare the anatomical and visual outcomes of 20 gauge (g) pars plana vitrectomy (PPV) with indocyanine green (ICG)-assisted internal limiting membrane (ILM) peeling and 23 g PPV with brilliant blue G (BBG)-assisted ILM peeling for idiopathic epiretinal membrane (ERM). 38 eyes of 38 patients with idiopathic ERM were included. They were divided in two groups: group 1 (18 eyes) underwent 20 g PPV with ICG-assisted ILM peeling and group 2 (20 eyes) 23 g PPV with BBG-assisted ILM peeling. Postoperative best-corrected visual acuity (BCVA) and central macular thickness (CMT) were compared. Average BCVA in group 1 improved significantly from 0.60 logarithm of the minimal angle of resolution (log MAR) at baseline to 0.3 log MAR postoperatively. Average BCVA in group 2 improved significantly from 0.60 log MAR at baseline to 0.3 log MAR postoperatively. Mean CMT reduced significantly from 473 to 375 μm in group 1 and from 486 to 396 μm in group 2. There were no significant differences in the BCVA and CMT between the groups. Both surgical methods appeared to be safe and provided similar anatomical and visual outcomes.

Incidence of retinopathy of prematurity in the United States: 1997 through 2005.

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Lad, Eleonora M; Hernandez-Boussard, Tina; Morton, John M; Moshfeghi, Darius M

2009-09-01

To determine the incidence of retinopathy of prematurity (ROP) based on a national database and to identify baseline characteristics, demographic information, comorbidities, and surgical interventions. Retrospective study based on the National Inpatient Sample from 1997 through 2005. The National Inpatient Sample was queried for all newborn infants with and without ROP. Multivariate logistic regression was used to predict risk factors for ROP. Thirty-four million live births were recorded during the study period. The total ROP incidence was 0.17% overall and 15.58% for premature infants with length of stay of more than 28 days. Our results conclusively demonstrated the importance of low birth weight as a risk for ROP development in infants with length of stay of more than 28 days, as well as association with respiratory conditions, fetal hemorrhage, intraventricular hemorrhage, and blood transfer. An interesting finding was the protective effect conferred by hypoxia, necrotizing enterocolitis, and hemolytic disease of the newborn. Infants with ROP had a higher incidence of undergoing laser photocoagulation therapy, pars plana vitrectomy, and scleral buckle surgery. The current study represents a large, retrospective analysis of newborns with ROP. The multivariate analysis emphasizes the role of birth weight in extended-stay infants, as well as respiratory conditions, fetal hemorrhage, intraventricular hemorrhage, and blood transfer.

Comparison of the Effect of Intravitreal Dexamethasone Implant in Vitrectomized and Nonvitrectomized Eyes for the Treatment of Diabetic Macular Edema

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Sadık Görkem Çevik

2018-01-01

Full Text Available Purpose. To compare the effectiveness of sustained-release dexamethasone (DEX intravitreal implant in nonvitrectomized eyes and vitrectomized eyes with diabetic macular edema (DME. Methods. A retrospective review of the medical records of 40 eyes of 30 consecutive patients with diabetic macular edema who underwent intravitreal DEX implant injection. Patients were divided into 2 subgroups: 31 eyes that were nonvitrectomized (group 1 and 9 eyes that had previously undergone standard pars plana vitrectomy (group 2. The main outcome measures were BCVA and foveal thickness (FT. Results. A significant improvement was seen in BCVA in both group 1 and group 2 at the 1st, 2nd, and 6th months after treatment with DEX implant (p<0.05. In group 1, a significant reduction in FT was observed at the 1st, 2nd, and 6th months (p<0.05. In group 2, a significant reduction in FT was seen at the 1st and 2nd months (p<0.05, but the reduction rate at the 6th month after the injection was not statistically significant (p=0.06. Conclusion. DEX implant is effective for the treatment of diabetic macular edema, and the effectiveness of the drug is similar in vitrectomized and nonvitrectomized eyes.

Evaluation of glutaraldehyde and povidone iodine for sterilization of wide-field contact vitrectomy lenses.

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Das, T; Sharma, S; Singh, J; Rao, V; Chalam, K V

2001-01-01

Wide-field vitrectomy contact lenses are currently sterilized with ethylene oxide gas, and other lenses with autoclaving. To maintain a large inventory or possibly run the risk of loss of lens quality with repeated autoclaving, glutaraldehyde 2% and povidone iodine 5% solution were evaluated as possible sterilizing agents. Ethylene oxide presterilized lenses were contaminated with known concentrations (10(5) organisms/mL) of bacteria (S. epidemidis, P. aeruginosa, B. subtilis), and fungi (A. flavus, C. albicans) for 5 minutes. The test lenses were treated with glutaraldehyde or povidone iodine for 5, 10, 30, 60, and 120 minutes, and controls with sterilized water for a similar duration. Following treatment, both test and control lenses were sampled with sterile cotton swabs. The swabs were cultured for bacteria (tryptone soya broth 48 hours), and fungi (Saubourd's dextrose broth 5 days). The culture was negative for both glutaraldehyde- and povidone iodine-treated lenses against all organisms at all time points except B subtilis, which needed 120 minutes treatment. Two hours contact time with glutaraldehyde 2% or providone iodine 5% can sterilize vitrectomy contact lenses against common bacteria and fungi without affecting lens quality.

Biodynamic modelling of the bioaccumulation of trace metals (Ag, As and Zn) by an infaunal estuarine invertebrate, the clam Scrobicularia plana

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Kalman, J., E-mail: judit.kalman@uca.es [Department of Life Sciences, The Natural History Museum, Cromwell Road, London SW7 5BD (United Kingdom); Smith, B.D. [Department of Life Sciences, The Natural History Museum, Cromwell Road, London SW7 5BD (United Kingdom); Bury, N.R. [Division of Diabetes and Nutritional Science, King' s College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH (United Kingdom); Rainbow, P.S. [Department of Life Sciences, The Natural History Museum, Cromwell Road, London SW7 5BD (United Kingdom)

2014-09-15

Highlights: • Biodynamic modelling is used to predict accumulation of Ag, As and Zn in S. plana. • Dissolved and sediment-associated metals contribute to total metal bioaccumulation. • Relative importance varies with water and sediment concentrations and geochemistries. - Abstract: Biodynamic modelling was used to investigate the uptake and accumulation of three trace metals (Ag, As, Zn) by the deposit feeding estuarine bivalve mollusc Scrobicularia plana. Radioactive labelling techniques were used to quantify the rates of trace metal uptake (and subsequent elimination) from water and sediment diet. The uptake rate constant from solution (±SE) was greatest for Ag (3.954 ± 0.375 l g{sup −1} d{sup −1}) followed by As (0.807 ± 0.129 l g{sup −1} d{sup −1}) and Zn (0.103 ± 0.016 l g{sup −1} d{sup −1}). Assimilation efficiencies from ingested sediment were 40.2 ± 1.3% (Ag), 31.7 ± 1.0% (Zn) and 25.3 ± 0.9% (As). Efflux rate constants after exposure to metals in the solution or sediment fell in the range of 0.014–0.060 d{sup −1}. By incorporating these physiological parameters into biodynamic models, our results showed that dissolved metal is the predominant source of accumulated Ag, As and Zn in S. plana, accounting for 66–99%, 50–97% and 52–98% of total accumulation of Ag, As and Zn, respectively, under different field exposure conditions. In general, model-predicted steady state concentrations of Ag, As and Zn matched well with those observed in clams collected in SW England estuaries. Our findings highlight the potential of biodynamic modelling to predict Ag, As and Zn accumulation in S. plana, taking into account specific dissolved and sediment concentrations of the metals at a particular field site, together with local water and sediment geochemistries.

Protective Effect of Tea Polyphenol Ophthalmic Gel on Lens Epithelial Cells in Rabbits with Silicone Oil Tamponade after Vitrectomy

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Xianzhen Ma

2014-01-01

Full Text Available Purpose. The aim of this study was to investigate the effect of tea polyphenols (TP ophthalmic gel on lens epithelial cells (LECs in rabbits with silicone oil tamponade after vitrectomy. Methods. In this study, unilateral vitrectomy with silicone oil tamponade was performed using 2-month-old New Zealand white rabbits (n = 72; meanwhile, age-matched nonoperated rabbits (n = 18 were used as controls. The TP ophthalmic gel was administered topically in the surgical eyes till they were sacrificed. On days 45 and 90 after operation, the levels of reactive oxygen species (ROS, mitochondrial membrane potential (ΔΨm, and apoptosis of LECs were analyzed, respectively. Meanwhile, caspase-3 mRNA and protein levels were also determined. Results. The results indicate that the levels of ROS and apoptosis were elevated for LECs in rabbits after operation, whereas ΔΨm was decreased. Caspase-3 was apparently increased at both mRNA and protein levels. Treatment of TP ophthalmic gel could reduce the generation of ROS, maintain ΔΨm, inhibit the overexpression of caspase-3, and thus decrease the apoptosis of LECs of rabbits after operation. Conclusions. TP ophthalmic gel can efficiently inhibit caspase-3 overexpression, reduce the apoptosis of LECs, and prevent LECs from damage. Our result provides a new approach to prevent the development of complicated cataract after vitrectomy.

An extraocular non-invasive transscleral LED-endoilluminator for eye speculum integration.

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Kölbl, Philipp Simon; Lindner, Christoph; Lingenfelder, Christian; Deuchler, Svenja; Singh, Pankaj; Koch, Frank; Hessling, Martin

2015-09-01

Conventional chandelier-endoilluminators used for pars-plana vitrectomy consist of a light-emitting tip attached to an optical fibre. The tip requires introduction into the ocular space through an incision. To achieve complete illumination of the intraocular space, the introduction of more than just one tip is sometimes necessary. An extraocular vitreoretinal LED-endoilluminator discussed in this paper represents a new approach to illuminate the intraocular space. The light source is integrated into a speculum and firmly apposed to the sclera. This approach offers the advantage of effectively illuminating the interior of the eye even though the procedure is non-invasive. Furthermore, this approach significantly reduces the risk of damage to the retina by phototoxic effects. A round white LED was used as a light source. By integrating the light source into a speculum, the LED was firmly held against the sclera. Thus, the ocular space was illuminated transsclerally. As a result, indirect uniform illumination of the complete intraocular space was achieved. The prototype was developed considering the relevant international standards. Porcine eyes were used because their properties are similar to those of human eyes. Porcine eyes could be acceptably illuminated with the selected LED. The LED-endoilluminator conforms with international standards for endoillumination. Thus, possible photochemical and thermal risks are considered and reduced to a minimum. A novel LED-endoilluminator which can be attached to a speculum was developed. The system does not need any connection to an external light source and, consequently, also avoids usage of an optical fibre. Regular and uniform illumination of the intraocular space was achieved by transmitted and scattered visible irradiation, avoiding an incision. The duration of potential light exposure, compared to existing illumination systems, can be significantly increased. This is also true when the illuminator is not directly placed

Radiación acústica por superficies planas: Aplicación a altavoces

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Alba, Jesús; Ramis, Jaime; Espinosa, Víctor; Sánchez, Víctor

2003-01-01

En los sistemas de reproducción sonora es habitual la utilización de altavoces dinámicos. Sin embargo, en aplicaciones específicas, puede ser necesaria y/o conveniente la utilización de altavoces alternativos con superficies planas como diafragma, como los electrostáticos o los basados en la tecnología NXT© . Estos altavoces generan el campo acústico mediante la vibración de una superficie rectangular. Se puede suponer, en una primera aproximación, que todos los puntos sobre su su...

VISUALIZATION FROM INTRAOPERATIVE SWEPT-SOURCE MICROSCOPE-INTEGRATED OPTICAL COHERENCE TOMOGRAPHY IN VITRECTOMY FOR COMPLICATIONS OF PROLIFERATIVE DIABETIC RETINOPATHY.

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Gabr, Hesham; Chen, Xi; Zevallos-Carrasco, Oscar M; Viehland, Christian; Dandrige, Alexandria; Sarin, Neeru; Mahmoud, Tamer H; Vajzovic, Lejla; Izatt, Joseph A; Toth, Cynthia A

2018-01-10

To evaluate the use of live volumetric (4D) intraoperative swept-source microscope-integrated optical coherence tomography in vitrectomy for proliferative diabetic retinopathy complications. In this prospective study, we analyzed a subgroup of patients with proliferative diabetic retinopathy complications who required vitrectomy and who were imaged by the research swept-source microscope-integrated optical coherence tomography system. In near real time, images were displayed in stereo heads-up display facilitating intraoperative surgeon feedback. Postoperative review included scoring image quality, identifying different diabetic retinopathy-associated pathologies and reviewing the intraoperatively documented surgeon feedback. Twenty eyes were included. Indications for vitrectomy were tractional retinal detachment (16 eyes), combined tractional-rhegmatogenous retinal detachment (2 eyes), and vitreous hemorrhage (2 eyes). Useful, good-quality 2D (B-scans) and 4D images were obtained in 16/20 eyes (80%). In these eyes, multiple diabetic retinopathy complications could be imaged. Swept-source microscope-integrated optical coherence tomography provided surgical guidance, e.g., in identifying dissection planes under fibrovascular membranes, and in determining residual membranes and traction that would benefit from additional peeling. In 4/20 eyes (20%), acceptable images were captured, but they were not useful due to high tractional retinal detachment elevation which was challenging for imaging. Swept-source microscope-integrated optical coherence tomography can provide important guidance during surgery for proliferative diabetic retinopathy complications through intraoperative identification of different complications and facilitation of intraoperative decision making.

Drug treatment for high IOP at early stage after vitrectomy for macular hole caused by high myopia

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Yu-Juan Zhou

2015-12-01

Full Text Available AIM:To study the effect of only latanoprost eye drops or combined with other medicines on lowering intraocular pressure(IOPafter early pars plana vitrectomy(PPVfor macular hole without retinal detachment caused by high myopia.METHODS:One hundred and eighty-eight cases(205 eyessuffered from macular hole caused by high myopia without reinal detachment who underwent PPV combined with C3F8 tamponade were studied retrospectively and measured the IOP at 1wk after surgeries. The patients whose IOP was 22～29mmHg were named as group A. Then they were divided randomly into two subgroups, group A1(treated by carteolol eye dropsand subgroup A2(treated by latanoprost eye drops. The patients whose IOP was 30～39mmHg were named as group B. Then they were divided randomly into two subgroups, group B1(treated by both carteolol and brimonidine tartrate eye dropsand subgroup B2(treated by both latanoprost and carteolol eye drops. The patients whose IOP was ≥40mmHg were named as group C and they were all treated by rapid intravenous injection of 20% Mannitol. Meanwhile, they were divided randomly into two subgroups, group C1(treated by carteolol,brimonidine tartrate and brinzolamide eye drops and subgroup C2(treated by carteolol,brimonidine tartrate and latanoprost eye drops. Continuous observation lasted 3d. If IOP dropped to below 21 mmHg, we considered it valid. And then,compare the effectiveness, IOP reduction and the average effective duration. RESULTS:Eighty-nine eyes met the criteria of high IOP and IOP of 70 eyes(78.6%increased within 3d after operations. There were 31 eyes in group A including 14 eyes in group A1 and 17 eyes in group A2.The number of effective cases of the two groups was 5(35.7%and 13(76.5%respectively, the difference was statistically significant(χ2=5.24,P=0.03.The IOP reduction of the two groups were 4.21±1.22mmHg(24%, 8.76±3.03mmHg(29.6%, respectively, and the difference was statistically significant(t=5.73,Pt=2.85,P=0.012.There

Supra choroidal buckling in managing myopic vitreoretinal interface disorders: 1-year data.

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El Rayes, Ehab N

2014-01-01

To evaluate the efficacy of supra choroidal buckling procedure using a supra choroidal catheter, as a new approach in treating myopic vitreomacular interface disorders specially in difficult cases of myopic traction maculopathy with or without macular hole retinal detachment in posterior staphyloma depending on the concept of indenting the choroid only, from a 1-year data study. A newly developed supra choroidal catheter was used to deliver stabilized, cross-linked, long-acting hyaluronic acid as a filler in the supra choroidal space in the area of the staphyloma forming a choroidal indenting effect. Before the injection, pars plana vitrectomy was performed without internal limiting membrane peeling to avoid the risk of break of the roof of foveal detachment in case of foveoschisis. This indentation was used to treat 11 patients with myopic foveoschisis and 12 patients with myopic macular hole retinal detachment, 5 of whom had failed primary repair by vitrectomy before inclusion in this trial. Clinical and optical coherence tomographic evaluations of these patients were performed over 1-year follow-up. Retinal layer restoration was achieved in all 11 eyes with myopic foveoschisis. This was gradual over a period of 2 to 6 weeks postoperatively. No recurrence over the 12-month follow-up was observed. Visual acuity improved by 1 line or more in 9 eyes (81.8%). Of the 12 eyes, 10 with macular hole detachment (83%) showed closure of the holes in association with the resolution of the detachment; 2 eyes showed resolution of the detachment and flatting of the edge of the holes but with incomplete closure on optical coherence tomography. Eight eyes (66.6%) showed improvement in visual acuity by 1 or more lines with no recurrence of retinal detachment over the 12-month follow-up period. The indentation effect was sufficient over the 12-month follow-up period. The indentation effect achieved by supra choroidal approach can be used as a method of managing myopic foveoschisis

The impacts of pharmaceutical drugs under ocean acidification: New data on single and combined long-term effects of carbamazepine on Scrobicularia plana.

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Freitas, Rosa; Almeida, Ângela; Calisto, Vânia; Velez, Cátia; Moreira, Anthony; Schneider, Rudolf J; Esteves, Valdemar I; Wrona, Frederick J; Figueira, Etelvina; Soares, Amadeu M V M

2016-01-15

Ocean acidification and increasing discharges of pharmaceutical contaminants into aquatic systems are among key and/or emerging drivers of environmental change affecting marine ecosystems. A growing body of evidence demonstrates that ocean acidification can have direct and indirect impacts on marine organisms although combined effects with other stressors, namely with pharmaceuticals, have received very little attention to date. The present study aimed to evaluate the impacts of the pharmaceutical drug Carbamazepine and pH 7.1, acting alone and in combination, on the clam Scrobicularia plana. For this, a long-term exposure (28 days)was conducted and a set of oxidative stress markers was investigated. The results obtained showed that S. plana was able to develop mechanisms to prevent oxidative damage when under low pH for a long period, presenting higher survival when exposed to this stressor compared to CBZ or the combination of CBZ with pH 7.1. Furthermore, the toxicity of CBZ on S. plana was synergistically increased under ocean acidification conditions (CBZ + pH 7.1): specimens survival was reduced and oxidative stress was enhanced when compared to single exposures. These findings add to the growing body of evidence that ocean acidification will act to increase the toxicity of CBZ to marine organisms,which has clear implications for coastal benthic ecosystems suffering chronic pollution from pharmaceutical drugs.

How life history influences the responses of the clam Scrobicularia plana to the combined impacts of carbamazepine and pH decrease

International Nuclear Information System (INIS)

Freitas, Rosa; Almeida, Ângela; Calisto, Vânia; Velez, Cátia; Moreira, Anthony; Schneider, Rudolf J.; Esteves, Valdemar I.; Wrona, Frederick J.; Soares, Amadeu M.V. M.; Figueira, Etelvina

2015-01-01

In the present study, the bivalve Scrobicularia plana, collected from two contrasting areas (pristine location and mercury contaminated area), was selected to assess the biochemical alterations imposed by pH decrease, carbamazepine (an antiepileptic) and the combined effect of both stressors. The effects on oxidative stress related biomarkers after 96 h exposure revealed that pH decrease and carbamazepine induced alterations on clams, with greater impacts on individuals from the contaminated area which presented higher mortality, higher lipid peroxidation and higher glutathione S-transferase activity. These results emphasize the risk of extrapolating results from one area to another, since the same species inhabiting different areas may be affected differently when exposed to the same stressors. Furthermore, the results obtained showed that, when combined, the impact of pH decrease and carbamazepine was lower than each stressor acting alone, which could be related to the defence mechanism of valves closure when bivalves are under higher stressful conditions. - Highlights: • Environmentally relevant concentrations of CBZ and pH 7.1 impacted the performance of Scrobicularia plana. • The combination of CBZ and pH 7.1 did not induce higher impacts compared with stressors acting alone. • Clams from a polluted area showed greater alterations than clams collected from an unpolluted area. - pH decrease and carbamazepine induced biochemical alterations on clams (Scrobicularia plana), with greater impacts on individuals from the contaminated area

Surgical treatment of hereditary lens subluxations.

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Ozdek, Sengul; Sari, Ayca; Bilgihan, Kamil; Akata, Fikret; Hasanreisoglu, Berati

2002-01-01

To evaluate the effectiveness and results of pars plana vitreolensectomy approach with transscleral fixation of intraocular lens in hereditary lens subluxations. Fifteen eyes of 9 consecutive patients with a mean age of 12.8+/-6.2 years (6-26 years) with hereditary lens subluxation were operated on and the results were evaluated in a prospective study. Surgery was considered if best spectacle corrected visual acuity (BSCVA) was less than 20/70. All eyes underwent a 2-port pars plana vitreolensectomy and transscleral fixation of an intraocular lens (IOL). The mean follow-up period was 12.6+/-7.5 months (6-22 months). There was no major intraoperative complication. Preoperatively, 8 eyes (53.3%) had a BSCVA of counting fingers (CF) and 7 eyes (46.6%) had a BSCVA of 20/200 to 20/70. Postoperatively, 14 eyes (93.3%) had a BSCVA of 20/50 or better. None of the patients had IOL decentration or intraocular pressure (IOP) increase during the follow-up period. There was a macular hole formation in 1 eye postoperatively. The early results of pars plana vitreolensectomy with IOL implantation using scleral fixation technique had shown that it not only promises a rapid visual rehabilitation but it is also a relatively safe method. More serious complications, however, may occur in the long term.

LONGITUDINAL CHANGES IN THICKNESSES OF THE MACULA, GANGLION CELL-INNER PLEXIFORM LAYER, AND RETINAL NERVE FIBER LAYER AFTER VITRECTOMY: A 12-Month Observational Study.

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Lim, Hyung-Bin; Lee, Min-Woo; Kwak, Baek-Soo; Jo, Young-Joon; Kim, Jung-Yeul

2018-01-01

To analyze longitudinal changes in the thicknesses of the macula, ganglion cell-inner plexiform layer (GC-IPL), and peripapillary retinal nerve fiber layer (RNFL) after vitrectomy. Thirty-eight patients diagnosed with intraocular lens (IOL) dislocation without evidence of other vitreoretinal diseases were included. They underwent conventional vitrectomy and IOL transscleral fixation, with a follow-up of 12 months. Using spectral domain optical coherence tomography, the thicknesses of the macula, GC-IPL, and peripapillary RNFL in the vitrectomized and fellow control eyes were measured. Various optic nerve head parameters were also determined. Optical coherence tomography showed that there were no significant differences in postoperative central macular thickness compared with baseline values. The average GC-IPL thickness increased 1 month after surgery from baseline (P = 0.038). The average RNFL thickness increased from baseline at 1 month (P = 0.001) and 3 months (P = 0.011) after vitrectomy. The mean foveal, GC-IPL, and RNFL thicknesses of the study eyes compared with the fellow control eyes increased at 1 month (P = 0.034), 1 month (P = 0.048), and 1 month (P = 0.013) to 3 months (P = 0.038), respectively, after surgery. However, no significant differences were found in intraocular pressure or optic nerve head parameters between the study and fellow control eyes at 12 months after surgery. Transient increases in the thickness of the macula and GC-IPL were observed at 1 month after vitrectomy, and the postoperative RNFL thickness increased until 3 months after surgery, after which it returned to preoperative levels. There was no significant change in intraocular pressure or optic nerve head parameters before and after surgery.

A comparative study of tissue glue and vicryl suture for conjunctival and scleral closure in conventional 20-gauge vitrectomy.

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Batman, C; Ozdamar, Y; Mutevelli, S; Sonmez, K; Zilelioglu, G; Karakaya, J

2009-06-01

To describe the use of tissue glue to close scleral and conjunctival wounds, and to compare the clinical outcomes using tissue glue and vicryl suture for closing these areas in conventional 20-gauge (G) vitrectomy. Thirty eyes of 30 patients were included in this study. The indications for vitreoretinal surgery were diabetic vitreous haemorrhage with severe vitreoretinal traction in 10 eyes, retinal detachment and proliferative vitreoretinopathy in 14 eyes, and vitreous opacity in 6 eyes. Tissue glue (Tisseel, Baxter AG Industries, Vienna, Austria) was used to attach scleral and conjunctival wounds in 15 eyes and vicryl sutures in 15 eyes. The patients were allotted into two subgroups as tissue glue group (TG) and vicryl suture group (VG). The sclerotomy sites were evaluated with ultrasound biomicroscopy (UBM) postoperatively in TG. Follow-up period was 2 months. The groups were statistically compared for ocular signs and symptoms by Mann-Whitney U-test. No scleral wound leakage and conjunctival reattachment were observed at the end of the surgical procedure and during the follow-up period. No adverse effects were seen in TG. Abnormal fibrous ingrowth was not detected at the sclerotomy sites by means of UBM in TG. Patient comfort was significantly higher in TG than VG (P<0.05). Tissue glue has no adverse effects on ocular tissue and can be used as a substitute for suture materials, and the use of tissue glue decreases patient symptoms during the postoperative period after 20-G vitrectomy. Tissue glue can enable to perform sutureless surgery in the conventional 20-G vitrectomy.

Assessment of Macular Function during Vitrectomy: New Approach Using Intraoperative Focal Macular Electroretinograms.

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Celso Soiti Matsumoto

Full Text Available To describe a new technique to record focal macular electroretinograms (FMERGs during vitrectomy to assess macular function.Intraoperative FMERGs (iFMERGs were recorded in ten patients (10 eyes who undergo vitrectomy. iFMERGs were elicited by focal macular stimulation. The stimulus light was directed to the macular area through a 25 gauge (25G glass fiber optic bundle. Background light was delivered through a dual chandelier-type light fiber probe. Focal macular responses elicited with combinations of stimulus and background luminances were analyzed.A stimulus luminance that was approximately 1.75 log units brighter than the background light was able to elicit focal macular responses that were not contaminated by stray light responses. Thus, a stimulus luminance of 160 cd/m2 delivered on a background of 3 cd/m2 elicited iFMEGs from only the stimulated area. This combination of stimulus and background luminances did not elicit a response when the stimulus was projected onto the optic nerve head. The iFMERGs elicited by a 10° stimulus with a duration of 100 ms and an interstimulus interval of 150 ms consisted of an a-, b-, and d-waves, the oscillatory potentials, and the photopic negative response (PhNR.Focal ERGs with all components can be recorded from the macula and other retinal areas during vitreous surgery. This new technique will allow surgeons to assess the function of focal areas of the retina intraoperatively.

Reseña de Coll-Planas (2012 La carne y la metáfora. Una reflexión sobre el cuerpo en la teoría queer

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Rodrigo Prieto Drouillas

2013-07-01

Full Text Available El artículo presenta una reseña del libro «La carne y la metáfora», de Gerard  Coll-Planas (Editorial UOC, 2012, en el cual el autor expone sus críticas a la manera en que han sido interpretados en los últimos años los planteamientos de la teoría queer por algunos sectores de este movimiento en España, poniendo especial atención a la manera de entender el cuerpo y su relación con las identidades de sexo/género. Para ello, Coll-Planas explica las ideas principales de este marco teórico, así como las críticas más recurrentes que se le plantean. En su recorrido, utiliza diferentes técnicas narrativas que invitan al lector a sumergirse en Internet para conocer algunos casos concretos que ejemplifican la forma en que hoy nos relacionamos con el cuerpo, o de cómo éste es maltratado o vejado por culpa de la homofobia imperante. Como conclusión, Coll-Planas propone la politización de la dependencia, la vulnerabilidad y la muerte.

Ecotoxicological Effects of Chemical Contaminants Adsorbed to Microplastics in the Clam Scrobicularia plana

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Sarit O'Donovan

2018-04-01

Full Text Available Although microplastics (MPs are distributed globally in the marine environment, a great deal of unknowns relating to their ecotoxicological effects on the marine biota remains. Due to their lipophilic nature, microplastics have the potential to adsorb persistent organic pollutants present in contaminated regions, which may increase their detrimental impact once assimilated by organisms. This study investigates the ecotoxicological effects of exposure to low-density polyethylene (LDPE microplastics (11–13 μm, with and without adsorbed contaminants (benzo[a]pyrene—BaP and perfluorooctane sulfonic acid—PFOS, in the peppery furrow shell clam, Scrobicularia plana. Environmentally relevant concentrations of contaminants (BaP−16.87 ± 0.22 μg g−1 and PFOS−70.22 ± 12.41 μg g−1 were adsorbed to microplastics to evaluate the potential role of plastic particles as a source of chemical contamination once ingested. S. plana were exposed to microplastics, at a concentration of 1 mg L−1, in a water-sediment exposure setup for 14 days. Clams were sampled at the beginning of the experiment (day 0 and after 3, 7, and 14 days. BaP accumulation, in whole clam tissues, was analyzed. A multi-biomarker assessment was conducted in the gills, digestive gland, and haemolymph of clams to clarify the effects of exposure. This included the quantification of antioxidant (superoxide dismutase, catalase, glutathione peroxidase and biotransformation (glutathione-S-transferases enzyme activities, oxidative damage (lipid peroxidation levels, genotoxicity (single and double strand DNA breaks, and neurotoxicity (acetylcholinesterase activity. Results suggest a potential mechanical injury of gills caused by ingestion of microplastics that may also affect the analyzed biomarkers. The digestive gland seems less affected by mechanical damage caused by virgin microplastic exposure, with the MPs-adsorbed BaP and PFOS exerting a negative influence over the assessed

Diseño de un colector solar de placa plana; Design of a Solar Flat Plate Collector

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Jeovany Rafael Rodríguez Mejía

2015-12-01

Full Text Available En el presente artículo se integra el uso de un software de diseño mecánico y un algoritmo de simulación de la operación de un colector solar de placa plana, con el objetivo de simplificar el proceso de diseño y manufactura de este último. Se exponen los resultados de la simulación de la operación del colector solar considerando diferentes combinaciones en los parámetros de los materiales utilizados, tales como sus propiedades y características físico químicas, además de la variación de las dimensiones del sistema adiseñar. Finalmente en el artículo se evalúa la operación de un colector solar para las condiciones climatológicas típicas de la irradiancia, velocidad de viento y temperatura ambiente a partir de una serie de curvas sinusoidales, típicas de Cuba, validándose la viabilidad del algoritmo como apoyo en la etapa de diseño y selección de materiales.In this article the use of mechanical design software and an algorithm for simulating the operation of a flat plate solar collector, with the objective of simplifying the process of design and manufacture of the latter isintegrated. The simulation results of the operation of the solar collector considering different combinations in the parameters of the materials used, such as its physicochemical properties and features in addition to thevariation of the dimensions of the system design are set. The article finally evaluates the operation of a solar collector for typical climatic conditions of irradiance, wind speed and ambient temperature from a series ofsinusoidal, typical Cuba curves is evaluated, validating the feasibility of the algorithm as support in step design and material selection.

Modified Approach in Management of Submacular Hemorrhage Secondary to Wet Age-Related Macular Degeneration.

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Kumar, Atul; Roy, Sangeeta; Bansal, Mayank; Tinwala, Sana; Aron, Neelima; Temkar, Shreyas; Pujari, Amar

2016-01-01

The aim of this study was to evaluate the surgical outcomes of a modified approach in the management of thick submacular hemorrhage in patients with wet age-related macular degeneration. This was a retrospective study. A retrospective chart review was performed on 10 eyes of 10 patients with submacular hemorrhage secondary to wet age-related macular degeneration treated with 23-gauge pars plana vitrectomy, followed by submacular injection of recombinant tissue plasminogen activator (12.5 μg/0.1 mL), bevacizumab (2.5 mg/0.1 mL), and air (0.3 mL). Gas tamponade was given with 20% SF6 and postoperative propped-up positioning. Patients were evaluated for displacement of hemorrhage, preoperative and postoperative best-corrected visual acuity, occurrence of intraoperative and postoperative complications, and recurrence of hemorrhage. All patients were followed up for 6 months. Displacement of the submacular bleed was achieved in all cases. Improvement of best-corrected visual acuity was seen in 8 of 10 patients. Rebleed was seen in 2 eyes that were retreated with intravitreal injection of recombinant tissue plasminogen activator, bevacizumab, and 20% SF6 gas. This modified technique aids in the effective displacement of thick submacular hemorrhage with simultaneous treatment of the underlying choroidal neovascular membrane, which halts the disease progression resulting in significant improvement of visual acuity.

Trace Elements Iron, Copper and Zinc in Vitreous of Patients with Various Vitreoretinal Diseases

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Sulochana Konerirajapuram

2004-01-01

Full Text Available Purpose: To measure the concentrations of iron, copper and zinc in human vitreous and to interpret their levels with various vitreoretinal diseases like proliferative diabetic retinopathy, retinal detachment, intraocular foreign body, Eales′ disease and macular hole. Methods: Undiluted vitreous fluid collected during pars plana vitrectomy was used to measure trace elements using an atomic absorption spectrophotometer. Results: The level of vitreous iron increased threefold in Eales′ disease (1.85 ± 0.36 pg/ml, 2.5-fold in proliferative diabetic retinopathy (1.534 ± 0.17 pg/ml and 2.3-fold in eyes with intraocular foreign body (1.341 ± 0.25 pg/ml when compared with macular hole (0.588 ± 0.16 pg/ml. This was statistically significant (P < 0.05. Zinc was found to be low in Eales′ disease (0.57 ± 0.22 pg/ml when compared with other groups, though the difference was not statistically significant. Conclusion: The increased level of iron with decreased zinc content in Eales′ disease confirms the earlier reported oxidative stress mechanism for the disease. In proliferative diabetic retinopathy and intraocular foreign body the level of iron increases. This is undesirable as iron can augment glycoxidation, which can lead to increased susceptibility to oxidative damage, in turn causing vitreous liquefaction, posterior vitreous detachment and ultimately retinal detachment and vision loss

Candida Endophthalmitis After Descemet Stripping Automated Endothelial Keratoplasty With Grafts From Both Eyes of a Donor With Possible Systemic Candidiasis.

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Palioura, Sotiria; Sivaraman, Kavitha; Joag, Madhura; Sise, Adam; Batlle, Juan F; Miller, Darlene; Espana, Edgar M; Amescua, Guillermo; Yoo, Sonia H; Galor, Anat; Karp, Carol L

2018-04-01

To report 2 cases with late postoperative Candida albicans interface keratitis and endophthalmitis after Descemet stripping automated endothelial keratoplasty (DSAEK) with corneal grafts originating from a single donor with a history of presumed pulmonary candidiasis. Two patients underwent uncomplicated DSAEK by 2 corneal surgeons at different surgery centers but with tissue from the same donor and were referred to the Bascom Palmer Eye Institute with multifocal infiltrates at the graft-host cornea interface 6 to 8 weeks later, and anterior chamber cultures that were positive for the same genetic strain of C. albicans. Immediate explantation of DSAEK lenticules and daily intracameral and instrastromal voriconazole and amphotericin injections failed to control the infection. Thus, both patients underwent therapeutic penetrating keratoplasty with intraocular lens explantation, pars plana vitrectomy, and serial postoperative intraocular antifungal injection. Both patients are doing well at 2 years postoperatively with best-corrected vision of 20/20 and 20/30+ with rigid gas permeable lenses. One patient required repeat optical penetrating keratoplasty and glaucoma tube implantation 1 year after the original surgery. Literature review reveals that donor lenticule explantation and intraocular antifungals are often inadequate to control fungal interface keratitis, and a therapeutic graft is commonly needed. Interface fungal keratitis and endophthalmitis due to infected donor corneal tissue is difficult to treat, and both recipients of grafts originating from the same donor are at risk of developing this challenging condition.

Comparison of intraocular pressure measured by non-contact air puff versus Goldmann applanation tonometers in gas-filled vitrectomized eyes.

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Patikulsila, Direk; Taweemankongsab, Srisuda; Ngamtipakorn, Supob

2003-05-01

To compare intraocular pressure (IOP) measured by two different instruments, air puff tonometer (APT) versus Goldmann applanation tonometer (GAT), in gas-filled vitrectomized eyes. Three-month, prospective, comparative trial. Thirty-eight patients (38 eyes), who underwent a pars plana vitrectomy (PPV) with gas injection, were enrolled in the study. The IOP was measured by an APT, followed by GAT within 10 minutes by two different, masked investigators. IOPs were measured by two methods and then were compared. Overall, there was a high correlation between both measurements (r = 0.908, p 0.05). By a subgroup analysis of 17 eyes with IOP measured by a GAT of 21 mmHg or less, the APT readings (15.28 +/- 4.81) and GAT readings (14.47 +/- 3.89) were not significantly different (p > 0.05). Of 21 eyes, with IOP measured by a GAT of 22 mmHg or more, the APT readings (26.88 +/- 8.81) were significantly lower than those obtained by the GAT (29.62 +/- 7.69) (p < 0.05). In gas-filled vitrectomized eyes, IOP measurements obtained by an APT correlated well with those obtained by GAT, especially when the IOP was within normal range. However, in eyes with elevated IOP, the APT significantly underestimated the IOP measurement when compared to the gold standard, GAT.

Multiple extrafoveal macular holes following internal limiting membrane peeling

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Hussain N

2018-05-01

Full Text Available Nazimul Hussain, Sandip Mitra Department of Ophthalmology, Al Zahra Hospital, Sharjah, United Arab Emirates Objective: Internal limiting membrane (ILM peeling has been the standard of treatment for macular holes. Besides, causing retinal nerve fiber layer surface abnormality, postoperative extrafoveal multiple retinal holes is a rare phenomenon following ILM peeling. We report an unusual complication of eight extrafoveal macular holes occurring following ILM peeling.Case presentation: A 60-year-old male presented with complaints of decreased and distorted vision in the right eye. He was diagnosed as having epiretinal membrane with lamellar macular hole. He underwent 23G pars plana vitrectomy, brilliant blue assisted ILM peeling and fluid gas exchange. Intraoperatively, ILM was found to be adherent to the underlying neurosensory retina. One month after cataract surgery, he underwent YAG capsulotomy in the right eye. He complained of visual distortion. His fundus evaluation in the right eye showed multiple (eight extrafoveal retinal holes temporal to the macula clustered together.Conclusion: This case demonstrated that peeling of ILM, especially when it is adherent to the underlying neurosensory retina, may cause unwanted mechanical trauma to the inner retina. Glial apoptosis and neuronal degeneration may presumably play a role in delayed appearance of multiple (eight extrafoveal macular holes, which has not been reported earlier. Keywords: internal limiting membrane, lamellar macular hole, full thickness macular holes, epiretinal membrane

Scleral depressed vitreous shaving, 360 laser, and perfluoropropane (C 3 F 8 for retinal detachment

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Vivek Chaturvedi

2014-01-01

Full Text Available Purpose : To review the characteristics and outcomes of patients who underwent pars plana vitrectomy (PPV with scleral depressed vitreous shaving, 360 degree peripheral endolaser, and 14% C3F8 gas for rhegmatogenous retinal detachment (RRD. Materials and Methods : A retrospective review of a consecutive series of patients who underwent primary repair of RRD by PPV with scleral depressed vitreous shaving, 360 degree peripheral endolaser, and 14% perfluoropropane (C 3 F 8 was conducted. Patients with less than 3 months follow-up, previous retinal surgery, and higher than grade B proliferative vitreoretinopathy were excluded. Results : Ninety-one eyes were included in the study. The mean age was 60.1 years. The mean follow-up was 13.7 months. The macula was detached in 63% (58/91 of the eyes. The reattachment rate after one surgical procedure was 95% (86/91 while overall reattachment rate was 100%. There was no statistically significant difference between reattachment rates of superior, nasal/temporal, or inferior RRDs. The mean final best corrected visual acuity (BCVA was 20/40. Of all the patients, 66% of patients with macula-off RRDs had a final BCVA of 20/40 or better. Conclusions: PPV with scleral depressed vitreous shaving, 360 degree peripheral endolaser, and 14% C 3 F 8 leads to successful anatomical reattachment with visual improvement in patients with primary RRD.

Intravitreal injection analysis at the Bascom Palmer Eye Institute: evaluation of clinical indications for the treatment and incidence rates of endophthalmitis

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Ludimila L Cavalcante

2010-05-01

Full Text Available Ludimila L Cavalcante, Milena L Cavalcante, Timothy G Murray, Michael M Vigoda, Yolanda Piña, Christina L Decatur, R Prince Davis, Lisa C Olmos, Amy C Schefler, Michael B Parrott, Kyle J Alliman, Harry W Flynn, Andrew A MoshfeghiBascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USAObjective: To report the incidence of endophthalmitis, in addition to its clinical and microbiological aspects, after intravitreal injection of vascular-targeting agents.Methods: A retrospective review of a consecutive series of 10,142 intravitreal injections of vascular targeting agents (bevacizumab, ranibizumab, triamcinolone acetonide, and preservative-free triamcinolone acetonide between June 1, 2007 and January 31, 2010, performed by a single service (TGM at the Bascom Palmer Eye Institute.Results: One case of clinically-suspected endophthalmitis was identified out of a total of 10,142 injections (0.009%, presenting within three days of injection of bevacizumab. The case was culture-positive for Staphylococcus epidermidis. Final visual acuity was 20/40 after pars plana vitrectomy surgery.Conclusions: In this series, the incidence of culture-positive endophthalmitis after intravitreal injection of vascular agents in an outpatient setting was very low. We believe that following a standardized injection protocol, adherence to sterile techniques and proper patient follow-up are determining factors for low incidence rates.Keywords: endophthalmitis, intravitreal injections, vascular targeting agents 

Outcome and Prognostic Factors for Traumatic Endophthalmitis over a 5-Year Period

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Simona Delia Nicoară

2014-01-01

Full Text Available Purpose. To evaluate the outcome and identify the prognostic factors of traumatic endophthalmitis over a 5-year period. Methods. We reviewed the medical records of all the traumatic endophthalmities that we treated in our department over the last 5 years (2009–2013. We extracted the following parameters: age, gender, wound anatomy, associated ocular lesions, treatment, and initial and final visual acuities. We used the program SPSS version 20.0.0. for the statistical analysis of our data. Results. During the last 5 years, we treated 14 traumatic endophthalmities, representing 46.66% of all types of endophthalmities. The infection rate in open globe injuries was 8.13% and 34.78%, if an intraocular foreign body (IOFB was associated. All the patients were males with the median age of 37 years. Initial visual acuities varied between light perception and 0.4 and the timing of treatment from a few hours to 10 days. We administered antibiotic and anti-inflammatory drugs, systemically and intravitreally, in all cases. We performed pars plana vitrectomy in 64.28% of cases. In 57.14% of cases, the final visual acuity was 0.1 or more. Conclusions. IOFBs increased significantly the risk for endophthalmitis. The worse prognostic factors were retinal detachment at presentation and delayed treatment. This trial is registered with IRCT2014082918966N1.

Endothelin-1 is associated with fibrosis in proliferative diabetic retinopathy membranes.

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Chang, William; Lajko, Michelle; Fawzi, Amani A

2018-01-01

To characterize the relationship between endothelin-1 and fibrosis in epiretinal membranes in proliferative diabetic retinopathy and explore the role of endothelial-mesenchymal transition in these membranes. Membranes were obtained from eyes undergoing pars plana vitrectomy for complicated proliferative diabetic retinopathy or idiopathic epiretinal membrane. Through standard immunohistochemical techniques, we labeled membranes to explore the distribution of endothelin-1 and endothelin receptor B, comparing proliferative diabetic retinopathy and idiopathic epiretinal membranes. In addition, membranes were also labeled with markers for fibroblasts, endothelial, and glial cells and studied with confocal laser scanning microscopy. The intensity of endothelin-1 labeling was quantified using standard image analysis software. Fourteen membranes were included in the analysis, nine from eyes with proliferative diabetic retinopathy and five idiopathic membranes. Flatmount diabetic membranes showed co-localization of endothelin-1 with S100A4 and CD31. Immunohistochemistry and quantitative analysis of cross-sectional membranes showed significantly higher endothelin-1 labeling in proliferative diabetic retinopathy membranes compared to idiopathic membranes (pmembranes showed more elements staining positive for S100A4 compared to idiopathic membranes. Epiretinal membrane formation in proliferative diabetic retinopathy involves higher tissue levels of endothelin-1 and fibroblastic activity. Furthermore, endothelin-1, endothelial and fibroblastic staining appear to be correlated, suggestive of endothelial-to-mesenchymal transition in proliferative diabetic retinopathy.

Morphometric analysis of fovea with spectral-domain optical coherence tomography and visual outcome postsurgery for retinal detachment

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Manish Nagpal

2014-01-01

Full Text Available Purpose: The purpose of this study was to correlate the postoperative best-corrected visual acuity (BCVA with spectral-domain optical coherence tomography (SD-OCT findings in fovea involving rhegmatogenous retinal detachment (RRD surgery. Materials and Methods: Thirty eyes with preoperative fovea-involving RRD, who underwent scleral buckling (SB (6 eyes and pars plana vitrectomy (PPV (19 eyes and combined SB and PPV (5 eyes were recruited. Patients underwent clinical examination and SD-OCT scan of fovea preoperatively and at 30 days and 90 days postoperatively. The correlations between SD-OCT findings and BCVA were analyzed. Results: Inner segment/outer segment (IS/OS junction integrity was the indicator of better BCVA at 30 days and 90 days (P = 0.0002 and P = 0.0003, respectively whereas outer retinal corrugation (ORC was related to worse BCVA at 30 days and 90 days (P = 0.001. External limiting membrane did not have a co-relation with visual outcome, but cystoid macular edema showed co-relation at 90 days (P = 0.047. All eyes of SB and 3 eyes of PPV had a minimal subfoveal fluid at 30 days follow-up that had no effect on visual acuity. All retinas were attached at final follow-up. Conclusion: IS/OS junction integrity and ORC may be important predictors of postoperative visual outcome after anatomically successful RRD surgery.

Retinal detachment repair and cataract surgery in patients with atopic dermatitis.

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Gnana Jothi, V; McGimpsey, S; Sharkey, J A; Chan, W C

2017-09-01

PurposeThe aim of this study is to report a case series of ocular complications including retinal detachment (RD) and cataract in atopic dermatitis (AD) and surgical management involving a majority of Caucasian patients.Patients and methodsThis study is an observational case series, originally designed as an audit. It involves detailed discussion of history, clinical features, and surgical management of patients presenting with retinal detachment and cataracts secondary to severe AD. Six consecutive patients with diagnosis of severe AD requiring posterior segment and cataract surgery were included in the study.ResultsEight eyes of six patients had retinal detachment. Most of them involved the temporal retina. The retinal breaks were located anteriorly close to the ora serrata in six eyes and Giant tear retinal (GRT) detachment was found in two eyes. Five eyes had proliferative vitreo-retinopathy (PVR) at presentation. All six patients had bilateral cataracts and cataract surgery was performed in eleven eyes. Bilateral simultaneous surgery was essential in two patients. Three eyes had secondary intra-ocular lens (IOL) implantation with pars plana vitrectomy for subluxed lens implant.ConclusionsAnterior retinal breaks and temporal RD are common in retinal detachment secondary to AD. PVR is often present, which makes surgical management difficult. Cataract formation is quite often and late subluxation of IOL may occur.

Six-month postoperative outcomes of intraoperative OCT-guided surgical cystotomy for refractory cystoid macular edema in diabetic eyes

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Asahina Y

2017-11-01

Full Text Available Yuichi Asahina, Naoko Tachi, Yumi Asahina, Kayoko Yoshimura, Yoshiki Ueta, Yoshihiro Hashimoto Eye Center, Shinseikai Toyama Hospital, Imizu, Toyama, Japan Purpose: This study evaluated the outcomes of surgical cystotomy for recurrent diabetic cystoid macular edema (CME.Patients and methods: We analyzed 20 eyes with a clinical diagnosis of diabetic retinopathy and refractory CME. Release of vitreoretinal adhesion, epiretinal membrane (ERM and internal limiting membrane (ILM peeling and cystotomy guided by intraoperative optical coherence tomography (iOCT were performed in every patient. Pars plana vitrectomy was also performed in 17 patients, 11 of whom also underwent lensectomy and intraocular lens implantation. Central retinal thickness (CRT, central minimum macular thickness (CMMT, macular volume (MV and best-corrected visual acuity (BCVA were compared preoperatively and 1 and 6 months post surgery.Results: CRT, CMMT and MV significantly improved 1 and 6 months post surgery in each group (P<0.01. Significant improvements in BCVA were only observed 6 months post surgery (P<0.01. No intra- or postoperative complications were observed in all patients.Conclusion: CRT, CMMT, MV and BCVA significantly improved 6 months following surgical cystectomy. This implies that iOCT-guided cystotomy could be another treatment option for refractory CME in diabetic eyes. Keywords: diabetic retinopathy, cystoid macular edema, intraoperative OCT, cystotomy

Evaluation of secondary surgery to enlarge the peeling of the internal limiting membrane following the failed surgery of idiopathic macular holes.

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Che, Xin; He, Fanglin; Lu, Linna; Zhu, Dongqing; Xu, Xiaofang; Song, Xin; Fan, Xianqun; Wang, Zhiliang

2014-03-01

The aim of the present study was to evaluate the clinical results of pars plana vitrectomy (PPV) combined with the surgical enlargement of internal limiting membrane (ILM) peeling in patients who had previously undergone failed idiopathic macular hole (IMH) surgery. In the study, 134 eyes from 130 IMH patients who had received PPV combined with ILM peeling surgery (2 disk diameters) were analyzed. Within this cohort, 14 eyes had IMHs that were not closed, of which 13 eyes underwent a second surgery involving enlargement of the ILM peeling. The extent of the ILM peeling was increased to the vascular arcades of the posterior fundus in the secondary surgery. Of the 13 eyes that underwent secondary surgery, five were in stage III and nine were in stage IV. The second surgery successfully achieved IMH closure in 61.5% (8/13) of the eyes. The IMH was completely closed following surgery and the logMAR vision increased from 0.98 to 0.84 (P=0.013) in the 8 successfully treated cases. The surgical enlargement of ILM peeling closed the IMHs and improved vision in the majority of patients. In addition, the procedures were safe. Therefore, the results of the present study indicate that enlargement of ILM peeling may be an effective therapy for patients who have previously undergone the failed surgical correction of an IMH.

Directed and persistent movement arises from mechanochemistry of the ParA/ParB system.

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Hu, Longhua; Vecchiarelli, Anthony G; Mizuuchi, Kiyoshi; Neuman, Keir C; Liu, Jian

2015-12-22

The segregation of DNA before cell division is essential for faithful genetic inheritance. In many bacteria, segregation of low-copy number plasmids involves an active partition system composed of a nonspecific DNA-binding ATPase, ParA, and its stimulator protein ParB. The ParA/ParB system drives directed and persistent movement of DNA cargo both in vivo and in vitro. Filament-based models akin to actin/microtubule-driven motility were proposed for plasmid segregation mediated by ParA. Recent experiments challenge this view and suggest that ParA/ParB system motility is driven by a diffusion ratchet mechanism in which ParB-coated plasmid both creates and follows a ParA gradient on the nucleoid surface. However, the detailed mechanism of ParA/ParB-mediated directed and persistent movement remains unknown. Here, we develop a theoretical model describing ParA/ParB-mediated motility. We show that the ParA/ParB system can work as a Brownian ratchet, which effectively couples the ATPase-dependent cycling of ParA-nucleoid affinity to the motion of the ParB-bound cargo. Paradoxically, this resulting processive motion relies on quenching diffusive plasmid motion through a large number of transient ParA/ParB-mediated tethers to the nucleoid surface. Our work thus sheds light on an emergent phenomenon in which nonmotor proteins work collectively via mechanochemical coupling to propel cargos-an ingenious solution shaped by evolution to cope with the lack of processive motor proteins in bacteria.

VITRECTOMY FOR INTERMEDIATE AGE-RELATED MACULAR DEGENERATION ASSOCIATED WITH TANGENTIAL VITREOMACULAR TRACTION: A CLINICOPATHOLOGIC CORRELATION.

Science.gov (United States)

Ziada, Jean; Hagenau, Felix; Compera, Denise; Wolf, Armin; Scheler, Renate; Schaumberger, Markus M; Priglinger, Siegfried G; Schumann, Ricarda G

2018-03-01

To describe the morphologic characteristics of the vitreomacular interface in intermediate age-related macular degeneration associated with tangential traction due to premacular membrane formation and to correlate with optical coherence tomography (OCT) findings and clinical data. Premacular membrane specimens were removed sequentially with the internal limiting membrane from 27 eyes of 26 patients with intermediate age-related macular degeneration during standard vitrectomy. Specimens were processed for immunocytochemical staining of epiretinal cells and extracellular matrix components. Ultrastructural analysis was performed using transmission electron microscopy. Spectral domain optical coherence tomography images and patient charts were evaluated in retrospect. Immunocytochemistry revealed hyalocytes and myofibroblasts as predominant cell types. Ultrastructural analysis demonstrated evidence of vitreoschisis in all eyes. Myofibroblasts with contractile properties were observed to span between folds of the internal limiting membrane and vitreous cortex collagen. Retinal pigment epithelial cells or inflammatory cells were not detected. Mean visual acuity (Snellen) showed significant improvement from 20/72 ± 20/36 to 20/41 ± 20/32 (P age-related macular degeneration predominantly consists of vitreous collagen, hyalocytes, and myofibroblasts with contractile properties. Vitreoschisis and vitreous-derived cells appear to play an important role in traction formation of this subgroup of eyes. In patients with intermediate age-related macular degeneration and contractile premacular membrane, release of traction by vitrectomy with internal limiting membrane peeling results in significantly functional and anatomical improvement.

Effects of internal limiting membrane peeling during vitrectomy for macula-off primary rhegmatogenous retinal detachment.

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Blanco-Teijeiro, María José; Bande Rodriguez, Manuel; Mansilla Cuñarro, Raquel; Paniagua Fernández, Laura; Ruiz-Oliva Ruiz, Francisco; Piñeiro Ces, Antonio

2018-03-01

To determine the effectiveness of internal limiting membrane peeling during vitrectomy for macula-off primary rhegmatogenous retinal detachment in the prevention of postoperative epiretinal membrane formation and achievement of good visual outcomes and to identify preoperative and intraoperative risk factors for epiretinal membrane formation. We retrospectively analyzed data from 62 eyes of 62 consecutive patients with macula-off primary rhegmatogenous retinal detachment who underwent vitrectomy with (n = 30) or without (n = 32) internal limiting membrane peeling between January 2014 and March 2016 and were followed up for at least 12 months. The effects of internal limiting membrane peeling on visual outcomes and postoperative recovery of the macular structure were determined. We subsequently divided patients into an epiretinal membrane group and a non-epiretinal membrane group and assessed the effects of various preoperative and intraoperative factors on postoperative epiretinal membrane formation. Postoperative epiretinal membrane developed in 10 patients in the no internal limiting membrane peeling group and three patients in the internal limiting membrane peeling group. Postoperative visual acuity significantly improved in both groups. Epiretinal membrane formation was found to be correlated with a higher number of retinal breaks. Our results suggest that internal limiting membrane peeling during macula-off primary rhegmatogenous retinal detachment surgery can reduce the occurrence of postoperative epiretinal membrane, is safe, and results in favorable visual outcomes.

Subretinal Fluid Drainage and Vitrectomy Are Helpful in Diagnosing and Treating Eyes with Advanced Coats' Disease

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Ayako Imaizumi

2016-04-01

Full Text Available Severe forms of Coats’ disease are often associated with total retinal detachment, and a differential diagnosis from retinoblastoma is critically important. In such eyes, laser- and/or cryoablation is often ineffective or sometimes impossible to perform. We report a case of advanced Coats’ disease in which a rapid pathological examination of subretinal fluid was effective for the diagnosis, and external subretinal drainage combined with vitrectomy was effective in preserving the eye.

New process for the wastewater reclamation. ACTDisc process demonstration in the WWTP at Castellon de la Plana (Spain); Nuevos procesos de regeneracion de aguas depuradas: demostracion del proceso ACTDisc en la EDAR de Castellon de la Plana

Energy Technology Data Exchange (ETDEWEB)

Sanz, J.; Guerrero, L.; Ortega, J. M.; Ferrer, C.; Migeul, D.; Martinez, F.; Morenilla Martinez, J. J.; Bernacer Bonora, I.

2006-07-01

During May 2005, the efficiency of ACTIDis process has been rested in Castellon de la Plana WWTP, in collaboration with Fecsa and Entitat de Sanejament d'Aigues Residuals de la Generalitat Valenciana. Test purpose has been to prove the suitability of ACTIDisc process in wastewater reclamation of this WWTP secondary effluent. The aim has been, mainly, to achieve a low level of suspended solid and turbidity in compliance with the regulations proposal for direct reuse of treated effluents as AEAS guidelines suggested in 2005. (Author) 6 refs.

Meta-analysis comparing same-day versus delayedvitrectomy clinical outcomes for intravitreal retained lens fragments after age-relatedcataract surgery

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Vanner EA

2014-11-01

Full Text Available Elizabeth A Vanner,1 Michael W Stewart21Department of Preventive Medicine, Pathology and Bioinformatics, Stony Brook University, Stony Brook, NY, USA; 2Department of Ophthalmology, Mayo Clinic College of Medicine, Jacksonville, FL, USAPurpose/design: We aimed to perform a systematic review and meta-analysis comparing the risk difference of clinical outcomes for same-day (SD vs delayed (DEL pars plana vitrectomy (PPV.Methods: We searched MEDLINE (English; January 1, 1985 to July 16, 2013 and article reference lists, for patients with crystalline retained lens fragments and discussion of SD-PPV vs DEL-PPV. For the meta-analysis, articles needed the number of patients receiving SD-PPV and DEL-PPV, and the number, in each group, who experienced one or more of the outcomes: not good visual acuity (VA (<20/40, bad VA (≤20/200, retinal detachment, increased intraocular pressure/glaucoma, intraocular infection/inflammation, cystoid macular edema, and corneal edema.Results: Of 304 articles identified, 23 provided data for the meta-analysis. Results were mixed, indicating 1 neither vitrectomy time produced better outcomes in all studies (not good VA risk difference =10.3% [positive numbers favored SD-PPV; negative numbers favored DEL-PPV], 95% confidence interval [CI] = [-0.4% to 21.0%], P=0.059; and bad VA risk difference =-0.3%, 95% CI = [-10.7% to 10.1%], P=0.953; 2 better outcomes with immediate SD-PPV compared with all DEL-PPV (not good VA risk difference =16.2%, 95% CI = [0.8% to 31.5%], P=0.039; and bad VA risk difference =8.5%; 95% CI = [0.8% to 16.2%], P=0.030; and 3 immediate SD-PPV and prompt DEL-PPV (3 to 14 days after cataract surgery had no significant differences and so may produce similar outcomes (not good VA risk differences range = [-19.9% to 6.5%], 95% CI = [-59.9% to 36.4%]; and bad VA risk differences range = [-6.9% to 7.4%], 95% CI = [-33.1% to 31.8%].Conclusion: Perhaps SD-PPV should be limited to facilities at which a

PERIPAPILLARY RETINAL NERVE FIBER THICKNESS CHANGES AFTER VITRECTOMY FOR EPIRETINAL MEMBRANE IN EYES WITH AND WITHOUT VITREOUS DETACHMENT.

Science.gov (United States)

Mariotti, Cesare; Nicolai, Michele; Longo, Antonio; Viti, Francesca; Bambini, Elisa; Saitta, Andrea; Pirani, Vittorio; Orsini, Emanuele; Baruffa, Daniela; Reibaldi, Michele

2017-12-01

To compare the changes in postoperative peripapillary retinal nerve fiber layer (p-RNFL) thickness after vitrectomy for epiretinal membrane in eyes with preexisting posterior vitreous detachment (PVD) and eyes with surgically induced PVD. This study included consecutive patients who underwent 25-gauge vitrectomy for epiretinal membrane. Eyes were divided, according to intraoperative PVD status, into a preexisting PVD group and surgically induced PVD group. Best-corrected visual acuity, p-RNFL thickness, and central retinal thickness were performed before and at 1, 3, and 6 months after surgery. One hundred and twenty eyes of 120 patients were enrolled: 64 eyes in the preexisting PVD group and 56 eyes in the surgically induced PVD group. In the preexisting PVD group at 6 months, the mean global p-RNFL thickness did not change, whereas it was reduced in the temporal sector (P = 0.034). In the surgically induced PVD group at 6 months, significant decreases were observed in global p-RNFL thickness (P = 0.027), temporal (P = 0.021), temporal inferior (P = 0.030), and nasal inferior sectors (P = 0.010). At 6 months, the two groups differed significantly in temporal (P PVD.

FooPar

DEFF Research Database (Denmark)

Hargreaves, F. P.; Merkle, D.

2013-01-01

We present FooPar, an extension for highly efficient Parallel Computing in the multi-paradigm programming language Scala. Scala offers concise and clean syntax and integrates functional programming features. Our framework FooPar combines these features with parallel computing techniques. Foo......, results based on a empirical analysis on two supercomputers are given. We achieve close-to-optimal performance wrt. theoretical peak performance. Based on this result we conclude that FooPar allows programmers to fully access Scalas design features without suffering from performance drops when compared...

Pistas planas en el tratamiento de la clase II: Presentación de un caso Flat strips in the treatment of class II malocclusion.: A case report

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Yulenia Cruz Rivas

2005-12-01

Full Text Available La maloclusión clase II división 1 es una de las anomalías que se presentan en las consultas de Ortodoncia con mayor frecuencia. Para solucionar esta problemática se han descrito diversos tratamientos. Se muestra un caso tratado mediante ortopedia funcional, específicamente con pistas planas de clase II, aparato funcional ideado por Pedro Planas , basado en la rehabilitación neuroclusal . Los resultados demuestran la efectividad de dicho aparato, pues se aprecian cambios a favor de la armonía esqueletal , la estética y la función, así como las modificaciones transversales que fueron alentadores. Dentro de los cambios esqueletales , se observó la apertura del eje facial y el aumento de la altura facial anteroinferior .Division 1 class II malocclusion is one of the abnormalities that are present in the Orthodontics offices more frequently. Different treatments have been described to solve this problem. A case treated by functional orthopedics, specifically with class II flat strips, an appliance created by Pedro Planas that is based on neuroocclusal rehabilitation, is reported. The results show the effectiveness of this appliance, since changes in favor of skeletal harmony, aesthetics and function are observed, and the transversal modifications are encouraging. The opening of the facial axis and the increase of the anteroinferior facial height are observed among the skeletal changes.

Vitrectomy and internal limiting membrane peeling with different vitreous tamponade for idiopathic macular epiretinal membrane

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Jie Dong

2013-06-01

Full Text Available AIM: To compare visual outcomes, central foveal thickness(CFT, and postoperative complications after vitrectomy and internal limiting membrane(ILMpeeling, with balanced salt solution(BSSor gas tamponade, for the treatment of idiopathic macular epiretinal membrane(IMEM. METHODS: Retrospective clinical study. 44 patients with IMEM were included in this study. All patients had undergone vitrectomy and ILM peeling. Eyes were divided into two groups: 20 eyes in group A with BSS tamponade. 24 patients in group B with gas tamponade(11 eyes were injected with filtered air and 13 eyes with perfluoropropane,100mL/L C3F8. The follow-up period was 12-16(mean 13months. The following parameters were collected and compared: best-corrected visual acuity(BCVAand CFT(at baseline and 1, 3, 6 and 12 months postoperatively, intraocular pressure(IOP(at baseline and on the 1th,7th day, 1, 3 months postoperatively. RESULTS: BCVA significantly improved, and 29 of 44 eyes(65.9%achieved visual recovery≥0.2 logMAR. There were no significant differences between group A and group B in mean baseline logMAR BCVA(0.53±0.18 vs 0.52±0.14; P>0.05and final logMAR BCVA(0.31±0.14 vs 0.28±0.09; P>0.05. With respect to OCT parameters, the mean CFT at 12 months(285.25±70.07μmwas significantly decreased from that of the baseline(407.82±97.00μm,(Z=4.29, Pvs 406.46±88.76μm; P>0.05and final CFT(287.60±66.94μm vs 283.29±73.95μm; P>0.05. With respect to IOP, there were no significant differences between group A and group B at mean baseline and on the 7th day, 1, 3 months postoperatively(P>0.05. The IOP in group A was significant lower at 1th postoperative day compared with group B(Z=3.12, PCONCLUSION: Vitrectomy and ILM peeling can significantly improve the visual acuity and decrease the CFT no matter with gas or with BSS tamponade, there were no significant differences in clinical outcomes, but it is neither necessary for patients with BSS tamponade to maintain a prone

Phosphorylation of Mycobacterium tuberculosis ParB participates in regulating the ParABS chromosome segregation system.

Science.gov (United States)

Baronian, Grégory; Ginda, Katarzyna; Berry, Laurence; Cohen-Gonsaud, Martin; Zakrzewska-Czerwińska, Jolanta; Jakimowicz, Dagmara; Molle, Virginie

2015-01-01

Here, we present for the first time that Mycobacterium tuberculosis ParB is phosphorylated by several mycobacterial Ser/Thr protein kinases in vitro. ParB and ParA are the key components of bacterial chromosome segregation apparatus. ParB is a cytosolic conserved protein that binds specifically to centromere-like DNA parS sequences and interacts with ParA, a weak ATPase required for its proper localization. Mass spectrometry identified the presence of ten phosphate groups, thus indicating that ParB is phosphorylated on eight threonines, Thr32, Thr41, Thr53, Thr110, Thr195, and Thr254, Thr300, Thr303 as well as on two serines, Ser5 and Ser239. The phosphorylation sites were further substituted either by alanine to prevent phosphorylation or aspartate to mimic constitutive phosphorylation. Electrophoretic mobility shift assays revealed a drastic inhibition of DNA-binding by ParB phosphomimetic mutant compared to wild type. In addition, bacterial two-hybrid experiments showed a loss of ParA-ParB interaction with the phosphomimetic mutant, indicating that phosphorylation is regulating the recruitment of the partitioning complex. Moreover, fluorescence microscopy experiments performed in the surrogate Mycobacterium smegmatis ΔparB strain revealed that in contrast to wild type Mtb ParB, which formed subpolar foci similar to M. smegmatis ParB, phoshomimetic Mtb ParB was delocalized. Thus, our findings highlight a novel regulatory role of the different isoforms of ParB representing a molecular switch in localization and functioning of partitioning protein in Mycobacterium tuberculosis.

Phosphorylation of Mycobacterium tuberculosis ParB participates in regulating the ParABS chromosome segregation system.

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Grégory Baronian

Full Text Available Here, we present for the first time that Mycobacterium tuberculosis ParB is phosphorylated by several mycobacterial Ser/Thr protein kinases in vitro. ParB and ParA are the key components of bacterial chromosome segregation apparatus. ParB is a cytosolic conserved protein that binds specifically to centromere-like DNA parS sequences and interacts with ParA, a weak ATPase required for its proper localization. Mass spectrometry identified the presence of ten phosphate groups, thus indicating that ParB is phosphorylated on eight threonines, Thr32, Thr41, Thr53, Thr110, Thr195, and Thr254, Thr300, Thr303 as well as on two serines, Ser5 and Ser239. The phosphorylation sites were further substituted either by alanine to prevent phosphorylation or aspartate to mimic constitutive phosphorylation. Electrophoretic mobility shift assays revealed a drastic inhibition of DNA-binding by ParB phosphomimetic mutant compared to wild type. In addition, bacterial two-hybrid experiments showed a loss of ParA-ParB interaction with the phosphomimetic mutant, indicating that phosphorylation is regulating the recruitment of the partitioning complex. Moreover, fluorescence microscopy experiments performed in the surrogate Mycobacterium smegmatis ΔparB strain revealed that in contrast to wild type Mtb ParB, which formed subpolar foci similar to M. smegmatis ParB, phoshomimetic Mtb ParB was delocalized. Thus, our findings highlight a novel regulatory role of the different isoforms of ParB representing a molecular switch in localization and functioning of partitioning protein in Mycobacterium tuberculosis.

Indications and Visual Outcome of First Hundred Pars Plana ...

African Journals Online (AJOL)

tulyasys

prevention programs because it is assumed that they are not a common cause of blindness and the outcome of treating retinal diseases do not justify the effort and expense involved.[4] The huge cost of equipment and shortage of trained man.

COMPLETE SUBRETINAL FLUID DRAINAGE IS NOT NECESSARY DURING VITRECTOMY SURGERY FOR MACULA-OFF RHEGMATOGENOUS RETINAL DETACHMENT WITH PERIPHERAL BREAKS: A Prospective, Nonrandomized Comparative Interventional Study.

Science.gov (United States)

Chen, Xiao; Zhang, Yong; Yan, Ying; Hong, Ling; Zhu, Li; Deng, Jun; Din, Qin; Huang, Zhijian; Zhou, Hezhen

2017-03-01

To compare clinical outcomes in eyes with macula-off rhegmatogenous retinal detachments managed by surgical protocols, the result in either complete (CSFD) or partial subretinal fluid drainage (PSFD). Fifty-four eyes with macula-off rhegmatogenous retinal detachments with peripheral retinal breaks of 54 patients were assigned prospectively to one of the two surgical designs (PSFD or CSFD, 2:1) in a sequence. Patients were treated with 25-gauge plus vitrectomy, either CSFD (n = 18) or PSFD (n = 36), and 14% C3F8 was used for intraocular tamponade. Anatomical and visual outcomes as well as intraoperative and postoperative complications of the two groups were compared. The single-operation success rates were 16/18 (88.9%) and 33/36 (91.6%), respectively, for the CSFD and the PSFD groups (P = 1.00). The mean BCVA improvement (Early Treatment Diabetic Retinopathy Study letters) at the 6-month postoperative was not significantly different between the two groups (26.50 ± 15.43 in CSFD group vs. 22.64 ± 15.43 in PSFD group, P = 0.43). Partial subretinal fluid drainage procedure during vitrectomy for the repair of macula-off rhegmatogenous retinal detachments revealed comparable results with CSFD in terms of anatomical and visual outcomes. Complete subretinal fluid drainage during vitrectomy seems to be unnecessary for all RRD reattachment surgical procedures.

Do it yourself smartphone fundus camera – DIYretCAM

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Biju Raju

2016-01-01

Full Text Available This article describes the method to make a do it yourself smartphone-based fundus camera which can image the central retina as well as the peripheral retina up to the pars plana. It is a cost-effective alternative to the fundus camera.

ParA and ParB coordinate chromosome segregation with cell elongation and division during Streptomyces sporulation

Science.gov (United States)

Donczew, Magdalena; Mackiewicz, Paweł; Wróbel, Agnieszka; Flärdh, Klas; Zakrzewska-Czerwińska, Jolanta

2016-01-01

In unicellular bacteria, the ParA and ParB proteins segregate chromosomes and coordinate this process with cell division and chromosome replication. During sporulation of mycelial Streptomyces, ParA and ParB uniformly distribute multiple chromosomes along the filamentous sporogenic hyphal compartment, which then differentiates into a chain of unigenomic spores. However, chromosome segregation must be coordinated with cell elongation and multiple divisions. Here, we addressed the question of whether ParA and ParB are involved in the synchronization of cell-cycle processes during sporulation in Streptomyces. To answer this question, we used time-lapse microscopy, which allows the monitoring of growth and division of single sporogenic hyphae. We showed that sporogenic hyphae stop extending at the time of ParA accumulation and Z-ring formation. We demonstrated that both ParA and ParB affect the rate of hyphal extension. Additionally, we showed that ParA promotes the formation of massive nucleoprotein complexes by ParB. We also showed that FtsZ ring assembly is affected by the ParB protein and/or unsegregated DNA. Our results indicate the existence of a checkpoint between the extension and septation of sporogenic hyphae that involves the ParA and ParB proteins. PMID:27248800

Par Pond water balance

International Nuclear Information System (INIS)

Hiergesell, R.A.; Dixon, K.L.

1996-06-01

A water budget for the Par Pond hydrologic system was established in order to estimate the rate of groundwater influx to Par Pond. This estimate will be used in modeling exercises to predict Par Pond reservoir elevation and spillway discharge in the scenario where Savannah River water is no longer pumped and discharged into Par Pond. The principal of conservation of mass was used to develop the water budget, where water inflow was set equal to water outflow. Components of the water budget were identified, and the flux associated with each was determined. The water budget was considered balanced when inflow and outflow summed to zero. The results of this study suggest that Par Pond gains water from the groundwater system in the upper reaches of the reservoir, but looses water to the groundwater system near the dam. The rate of flux of groundwater from the water table aquifer into Par Pond was determined to be 13 cfs. The rate of flux from Par Pond to the water table aquifer near the dam was determined to be 7 cfs

suPAR

DEFF Research Database (Denmark)

Hodges, Gethin W; Bang, Casper N; Wachtell, Kristian

2015-01-01

The fundamental role of inflammation in cardiovascular disease (CVD) has prompted interest in numerous biomarkers that detect subclinical levels of inflammation. Soluble urokinase plasminogen activator receptor (suPAR) is a novel biomarker that correlates significantly with cardiovascular events ...... comprehensive review of suPAR in CVD and explore its function and usefulness in predicting cardiovascular events....

Two Cases of Severe Degeneration of the Macula Following Vitrectomy with Indocyanine Green-Assisted Internal Limiting Membrane Peeling for Idiopathic Macular Hole

OpenAIRE

Inoue, Junji; Sakuma, Toshiro; Kiyokawa, Masatoshi; Kobayashi, Yasuhiko; Takebayashi, Hiroshi; Mizota, Atsushi; Tanaka, Minoru

2008-01-01

We describe three eyes of two cases of severe degeneration of the macula following vitrectomy with indocyanine green-assisted internal limiting membrane peeling for idiopathic macular hole. We need to remember the possibility of these complications and have to select the procedures that are safest to use for macular hole surgery.

C9.A/14 steelwork joints de poutres par plaque frontale : assemblages par gousset

CERN Document Server

2015-01-01

Les Tables de résistances ultimes des assemblages boulonnés par plaque frontale et par gousset, complétées par une description des modèles de calcul et des exemples d’application, ont pour but de faciliter la tâche de l'ingénieur et du constructeur. Cette première partie C9.A/14 contient les chapitres suivants: - Joints de poutres par plaque frontale en acier S235 et S355 - Assemblages par gousset en acier S235 et S355 Les Tables contiennent des données relatives à la géométrie ainsi que les valeurs de calcul correspondantes des résistances ultimes des assemblages ; elles remplacent le chapitre « Assemblages par plaques frontales et boulons HR » des anciennes Tables C9.1 de 1983 / 2002. Le calcul de ces assemblages par plaque frontale est basé sur les hypothèses du modèle de la méthode des composants décrite dans la norme SN EN 1993-1-8. Les vérifications sont effectuées selon la norme SIA 263:2013. Les assemblages par gousset remplacent les assemblages par double cornière, (telle...

Bilateral Asymmetric Rhegmatogenous Retinal Detachment in a Patient with Stickler Syndrome

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Caner Öztürk

2018-04-01

Full Text Available Here we present the long-term anatomical and visual outcomes of bilateral asymmetric rhegmatogenous retinal detachment repair in a patient with Stickler syndrome. A 17-year-old girl presented with decreased visual acuity in both eyes for more than one year. Her best-corrected visual acuity (BCVA was 0.1 in the right eye and 0.05 in the left eye. Slit-lamp anterior segment examination revealed subcapsular cataract in both eyes. Fundus examination showed bilateral rhegmatogenous retinal detachment, chronic retinal detachment accompanied by multiple retinal holes, tears and membranous fibrillary vitreous in the peripheral retina. Grade C2 proliferative vitreoretinopathy was observed in the left eye. Scleral buckling surgery was performed initially for both eyes. After the primary surgical procedure, retinal reattachment was achieved in the right eye and the left eye underwent phacoemulsification, intraocular lens implantation, pars plana vitrectomy (PPV, and silicone oil injection. After these surgical procedures retinal reattachment was achieved in the left eye. Silicone oil removal was performed six months after PPV surgery. After surgical treatment, BCVA was 0.6 in the right eye at the end of the 3.5-year follow-up period. After silicone oil removal, BCVA reached 0.2 in the left eye after 36 months of follow-up and retinal reattachment was achieved in both eyes. Scleral buckling surgery and PPV are effective and confidential methods for the treatment of chronic retinal detachment cases in Stickler syndrome.

Endophthalmitis caused by Pantoea agglomerans: clinical features, antibiotic sensitivities, and outcomes

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Venincasa VD

2015-07-01

Full Text Available Vincent D Venincasa, Ajay E Kuriyan, Harry W Flynn Jr, Jayanth Sridhar, Darlene Miller Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA Purpose: To report the clinical findings, antibiotic sensitivities, and visual outcomes associated with endophthalmitis caused by Pantoea agglomerans.Methods: A consecutive case series of patients with vitreous culture-positive endophthalmitis caused by P. agglomerans from January 1, 1990 to December 31, 2012 at a large university referral center. Findings from the current study were compared to prior published studies.Results: Of the three study patients that were identified, clinical settings included trauma (n=2 and post-cataract surgery (n=1. Presenting visual acuity was hand motion or worse in all three cases. All isolates were sensitive to ceftazidime, gentamicin, imipenem, and fluoroquinolones. All isolates were resistant to ampicillin. Initial treatment strategies were vitreous tap and intravitreal antibiotic injection (n=1 and pars plana vitrectomy with intravitreal antibiotic injection (n=2. At last follow-up, one patient had no light perception vision, while the other two had best-corrected visual acuity of 20/200 and 20/400.Conclusion: All Pantoea isolates were sensitive to ceftazidime, gentamicin, imipenem, and fluoroquinolones. All patients in the current study received at least one intravitreal antibiotic to which P. agglomerans was shown to be sensitive in vitro. In spite of this, the visual outcomes were generally poor.Keywords: ocular infection, trauma, antibiotic resistance

Gamma Knife Perfexion® radiosurgery and endo diode laser thermotherapy for choroidal melanoma with technical analysis: A case report.

Science.gov (United States)

Tsai, Yi-Chieh; Kuo, Chun-Yuan; Lin, Jia-Wei; Yang, Shun-Tai; Lai, Shih-Chung; Tsai, Jo-Ting

2018-01-01

Radiosurgery serves an important function in the treatment of patients with intraocular tumors and preserves visual function via organ conservation. Therefore, it is important to ensure the safety and precision of GK-SRS as a primary treatment for intraocular tumors. The present case study described a 57-year-old female with uveal melanoma treated with GK-SRS. Retrobulbar anesthesia following fixation of the treated eye, via the suture of two of the extraocular muscles to the stereotactic frame, was performed to immobilize the eye during treatment. Computed tomography (CT) scans were performed following eye fixation, immediately prior to and following GK-SRS, to validate the accuracy of the tumor localization. The eye movement analysis revealed that the gravity center point deviations of the tumor and lens during treatment were <0.110 mm. At least 95% of the tumor volume was covered by the prescription dose according to three sets of CT images. The patient underwent a trans pars plana vitrectomy owing to a right eye vitreous hemorrhage. A 37-month follow-up assessment revealed tumor shrinkage, and the disappearance of the serous retinal detachments was noted on the basis of ophthalmoscopy and orbital magnetic resonance imaging. No major complications developed during the follow-up period. Using our treatment protocol, GK-SRS is a non-invasive procedure which is used as a brief single fraction treatment for intraocular tumor. The eye fixation method used in the present study has high accuracy.

Internal limiting membrane flap transposition for surgical repair of macular holes in primary surgery and in persistent macular holes.

Science.gov (United States)

Leisser, Christoph; Hirnschall, Nino; Döller, Birgit; Varsits, Ralph; Ullrich, Marlies; Kefer, Katharina; Findl, Oliver

2018-03-01

Classical or temporal internal limiting membrane (ILM) flap transposition with air or gas tamponade are current trends with the potential to improve surgical results, especially in cases with large macular holes. A prospective case series included patients with idiopathic macular holes or persistent macular holes after 23-G pars plana vitrectomy (PPV) and ILM peeling with gas tamponade. In all patients, 23-G PPV and ILM peeling with ILM flap transposition with gas tamponade and postoperative face-down position was performed. In 7 of 9 eyes, temporal ILM flap transposition combined with pedicle ILM flap could be successfully performed and macular holes were closed in all eyes after surgery. The remaining 2 eyes were converted to pedicle ILM flap transposition with macular hole closure after surgery. Three eyes were scheduled as pedicle ILM flap transposition due to previous ILM peeling. In 2 of these eyes, the macular hole could be closed with pedicle ILM flap transposition. In 3 eyes, free ILM flap transposition was performed and in 2 of these eyes macular hole could be closed after surgery, whereas in 1 eye a second surgery, performed as pedicle ILM flap transposition, was performed and led to successful macular hole closure. Use of ILM flaps in surgical repair of macular hole surgery is a new option of treatment with excellent results independent of the diameter of macular holes. For patients with persistent macular holes, pedicle ILM flap transposition or free ILM flap transposition are surgical options.

A Rare Manifestation of Uveitis-glaucoma-hyphema Syndrome.

Science.gov (United States)

Sousa, David Cordeiro; Leal, Inês; Faria, Mun Yueh; Pinto, Luís Abegão

2016-01-01

To report a case of a patient who developed uveitis-glaucoma-hyphema (UGH) syndrome after an uneventful cataract surgery and to discuss risk factors, diagnostic challenges, management options, and clinical implications. Uveitis-glaucoma-hyphema syndrome is a rare but potentially serious cataract surgery complication. Clinical manifestations include increased intraocular pressure (IOP), anterior chamber inflammation, and recurrent hyphema or microhyphema. Uveitis-glaucoma-hyphema Plus syndrome also includes accompanying vitreous hemorrhage. Although classically associated with rigid anterior chamber intraocular lenses (lOLs), cases of malpositioning and subluxated posterior chamber lOLs have also been described as possible triggers. We report a case of a 70-year-old Caucasian man who developed UGH Plus syndrome after an uneventful cataract surgery with an lOL implanted in the capsular bag. During postoperative follow-up, persistent intraocular inflammation, increased IOP, hyphema, and vitreous hemorrhage were consistent with this diagnosis. Slit-lamp examination demonstrated progressive localized iris atrophy, compatible with chafing of the posterior iris by the IOL haptic as the trigger for UGH syndrome. A pars plana vitrectomy was performed and a retropupillary intraocular lens was implanted. No further complications occurred during follow-up. Given the increasing prevalence of single-piece lOLs implanted in the capsular bag, it is important to recognize UGH syndrome as a rare but potentially serious complication. How to cite this article: Sousa DC, Leal I, Faria MY, Pinto LA. A Rare Manifestation of Uveitis-glaucoma-hyphema Syndrome. J Curr Glaucoma Pract 2016;10(2):76-78.

Clinical outcomes in traumatic pseudophacocele: A rare clinical entity.

Science.gov (United States)

Narang, Priya; Agarwal, Amar

2017-12-01

The purpose of this study is to evaluate the clinical outcomes in patients with traumatic pseudophacocele. In this retrospective, interventional case series, scleral wound repair with pars plana vitrectomy and glued intrascleral fixation of an intraocular lens (glued IOL) was performed in 5 eyes of 5 patients. Pupilloplasty was performed in 3 cases whereas aniridia glued IOL fixation was done in 1 case that had total avulsion and loss of iris tissue. The main outcome measures were best-corrected visual acuity (BCVA), intraoperative and postoperative complications during the entire follow-up period. The preoperative vision ranged from hand movement to perception of light in all the patients. The mean postoperative BCVA was 0.42 ± 0.21 Snellen's decimal equivalent (SDE) at final follow-up. Postoperatively, all the cases retained good visual acuity with case 1 and case 2 reporting 0.5 SDE, case 3 had 0.33 SDE, case 5 had 0.67 SDE whereas case 4 had a final visual acuity limited to 0.1 SDE due to associated corneal opacity. The mean follow-up period was 20.2 ± 11.7 months (range from 9 months to 36 months). The IOL was well centered, all the wounds were well apposed and the mean postoperative intraocular pressure was 14.6 ± 1.95 mm Hg. No complications were reported in the entire follow-up period. The clinical outcomes of management of pseudophacocele were encouraging with retention of reasonably good visual potential in all cases.

Pathological findings in the lens capsules and intraocular lens in chronic pseudophakic endophthalmitis: an electron microscopy study.

Science.gov (United States)

Adán, A; Casaroli-Marano, R P; Gris, O; Navarro, R; Bitrian, E; Pelegrin, L; Sanchez-Dalmau, B

2008-01-01

The aim of this study was to describe the pathological findings in lens capsules and intraocular lens (IOL) studied by scanning and/or transmission electron microscopy (SEM and TEM, respectively) in a series of four eyes with chronic pseudophakic endophthalmitis (CPE). We performed a retrospective study of four patients presenting CPE in whom surgical treatment with pars plana vitrectomy, capsulectomy with extraction of the IOL, and intravitreous antibiotic therapy was thereafter performed. The extracted IOL and the capsular remains were studied by SEM and/or TEM and microbiologic analysis of aqueous humour and vitreous aspirate was also carried out in all the cases. The presence of microorganisms was observed in the material analysed in all the cases studied. The use of TEM identified bacterial contamination by Staphylococcus spp and mixed contamination with microorganisms presenting a bacillar morphology suggestive of infection by Propionibacterium acnes in addition to the presence of cocci in the capsular remains. In another two cases, SEM localized colonies of Staphylococcus spp on the surface of the IOL in one case and mixed bacterial colonization with cocci plus filamentous bacteria in the other. The presence of macrophages associated with bacteria was observed in the capsular remains. Microorganisms were found in the IOL or the capsular material in the four cases studied, thereby explaining the refractoriness and severity of infection. The possible presence of polymicrobial infections, especially in the cases with filamentous bacteria, also explains the recurrence of infection.

Visual and anatomical outcomes following idiopathic macular epiretinal membrane surgery

International Nuclear Information System (INIS)

Shahzadi, B.; Rizvi, S.F.; Latif, K.; Naz, S.

2016-01-01

To assess the visual and anatomical outcomes following idiopathic macular epiretinal membrane (IERM) surgery. Study Design: Case series. Place and Duration of Study: Layton Rehmatulla Benevolent Trust (L.R.B.T), Free Base Eye Hospital, Karachi, from January 2015 to June 2016. Methodology: Thirty eyes of thirty patients affected with idiopathic macular epiretinal membrane stage 2 were enrolled in this study. They subsequently underwent 23-gauge pars plana vitrectomy (PPV) with epiretinal membrane removal without internal limiting membrane peeling. The visual outcome was measured as improvement in best corrected visual acuity (BCVA) of at least two or more lines on ETDRS chart as compared to preoperative BCVA. The anatomical outcome was measured as decrease in foveal thickness on Spectral Domain-Optical Coherence Tomography (SD-OCT). Patients were followed for a period of 06 months. Results: At the end of follow-ups, 23 (76%) eyes out of 30 gained 2 or more lines of vision. In 05 (16%) eyes, BCVA remained same and only 02 (6.6%) eyes showed worsening of vision. Mean preoperative foveal thickness was 392 ± 20 micro m, whereas mean postoperative thickness was 305 ± 16 micro m with an average decrease of 87 micro m, in foveal thickness. Recurrence of ERM was found to be the most frequent complication. Conclusion: IERM surgery is a safe procedure and beneficial in achieving significant visual acuity improvement and anatomical recovery in the majority of cases. (author)

Radiation therapy for neovascular age-related macular degeneration

Directory of Open Access Journals (Sweden)

Robert Petrarca

2011-01-01

Full Text Available Robert Petrarca, Timothy L JacksonDepartment of Ophthalmology, King’s College Hospital NHS Foundation Trust, London, UKAbstract: Antivascular endothelial growth factor (anti-VEGF therapies represent the standard of care for most patients presenting with neovascular (wet age-related macular degeneration (neovascular AMD. Anti-VEGF drugs require repeated injections and impose a considerable burden of care, and not all patients respond. Radiation targets the proliferating cells that cause neovascular AMD, including fibroblastic, inflammatory, and endothelial cells. Two new neovascular AMD radiation treatments are being investigated: epimacular brachytherapy and stereotactic radiosurgery. Epimacular brachytherapy uses beta radiation, delivered to the lesion via a pars plana vitrectomy. Stereotactic radiosurgery uses low voltage X-rays in overlapping beams, directed onto the lesion. Feasibility data for epimacular brachytherapy show a greatly reduced need for anti-VEGF therapy, with a mean vision gain of 8.9 ETDRS letters at 12 months. Pivotal trials are underway (MERLOT, CABERNET. Preliminary stereotactic radiosurgery data suggest a mean vision gain of 8 to 10 ETDRS letters at 12 months. A large randomized sham controlled stereotactic radiosurgery feasibility study is underway (CLH002, with pivotal trials to follow. While it is too early to conclude on the safety and efficacy of epimacular brachytherapy and stereotactic radiosurgery, preliminary results are positive, and these suggest that radiation offers a more durable therapeutic effect than intraocular injections.Keywords: wet age-related macular degeneration, neovascular, radiation therapy, epimacular brachytherapy, stereotactic radiosurgery, anti-VEGF

Dashed line relaxing retinotomy in the management of retinal detachment with anterior proliferative vitreoretinopathy

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Tsen CL

2015-04-01

Full Text Available Chui-Lien Tsen,1 Yu-Harn Horng,1 Shwu-Jiuan Sheu1,2 1Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; 2School of Medicine, National Yang-Ming University, Taipei, Taiwan Background: We describe the anatomical and functional outcomes of eyes that underwent a modified technique of relaxing retinotomy, dashed line relaxing retinotomy, in the management of retinal detachment with anterior proliferative vitreoretinopathy.Methods: We retrospectively reviewed 54 consecutive eyes in 52 patients who received pars plana vitrectomy with relaxing retinotomy during retinal detachment repair. Perfluorocarbon liquid (PFCL was used as a standard procedure to stabilize the retina during retinotomy to prevent slippage or inversion of the posterior flap. If PFCL was not available due to economic reasons, dashed line relaxing retinotomy was performed instead. Best-corrected visual acuity, slit-lamp biomicroscopy, intraocular pressure measurement, lens status, and fundus examination were analyzed. We excluded patients who were followed up <4 months.Results: Regarding anatomical success rates and visual outcomes, we found no significant differences between patients treated with intraoperative PFCL and those treated with dashed line relaxing retinotomy without PFCL.Conclusion: Compared to the simple and efficient PFCL-assisted relaxing retinotomy, dashed relaxing retinotomy is not the first choice when PFCL is available. Based on our results, this modified technique may offer an alternative in patients with anterior proliferative vitreoretinopathy for whom PFCL is not available. Keywords: perfluorocarbon liquid, PFCL 

¿Neumodesplazamiento vigente? Uso en hemorragia subretiniana y agujero macular traumático

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Gabriela Papa-Oliva

2015-07-01

Conclusiones: El trauma ocular representa todo un desafío para el oftalmólogo, en este caso producto de un trauma ocular contuso. Para la resolución de la hemorragia subretiniana producto de una rotura coroidea yuxtapapilar y del agujero macular traumático, tenemos varias opciones quirúrgicas que dependerán de la decisión del especialista en cuanto conocimiento, experiencia y experticia del mismo. El neumodesplazamiento sin vitrectomía vía pars plana ha sido utilizado para desplazar sangre subretiniana secundaria a degeneración macular relacionada con la edad. Usando el mismo principio pero aplicado a diferente patología, se decidió realizar desplazamiento neumático, obteniendo como resultado drenaje a cavidad vítrea de la hemorragia subretiniana y cierre del agujero macular. El neumodesplazamiento puede ser considerado una opción terapéutica eficaz versus la vitrectomía vía pars plana en el manejo de esta dolencia.

Vision development over an extended follow-up period in babies after successful vitrectomy for stage 4b retinopathy of prematurity.

Science.gov (United States)

Gadkari, Salil; Kamdar, Rushita; Kulkarni, Sucheta; Deshpande, Madan; Taras, Sudhir

2015-05-01

To demonstrate improvement in the vision of babies after successful vitrectomy for stage 4b retinopathy of prematurity (ROP) over an extended period of time. This was an observational prospective case series. Eight babies who had undergone successful vitrectomy in either their only seeing eye (or both eyes) with stage 4b ROP were followed up post-operatively for a period of 80 weeks or more. Vision with Teller acuity chart, refraction, binocular indirect ophthalmoscopy, and documentation with RetCam was done at each visit. Vision of the (only/better) seeing operated eye with corrective glasses was graded for the purpose of statistical evaluation. Paired t test was performed to compare the vision prior to 30 weeks and at or after 80 weeks. Statistically significant improvement in vision was noted at or after 80 weeks as compared to the vision recorded before 30 weeks (p = 0.0062). Unlike in adult intraocular surgeries where stable visual acuity is reached well before 30 weeks, continuing improvement at 80 weeks and beyond is noted. Gradual restoration of the retinal architecture and plasticity of the infant's developing brain are thought to be responsible.

Parálisis cerebral :

OpenAIRE

Cabrero Izquierdo, María del Carmen

2012-01-01

Se aborda el tema de la parálisis cerebral definiendo qué es, clasificando los tipos de parálisis dependiendo de la afectación y las características principales. Se explican algunos de sus tratamientos, se dan sistemas alternativos y/o aumentativos de comunicación para un alumno con PC (parálisis cerebral).

[Prader-Willi syndrome case with proliferative diabetic retinopathy in both eyes treated by early vitrectomy under local anesthesia].

Science.gov (United States)

Hori, Hideyuki; Sato, Yukihiro; Nakashima, Motohiro; Nakajima, Motohiro

2012-02-01

Although patients with Prader-Willi syndrome have a high rate of diabetes, to date, there have been only 4 reported cases (6 eyes) undergoing vitrectomy for proliferative diabetic retinopathy. Herein, we report a case of Prader-Willi syndrome with proliferative diabetic retinopathy that was treated by early vitrectomy OU under local anesthesia. A 30-year-old man was diagnosed as having Prader-Willi syndrome at the age of 2 years and diabetes at age 17. He was referred to our hospital as diabetic retinopathy had been detected in his first ophthalmological examination at age 29. Visual acuity was 0.6 bilaterally. Proliferative retinopathy, with cataract and macular edema, was identified in both eyes. Panretinal photocoagulation was performed on both eyes. However, proliferative membranes developed bilaterally, and vitreous hemorrhage occurred OS. Visual acuity decreased to 0.3 OU. The patient was hospitalized at our internal medicine department for blood glucose control. Subsequently, with an anesthesiologist on standby, a hypnotic sedative was injected intramuscularly, achieving retro-bulbar anesthesia. Combined cataract and vitreous surgery was performed on the left eye. One week later, a similar operation was performed on the right eye. The patient was discharged four days later. In the two years since these operation, visual acuity has been maintained at 0.8 OU. Patients with Prader-Willi syndrome should be examined for early detection and treatment of diabetic retinopathy.

Diseño de un colector solar de placa plana; Design of a solar fl at plate collector

Directory of Open Access Journals (Sweden)

Jeovany Rafael Rodríguez Mejía

2016-02-01

Full Text Available En el presente artículo se integra el uso de un software de dis eño mecánico y un algoritmo de simulación de la operación de un colector solar de placa plana, con el objeti vo de simplificar el proceso de diseño y manufactura de este último. Se exponen los resultados de la sim ulación de la operación del colector solar considerando diferentes combinaciones en los parámetros de los materiales utilizados, tales como sus propiedades y características físico químicas, además de la var iación de las dimensiones del sistema a diseñar. Finalmente en el artículo se evalúa la operación de un colector solar para las condiciones climatológicas típicas de la irradiancia, velocidad de viento y temperatura ambiente a partir de una serie de curvas sinusoidales, típicas de Cuba, validándose la viabilidad del algoritmo como apoyo en la etapa de diseño y selección de materiales. In this article the use of mechanical design software and an al gorithm for simulating the operation of a flat plate solar collector, with the objective of simplifying the pr ocess of design and manufacture of the latter is integrated. The simulation results of the operation of the sola r collector considering different combinations in the parameters of the materials used, such as its physicochemic al properties and features in addition to the variation of the dimensions of the system design are set. The a rticle finally evaluates the operation of a solar collector for typical climatic conditions of irradiance, wind s peed and ambient temperature from a series of sinusoidal, typical Cuba curves is evaluated, validating the fe asibility of the algorithm as support in step design and material selection.

[Posterior vitrectomy with gas endotamponade and retinal laser therapy in treatment of patients with macular complications of the optic disc pit].

Science.gov (United States)

Cywiński, Adam; Kałużny, Jakub; Ferda, Daniela; Piwońska-Lobermajer, Anna

2015-01-01

Retrospective evaluation of functional and anatomical treatment outcomes in patients with macular cornplications of optic disc pit. 9 patients (eyes) underwent central posterior vitrectomy in conjunction with posterior vitreous detachment, retinal laser therapy to the optic disc pit area and endotamponade with expansile gas. It was followed by the patient's forced positioning (recommended for a few days especially at night), which ended the treatment protocol. Improved anatomical relationships, accompanied by functional improvement were achieved in each reported case. The resolution of macular lesions was slow, lasting even for several months. Too long delay in performing the surgery (over 5 months since the onset of visual impairment) was associated with the development of retinal complications, mainly macular hole formation, most likely caused by the long-term ischemia. The central posterior vitrectomy combined with posterior vitreous detachment, laser therapy, andd expansile gas tamponade offers good outcomes in patients with retinal complications of optic disc pit. Surgery performed shortly after the onset of visual dysfunction gives the best functional outcomes. Restoration of normal anatomical relationships is a long-term process. In some cases, though, these abnormalities may not resolve completely.

Novel role for proteinase-activated receptor 2 (PAR2) in membrane trafficking of proteinase-activated receptor 4 (PAR4).

Science.gov (United States)

Cunningham, Margaret R; McIntosh, Kathryn A; Pediani, John D; Robben, Joris; Cooke, Alexandra E; Nilsson, Mary; Gould, Gwyn W; Mundell, Stuart; Milligan, Graeme; Plevin, Robin

2012-05-11

Proteinase-activated receptors 4 (PAR(4)) is a class A G protein-coupled receptor (GPCR) recognized through the ability of serine proteases such as thrombin and trypsin to mediate receptor activation. Due to the irreversible nature of activation, a fresh supply of receptor is required to be mobilized to the cell surface for responsiveness to agonist to be sustained. Unlike other PAR subtypes, the mechanisms regulating receptor trafficking of PAR(4) remain unknown. Here, we report novel features of the intracellular trafficking of PAR(4) to the plasma membrane. PAR(4) was poorly expressed at the plasma membrane and largely retained in the endoplasmic reticulum (ER) in a complex with the COPI protein subunit β-COP1. Analysis of the PAR(4) protein sequence identified an arginine-based (RXR) ER retention sequence located within intracellular loop-2 (R(183)AR → A(183)AA), mutation of which allowed efficient membrane delivery of PAR(4). Interestingly, co-expression with PAR(2) facilitated plasma membrane delivery of PAR(4), an effect produced through disruption of β-COP1 binding and facilitation of interaction with the chaperone protein 14-3-3ζ. Intermolecular FRET studies confirmed heterodimerization between PAR(2) and PAR(4). PAR(2) also enhanced glycosylation of PAR(4) and activation of PAR(4) signaling. Our results identify a novel regulatory role for PAR(2) in the anterograde traffic of PAR(4). PAR(2) was shown to both facilitate and abrogate protein interactions with PAR(4), impacting upon receptor localization and cell signal transduction. This work is likely to impact markedly upon the understanding of the receptor pharmacology of PAR(4) in normal physiology and disease.

Vitrectomy with internal limiting membrane peeling versus inverted internal limiting membrane flap technique for macular hole-induced retinal detachment: a systematic review of literature and meta-analysis.

Science.gov (United States)

Yuan, Jing; Zhang, Ling-Lin; Lu, Yu-Jie; Han, Meng-Yao; Yu, Ai-Hua; Cai, Xiao-Jun

2017-11-28

To evaluate the effects on vitrectomy with internal limiting membrane (ILM) peeling versus vitrectomy with inverted internal limiting membrane flap technique for macular hole-induced retinal detachment (MHRD). Pubmed, Cochrane Library, and Embase were systematically searched for studies that compared ILM peeling with inverted ILM flap technique for macular hole-induced retinal detachment. The primary outcomes are the rate of retinal reattachment and the rate of macular hole closure 6 months later after initial surgery, the secondary outcome is the postoperative best-corrected visual acuity (BCVA) 6 months later after initial surgery. Four studies that included 98 eyes were selected. All the included studies were retrospective comparative studies. The preoperative best-corrected visual acuity was equal between ILM peeling and inverted ILM flap technique groups. It was indicated that the rate of retinal reattachment (odds ratio (OR) = 0.14, 95% confidence interval (CI):0.03 to 0.69; P = 0.02) and macular hole closure (OR = 0.06, 95% CI:0.02 to 0.19; P peeling. However, there was no statistically significant difference in postoperative best-corrected visual acuity (mean difference (MD) 0.18 logarithm of the minimum angle of resolution; 95% CI -0.06 to 0.43 ; P = 0.14) between the two surgery groups. Compared with ILM peeling, vitrectomy with inverted ILM flap technique resulted significantly higher of the rate of retinal reattachment and macular hole closure, but seemed does not improve postoperative best-corrected visual acuity.

Par Pond vegetation status 1996

International Nuclear Information System (INIS)

Mackey, H.E. Jr.; Riley, R.S.

1996-12-01

The water level of Par Pond was lowered approximately 20 feet in mid-1991 in order to protect downstream residents from possible dam failure suggested by subsidence on the downstream slope of the dam and to repair the dam. This lowering exposed both emergent and nonemergent macrophyte beds to drying conditions resulting in extensive losses. A survey of the newly emergent, shoreline aquatic plant communities of Par Pond began in June 1995, three months after the refilling of Par Pond to approximately 200 feet above mean sea level. These surveys continued in July, September, and late October, 1995, and into the early spring and late summer of 1996. Communities similar to the pre-drawdown, Par Pond aquatic plant communities continue to become re-established. Emergent beds of maidencane, lotus, waterlily, watershield, and Pontederia are extensive and well developed. Measures of percent cover, width of beds, and estimates of area of coverage with satellite data indicate regrowth within two years of from 40 to 60% of levels prior to the draw down. Cattail occurrence continued to increase during the summer of 1996, especially in the former warm arm of Par Pond, but large beds common to Par Pond prior to the draw down still have not formed. Lotus has invaded and occupies many of the areas formerly dominated by cattail beds. To track the continued development of macrophytes in Par Pond, future surveys through the summer and early fall of 1997, along with the evaluation of satellite data to map the extent of the macrophyte beds of Par Pond, are planned

Surgical treatment and optical coherence tomographic evaluation for accidental laser-induced full-thickness macular holes.

Science.gov (United States)

Qi, Y; Wang, Y; You, Q; Tsai, F; Liu, W

2017-07-01

PurposeTo report OCT appearance and surgical outcomes of full-thickness macular holes (MHs) accidentally caused by laser devices.Patients and methodsThis retrospective case series included 11 eyes of 11 patients with laser-induced MHs treated by pars plana vitrectomy, internal limiting membrane (ILM) peeling, and gas or silicone oil tamponade. Evaluations included a full ophthalmic examination, macular spectral-domain optical coherence tomography (SD-OCT), and fundus photography. Main outcome measures is MH closure and final visual acuity; the secondary outcome was the changes of retinal pigment epithelium and photoreceptor layer evaluated by sequential post-operative SD-OCT images.ResultsFive patients were accidentally injured by a yttrium aluminum garnet (YAG) laser and six patients by handheld laser. MH diameters ranged from 272 to 815 μm (mean, 505.5±163.0 μm) preoperatively. Best-corrected visual acuity (BCVA) improved from a mean of 0.90 logMAR (range, counting finger-8/20) preoperatively to a mean of 0.34 logMAR (range, a counting finger-20/20) postoperatively (P=0.001, t=4.521). Seven of 11 patients (63.6%) achieved a BCVA better than 10/20. Ten patients had a subfoveal hyperreflectivity and four patients had a focal choroidal depression subfoveal preoperatively. At the last follow-up, all 11 eyes demonstrated the following: closure of the macular hole, variable degrees of disruption of external limiting membrane (ELM) and outer photoreceptor ellipsoid and interdigitation bands. In 10 eyes, the disruption was in the form of focal defects in the outer retina. After surgery, the subfoveal hyperreflectivity and focal choroidal depression remained.ConclusionAccidental laser-induced full-thickness macular holes can be successfully closed with surgery. Inadvertent retinal injury from laser devices, especially handheld laser injury has occurred with increasing frequency in recent years. However, there is a paucity of data regarding these types of injuries

Algoritmo para generar formulas de características geométricas de las secciones planas, su implementación en DERIVE

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Rolando Rivero-Galán

2010-01-01

Full Text Available En la esfera del diseño de estructuras y de elementos de maquinas, se presenta con relativa frecuencia el cálculo de determinadas características o propiedades geométricas de secciones planas, como son entre otras: el área de una sección transversal, el centro de gravedad, un momento de inercia o más general la determinación de alguna característica geométrica definida por una integral doble extendida en la región del plano que ocupa la sección, pieza o elemento.El presente trabajo tiene como objetivo la confección de un programa para computadora, utilizando el asistente matemático DERIVE, para la determinación de las características geométricas de secciones planas cuyo contorno este constituido por segmentos de rectas.In the sphere of the design of structures, is relative frequency the calculation of certain characteristic or geometric properties of plane sections, like: the area of a traverse section, the center of gravity, a moment of inertia or more general the determination of some geometric characteristic defined by a double integral extended in the region of the plane that occupies the section, piece or element.The present work has as objective the making of a program for computer, using the mathematical assistant DERIVE, for the determination of the geometric characteristics of plane sections whose contour this constituted by segments of right

Photoreceptor Outer Segment on Internal Limiting Membrane after Macular Hole Surgery: Implications for Pathogenesis.

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Grinton, Michael E; Sandinha, Maria T; Steel, David H W

2015-01-01

This report presents a case, which highlights key principles in the pathophysiology of macular holes. It has been hypothesized that anteroposterior (AP) and tangential vitreous traction on the fovea are the primary underlying factors causing macular holes [Nischal and Pearson; in Kanski and Bowling: Clinical Ophthalmology: A Systemic Approach, 2011, pp 629-631]. Spectral domain optical coherence tomography (OCT) has subsequently corroborated this theory in part but shown that AP vitreofoveal traction is the more common scenario [Steel and Lotery: Eye 2013;27:1-21]. This study was conducted as a single case report. A 63-year old female presented to her optician with blurred and distorted vision in her left eye. OCT showed a macular hole with a minimum linear diameter of 370 µm, with persistent broad vitreofoveal attachment on both sides of the hole edges. The patient underwent combined left phacoemulsification and pars plana vitrectomy, internal limiting membrane (ILM) peel and gas injection. The ILM was examined by electron microscopy and showed the presence of a cone outer segment on the retinal side. Post-operative OCT at 11 weeks showed a closed hole with recovery of the foveal contour and good vision. Our case shows the presence of a photoreceptor outer segment on the retinal side of the ILM and reinforces the importance of tangential traction in the development of some macula holes. The case highlights the theory of transmission of inner retinal forces to the photoreceptors via Müller cells and how a full thickness macular hole defect can occur in the absence of AP vitreomacular traction.

PREVALENCE OF FOVEOLAR LUCENCY WITH DIFFERENT GAS TAMPONADES IN SURGICALLY CLOSED MACULAR HOLES ASSESSED BY SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY.

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Zarranz-Ventura, Javier; Ellabban, Abdallah A; Sim, Dawn A; Keane, Pearse A; Kirkpatrick, James N; Sallam, Ahmed A B

2017-07-07

To evaluate the prevalence of foveolar lucency (FL) in surgically closed macular holes by spectral domain optical coherence tomography. One hundred forty-two eyes of 132 patients underwent pars plana vitrectomy, internal limiting membrane peeling, and gas tamponade in a 60-month time frame. Anatomical success and FL rates assessed by spectral domain optical coherence tomography, mean preoperative, and postoperative best-measured visual acuity and surgical details were retrospectively analyzed. Spectral domain optical coherence tomography confirmed closed holes with FL in 33.7% (34/101) of eyes at 1 month, 7.3% (9/123) at 3 months, 4.6% (6/129) at 6 months, and 3% (4/133) at 12 months. Prevalence of FL in closed holes at Month 1 was lower in C3F8-treated eyes (9.5%, 2/21) compared with C2F6 (40.9%, 18/44, P = 0.03) and SF6-treated eyes (38.9%, 14/36, P = 0.05). No differences were observed at Month 3. No differences in best-measured visual acuity change were observed between closed holes with or without FL at Month 1 (-0.14 ± 0.19 vs. -0.11 ± 0.23, P = 0.48) or any of the other time points. Temporary FL is a highly prevalent feature in successfully closed macular holes. Eyes treated with C3F8 gas had lower rates of FL at Month 1 than C2F6 and SF6-treated eyes. The presence of FL in closed holes does not seem to have any effect on the visual outcomes.

Pediatric retinal detachment in the Eastern Province of Saudi Arabia: experience of a tertiary care hospital.

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Cheema, Rizwan A; Al-Khars, Wajeeha; Al-Askar, Essam; Amin, Yasir M

2009-01-01

Because no previous studies have addressed the issue, we describe clinical characteristics and surgical outcome of patients with rhegmatogenous retinal detachment (RRD) in a pediatric population of the Eastern province of Saudi Arabia. We conducted a retrospective review of all consecutive cases of pediatric RRD (0-18 years) patients presenting at Dhahran Eye Specialist Hospital, a tertiary care hospital, in the Eastern Province of Saudi Arabia over a period of 3 years. Twenty patients were included in the study, accounting for 9.4% of all retinal detachment surgery cases performed over a period of 3 years (January 2006 to December 2008). The median age was 11.0 years, (range, birth to 18 years). Trauma, (45%) myopia/vitreoretinal degeneration (10%) and prior ocular surgery (25%) were significant risk factors for RRD. Proliferative vitreoretinopathy (PVR) more than grade C was present in 14/20 (70%) of cases. Most patients (15/20, 75%) were treated with pars plana vitrectomy and placement of an encircling buckle, while silicone oil or gas was used as tamponade in 13/20 (65%) patients. Surgery was successful in 17/20 (85%) cases in achieving retinal re-attachment. Visual acuity improved significantly following surgery (Mean preop 2.146 LogMAR, Mean postop 1.497 LogMAR) ( P= .014). Longer duration of RRD ( P =.007) and macular involvement ( P =.05) were associated with worse anatomical outcomes following surgery. Pediatric RRD in the Eastern province is often associated with predisposing pathology. Surgery is successful in achieving anatomical reattachment of the retina in a majority of cases with improvement of visual acuity.

Tamponade in surgery for retinal detachment associated with proliferative vitreoretinopathy.

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Schwartz, Stephen G; Flynn, Harry W; Lee, Wen-Hsiang; Ssemanda, Elizabeth; Ervin, Ann-Margret

2009-10-07

Retinal detachment (RD) with proliferative vitreoretinopathy (PVR) often requires surgery. During surgery, a tamponade agent is needed to reduce the rate of recurrent retinal detachment. The objective of this review was to evaluate the benefits and adverse outcomes of surgery with various tamponade agents. We searched the Cochrane Controlled Register (CENTRAL), MEDLINE, EMBASE, Latin America and Carribbean Health Sciences (LILACS) and the UK Clinical Trials Gateway (UKCTG). There were no language or date restrictions in the search for trials. The electronic databases were last searched on 9 July 2009. We included randomized clinical trials comparing patients treated with various tamponade agents. Two individuals screened the search results independently. One study with two trials was eligible for inclusion in the review. One study with two trials was included in the review. The first trial randomized 151 eyes to receive either silicone oil or sulfur hexafluoride (SF(6)) gas tamponades; the second trial randomized 271 eyes to receive either silicone oil or perfluropropane (C(3)F(8)) gas tamponades. In patients with RD associated with PVR, pars plana vitrectomy and infusion of either silicone oil or perfluropropane gas appear comparable for a broad variety of cases. Sulfur hexafluoride gas was associated with worse anatomic and visual outcomes than either silicone oil or perfluropropane gas. The use of either C(3)F(8) or silicone oil appears reasonable for most patients with RD associated with PVR. Because there do not appear to be any major differences in outcomes between the two agents, the choice of a tamponade agent should be individualized for each patient.

F6H8 as an Intraoperative Tool and F6H8/Silicone Oil as a Postoperative Tamponade in Inferior Retinal Detachment with Inferior PVR

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Gian Marco Tosi

2014-01-01

Full Text Available Purpose. To evaluate the effectiveness and safety of perfluorohexyloctane (F6H8 for intraoperative flattening of the retina and of F6H8/silicone oil (SO 1000 cSt as a postoperative tamponade for inferior retinal detachment with inferior proliferative vitreoretinopathy. Methods. This is a retrospective review of 22 patients who underwent pars plana vitrectomy using F6H8 as an intraoperative tool to flatten the retina. At the end of the surgery a direct partial exchange between F6H8 and SO 1000 cSt was performed, tamponing the eye with different ratios of F6H8/SO (70/30, 60/40, 50/50, 40/30, and 30/70. Anatomical and functional results and complications were evaluated over the follow-up period (mean 22.63 months. Results. F6H8 was efficacious for intraoperative flattening of the retina. Twenty-one of the 22 patients achieved a complete retinal reattachment. Postoperative visual acuity (VA ranged from light perception to 20/70, with 72% of patients obtaining VA better than 20/400. No emulsification/inflammation was observed whatever the ratio of F6H8/SO used. With higher ratios of F6H8/SO (70/30 and 60/40 cloudiness of the tamponade was observed. A transparent mixture was present with all the other ratios. Conclusions. The surgical technique adopted is very simple and safe. The optimal F6H8/SO ratio seems to be between 50/50 and 30/70.

Spontaneous resolution of macular edema after silicone oil removal

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Eyyup Karahan

2014-12-01

Full Text Available AIM:To investigate the macular changes in eyes filled with silicone oil (SO and course of these changes after SO removal.METHODS:A retrospective optical coherence tomography scan review was conducted for twenty-four patients who underwent uncomplicated pars plana vitrectomy with SO tamponade for complex retinal detachments were detected with optical coherence tomography before, and one week, one month and three months after SO removal.RESULTS:Mean duration of SO tamponade was 3.6±1.0mo (range:3-7mo. Cystoid macular edema (CME was detected in 3 eyes before SO removal. Submacular fluid was represented in 1 eye before silicone SO removal. Resolution of CME and submacular fluid was achieved 1mo after SO removal in all eyes. Mean best corrected visual acuity (BCVA was 1.15±0.65 (range, hand movement to 0.2 before SO removal in the eyes without macular changes. After SO removal, the mean BCVA values at 1wk and 1 and 3mo, and 0.82±0.23, 0.76±0.21, and 0.70±0.19, all of which were significantly better than baseline (P=0.030, 0.017, 0.006 respectively. In the eyes with macular CME and subretinal fluid the mean BCVA was significantly improved at 3mo after SO removal compared with baseline (P=0.037.CONCLUSION:Decreased visual acuity in eyes filled with SO could be caused by macular complications due to SO. CME and subretinal fluid may resolve without any additional macular surgery after SO removal.

Ahmed glaucoma valve implantation with tube insertion through the ciliary sulcus in pseudophakic/aphakic eyes.

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Eslami, Yadolla; Mohammadi, Massood; Fakhraie, Ghasem; Zarei, Reza; Moghimi, Sasan

2014-02-01

To report the efficacy and safety of Ahmed glaucoma valve (AGV) insertion into the ciliary sulcus in pseudophakic/aphakic patients. A chart review was done on patients with uncontrolled glaucoma, who underwent AGV implantation with tube inserted into the ciliary sulcus. Baseline intraocular pressure (IOP) and number of medications were compared with that of postoperative follow-up visits. Surgical success was defined as last IOP glaucoma control, and without loss of light perception. Postoperative complications were recorded. Twenty-three eyes of 23 patients were recruited with the mean follow-up of 9 months (range, 3 to 24 mo). The mean (SD) age of patients was 49.9 (16.9) years (range, 22 to 80 years). The mean (SD) IOP (mm Hg) was reduced from 37.9 (12.4) before surgery to 16.2 (3.6) at the last follow-up visit (P<0.001). The mean (SD) number of medications was reduced from 3.3 (0.9) preoperatively to 1 (1.1) at the last follow-up (P<0.001). Success rate was 18/23 (78.6%). Complications included endophthalmitis in 1 eye, tube exposure in 1 diabetic patient, and vitreous tube occlusion in 1 eye. No case of corneal decompensation or graft failure was seen during follow-up. Ciliary sulcus placement of the tube of AGV effectively reduces IOP and medication use in short term. It has the potential to lower corneal complications of anterior chamber tube insertion and avoids the need for pars plana vitrectomy and tube insertion in patients at higher risk of corneal decompensation.

Optical coherence tomography evaluation of patients with macula-off retinal detachment after different postoperative posturing: a randomized pilot study.

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Peiretti, Enrico; Nasini, Francesco; Buschini, Elisa; Caminiti, Giulia; Lesnik Oberstein, Sarit Y; Willig, Alissa; Bijl, Heico M; Mura, Marco

2017-08-01

To assess the presence of outer and inner retinal folds (RFs) and drop-out of the ellipsoid zone (EZ) occurring after surgical repair of macula-off rhegmatogenous retinal detachment (RRD) with different postoperative posture and preoperative use of adjuvant perfluorocarbon liquid (PFCO). In this prospective study, 56 eyes of 56 consecutive patients affected by RRD were subjected to 23- or 25-gauge pars plana vitrectomy (PPV). The patients were randomized in four groups (14 prone 5 hr without PFCO, 14 supine 5 hr without PFCO, 14 prone 5 hr with PFCO and 14 supine 5 hr with PFCO) and followed up with spectral domain optical coherence tomography (SD-OCT). Spectral domain optical coherence tomography (SD-OCT) was recorded before surgery, at days 30 and 90 to detect the presence of outer RFs, inner RFs and drop-out of EZ and to follow their variation over time. No statistical significance was found in our groups for outer RFs, inner RFs, drop-out of EZ formation and evolution. The postoperative best-corrected visual acuity (BCVA) improved in all groups (mean preoperative BCVA 1.47 logMar ± 0.19, mean postoperative BCVA 0.27 logMar ± 0.11, p < 0.01), without statistical variations between the four groups in BCVA after surgery. The use of adjuvant and variation in postoperative position did not change the risk of presenting outer RFs, inner RFs and drop-out of EZ after RRD. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Late dislocation of in-the-bag intraocular lenses in uveitic eyes: An analysis of management and complications

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Sudha K Ganesh

2017-01-01

Full Text Available Aim: An analysis of late in-the-bag dislocation of intraocular lenses (IOL, in uveitic eyes. Setting: Referral uveitis clinic. Design: Retrospective case series. Materials and Methods: All case records of eyes with chronic uveitis that had phacoemulsification with IOL implantation, at a referral uveitis clinic between February 1997 and January 2015 were retrieved and analyzed. Only those eyes with no documented intraoperative complication and no predisposing risks to IOL dislocation, such as pseudoexfoliation, high myopia, trauma, and prior VR surgery were included in this study. Results: A total of 581 eyes with chronic uveitis underwent phacoemulsification with IOL implantation under steroid cover from February 1997 to December 2015. Out of these 581 eyes, 10 patients (11 eyes had experienced late in-the-bag IOL dislocation (1.89%. All 11 eyes had chronic intermediate uveitis. The mean duration from the time of cataract surgery to IOL dislocation was 11.24 years. 5 out of 11 eyes had pars plana vitrectomy (PPV with IOL removal with 4-point sutured scleral fixated IOL. Two out of 11 eyes had PPV with in-the-bag IOL re-fixation. Out of 11, 2 eyes had PPV with IOL removal only. Remaining 2 eyes of 2 patients did not opt for surgery. Out of 11, 8 eyes had improved vision at last follow-up. Conclusions: In-the-bag dislocation of IOL is a rare late complication in uveitic eyes. With tight perioperative inflammatory control, scleral-fixated posterior chamber intraocular lens or IOL re-fixation are good options of restoring vision in these high-risk eyes.

The Risk of Intraocular Pressure Elevation in Pediatric Non-infectious Uveitis

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Kothari, Srishti; Foster, C. Stephen; Pistilli, Maxwell; Liesegang, Teresa L.; Daniel, Ebenezer; Sen, H. Nida; Suhler, Eric B.; Thorne, Jennifer E.; Jabs, Douglas A.; Levy-Clarke, Grace A.; Nussenblatt, Robert B.; Rosenbaum, James T.; Lawrence, Scott D.; Kempen, John H.

2015-01-01

Purpose To characterize the risk and risk factors for intraocular pressure (IOP) elevation in pediatric non-infectious uveitis. Design Multi-center retrospective cohort study. Participants Nine hundred sixteen children (1593 eyes) uveitis followed between January 1978 through December 2007 at five academic uveitis centers in United States. Methods Medical records review by trained, certified experts. Main outcome measures Prevalence and incidence of IOP≥21 and ≥30mmHg and incidence of a rise in IOP by ≥10mmHg. To avoid under ascertainment, outcomes were counted as present when IOP-lowering therapies were in use. Results Initially 251 (15.8%) and 46 eyes (2.9%) had IOP≥21 and ≥30mmHg, respectively. Factors associated with presenting IOP elevation included age 6–12 years (versus other pediatric ages), prior cataract surgery (adjusted odds ratio≥21mmHg [aOR21]=2.42, P=0.01), pars plana vitrectomy (adjusted odds ratio≥30mmHg[aOR30]=11.1, P=0.03), duration of uveitis ≥6 months (aORs30 up to 11.8, Puveitis. Statistically significant risk factors include IOP elevation or use of IOP-lowering treatment in the contralateral eye and local corticosteroid use – that demonstrated a dose-and route of administration-dependent relationship. In contrast, use of immunosuppressive drug therapy did not increase such risk. Pediatric eyes with non-infectious uveitis should be followed closely for IOP elevation when strong risk factors such as the use of local corticosteroids and contralateral IOP elevation are present. PMID:26233626

Primary Repair of Moderate Severity Rhegmatogenous Retinal Detachment: A Critical Decision-Making Algorithm.

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Velez-Montoya, Raul; Jacobo-Oceguera, Paola; Flores-Preciado, Javier; Dalma-Weiszhausz, Jose; Guerrero-Naranjo, Jose; Salcedo-Villanueva, Guillermo; Garcia-Aguirre, Gerardo; Fromow-Guerra, Jans; Morales-Canton, Virgilio

2016-01-01

We reviewed all the available data regarding the current management of non-complex rhegmatogenous retinal detachment and aimed to propose a new decision-making algorithm aimed to improve the single surgery success rate for mid-severity rhegmatogenous retinal detachment. An online review of the Pubmed database was performed. We searched for all available manuscripts about the anatomical and functional outcomes after the surgical management, by either scleral buckle or primary pars plana vitrectomy, of retinal detachment. The search was limited to articles published from January 1995 to December 2015. All articles obtained from the search were carefully screened and their references were manually reviewed for additional relevant data. Our search specifically focused on preoperative clinical data that were associated with the surgical outcomes. After categorizing the available data according to their level of evidence, with randomized-controlled clinical trials as the highest possible level of evidence, followed by retrospective studies, and retrospective case series as the lowest level of evidence, we proceeded to design a logical decision-making algorithm, enhanced by our experiences as retinal surgeons. A total of 7 randomized-controlled clinical trials, 19 retrospective studies, and 9 case series were considered. Additional articles were also included in order to support the observations further. Rhegmatogenous retinal detachment is a potentially blinding disorder. Its surgical management seems to depend more on a surgeon´s preference than solid scientific data or is based on a good clinical history and examination. The algorithms proposed herein strive to offer a more rational approach to improve both anatomical and functional outcomes after the first surgery.

THE RESULTS OF RADIAL OPTIC NEUROTOMY FOR TREATMENT OF CENTRAL RETINAL VEIN OCCLUSION

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S A Tabatabaii

2008-11-01

Full Text Available "nCentral retinal vein occlusion (CRVO is the third most common blinding vascular retinal disorder. As there is no proven treatment for CRVO, we performed this study to evaluate the effectiveness of radial optic neurotomy (RON on visual acuity in eyes with CRVO. This study was designed as an interventional case series. Pars plana vitrectomy with RON was performed in 18 eyes of 16 patients with ischemic CRVO with visual acuities of 20/400 or less. Postoperative and preoperative visual acuities were compared using t paired test. Mean preoperative visual acuity was 20/1000 (range, 20/1600 to 20/630. Mean follow-up time was 3.6 months (range, 1 to 9 months. Mean postoperative visual acuity was 20/400 (range, 20/1600 to 20/50 at last follow-up and the difference was significant (P < 0.01; t paired test. Six patients (33% improved to 20/200 postoperatively. There were no major complications intraoperatively. Chorioretinal shunts developed in neurotomy site in 9 cases (50% 4 to 10 weeks after procedure which were associated with faster resolving of hemorrhage and venous dilation. There were no major complications noted with this procedure but vitreous hemorrhage and iris neovascularization was observed in the early postoperative period in 2 (11% of 18 cases. RON may improve visual acuity in eyes with CRVO. It is a technically feasible and fairly safe procedure but postoperatively it may result in some complications such as vitreous hemorrhage, iris neovascularization and retinal detachment.

[Accuracy and relevance of CT volumetry in open ocular injuries with intraocular foreign bodies].

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Maneschg, O A; Volek, E; Lohinai, Z; Resch, M D; Papp, A; Korom, C; Karlinger, K; Németh, J

2015-04-01

The aim of the study was to evaluate the volume of intraocular foreign bodies (IOFB) using computed tomography (CT) volumetry as a prognostic factor for clinical outcome in open ocular injuries. This study compared the volume of 11 IOFBs more than 5 mm(3) in size based on CT volumetry with the real size determined by in vitro measurement. A retrospective evaluation of clinical data, visual acuity, complications and relation of size of IOFBs with clinical outcome in 33 patients (mean age 41.0 ± 13.5 years) with open ocular injuries treated at our department between January 2005 and December 2010 was carried out. No significant differences were found between pairwise in vitro measurement and CT volumetric size (p = 0.07). All patients were surgically treated by pars plana vitrectomy. The mean follow-up time was 7.6± 6.2 months and the mean preoperative best corrected visual acuity (BCVA) was 0.063 ± 0.16 (logMAR 1.2 ± 0.79). Postoperatively, a mean BCVA of 0.25 ± 0.2 (logMAR 0.6 ± 0.69) could be achieved. Clinical outcomes were significantly better in injuries with small IOFBs measuring volumetry is an accurate method for measurement of IOFBs. Exact data about the size and measurement of volume are also an important factor for the prognosis of clinical outcome in open ocular injuries with IOFBs and CT volumetry can also provide important information about the localization of IOFBs.

Comparisons of foveal thickness and slope after macular hole surgery with and without internal limiting membrane peeling.

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Ohta, Kouichi; Sato, Atsuko; Senda, Nami; Fukui, Emi

2018-01-01

We have shown that the foveal contour was asymmetrical after idiopathic macular hole (MH) closure by pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling. The purpose of this study was to determine whether these morphological changes differ in eyes after PPV without ILM peeling. Ten eyes of 10 patients that underwent PPV without ILM peeling and 12 eyes of 11 patients with ILM peeling were studied. The MH in all eyes was 6 months after the surgery. The mean parafoveal retinal thickness in the non-peeled group was 367.1 µm in the nasal (N), 353.0 µm in the temporal (T), 366.9 µm in the superior (S), and 357.3 µm in the inferior (I) sectors. The T, S, and I sectors were significantly thicker than the corresponding sectors in the ILM peeled group ( p =0.0008, 0.003, and 0.03, respectively). The mean ganglion cell complex was thicker not only in the N sector but also in the T sector in the non-peeled group. The mean retinal slopes in the non-peeled group (N, 40.2°; T, 37.6°; S, 41.2°; I, 39.5°) were flatter than those in the peeled group (N, 52.3°; T, 43.6°; S, 50.8°; I, 51.9°; p =0.009, 0.09, 0.008, and 0.017, respectively). The symmetrical fovea after MH surgery in the non-ILM peeled eyes indicates that the asymmetrical fovea after ILM peeling was probably due to the ILM peeling.

[Anatomical and functional results of macular hole surgery with internal limiting membrane peeling after 10-year follow-up].

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Foveau, P; Conart, J-B; Hubert, I; Selton, J; Berrod, J-P

2016-09-01

To evaluate the anatomical and functional results of macular hole surgery with internal limiting membrane (ILM) peeling after 10 years follow-up. Monocentric retrospective study of patients who had undergone macular hole surgery between 2003 and 2005 in the Nancy University Medical Center and still followed in the department in 2014. All patients underwent pars plana vitrectomy and ILM peeling without staining. Clinical examination at ten years including determination of best-corrected visual acuity (BCVA), evaluation of quality of life and spectral domain optical coherence tomography was performed. Four men and six women with mean age of 64±8 years were included. The mean diameter of the MH was 395±133μm. The mean best corrected visual acuity improved significantly from 0.90±0.22 logMAR to 0.14±0.14 logMAR after 10 years with a satisfactory quality of life in 90 % of patients. The integrity of the IS/OS layer was preserved in 9 eyes. Inner retinal dimples located in the temporal quadrant related to ILM peeling initiation were observed in 8 eyes. No significant RNFL or ganglion cell complex changes were found compared to the contralateral eye. Macular hole surgery with ILM peeling in this series resulted in a visual acuity gain of 8 ETDRS lines and persistent improvement in quality of life after a 10-year follow-up. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Seasonal variability in somatic and reproductive investment of the bivalve Scrobicularia plana (da Costa, 1778) along a latitudinal gradient

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Santos, Sílvia; Cardoso, Joana F. M. F.; Carvalho, Célia; Luttikhuizen, Pieternella C.; van der Veer, Henk W.

2011-03-01

Monthly investment in soma and gonads in the bivalve Scrobicularia plana is described for three populations along its distributional range: Minho estuary, Portugal; Westerschelde estuary, The Netherlands and Buvika estuary, Norway. Seasonal cycles in body mass (BMI), somatic mass (SMI) and gonadal mass (GMI) indices were observed for all populations. In Portugal, BMI and SMI peaked in mid-autumn, while in The Netherlands both indices were at their highest in mid-spring. Norway showed a different pattern with two distinct peaks: one in mid-autumn and a second peak in spring. GMI reached maximum values in July in Portugal and Netherlands and in June in Norway. Overall, mean BMI and SMI were lower in Portugal while mean GMI was lower in Norway. The spawning period lasted the whole summer in Portugal, but was shorter (only two months) in The Netherlands and Norway. The reproductive investment in The Netherlands was significantly higher than in Portugal and Norway, with the lowest values being observed in Norway. Differences in annual cycles between populations were attributed to environmental factors, namely temperature and food availability. Temperature seems important in shaping the reproductive pattern with more northern populations showing shorter reproductive periods starting later in the year, and a lower reproductive output. In addition, winter water temperatures can explain the lower mean body and somatic mass values observed in Portugal. Food availability influenced the physiological performance of the species with peaks in somatic mass coinciding with phytoplankton blooms. This relation between physiological performance and environmental factors influences S. plana distribution, densities and even survival, with natural consequences on its commercial importance.

23-gauge vitrectomy with intraocular foreign body removal via the limbus: An alternative approach for select cases

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Ramandeep Singh

2014-01-01

Full Text Available Purpose: To study the outcome of removal of retained intraocular foreign bodies (RIOFBs via limbus using 23-gauge transconjunctival sutureless vitrectomy (TSV. Materials and Methods: In this prospective, non-comparative interventional case series, fourteen eyes of 14 patients fulfilling the inclusion criteria were enrolled. They underwent 23-gauge TSV for management of posterior segment RIOFB and reviewed at 1 day, 7 days, 6 weeks, 3, 6 and 12 months. Eyes with penetrating eye injury involving cornea or limbus (corneal injury not so severe to hinder vitrectomy, cataract associated with anterior and/or posterior capsular tear requiring cataract surgery and posterior segment RIOFB with minimal posterior segment involvement were included. Main outcome measures include success in removal of RIOFB without enlarging sclerotomy, ability to preserve capsular support, improvement in visual acuity and complications, if any. Results: All eyes underwent the successful RIOFB removal through limbal port without enlarging scleral ports. None of the eyes required suturing of the sclera, cornea or conjunctiva. Anterior capsular rim could be preserved in all eyes except one. Postoperatively follow up ranged from one year in 8, 6 months in 4 and 3 months in 2 eyes. The mean logMAR visual acuity at 3, 6, and 12 months showed significant improvement. There were no intraoperative complications. Postoperative complications include microscopic hyphema and loose blood in vitreous cavity in one eye. Conclusion: The advantages of 23-gauge TSV for removal of RIOFB may be passed on to select cases. RIOFB removal through limbal route obviated the need for scleral port enlargement and preserved capsular support for early visual rehabilitation.

Good visual outcome in a longstanding macular detachment associated with an optic disc pit treated with vitrectomy, laser, and gas tamponade: case report. doi: 10.20513/2447-6595.2016v56n1p68-70

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Ricardo Evangelista Marrocos de Aragao

2016-06-01

Full Text Available Optic disc pit is a congenital anomaly of the optic nerve frequently associated with macula detachment. It has a poor visual prognosis if left untreated. The treatment of the optic disc remains controversial and includes the use of laser along the edge of the optic nerve, vitrectomy with gas tamponade with or without removal of posterior hyaloid. We report a case of a 19-year-old female with a longstanding macula detachment due to optic disc pit who was treated with vitrectomy with removal of posterior hyaloid, gas tamponade, and laser. Despite longstanding macular detachment the final visual acuity was 20/25.

[Outcomes of surgical management of retinopathy of prematurity--an overview].

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Kuprjanowicz, Leszek; Kubasik-Kładna, Katarzyna; Modrzejewska, Monika

2014-01-01

According to the guidelines by the ETROP (Early Treatment for Retinopathy of Prematurity) study group, laser therapy is the gold standard in the treatment of retinopathy of prematurity. However, progression of the disease is seen in 12% of eyes despite the treatment. Since there is no causal treatment, new therapies of retinopathy of prematurity, are continually sought, such as anti-VEGF agents, beta-blockers, or insulin-like growth factor gene therapy. In cases with concomitant retinal detachment, surgery is performed. The standard therapy for retinopathy of prematurity stages 4-5 involves pars plicata vitrectomy and lensectomy (stage 5), ab externo surgery (scleral buckling) and lens-sparing vitrectomy (some cases of stage 4). Classic vitrectomy with lensectomy is reserved only for cases with advanced retinal tractions, retina-lens apposition or for cases of intraoperative lens damage during the lens-sparing vitrectomy. The ab externo surgery does not eliminate vitreous tractions, but it stabilises the neovascular membrane activity (transforming it into a scar). The indication for this type of operation is stage 4 retinopathy of prematurity with peripheral proliferations, except for the posterior--aggressive form of retinopathy of prematurity. Many papers have been published on combined therapy involving vitrectomy and conservative treatment. In conclusion, optimal timing of surgical intervention is difficult to determine in stages 4 and 5, because the anatomical and functional outcomes in stage 5 are unfavourable. Both, ab externo surgery and vitrectomy tend to produce poor macular vision in eyes with advanced retinopathy of prematurity, therefore surgical intervention at stage 4 just before the local macular retinal detachment provides better anatomical and functional outcomes.

Vitrectomy with internal limiting membrane peeling versus no peeling for idiopathic full-thickness macular hole.

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Spiteri Cornish, Kurt; Lois, Noemi; Scott, Neil W; Burr, Jennifer; Cook, Jonathan; Boachie, Charles; Tadayoni, Ramin; la Cour, Morten; Christensen, Ulrik; Kwok, Alvin K H

2014-03-01

To determine whether internal limiting membrane (ILM) peeling improves anatomic and functional outcomes of full-thickness macular hole (FTMH) surgery when compared with the no-peeling technique. Systematic review and individual participant data (IPD) meta-analysis undertaken under the auspices of the Cochrane Eyes and Vision Group. Only randomized controlled trials (RCTs) were included. Patients with idiopathic stage 2, 3, and 4 FTMH undergoing vitrectomy with or without ILM peeling. Macular hole surgery, including vitrectomy and gas endotamponade with or without ILM peeling. Primary outcome was best-corrected distance visual acuity (BCdVA) at 6 months postoperatively. Secondary outcomes were BCdVA at 3 and 12 months; best-corrected near visual acuity (BCnVA) at 3, 6, and 12 months; primary (after a single surgery) and final (after >1 surgery) macular hole closure; need for additional surgical interventions; intraoperative and postoperative complications; patient-reported outcomes (PROs) (EuroQol-5D and Vision Function Questionnaire-25 scores at 6 months); and cost-effectiveness. Four RCTs were identified and included in the review. All RCTs were included in the meta-analysis; IPD were obtained from 3 of the 4 RCTs. No evidence of a difference in BCdVA at 6 months was detected (mean difference, -0.04; 95% confidence interval [CI], -0.12 to 0.03; P=0.27); however, there was evidence of a difference in BCdVA at 3 months favoring ILM peeling (mean difference, -0.09; 95% CI, -0.17 to-0.02; P=0.02). There was evidence of an effect favoring ILM peeling with regard to primary (odds ratio [OR], 9.27; 95% CI, 4.98-17.24; Ppeeling was found to be highly cost-effective. Available evidence supports ILM peeling as the treatment of choice for patients with idiopathic stage 2, 3, and 4 FTMH. Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Update to a protocol for a feasibility cluster randomised controlled trial of a peer-led school-based intervention to increase the physical activity of adolescent girls (PLAN-A).

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Sebire, Simon J; Edwards, Mark J; Campbell, Rona; Jago, Russell; Kipping, Ruth; Banfield, Kathryn; Kadir, Bryar; Garfield, Kirsty; Lyons, Ronan A; Blair, Peter S; Hollingworth, William

2016-01-01

Physical activity levels are low amongst adolescent girls, and this population faces specific barriers to being active. Peer influences on health behaviours are important in adolescence, and peer-led interventions might hold promise to change behaviour. This paper describes the protocol for a feasibility cluster randomised controlled trial of Peer-Led physical Activity iNtervention for Adolescent girls (PLAN-A), a peer-led intervention aimed at increasing adolescent girls' physical activity levels. In addition, this paper describes an update that has been made to the protocol for the PLAN-A feasibility cluster randomised controlled trial. A two-arm cluster randomised feasibility trial will be conducted in six secondary schools (intervention n  = 4; control n  = 2) with year 8 (12-13 years old) girls. The intervention will operate at a year group level and consist of year 8 girls nominating influential peers within their year group to become peer supporters. Approximately 15% of the cohort will receive 3 days of training about physical activity and interpersonal communication skills. Peer supporters will then informally diffuse messages about physical activity amongst their friends for 10 weeks. Data will be collected at baseline (time 0 (T0)), immediately after the intervention (time 1 (T1)) and 12 months after baseline measures (time 2 (T2)). In this feasibility trial, the primary interest is in the recruitment of schools and participants (both year 8 girls and peer supporters), delivery and receipt of the intervention, data provision rates and identifying the cost categories for future economic analysis. Physical activity will be assessed using 7-day accelerometry, with the likely primary outcome in a fully powered trial being daily minutes of moderate-to-vigorous physical activity. Participants will also complete psychosocial questionnaires at each time point: assessing motivation, self-esteem and peer physical activity norms. Data analysis will be

Protease-activated receptor (PAR)-2 is required for PAR-1 signalling in pulmonary fibrosis

NARCIS (Netherlands)

Lin, Cong; von der Thüsen, Jan; Daalhuisen, Joost; ten Brink, Marieke; Crestani, Bruno; van der Poll, Tom; Borensztajn, Keren; Spek, C. Arnold

2015-01-01

Idiopathic pulmonary fibrosis is the most devastating diffuse fibrosing lung disease of unknown aetiology. Compelling evidence suggests that both protease-activated receptor (PAR)-1 and PAR-2 participate in the development of pulmonary fibrosis. Previous studies have shown that bleomycin-induced

Toxicity and the fractional distribution of trace metals accumulated from contaminated sediments by the clam Scrobicularia plana exposed in the laboratory and the field

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Kalman, J., E-mail: judit.kalman@uca.es [Department of Life Sciences, The Natural History Museum, Cromwell Road, London SW7 5BD (United Kingdom); Bonnail-Miguel, E. [Department of Physical-Chemistry, University of Cadiz, Poligono Industrial Rio San Pedro s/n, 11,510 Puerto Real, Cadiz (Spain); Smith, B.D. [Department of Life Sciences, The Natural History Museum, Cromwell Road, London SW7 5BD (United Kingdom); Bury, N.R. [Division of Diabetes and Nutritional Science, King' s College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH (United Kingdom); Rainbow, P.S. [Department of Life Sciences, The Natural History Museum, Cromwell Road, London SW7 5BD (United Kingdom)

2015-02-15

The relationship between the subcellular distribution of accumulated toxic metals into five operational fractions (subsequently combined into presumed detoxified and non-detoxified components) and toxicity in the clam Scrobicularia plana was investigated under different laboratory exposures. Clams were exposed to metal contaminated media (water and diet) and analysed for the partitioning of accumulated As, Cu and Zn into subcellular fractions. In general, metallothionein-like proteins, metal-rich granules and cellular debris in different proportions acted as main storage sites of accumulated metals in the clam soft tissues for these three metals. No significant differences were noted in the accumulation rates of As, Cu and Zn of groups of individuals with or without apparent signs of toxicity after up to 30 days of exposure to naturally contaminated sediment mixtures. There was, however, an increased proportional accumulation of Cu in the non-detoxified fraction with increased Cu accumulation rate in the clams, suggesting that the Cu uptake rate from contaminated sediments exceeded the combined rates of elimination and detoxification of Cu, with the subsequent likelihood for toxic effects in the clams. - Highlights: • Scrobicularia plana accumulated As, Cu and Zn from naturally toxic sediments. • Toxic metals were accumulated in detoxified and non-detoxified components. • Cu accumulation in the non-detoxified pool increased with increased Cu uptake rate. • Cu uptake rate exceeded combined loss and detoxification rates to cause toxicity.

Toxicity and the fractional distribution of trace metals accumulated from contaminated sediments by the clam Scrobicularia plana exposed in the laboratory and the field

International Nuclear Information System (INIS)

Kalman, J.; Bonnail-Miguel, E.; Smith, B.D.; Bury, N.R.; Rainbow, P.S.

2015-01-01

The relationship between the subcellular distribution of accumulated toxic metals into five operational fractions (subsequently combined into presumed detoxified and non-detoxified components) and toxicity in the clam Scrobicularia plana was investigated under different laboratory exposures. Clams were exposed to metal contaminated media (water and diet) and analysed for the partitioning of accumulated As, Cu and Zn into subcellular fractions. In general, metallothionein-like proteins, metal-rich granules and cellular debris in different proportions acted as main storage sites of accumulated metals in the clam soft tissues for these three metals. No significant differences were noted in the accumulation rates of As, Cu and Zn of groups of individuals with or without apparent signs of toxicity after up to 30 days of exposure to naturally contaminated sediment mixtures. There was, however, an increased proportional accumulation of Cu in the non-detoxified fraction with increased Cu accumulation rate in the clams, suggesting that the Cu uptake rate from contaminated sediments exceeded the combined rates of elimination and detoxification of Cu, with the subsequent likelihood for toxic effects in the clams. - Highlights: • Scrobicularia plana accumulated As, Cu and Zn from naturally toxic sediments. • Toxic metals were accumulated in detoxified and non-detoxified components. • Cu accumulation in the non-detoxified pool increased with increased Cu uptake rate. • Cu uptake rate exceeded combined loss and detoxification rates to cause toxicity

Review of Balltondre (2012 Éxtasis y visiones. La experiencia contemplativa de Teresa de Ávila Reseña de Coll-Planas (2012 La carne y la metáfora. Una reflexión sobre el cuerpo en la teoría queer

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Rodrigo Prieto Drouillas

2013-07-01

Full Text Available El artículo presenta una reseña del libro «La carne y la metáfora», de Gerard  Coll-Planas (Editorial UOC, 2012, en el cual el autor expone sus críticas a la manera en que han sido interpretados en los últimos años los planteamientos de la teoría queer por algunos sectores de este movimiento en España, poniendo especial atención a la manera de entender el cuerpo y su relación con las identidades de sexo/género. Para ello, Coll-Planas explica las ideas principales de este marco teórico, así como las críticas más recurrentes que se le plantean. En su recorrido, utiliza diferentes técnicas narrativas que invitan al lector a sumergirse en Internet para conocer algunos casos concretos que ejemplifican la forma en que hoy nos relacionamos con el cuerpo, o de cómo éste es maltratado o vejado por culpa de la homofobia imperante. Como conclusión, Coll-Planas propone la politización de la dependencia, la vulnerabilidad y la muerte.

Par Pond vegetation status Summer 1995 -- Summary

International Nuclear Information System (INIS)

Mackey, H.E. Jr.; Riley, R.S.

1996-01-01

The water level of Par Pond was lowered approximately 20 feet in mid-1991 in order to protect downstream residents from possible dam failure suggested by subsidence on the downstream slope of the dam and to repair the dam. This lowering exposed both emergent and nonemergent macrophyte beds to drying conditions resulting in extensive losses. A survey of the newly emergent, shoreline aquatic plant communities of Par Pond began in June 1995, three months after the refilling of Par Pond to approximately 200 feet above mean sea level. These surveys continued in July, September, and late October, 1995. Communities similar to the pre-drawdown, Par Pond aquatic plant communities are becoming re-established. Emergent beds of maidencane, lotus, waterlily, and watershield are extensive and well developed. Cattail occurrence continued to increase during the summer, but large beds common to Par Pond prior to the drawdown have not formed. Estimates from SPOT HRV, remote sensing satellite data indicated that as much as 120 hectares of emergent wetlands vegetation may have been present along the Par Pond shoreline by early October, 1995. To track the continued development of macrophytes in Par Pond, future surveys throughout 1996 and 1997, along with the continued evaluation of satellite data to map the areal extent of the macrophyte beds of Par Pond, are planned

Macula-On Versus Macula-Off Pseudophakic Rhegmatogenous Retinal Detachment Following Primary 23-Gauge Vitrectomy Plus Endotamponade.

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Rezar, Sandra; Sacu, Stefan; Blum, Robert; Eibenberger, Katharina; Schmidt-Erfurth, Ursula; Georgopoulos, Michael

2016-04-01

To evaluate anatomical and functional outcomes of macula-on and macula-off rhegmatogenous retinal detachment (RRD) after 23-gauge vitrectomy and gas endotamponade, in eyes after successful cataract surgery. Forty-six pseudophakic eyes of 46 consecutive patients who underwent surgery for RRD repair were included. Based on the severity degree and extension of the RRD, diluted C3F8, SF6 or C2F6 gases were used for endotamponade. Patients were followed 1 month, 3 months, 6 months and 12 months after surgery. Main outcome variables were functional and anatomic outcomes till 12 months after surgery. Proliferative vitreoretinopathy of grade B or C was observed in 43%. C3F8 was used in 59%, SF6 in 28% and C2F6 in 13%. Reattachment after the first intervention was achieved in 89%. Preoperatively, 63% of patients presented with fovea-off retinal detachment. No intraoperative complications were registered. Preoperatively, eyes with macula-on RRD had a logMar BCVA of 0.3 ± 0.6 compared with 1.2 ± 0.7 in the macula-off group (p = 0.01). The mean visual acuity significantly improved to 0.06 ± 0.1 logMar in macula-on eyes and to 0.2 ± 0.3 logMar in macula-off eyes at 12 months (p = 0.01 compared to baseline and p = 0.04 between both the groups). The mean final postoperative CRT was 318 ± 48 µm in the macula-on group compared with 305 ± 71 µm in the macula-off group (p = 0.5). Even morphological improvement after 23-gauge vitrectomy and gas endotamponade was comparable between macula-on and macula-off eyes, macula-off RRDs showed delayed visual rehabilitation. Both groups showed significant visual acuity improvement until 12 months, however, macula-on RRDs showed significantly more improvement than macula-off RRDs.

ParABS system in chromosome partitioning in the bacterium Myxococcus xanthus.

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Antonio A Iniesta

Full Text Available Chromosome segregation is an essential cellular function in eukaryotic and prokaryotic cells. The ParABS system is a fundamental player for a mitosis-like process in chromosome partitioning in many bacterial species. This work shows that the social bacterium Myxococcus xanthus also uses the ParABS system for chromosome segregation. Its large prokaryotic genome of 9.1 Mb contains 22 parS sequences near the origin of replication, and it is shown here that M. xanthus ParB binds preferentially to a consensus parS sequence in vitro. ParB and ParA are essential for cell viability in M. xanthus as in Caulobacter crescentus, but unlike in many other bacteria. Absence of ParB results in anucleate cells, chromosome segregation defects and loss of viability. Analysis of ParA subcellular localization shows that it clusters at the poles in all cells, and in some, in the DNA-free cell division plane between two chromosomal DNA masses. This ParA localization pattern depends on ParB but not on FtsZ. ParB inhibits the nonspecific interaction of ParA with DNA, and ParA colocalizes with chromosomal DNA only when ParB is depleted. The subcellular localization of ParB suggests a single ParB-parS complex localized at the edge of the nucleoid, next to a polar ParA cluster, with a second ParB-parS complex migrating after the replication of parS takes place to the opposite nucleoid edge, next to the other polar ParA cluster.

Combined proteomic and metallomic analyses in Scrobicularia plana clams to assess environmental pollution of estuarine ecosystems.

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González-Domínguez, Raúl; Santos, Hugo Miguel; Bebianno, Maria João; García-Barrera, Tamara; Gómez-Ariza, José Luis; Capelo, José Luis

2016-12-15

Estuaries are very important ecosystems with great ecological and economic value, but usually highly impacted by anthropogenic pressure. Thus, the assessment of pollution levels in these habitats is critical in order to evaluate their environmental quality. In this work, we combined complementary metallomic and proteomic approaches with the aim to monitor the effects of environmental pollution on Scrobicularia plana clams captured in three estuarine systems from the south coast of Portugal; Arade estuary, Ria Formosa and Guadiana estuary. Multi-elemental profiling of digestive glands was carried out to evaluate the differential pollution levels in the three study areas. Then, proteomic analysis by means of two-dimensional gel electrophoresis and mass spectrometry revealed twenty-one differential proteins, which could be associated with multiple toxicological mechanisms induced in environmentally stressed organisms. Accordingly, it could be concluded that the combination of different omic approaches presents a great potential in environmental research. Copyright © 2016 Elsevier Ltd. All rights reserved.

Intraoperative Optical Coherence Tomography-Assisted 27-Gauge Vitrectomy in Eyes with Vitreoretinal Diseases

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Hiroshi Kunikata

2015-07-01

Full Text Available Objective: To report intraoperative optical coherence tomography (iOCT-assisted 27-gauge microincision vitrectomy surgery (MIVS in eyes with vitreoretinal disease. Methods: A retrospective, interventional case series performed at a single center, including 6 eyes with retinal disease that underwent iOCT-assisted 27-gauge MIVS. Results: The advantages of iOCT were most notable when it was used to evaluate, in real time, different macular areas: the pre-macula, in vitreomacular traction or epiretinal membrane; the intra-macula, in macular edema or macular hole; and the sub-macula, in macular detachment. Real-time imaging and the minimization of shadows cast on the underlying tissues by the 27-gauge instrumentation made it possible to quickly select the best procedure at each critical juncture of the surgery. No patients experienced any complications. Conclusion: Real-time iOCT imaging during 27-gauge MIVS provided excellent intraoperative visualization of retinal tissues without causing significant obstructions to the surgeon. The positive feedback from the system allowed the surgeon to better judge the necessity of additional surgical procedures.

Analysis of ParB-centromere interactions by multiplex SPR imaging reveals specific patterns for binding ParB in six centromeres of Burkholderiales chromosomes and plasmids.

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Pillet, Flavien; Passot, Fanny Marie; Pasta, Franck; Anton Leberre, Véronique; Bouet, Jean-Yves

2017-01-01

Bacterial centromeres-also called parS, are cis-acting DNA sequences which, together with the proteins ParA and ParB, are involved in the segregation of chromosomes and plasmids. The specific binding of ParB to parS nucleates the assembly of a large ParB/DNA complex from which ParA-the motor protein, segregates the sister replicons. Closely related families of partition systems, called Bsr, were identified on the chromosomes and large plasmids of the multi-chromosomal bacterium Burkholderia cenocepacia and other species from the order Burkholeriales. The centromeres of the Bsr partition families are 16 bp palindromes, displaying similar base compositions, notably a central CG dinucleotide. Despite centromeres bind the cognate ParB with a narrow specificity, weak ParB-parS non cognate interactions were nevertheless detected between few Bsr partition systems of replicons not belonging to the same genome. These observations suggested that Bsr partition systems could have a common ancestry but that evolution mostly erased the possibilities of cross-reactions between them, in particular to prevent replicon incompatibility. To detect novel similarities between Bsr partition systems, we have analyzed the binding of six Bsr parS sequences and a wide collection of modified derivatives, to their cognate ParB. The study was carried out by Surface Plasmon Resonance imaging (SPRi) mulitplex analysis enabling a systematic survey of each nucleotide position within the centromere. We found that in each parS some positions could be changed while maintaining binding to ParB. Each centromere displays its own pattern of changes, but some positions are shared more or less widely. In addition from these changes we could speculate evolutionary links between these centromeres.

La pelade par plaques

Science.gov (United States)

Spano, Frank; Donovan, Jeff C.

2015-01-01

Résumé Objectif Présenter aux médecins de famille des renseignements de base pour faire comprendre l’épidémiologie, la pathogenèse, l’histologie et l’approche clinique au diagnostic de la pelade par plaques. Sources des données Une recension a été effectuée dans PubMed pour trouver des articles pertinents concernant la pathogenèse, le diagnostic et le pronostic de la pelade par plaques. Message principal La pelade par plaques est une forme de perte pileuse auto-immune dont la prévalence durant une vie est d’environ 2 %. Des antécédents personnels ou familiaux de troubles auto-immuns concomitants, comme le vitiligo ou une maladie de la thyroïde, peuvent être observés dans un petit sous-groupe de patients. Le diagnostic peut souvent être posé de manière clinique en se fondant sur la perte de cheveux non cicatricielle et circulaire caractéristique, accompagnée de cheveux en « point d’exclamation » en périphérie chez ceux dont le problème en est aux premiers stades. Le diagnostic des cas plus complexes ou des présentations inhabituelles peut être facilité par une biopsie et un examen histologique. Le pronostic varie largement et de mauvais résultats sont associés à une apparition à un âge précoce, une perte importante, la variante ophiasis, des changements aux ongles, des antécédents familiaux ou des troubles auto-immuns concomitants. Conclusion La pelade par plaques est une forme auto-immune de perte de cheveux périodiquement observée en soins primaires. Les médecins de famille sont bien placés pour identifier la pelade par plaques, déterminer la gravité de la maladie et poser le diagnostic différentiel approprié. De plus, ils sont en mesure de renseigner leurs patients à propos de l’évolution clinique de la maladie ainsi que du pronostic général selon le sous-type de patients.

INDUCTION OF MACULAR DETACHMENT FOR THE TREATMENT OF PERSISTENT OR RECURRENT IDIOPATHIC MACULAR HOLES.

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Szigiato, Andrei-Alexandru; Gilani, Fatimah; Walsh, Mark K; Mandelcorn, Efrem D; Muni, Rajeev H

2016-09-01

To analyze the efficacy of induced macular detachment for the treatment of persistent or recurrent idiopathic macular holes after treatment with one or more standard pars plana vitrectomies (PPVs) with internal limiting membrane peeling. This study is a retrospective consecutive case series of 10 patients who underwent a PPV with subretinal balanced salt solution injection from 2011 to 2014 to treat persistent or recurrent idiopathic macular holes. All patients had previously undergone PPV with internal limiting membrane peeling. Visual acuity, ocular examination findings, and optical coherence tomographic images were reviewed preoperatively and postoperatively to assess the anatomical and visual outcomes of this procedure. Nine of the 10 patients who underwent the procedure had closure of their macular holes postoperatively (90%) and remained closed 6 months postoperatively. Most patients reported a subjective visual improvement. A mean objective visual improvement of 16 letters (Early Treatment Diabetic Retinopathy Study, 0.324 logMAR) was seen between preoperative and 6-month postoperative assessments of all patients (pre = 1.490, post = 1.166; P = 0.022). Subgroup analysis of patients with successful closure revealed 20 letters of improvement (0.398 logMAR) in visual acuity (pre = 1.491, post = 1.093; P = 0.004). There were no intraoperative or postoperative complications. In eyes with persistent or recurrent idiopathic macular holes after standard PPV with internal limiting membrane peeling, repeat PPV with subretinal balanced salt solution injection to create a macular detachment may be a viable surgical treatment option. Our results show improved anatomical and visual outcomes postoperatively that compare favorably to other case series describing various surgical treatments for these challenging cases.

Retinopathy of Prematurity; Risk Factors, Prognosis and Treatment

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Sibel Kocabeyo¤lu

2011-06-01

Full Text Available Purpose: To evaluate the prevalence, related risk factors, treatment and follow-up results in cases of retinopathy of prematurity (ROP. Material and Method: Medical records of 405 premature infants who attended our clinic between August 1999 and September 2004 were retrospectively screened. Among these patients, 379 infants were followed up in our neonatology unit and 26 were referred to us from other clinics. Indirect diode laser photocoagulation and/or cryotherapy were performed when prethreshold or threshold ROP was detected. Surgery was performed in stage IV-V ROP. Results: ROP was detected in 88 out of 405 infants (21.72%. At the first examination, stage I ROP was detected in 18 eyes (10.4%, stage II - in 67 eyes (38.72%, stage III - in 82 eyes (47.39%, and stage IV-V – in 6 eyes (3.46%. Indirect diode laser photocoagulation was applied to 34 eyes with stage II and in 47 eyes with stage III ROP. Ten eyes with threshold ROP and 4 eyes which progressed to threshold ROP were treated with cryotherapy. Scleral buckling was performed in 3 eyes that progressed to stage IV ROP. At the first examination, 2 eyes with stage IV-V ROP were treated with pars plana vitrectomy (PPV. Discussion: In our series, the most important risk factors for development and progression of ROP were found to be low birth weight, low gestational age, mechanical ventilation and multiple pregnancy. Effective screening, follow-up and appropriate treatment are important for prevention of permanent damage and unfavorable outcome in ROP. (Turk J Ophthalmol 2011; 41: 128-32

Ahmed Glaucoma Valve Implantation in Vitrectomized Eyes

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Nimet Yeşim Erçalık

2018-01-01

Full Text Available Purpose. To evaluate the outcomes of Ahmed glaucoma valve (AGV implantation in vitrectomized eyes. Materials and Methods. The medical records of 13 eyes that developed glaucoma due to emulsified silicon oil or neovascularization following pars plana vitrectomy and underwent AGV implantation were retrospectively reviewed. The main outcome measures were intraocular pressure (IOP, best-corrected visual acuity (BCVA, number of antiglaucoma medications, and postoperative complications. Surgical success was defined as last IOP ≤21 mmHg or ≥6 mmHg and without loss of light perception. Results. The mean follow-up duration was 11.7 ± 5.5 (range, 6–23 months. The mean IOP before the AGV implantation was 37.9 ± 6.7 mmHg with an average of 3.5 ± 1.2 drugs. At the final visit, the mean IOP was 15.9 ± 4.6 mmHg (p=0.001 and the mean number of glaucoma medications decreased to 2.3 ± 1.3 (p=0.021. At the last visit, 11 eyes (84.4% had stable or improved VA and one eye (7.7% had a final VA of no light perception. Surgical success was achieved in 11 of the 13 eyes (84.4%. Postoperative complications were bleb encapsulation (69.2%, early hypotony (38.5%, hyphema (23.1%, decompression retinopathy (23.1%, choroidal detachment (15.4%, intraocular hemorrhage (7.7%, and late endophthalmitis (7.7%. One eye (7.7% was enucleated because of late endophthalmitis. Conclusions. Despite complications necessitating medical and surgical interventions, vitrectomized eyes were effectively managed with AGV implantation.

Comparison of 1000-Centistoke versus 5000-Centistoke Silicone Oil in Complex Retinal Detachment Surgery.

Science.gov (United States)

Zafar, Shakir; Shakir, Munira; Mahmood, Syed Asaad; Amin, Saima; Iqbal, Zafar

2016-01-01

To compare the efficacy and complications of using 1000-centistoke versus 5000-centistoke silicone oil for complex retinal detachment repair. Case series. LRBT Tertiary Eye Hospital, Karachi, from January 2007 to June 2013. Eighty-five eyes (85 patients) presenting with superior rhegmatogenous retinal detachments associated with PVR grades B and C (involving not more than 3 clock hours) were randomized to either 1000 centistokes (n=44) or 5000 centistokes (n=41) silicone oil group. All patients underwent 23-gauge pars plana vitrectomy surgery with silicone oil intraocular tamponade. Patient data was analysed at 18 months post-operatively. IBM SPSS 21 was used for data analysis. There were 52 male and 33 female patients aged between 22 and 70 years (45.2 ±16.2). After the first surgery, successful reattachment of the retina was achieved in 67 eyes (78.8%); of which 35 eyes were in 1000-centistoke and 32 eyes in 5000-centistoke groups. Mean pre-operative Best Corrected Visual Acuity (BCVA) was 1.63 ±0.54 which was improved to a mean post-operative BCVAof 1.46 ±0.78 (1.42 ±0.74 in 1000-centistoke group; 1.49 ±0.78 in 5000 centistoke group). The 1000-centistoke group had a significantly higher frequency of oil emulsification which necessitated early removal of silicone oil. There were 66 eyes (77%) with at least one complication (34 eyes in 1000-centistoke group; 32 eyes in 5000-centistoke group) including cataract, corneal abnormalities, raised IOP, hypotony, vitreous haemorrhage and retinal redetachment. Although visual and anatomical outcomes were comparable between the two groups, the 1000-centistoke silicone oil group developed early oil emulsification necessitating its early removal.

The Expansion of RPE Atrophy after the Inverted ILM Flap Technique for a Chronic Large Macular Hole

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Hisanori Imai

2014-03-01

Full Text Available Purpose: To report a case of the expansion of submacular retinal pigment epithelium (RPE atrophy after using the inverted internal limiting membrane (ILM flap technique for a persisting, large, stage IV macular hole (MH. Case Report: A 79-year-old woman presented with a chronic large MH that remained open despite pars plana vitrectomy (PPV. The surgery was performed twice for the MH closure 14 years earlier. ILM peeling was not performed during the previous surgeries. The best-corrected visual acuity (BCVA with the Landolt ring chart was 0.08 at her visit. The minimum MH diameter was 1,240 μm. Inverted ILM flap technique with 20% SF6 gas tamponade was performed for the MH closure. For the inverted ILM flap technique, 25-gauge PPV and ILM staining with indocyanine green were used. The ILM was peeled off for 2 disc diameters around the MH, but the ILM was not removed completely. The ILM was then inverted and covered the MH. Results: One month after surgery, the MH was closed, accompanied by glial cell proliferation spreading from the inverted ILM flap (as reported before. On the other hand, the area of the submacular RPE atrophy, which was already observed 1 week after surgery, gradually increased in size. BCVA improved to 0.3 six months after the surgery. Conclusions: The inverted ILM flap technique may be promising even for persisting large MH which were not closed in previous surgeries, but long-term observation is needed because the detailed behavior of the inverted ILM and the Müller cells after surgery is not yet known.

Diabetic retinopathy - ocular complications of diabetesmellitus

Institute of Scientific and Technical Information of China (English)

Martin M Nentwich; Michael W Ulbig

2015-01-01

In industrialized nations diabetic retinopathy is the mostfrequent microvascular complication of diabetes mellitusand the most common cause of blindness in the workingagepopulation. In the next 15 years, the number ofpatients suffering from diabetes mellitus is expected toincrease significantly. By the year 2030, about 440 millionpeople in the age-group 20-79 years are estimated to besuffering from diabetes mellitus worldwide （prevalence7.7%）, while in 2010 there were 285 million people withdiabetes mellitus （prevalence 6.4%）. This accounts foran increase in patients with diabetes in industrialized nations by 20% and in developing countries by 69% until the year 2030. Due to the expected rise in diabetic patients, the need for ophthalmic care of patients （i.e. , exams and treatments） will also increase and represents a challenge for eye-care providers. Development of optimized screening programs, which respect available resources of the ophthalmic infrastructure, will become even more important. Main reasons for loss of vision in patients with diabetes mellitus are diabetic macular edema and proliferative diabetic retinopathy. Incidence or progression of these potentially blinding complications can be greatly reduced by adequate control of blood glucose and blood pressure levels. Additionally, regular ophthalmic exams are mandatory for detecting ocular complications and initiating treatments such as laser photocoagulation in case of clinical significant diabetic macular edema or early proliferative diabetic retinopathy. In this way, the risk of blindness can considerably be reduced. In advanced stages of diabetic retinopathy, pars-plana vitrectomy is performed to treat vitreous hemorrhage and tractional retinal detachment. In recent years, the advent of intravitreal medication has improved therapeutic options for patients with advanced diabetic macular edema.

Current visual and anatomic outcomes of pneumatic retinopexy.

Science.gov (United States)

Kulkarni, Kaushal M; Roth, Daniel B; Prenner, Jonathan L

2007-10-01

To assess current visual and anatomic outcomes of pneumatic retinopexy (PR) for the repair of rhegmatogenous retinal detachment (RD). Retrospective chart review of 150 patients who underwent PR for RD between January 2000 and February 2005. Patients with a history of scleral buckling, Lincoff balloon, or proliferative diabetic retinopathy in the same eye were excluded. Successful reattachment was achieved in 76.7% with a single procedure and 98.7% after additional procedures. A total of 17.3% underwent a subsequent procedure for a new or persistent tear. The success rate remained consistent in pseudophakic and aphakic eyes, and eyes with traumatic detachments, macular detachment, multiple breaks, poor preoperative visual acuity (VA) (lattice degeneration, >or=6 clock hours of detachment, and prior pars plana vitrectomy. A total of 2.7% of eyes underwent a second additional procedure for RD. A total of 32% of males versus 15.3% of females underwent an additional procedure for RD (P = 0.07). Final VA >or=20/50 was achieved in 80.8% of macula-on and 73.6% of macula-off RDs. Of eyes that underwent an additional procedure, final VA >or=20/50 was achieved in 63.2% of macula-on and 43.8% of macula-off RDs, and those with macula-on RD lost a mean of 1.79 (+/-4.9) lines of Snellen VA, while those with macula-off RD gained a mean of 5.6 (+/-4.6) lines (P = 0.00006). : PR had a high anatomic success rate in eyes with a wide variety of complicated RDs. Male sex may be a risk factor for failed PR. Careful monitoring and treatment of postoperative tears is important in preventing redetachment.

Ahmed Glaucoma Valve Implantation in Vitrectomized Eyes.

Science.gov (United States)

Erçalık, Nimet Yeşim; İmamoğlu, Serhat

2018-01-01

To evaluate the outcomes of Ahmed glaucoma valve (AGV) implantation in vitrectomized eyes. The medical records of 13 eyes that developed glaucoma due to emulsified silicon oil or neovascularization following pars plana vitrectomy and underwent AGV implantation were retrospectively reviewed. The main outcome measures were intraocular pressure (IOP), best-corrected visual acuity (BCVA), number of antiglaucoma medications, and postoperative complications. Surgical success was defined as last IOP ≤21 mmHg or ≥6 mmHg and without loss of light perception. The mean follow-up duration was 11.7 ± 5.5 (range, 6-23) months. The mean IOP before the AGV implantation was 37.9 ± 6.7 mmHg with an average of 3.5 ± 1.2 drugs. At the final visit, the mean IOP was 15.9 ± 4.6 mmHg ( p =0.001) and the mean number of glaucoma medications decreased to 2.3 ± 1.3 ( p =0.021). At the last visit, 11 eyes (84.4%) had stable or improved VA and one eye (7.7%) had a final VA of no light perception. Surgical success was achieved in 11 of the 13 eyes (84.4%). Postoperative complications were bleb encapsulation (69.2%), early hypotony (38.5%), hyphema (23.1%), decompression retinopathy (23.1%), choroidal detachment (15.4%), intraocular hemorrhage (7.7%), and late endophthalmitis (7.7%). One eye (7.7%) was enucleated because of late endophthalmitis. Despite complications necessitating medical and surgical interventions, vitrectomized eyes were effectively managed with AGV implantation.

Centromere pairing by a plasmid-encoded type I ParB protein

DEFF Research Database (Denmark)

Ringgaard, Simon; Löwe, Jan; Gerdes, Kenn

2007-01-01

The par2 locus of Escherichia coli plasmid pB171 encodes two trans-acting proteins, ParA and ParB, and two cis-acting sites, parC1 and parC2, to which ParB binds cooperatively. ParA is related to MinD and oscillates in helical structures and thereby positions ParB/parC-carrying plasmids regularly......, hence identifying the N terminus of ParB as a requirement for ParB-mediated centromere pairing. These observations suggest that centromere pairing is an important intermediate step in plasmid partitioning mediated by the common type I loci....

Analysis of ParB-centromere interactions by multiplex SPR imaging reveals specific patterns for binding ParB in six centromeres of Burkholderiales chromosomes and plasmids.

Directory of Open Access Journals (Sweden)

Flavien Pillet

Full Text Available Bacterial centromeres-also called parS, are cis-acting DNA sequences which, together with the proteins ParA and ParB, are involved in the segregation of chromosomes and plasmids. The specific binding of ParB to parS nucleates the assembly of a large ParB/DNA complex from which ParA-the motor protein, segregates the sister replicons. Closely related families of partition systems, called Bsr, were identified on the chromosomes and large plasmids of the multi-chromosomal bacterium Burkholderia cenocepacia and other species from the order Burkholeriales. The centromeres of the Bsr partition families are 16 bp palindromes, displaying similar base compositions, notably a central CG dinucleotide. Despite centromeres bind the cognate ParB with a narrow specificity, weak ParB-parS non cognate interactions were nevertheless detected between few Bsr partition systems of replicons not belonging to the same genome. These observations suggested that Bsr partition systems could have a common ancestry but that evolution mostly erased the possibilities of cross-reactions between them, in particular to prevent replicon incompatibility. To detect novel similarities between Bsr partition systems, we have analyzed the binding of six Bsr parS sequences and a wide collection of modified derivatives, to their cognate ParB. The study was carried out by Surface Plasmon Resonance imaging (SPRi mulitplex analysis enabling a systematic survey of each nucleotide position within the centromere. We found that in each parS some positions could be changed while maintaining binding to ParB. Each centromere displays its own pattern of changes, but some positions are shared more or less widely. In addition from these changes we could speculate evolutionary links between these centromeres.

Case report: a novel KERA mutation associated with cornea plana and its predicted effect on protein function

DEFF Research Database (Denmark)

Roos, Laura; Bertelsen, Birgitte; Harris, Pernille

2015-01-01

individuals, hypotrichosis was found. KERA was screened for mutations using Sanger sequencing. We detected a novel KERA variant, p.(Ile225Thr), that segregates with the disease in the homozygous form. The three-dimensional structure of keratocan protein was modelled, and we showed that this missense variation...... of the keratocan gene (KERA) on chromosome 12q22. To date, only nine different disease-associated KERA mutations, including four missense mutations, have been described. Case presentation: In this report, we present clinical data from a Turkish family with autosomal recessive cornea plana. In some of the affected...... are predicted to result in destabilization of the protein. Conclusion: We present the 10th pathogenic KERA mutation identified so far. Protein modelling is a useful tool in predicting the effect of missense mutations. This case underline the importance of the leucin rich repeat domain for the protein function...

CFD analysis of PAR performance as function of inlet design

International Nuclear Information System (INIS)

Park, Kweonha; Khor, Chong Lee

2016-01-01

Highlights: • The new concept of PAR (passive autocatalytic recombiner) was proposed and analyzed. • Guidance wall was added at the bottom of PAR to enhance the flow rate through the catalyst. • The new concept of PAR was proved to have a better hydrogen removal performance. - Abstract: Passive autocatalytic recombiner (PAR) is very useful hydrogen mitigation measurement. It is widely implemented in the current and advanced light water reactors (ALWRs). The design of the PARs should be optimized for the specific use under severe accident scenarios. Several techniques and innovations have been fused into the PAR, as an effort to increase its efficiency of hydrogen mitigation. This study proposes different concepts of PAR, which applied some changes to the honeycomb catalyst PAR made by the Korea Nuclear Technology (KNT) Inc. Two slices of plate are added to the bottom of PAR model, which intended to act as a reflection wall and promote the gas flow into PAR. Hydrogen volume fraction was given 4 vol. % which tested by KNT to investigate the performance of PAR in different direction gas flow conditions to see maximum hydrogen recombination rate. The new concept of PAR was proved to have a better hydrogen removal performance compared to the original honeycomb catalyst PAR.

CFD analysis of PAR performance as function of inlet design

Energy Technology Data Exchange (ETDEWEB)

Park, Kweonha, E-mail: khpark@kmou.ac.kr [Division of Mechanical and Energy systems Engineering, Korea Maritime University, Dongsam-dong, Yeongdo-gu, Busan 606-791 (Korea, Republic of); Khor, Chong Lee, E-mail: itachi_829@hotmail.com [Department of Mechanical Engineering, Korea Maritime University (Korea, Republic of)

2016-01-15

Highlights: • The new concept of PAR (passive autocatalytic recombiner) was proposed and analyzed. • Guidance wall was added at the bottom of PAR to enhance the flow rate through the catalyst. • The new concept of PAR was proved to have a better hydrogen removal performance. - Abstract: Passive autocatalytic recombiner (PAR) is very useful hydrogen mitigation measurement. It is widely implemented in the current and advanced light water reactors (ALWRs). The design of the PARs should be optimized for the specific use under severe accident scenarios. Several techniques and innovations have been fused into the PAR, as an effort to increase its efficiency of hydrogen mitigation. This study proposes different concepts of PAR, which applied some changes to the honeycomb catalyst PAR made by the Korea Nuclear Technology (KNT) Inc. Two slices of plate are added to the bottom of PAR model, which intended to act as a reflection wall and promote the gas flow into PAR. Hydrogen volume fraction was given 4 vol. % which tested by KNT to investigate the performance of PAR in different direction gas flow conditions to see maximum hydrogen recombination rate. The new concept of PAR was proved to have a better hydrogen removal performance compared to the original honeycomb catalyst PAR.

Par Pond Fish, Water, and Sediment Chemistry

International Nuclear Information System (INIS)

Paller, M.H.; Wike, L.D.

1996-06-01

The objectives of this report are to describe the Par Pond fish community and the impact of the drawdown and refill on the community, describe contaminant levels in Par Pond fish, sediments, and water and indicate how contaminant concentrations and distributions were affected by the drawdown and refill, and predict possible effects of future water level fluctuations in Par Pond

Par Pond Fish, Water, and Sediment Chemistry

Energy Technology Data Exchange (ETDEWEB)

Paller, M.H. [Westinghouse Savannah River Company, AIKEN, SC (United States); Wike, L.D.

1996-06-01

The objectives of this report are to describe the Par Pond fish community and the impact of the drawdown and refill on the community, describe contaminant levels in Par Pond fish, sediments, and water and indicate how contaminant concentrations and distributions were affected by the drawdown and refill, and predict possible effects of future water level fluctuations in Par Pond.

Concerning the dynamic instability of actin homolog ParM

International Nuclear Information System (INIS)

Popp, David; Yamamoto, Akihiro; Iwasa, Mitsusada; Narita, Akihiro; Maeda, Kayo; Maeda, Yuichiro

2007-01-01

Using in vitro TIRF- and electron-microscopy, we reinvestigated the dynamics of native ParM, a prokaryotic DNA segregation protein and actin homolog. In contrast to a previous study, which used a cysteine ParM mutant, we find that the polymerization process of wild type ATP-ParM filaments consists of a polymerization phase and a subsequent steady state phase, which is dynamically unstable, like that of microtubules. We find that the apparent bidirectional polymerization of ParM, is not due to the intrinsic nature of this filament, but results from ParM forming randomly oriented bundles in the presence of crowding agents. Our results imply, that in the bacterium, ParM filaments spontaneously form bipolar bundles. Due to their intrinsic dynamic instability, ParM bundles can efficiently 'search' the cytoplasmic lumen for DNA, bind it equally well at the bipolar ends and segregate it approximately symmetrically, by the insertion of ParM subunits at either end

First-in-human uPAR PET

DEFF Research Database (Denmark)

Persson, Morten; Skovgaard, Dorthe; Brandt-Larsen, Malene

2015-01-01

A first-in-human clinical trial with Positron Emission Tomography (PET) imaging of the urokinase-type plasminogen activator receptor (uPAR) in patients with breast, prostate and bladder cancer, is described. uPAR is expressed in many types of human cancers and the expression is predictive...... for targeted molecular imaging with PET. The safety, pharmacokinetic, biodistribution profile and radiation dosimetry after a single intravenous dose of (64)Cu-DOTA-AE105 were assessed by serial PET and computed tomography (CT) in 4 prostate, 3 breast and 3 bladder cancer patients. Safety assessment...... of invasion, metastasis and indicates poor prognosis. uPAR PET imaging therefore holds promise to be a new and innovative method for improved cancer diagnosis, staging and individual risk stratification. The uPAR specific peptide AE105 was conjugated to the macrocyclic chelator DOTA and labeled with (64)Cu...

uPAR as anti-cancer target

DEFF Research Database (Denmark)

Lund, Ida K; Illemann, Martin; Thurison, Tine

2011-01-01

, and a potential diagnostic and predictive impact of the different uPAR forms has been reported. Hence, pericellular proteolysis seems to be a suitable target for anti-cancer therapy and numerous approaches have been pursued. Targeting of this process may be achieved by preventing the binding of uPA to u...... using mouse monoclonal antibodies (mAbs) against mouse uPA or uPAR. These reagents will target uPA and uPAR in both stromal cells and cancer cells, and their therapeutic potential can now be assessed in syngenic mouse cancer models....

Protease-activated receptor (PAR2, but not PAR1, is involved in collateral formation and anti-inflammatory monocyte polarization in a mouse hind limb ischemia model.

Directory of Open Access Journals (Sweden)

Lisa G van den Hengel

Full Text Available AIMS: In collateral development (i.e. arteriogenesis, mononuclear cells are important and exist as a heterogeneous population consisting of pro-inflammatory and anti-inflammatory/repair-associated cells. Protease-activated receptor (PAR1 and PAR2 are G-protein-coupled receptors that are both expressed by mononuclear cells and are involved in pro-inflammatory reactions, while PAR2 also plays a role in repair-associated responses. Here, we investigated the physiological role of PAR1 and PAR2 in arteriogenesis in a murine hind limb ischemia model. METHODS AND RESULTS: PAR1-deficient (PAR1-/-, PAR2-deficient (PAR2-/- and wild-type (WT mice underwent femoral artery ligation. Laser Doppler measurements revealed reduced post-ischemic blood flow recovery in PAR2-/- hind limbs when compared to WT, while PAR1-/- mice were not affected. Upon ischemia, reduced numbers of smooth muscle actin (SMA-positive collaterals and CD31-positive capillaries were found in PAR2-/- mice when compared to WT mice, whereas these parameters in PAR1-/- mice did not differ from WT mice. The pool of circulating repair-associated (Ly6C-low monocytes and the number of repair-associated (CD206-positive macrophages surrounding collaterals in the hind limbs were increased in WT and PAR1-/- mice, but unaffected in PAR2-/- mice. The number of repair-associated macrophages in PAR2-/- hind limbs correlated with CD11b- and CD115-expression on the circulating monocytes in these animals, suggesting that monocyte extravasation and M-CSF-dependent differentiation into repair-associated cells are hampered. CONCLUSION: PAR2, but not PAR1, is involved in arteriogenesis and promotes the repair-associated response in ischemic tissues. Therefore, PAR2 potentially forms a new pro-arteriogenic target in coronary artery disease (CAD patients.

Protocol for a feasibility cluster randomised controlled trial of a peer-led school-based intervention to increase the physical activity of adolescent girls (PLAN-A).

Science.gov (United States)

Sebire, Simon J; Edwards, Mark J; Campbell, Rona; Jago, Russell; Kipping, Ruth; Banfield, Kathryn; Tomkinson, Keeley; Garfield, Kirsty; Lyons, Ronan A; Simon, Joanne; Blair, Peter S; Hollingworth, William

2016-01-01

Physical activity levels are low amongst adolescent girls, and this population faces specific barriers to being active. Peer influences on health behaviours are important in adolescence and peer-led interventions might hold promise to change behaviour. This paper describes the protocol for a feasibility cluster randomised controlled trial of Peer-Led physical Activity iNtervention for Adolescent girls (PLAN-A), a peer-led intervention aimed at increasing adolescent girls' physical activity levels. A two-arm cluster randomised feasibility trial will be conducted in six secondary schools (intervention n  = 4; control n  = 2) with year 8 (12-13 years old) girls. The intervention will operate at a year group level and consist of year 8 girls nominating influential peers within their year group to become peer-supporters. Approximately 15 % of the cohort will receive 3 days of training about physical activity and interpersonal communication skills. Peer-supporters will then informally diffuse messages about physical activity amongst their friends for 10 weeks. Data will be collected at baseline (time 0 (T0)), immediately after the intervention (time 1 (T1)) and 12 months after baseline measures (time 2 (T2)). In this feasibility trial, the primary interest is in the recruitment of schools and participants (both year 8 girls and peer-supporters), delivery and receipt of the intervention, data provision rates and identifying the cost categories for future economic analysis. Physical activity will be assessed using 7-day accelerometry, with the likely primary outcome in a fully-powered trial being daily minutes of moderate-to-vigorous physical activity. Participants will also complete psychosocial questionnaires at each time point: assessing motivation, self-esteem and peer physical activity norms. Data analysis will be largely descriptive and focus on recruitment, attendance and data provision rates. The findings will inform the sample size required for a

Apoplejía pituitaria con parálisis del III par craneal: Reporte de caso

Directory of Open Access Journals (Sweden)

Miguel Pinto Valdivia

2011-10-01

Full Text Available Se describe el caso de un varón de 65 años de edad, sin antecedentes patológicos de importancia, que acudió a emergencia del Hospital Nacional Cayetano Heredia por presentar cefalea intensa y ptosis palpebral izquierda. El examen físico mostró parálisis aislada del III par craneal izquierdo. Los análisis de laboratorio mostraron hiponatremia e hipopituitarismo y la resonancia magnética nuclear un adenoma pituitario con áreas de hemorragia e invasión de los senos cavernosos. El tratamiento incluyó glucocorticoides y descompresión quirúrgica transesfenoidal. La anatomía patológica confirmó el diagnóstico de infarto hemorrágico de un adenoma pituitario. El paciente fue dado de alta con terapia sustitutiva de levotiroxina y prednisona. La ptosis palpebral izquierda se recuperó en forma parcial. La apoplejía pituitaria es un síndrome clínico producido por un proceso expansivo dentro de la silla turca, secundario a hemorragia o infarto de un adenoma pituitario, que se caracteriza por cefalea, déficit visual, oftalmoplejía y alteración del nivel de conciencia. Este proceso expansivo puede comprimir los pares craneales en los senos cavernosos, produciendo diferentes grados de parálisis de los músculos oculomotores. La parálisis aislada del III par craneal es rara.(Rev Med Hered 2011;22:186-189.

Copenhagen uPAR prostate cancer (CuPCa) database

DEFF Research Database (Denmark)

Lippert, Solvej; Berg, Kasper D; Høyer-Hansen, Gunilla

2016-01-01

AIM: Urokinase plasminogen activator receptor (uPAR) plays a central role during cancer invasion by facilitating pericellular proteolysis. We initiated the prospective 'Copenhagen uPAR Prostate Cancer' study to investigate the significance of uPAR levels in prostate cancer (PCa) patients. METHODS...

Recombination in the human Pseudoautosomal region PAR1.

Directory of Open Access Journals (Sweden)

Anjali G Hinch

2014-07-01

Full Text Available The pseudoautosomal region (PAR is a short region of homology between the mammalian X and Y chromosomes, which has undergone rapid evolution. A crossover in the PAR is essential for the proper disjunction of X and Y chromosomes in male meiosis, and PAR deletion results in male sterility. This leads the human PAR with the obligatory crossover, PAR1, to having an exceptionally high male crossover rate, which is 17-fold higher than the genome-wide average. However, the mechanism by which this obligatory crossover occurs remains unknown, as does the fine-scale positioning of crossovers across this region. Recent research in mice has suggested that crossovers in PAR may be mediated independently of the protein PRDM9, which localises virtually all crossovers in the autosomes. To investigate recombination in this region, we construct the most fine-scale genetic map containing directly observed crossovers to date using African-American pedigrees. We leverage recombination rates inferred from the breakdown of linkage disequilibrium in human populations and investigate the signatures of DNA evolution due to recombination. Further, we identify direct PRDM9 binding sites using ChIP-seq in human cells. Using these independent lines of evidence, we show that, in contrast with mouse, PRDM9 does localise peaks of recombination in the human PAR1. We find that recombination is a far more rapid and intense driver of sequence evolution in PAR1 than it is on the autosomes. We also show that PAR1 hotspot activities differ significantly among human populations. Finally, we find evidence that PAR1 hotspot positions have changed between human and chimpanzee, with no evidence of sharing among the hottest hotspots. We anticipate that the genetic maps built and validated in this work will aid research on this vital and fascinating region of the genome.

Plasma suPAR is lowered by smoking cessation

DEFF Research Database (Denmark)

Eugen-Olsen, Jesper; Ladelund, Steen; Sørensen, Lars Tue

2016-01-01

BACKGROUND: Soluble urokinase plasminogen activator receptor (suPAR) is a stable inflammatory biomarker. In patients, suPAR is a marker of disease presence, severity and prognosis. In the general population, suPAR is predictive of disease development, such as diabetes and cardiovascular disease a...

The inflammatory marker suPAR after cardiac arrest

DEFF Research Database (Denmark)

Rundgren, Malin; Lyngbaek, Stig; Fisker, Helle

2015-01-01

. This pilot study aimed at investigating suPAR levels in relation to outcome after CA and mild induced hypothermia. METHODS: suPAR levels were measured at 6, 36, and 72 hours in patients treated with hypothermia after CA. suPAR levels were analyzed in relation to survival after 6 months. Receiver operating...

Comparação de parâmetros periodontais após utilização de contenção convencional 3x3 plana e contenção modificada Comparison of periodontal indexes after the use of conventional 3X3 plain retainer and modified retainer

Directory of Open Access Journals (Sweden)

Bianca Keiko Shirasu

2007-02-01

Full Text Available OBJETIVO: o presente estudo teve como propósito comparar os parâmetros periodontais após a utilização de dois tipos de contenções ortodônticas fixas: contenção convencional 3x3 plana (fio ortodôntico 0,8mm retilíneo fixado apenas nos caninos contralaterais e a contenção modificada (fio ortodôntico 0,6mm com dobras permitindo o livre acesso do fio dental e fixado em todos os dentes do segmento anterior. METODOLOGIA: quinze voluntários primeiramente utilizaram a contenção convencional por seis meses. Após um intervalo de quinze dias, foi instalada a contenção modificada, utilizada pelo mesmo período de tempo. Antes de cada fase os voluntários passaram por raspagem e alisamento radicular dos dentes e orientação de higiene bucal. Ao final de cada fase os seguintes parâmetros foram avaliados: índice de placa dentária, índice gengival e índice de cálculo dentário. Além disso, foi realizada a mensuração do cálculo no fio da contenção e todos os voluntários responderam a um questionário sobre a utilização, aceitação e conforto dos dois tipos de contenções. RESULTADOS E CONCLUSÕES: foi observado que o índice de placa e o índice gengival foram maiores para a contenção modificada (pAIM: the purpose of the present study was to compare periodontal indexes after the use of two types of bonded fixed retainers: conventional 3x3 plain retainer (orthodontic wire 0.8mm, bonded to the canine teeth only and the modified retainer (0.6mm multi strand wire, allowing free access to dental floss and bonded to all anterior teeth. METHODS: a test group of fifteen patients used the conventional retainer for 6 months. After a two week interval, the modified retainer was used for another 6 months. Previous to each phase, the patients went through tooth scaling, root planing and oral hygiene orientation. At the end of each phase the dental plaque index, gingival index and dental calculus index were evaluated. Furthermore, the

Comparison of attraction capabilities associated with high-speed, dual-pneumatic vitrectomy probes.

Science.gov (United States)

Dugel, Pravin U; Abulon, Dina J K; Dimalanta, Ramon

2015-05-01

To measure membrane attraction capabilities of enhanced 27-gauge, enhanced 25-gauge, and 23-gauge vitrectomy probes under various parameters. A membrane-on-cantilever apparatus was used to measure membrane attraction for enhanced 27-, enhanced 25-, and 23-gauge UltraVit probes (n = 6 for each). The following parameters were evaluated: effects of cut rates and duty cycles on membrane attraction distances, and flow rates and vacuum levels required to attract a membrane at a fixed distance. The enhanced 27-gauge probe had the shortest attraction distance across all cutting speeds and duty cycles. To attract a membrane at a fixed distance, increasing vacuum was necessary with higher cutting rates and smaller probe gauges but flow rate remained relatively constant. The biased open duty cycle was associated with a longer attraction distance than 50/50 or biased closed modes. The shorter membrane attraction distance of the enhanced 27-gauge probe versus 23-gauge and enhanced 25-gauge probes may permit greater membrane dissection precision while providing improved access to small tissue planes. Equivalent fluid flow capabilities of the 27-gauge probe compared with the 23-gauge and 25-gauge probes may provide efficient aspiration. Surgeon selection of duty cycle modes may improve intraoperative fluid control and expand the cutter utility as a multifunctional tool.

The origins of mercury found in the coastal aquifer of La Plana de Castellon (Eastern Spain)

International Nuclear Information System (INIS)

Lopez Gutierrez, J.; Garcia Menendez, O.; Ballesteros Navarro, B. J.

2010-01-01

Mercury was detected in the Plio-Quaternary detrital coastal aquifer of La Plana de Castellon in the second half of the 1990s in the area of Nules-Moncofar-Vall d'Uixo at concentrations of between 5 and 12 μg/L according to groundwater analysis. The most reliable hypothesis pointed originally to an anthropic origin, although no precise sources were identified. This paper describes the results of investigation undertaken by the Geological Survey of Spain (IGME) to either corroborate or reject this hypothesis. A wide sampling array was set up to collect groundwater, sediments, wastewaters and rainwater together with an exhaustive inventory of possible anthropic and natural sources of mercurial contamination. All these data were integrated into the geological and metallogenic context of the Plio-Quaternary sediments of the aquifer and the Mesozoic formations of its rim. The results have led us to arrive at a new hypothesis that points to a geogenic origin for the mercury, although is mobilisation would still appear be related to the intensive human exploitation of the groundwater in the area. (Author) 30 refs.

It's quicker "Par Avignon"!

CERN Multimedia

2005-01-01

For a few years, the CERN Library has been receiving books from the University of Hanover sent via Avignon, at least that's what it says on the envelope. Such a detour would mean that parcels were travelling 720 km more than the distance separating Geneva and Hanover, which would be a very strange state of affairs. The explanation lies in a spelling mistake. The sender has been stamping parcels with a stamp that says "Par Avignon prioritaire" (first-class via Avignon) instead of "Par Avion prioritaire" (First Class Air Mail), a source of much amusement to the librarians!

Serum suPAR in patients with FSGS: trash or treasure?

Science.gov (United States)

Maas, Rutger J H; Deegens, Jeroen K J; Wetzels, Jack F M

2013-07-01

The urokinase-type plasminogen activator receptor (uPAR) has important functions in cell migration. uPAR can be shed from the cell membrane resulting in soluble uPAR (suPAR). Further cleavage gives rise to shorter fragments with largely unknown functions. Recent studies have demonstrated that both overexpression of uPAR on podocytes and the administration of suPAR cause proteinuria in mice. The common pathogenic mechanism involves the activation of podocyte β3-integrin. Increased activation of β3-integrin is also observed in patients with focal and segmental glomerulosclerosis (FSGS). These observations form the basis for the hypothesis that suPAR may be the circulating factor causing FSGS. A recent study fosters this idea by demonstrating increased suPAR levels in the serum of patients with FSGS and reporting an association with recurrence after transplantation and response to plasmapheresis. However, this study was heavily biased, and subsequent studies have given conflicting results. Although the experimental work is very suggestive, at present there is no proof that any known human suPAR fragment causes FSGS in humans. We therefore suggest that the measurement of suPAR using currently available assays has absolutely no value at the present time in decision-making in routine clinical practice.

Proteinase-Activated Receptor 1 (PAR1 regulates leukemic stem cell functions.

Directory of Open Access Journals (Sweden)

Nicole Bäumer

Full Text Available External signals that are mediated by specific receptors determine stem cell fate. The thrombin receptor PAR1 plays an important role in haemostasis, thrombosis and vascular biology, but also in tumor biology and angiogenesis. Its expression and function in hematopoietic stem cells is largely unknown. Here, we analyzed expression and function of PAR1 in primary hematopoietic cells and their leukemic counterparts. AML patients' blast cells expressed much lower levels of PAR1 mRNA and protein than CD34+ progenitor cells. Constitutive Par1-deficiency in adult mice did not affect engraftment or stem cell potential of hematopoietic cells. To model an AML with Par1-deficiency, we retrovirally introduced the oncogene MLL-AF9 in wild type and Par1-/- hematopoietic progenitor cells. Par1-deficiency did not alter initial leukemia development. However, the loss of Par1 enhanced leukemic stem cell function in vitro and in vivo. Re-expression of PAR1 in Par1-/- leukemic stem cells delayed leukemogenesis in vivo. These data indicate that Par1 contributes to leukemic stem cell maintenance.

Proteinase-Activated Receptor 1 (PAR1) regulates leukemic stem cell functions.

Science.gov (United States)

Bäumer, Nicole; Krause, Annika; Köhler, Gabriele; Lettermann, Stephanie; Evers, Georg; Hascher, Antje; Bäumer, Sebastian; Berdel, Wolfgang E; Müller-Tidow, Carsten; Tickenbrock, Lara

2014-01-01

External signals that are mediated by specific receptors determine stem cell fate. The thrombin receptor PAR1 plays an important role in haemostasis, thrombosis and vascular biology, but also in tumor biology and angiogenesis. Its expression and function in hematopoietic stem cells is largely unknown. Here, we analyzed expression and function of PAR1 in primary hematopoietic cells and their leukemic counterparts. AML patients' blast cells expressed much lower levels of PAR1 mRNA and protein than CD34+ progenitor cells. Constitutive Par1-deficiency in adult mice did not affect engraftment or stem cell potential of hematopoietic cells. To model an AML with Par1-deficiency, we retrovirally introduced the oncogene MLL-AF9 in wild type and Par1-/- hematopoietic progenitor cells. Par1-deficiency did not alter initial leukemia development. However, the loss of Par1 enhanced leukemic stem cell function in vitro and in vivo. Re-expression of PAR1 in Par1-/- leukemic stem cells delayed leukemogenesis in vivo. These data indicate that Par1 contributes to leukemic stem cell maintenance.

Surgical management of spontaneous in-the-bag intraocular lens and capsular tension ring complex dislocation

Directory of Open Access Journals (Sweden)

Uzeyir Gunenc

2014-01-01

Full Text Available We describe a technique to manage late spontaneous intraocular lens (IOL and capsular tension ring (CTR dislocation within the intact capsular bag. The subluxated IOL and CTR complex can be positioned in a closed chamber and fixed to the pars plana at both 3 and 9 o′clock quadrants with the presented ab externo direct scleral suturation technique which provides an easy, safe and effective surgical option for such cases.

Serum suPAR in patients with FSGS: trash or treasure?

NARCIS (Netherlands)

Maas, R.J.H.; Deegens, J.K.J.; Wetzels, J.F.M.

2013-01-01

The urokinase-type plasminogen activator receptor (uPAR) has important functions in cell migration. uPAR can be shed from the cell membrane resulting in soluble uPAR (suPAR). Further cleavage gives rise to shorter fragments with largely unknown functions. Recent studies have demonstrated that both

Intersex related gene expression profiles in clams Scrobicularia plana: Molecular markers and environmental application

International Nuclear Information System (INIS)

Ciocan, Corina M.; Cubero-Leon, Elena; Langston, William J.; Pope, Nick; Cornelius, Keith; Hill, E.M.; Alvarez-Munoz, Diana; Indiveri, Paolo; Lerebours, Adelaide; Minier, Christophe; Rotchell, Jeanette M.

2015-01-01

Highlights: • Expression of intersex-related genes was analysed in clam gonads sampled from the Channel. • Genes were differentially expressed at sites with varying levels of intersex and contaminants. • Correlations between gene expressions, key contaminants and sampling sites were identified. • No single gene expression studied correlated with intersex incidence. - Abstract: Intersex, the appearance of female characteristics in male gonads, has been identified in several aquatic species. It is a widespread phenomenon in populations of the bivalve, Scrobicularia plana, from the southwest coast of the U.K. Genes previously identified as differentially expressed (ferritin, testicular haploid expressed gene, THEG, proliferating cell nuclear antigen, PCNA; receptor activated protein kinase C, RACK; cytochrome B, CYB; and cytochrome c oxidase 1, COX1) in intersex clams relative to normal male clams, were selected for characterisation and an environmental survey of the Channel region. Transcripts were significantly differentially expressed at sites with varying intersex incidence and contaminant burdens. Significant correlations between specific gene expressions, key contaminants and sampling locations have been identified, though no single gene was associated with intersex incidence. The results highlight the difficulty in understanding the intersex phenomenon in molluscs where there is still a lack of knowledge on the control of normal reproduction

Accouchement par forceps: indications et pronostic materno-foetal ...

African Journals Online (AJOL)

L'accouchement par voie basse, peut être parfois compromis par des facteurs maternels, foetaux ou materno-foetaux nécessitant des moyens thérapeutiques comme le forceps pour achever l'accouchement par voie naturelle. Le forceps, une méthode qui n'est pas sans risque pour la mère et le nouveau-né. Nous avons ...

Protease-Activated Receptor 4 (PAR4): A Promising Target for Antiplatelet Therapy.

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Rwibasira Rudinga, Gamariel; Khan, Ghulam Jilany; Kong, Yi

2018-02-14

Cardiovascular diseases (CVDs) are currently among the leading causes of death worldwide. Platelet aggregation is a key cellular component of arterial thrombi and major cause of CVDs. Protease-activated receptors (PARs), including PAR1, PAR2, PAR3 and PAR4, fall within a subfamily of seven-transmembrane G-protein-coupled receptors (GPCR). Human platelets express PAR1 and PAR4, which contribute to the signaling transduction processes. In association with CVDs, PAR4 not only contributes to platelet activation but also is a modulator of cellular responses that serve as hallmarks of inflammation. Although several antiplatelet drugs are available on the market, they have many side effects that limit their use. Emerging evidence shows that PAR4 targeting is a safer strategy for preventing thrombosis and consequently may improve the overall cardiac safety profile. Our present review summarizes the PAR4 structural characteristics, activation mechanism, role in the pathophysiology of diseases and understanding the association of PAR4 targeting for improved cardiac protection. Conclusively, this review highlights the importance of PAR4 antagonists and its potential utility in different CVDs.

PAR1 activation affects the neurotrophic properties of Schwann cells.

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Pompili, Elena; Fabrizi, Cinzia; Somma, Francesca; Correani, Virginia; Maras, Bruno; Schininà, Maria Eugenia; Ciraci, Viviana; Artico, Marco; Fornai, Francesco; Fumagalli, Lorenzo

2017-03-01

Protease-activated receptor-1 (PAR1) is the prototypic member of a family of four G-protein-coupled receptors that signal in response to extracellular proteases. In the peripheral nervous system, the expression and/or the role of PARs are still poorly investigated. High PAR1 mRNA expression was found in the rat dorsal root ganglia and the signal intensity of PAR1 mRNA increased in response to sciatic nerve transection. In the sciatic nerve, functional PAR1 receptor was reported at the level of non-compacted Schwann cell myelin microvilli of the nodes of Ranvier. Schwann cells are the principal population of glial cells of the peripheral nervous system which myelinate axons playing an important role during axonal regeneration and remyelination. The present study was undertaken in order to determine if the activation of PAR1 affects the neurotrophic properties of Schwann cells. Our results suggest that the stimulation of PAR1 could potentiate the Schwann cell ability to favour nerve regeneration. In fact, the conditioned medium obtained from Schwann cell cultures challenged with a specific PAR1 activating peptide (PAR1 AP) displays increased neuroprotective and neurotrophic properties with respect to the culture medium from untreated Schwann cells. The proteomic analysis of secreted proteins in untreated and PAR1 AP-treated Schwann cells allowed the identification of factors differentially expressed in the two samples. Some of them (such as macrophage migration inhibitory factor, matrix metalloproteinase-2, decorin, syndecan 4, complement C1r subcomponent, angiogenic factor with G patch and FHA domains 1) appear to be transcriptionally regulated after PAR1 AP treatment as shown by RT-PCR. Copyright © 2017 Elsevier Inc. All rights reserved.

Protease-Activated Receptor 4 (PAR4: A Promising Target for Antiplatelet Therapy

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Gamariel Rwibasira Rudinga

2018-02-01

Full Text Available Cardiovascular diseases (CVDs are currently among the leading causes of death worldwide. Platelet aggregation is a key cellular component of arterial thrombi and major cause of CVDs. Protease-activated receptors (PARs, including PAR1, PAR2, PAR3 and PAR4, fall within a subfamily of seven-transmembrane G-protein-coupled receptors (GPCR. Human platelets express PAR1 and PAR4, which contribute to the signaling transduction processes. In association with CVDs, PAR4 not only contributes to platelet activation but also is a modulator of cellular responses that serve as hallmarks of inflammation. Although several antiplatelet drugs are available on the market, they have many side effects that limit their use. Emerging evidence shows that PAR4 targeting is a safer strategy for preventing thrombosis and consequently may improve the overall cardiac safety profile. Our present review summarizes the PAR4 structural characteristics, activation mechanism, role in the pathophysiology of diseases and understanding the association of PAR4 targeting for improved cardiac protection. Conclusively, this review highlights the importance of PAR4 antagonists and its potential utility in different CVDs.

Interventions for the treatment of uveitic macular edema: a systematic review and meta-analysis

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Karim, Rushmia; Sykakis, Evripidis; Lightman, Susan; Fraser-Bell, Samantha

2013-01-01

Background Uveitic macular edema is the major cause of reduced vision in eyes with uveitis. Objectives To assess the effectiveness of interventions in the treatment of uveitic macular edema. Search strategy Cochrane Central Register of Controlled Trials, Medline, and Embase. There were no language or data restrictions in the search for trials. The databases were last searched on December 1, 2011. Reference lists of included trials were searched. Archives of Ophthalmology, Ophthalmology, Retina, the British Journal of Ophthalmology, and the New England Journal of Medicine were searched for clinical trials and reviews. Selection criteria Participants of any age and sex with any type of uveitic macular edema were included. Early, chronic, refractory, or secondary uveitic macular edema were included. We included trials that compared any interventions of any dose and duration, including comparison with another treatment, sham treatment, or no treatment. Data collection and analysis Best-corrected visual acuity and central macular thickness were the primary outcome measures. Secondary outcome data including adverse effects were collected. Conclusion More results from randomized controlled trials with long follow-up periods are needed for interventions for uveitic macular edema to assist in determining the overall long-term benefit of different treatments. The only intervention with sufficiently robust randomized controlled trials for a meta-analysis was acetazolamide, which was shown to be ineffective in improving vision in eyes with uveitic macular edema, and is clinically now rarely used. Interventions showing promise in this disease include dexamethasone implants, immunomodulatory drugs and anti-vascular endothelial growth-factor agents. When macular edema has become refractory after multiple interventions, pars plana vitrectomy could be considered. The disease pathophysiology is uncertain and the course of disease unpredictable. As there are no clear guidelines from

[Detection of leptospira by culture of vitreous humor and detection of antibodies against leptospira in vitreous humor and serum of 225 horses with equine recurrent uveitis].

Science.gov (United States)

Dorrego-Keiter, Elisa; Tóth, József; Dikker, Lieke; Sielhorst, Jutta; Schusser, Gerald Fritz

2016-01-01

In the ongoing discussion regarding the aetiopathogenesis of equine recurrent uveitis (ERU) it was the aim of the present study to elucidate the relationship of leptospira infection and ERU. In a population of 225 horses leptospira were examined in vitreous humor by culture and leptospira antibody were detected in vitreous humor and serum samples. Preoperative serum samples were collected from 221/225 ERU patients of different age, gender and breed. Undiluted vitreous humor was aseptically taken from 198/225 patients that underwent pars plana vitrectomy at the beginning of surgery and from 27/225 patients' eyeball after enucleation: Serum and vitreous humor were tested for specific leptospiral antibodies by microscopic agglutination test (MAT). Furthermore, vitreous humor was examined by culture. 20 patients which were euthanized due to a live-threatening disease other than ERU served as a control group. A total of 127/221 (57.5%) horses had serum antibodies (≥ 1:100). Most frequently antibodies against L. interrogans serovar Grippotyphosa were detected (79/127), followed by L. interrogans serovar lcterohaemorrhagiae (34/127) and L. interrogans serovar Bratislava (29/127). Only 79/225 horses (35.1%) had leptospiral antibodies in vitreous humor, in which L. interrogans serovar Grippotyphosa (67/79) was identified most frequently followed by L. interrogans serovar Pomona (18/79) and L. interrogans serovar lcterohaemorrhagiae (8/79) which was identified as single or multiple reaction. Isolation of leptospira from vitreous humor was positive in 34/212 horses (16%). 10/20 control horses had a positive antibody titer against leptospira in serum and 2/20 horses in vitreous humor, whereas there was no leptospira detected in culture. The result of 84% negative cultures from vitreous humor of 212 ERU patients is decisive for the diagnosis and therapy of ERU.

Densiron® 68 as an intraocular tamponade for complex inferior retinal detachments

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Hussain RN

2011-05-01

Full Text Available Rumana N Hussain, Somnath BanerjeeLeicester Royal Infirmary, Leicester, UKIntroduction: Densiron® 68 is a high-density liquid used to tamponade inferior retinal detachments. We present a case series of 12 patients treated with Densiron as an intraocular tamponade agent.Methods: A retrospective analysis of 12 eyes in 12 patients was carried out. The primary endpoint was anatomic reattachment of the retina following removal of Densiron oil.Results: All patients had inferior detachments; 33% had associated proliferative vitreoretinopathy (PVR. Densiron was utilized as a primary agent in five patients (42%; the remaining patients had prior unsuccessful surgery for retinal reattachment, including pars plana vitrectomy, cryotherapy, laser, encirclement, gas (C3F8 or C2F6, or silicone oil. Eleven patients (91% had successful reattachment of the retina at 3 months following removal of Densiron; one patient had extensive PVR, total retinal detachment, preretinal macula fibrosis, and chronic hypotony, and surgical intervention was unsuccessful. Six patients (50% had raised intraocular pressure (IOP, resolving in the majority of cases following Densiron removal; two patients had long-term raised IOP requiring topical or surgical therapy. Of the six phakic patients, 50% developed significant cataract in the operated eye. Of those with successful retinal reattachment, visual outcome was variable, with 36% patients gaining two to four lines on Snellen, 27% remaining objectively the same, and 36% losing one to two lines.Conclusion: The anatomic success rate is high (91% in patients requiring Densiron tamponade for inferior retinal detachments with or without evidence of PVR either as a primary or secondary intervention. A common complication is raised IOP; however, this most often resolves following removal of the oil.Keywords: intraocular tamponade, silicone oil, retinal detachment, retinal reattachments

Conjunctival inclusion cyst following repair of tube erosion in a child with aphakic glaucoma, leading to endophthalmitis

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Roy, Avik Kumar

2015-05-01

Full Text Available Introduction: Glaucoma in aphakia is a major long term complication following congenital cataract surgery. Implantation of glaucoma drainage device provides an effective approach to manage refractory paediatric glaucoma. However implant surgery in young individuals is not free of complications. The prompt detection and management of tube erosion is of utmost importance to prevent devastating sequel of endophthalmitis. Implantation cyst following repair of tube erosion has not been reported so far. This case illustrates the rare occurrence of inclusion cyst following repair of tube erosion, the possible causes and its consequences. Case description: A 2-year-old child with aphakia developed intractable glaucoma. Following a failed glaucoma filtering surgery he underwent sequential Ahmed Glaucoma Valve implantation in both the eyes. Six weeks following right eye surgery, the child presented with conjunctival erosion overlying the tube, which was treated with scleral patch graft and conjunctival advancement. One month after the repair of tube erosion, the child presented with implantation cyst under the scleral patch graft, which was treated by drainage with a 29G needle. The child presented with endophthalmitis of his right eye following an episode of bilateral conjunctivitis. This was managed by an emergency pars plana vitrectomy, intraocular antibiotics and tube excision. At the last follow up visit, the IOP was 20 mmHg with 2 topical antiglaucoma medications in the right eye following a trans scleral photocoagulation.Discussion: Lifelong careful follow-up of paediatric eyes with implant surgery is mandatory to look for complication such as tube erosion. It is important to place additional sutures to secure the patch graft during implantation of glaucoma drainage devices in children to prevent graft displacement and consequent tube erosion. During repair of tube erosion, it is crucial to remove all the conjunctival epithelium around the tube

Tumor vasoproliferativo de retina.: Reporte de dos casos Vasoproliferative retinal tumor.: Report of two cases

Directory of Open Access Journals (Sweden)

Danaides Arencibia González

2010-12-01

Full Text Available El tumor vasoproliferativo de retina es una condición rara y benigna que presenta una lesión exudativa de retina periférica. La lesión puede ser clasificada en primaria (idiopática o secundaria a otros procesos oculares. Las opciones terapéuticas incluyen observación, crioablación tisular, fotocoagulación láser, remoción quirúrgica mediante vitrectomía, terapia fotodinámica y braquiterapia epiescleral con isótopos radioactivos, asociadas o no al uso de antiangiogénicos o antiinflamatorios, siendo la elección de la modalidad de manejo particular en cada caso. Presentamos dos casos en pacientes femeninas portadoras de esta condición de los que describimos las características más importantes del cuadro clínico, retinografías, angiografía fluoresceínica y ecografía, así como el manejo y curso evolutivo-terapéutico.Vasoproliferative retinal tumor is a rare and benign condition that presents as an exudative lesion in the peripheral retina. The lesion can be classified in primary (idiopathic or secondary to other ocular processes. Therapeutic options include observation, cryotherapy, laser photocoagulation, surgical removal by pars plana vitrectomy, photodynamic therapy and epiescleral brachytheraphy with radio-active isotopes associated or not to the use of anti-angiogenic or anti-inflammatory drugs. The selection of a particular management modality depends on the type of case. Two female patients affected with this condition were presented; the most important characteristics in their clinical pictures, as well as the results of other tests as retinography, fluorescent and ICG angiography and echography were described. The management and the therapeutical and evolutive course of both patients were also discussed.

CD18 expression in granulocytes infiltrating the vitreous fluid in patients with diabetic retinopathy

Institute of Scientific and Technical Information of China (English)

Qi; Zhu; Hu-Ping; Song

2015-01-01

AIM: To assess the levels of CD18 on the surface of granulocytes infiltrating the vitreous fluid in patients with diabetic retinopathy(DR).METHODS: Vitreous samples from twelve patients with non-proliferative DR with significant macula edema(group A), 33 patients with proliferative DR(grade 3 as group B, n =14, and, grade 4 as group C, n =19) were obtained during pars plana vitrectomy. Vitreous samples from 12 patients with macular hole as controls(group D)were analyzed together. The infiltrating of granulocytes and its surface level of CD18 were measured by flow cytometry. The level of CD18 was presented as the mean channel fluorescence(MCF) on a logarithmic scale. RESULTS: Granulocytes were detected in 6 of 12 vitreous samples from group A, 9 of 14 from group B, 15 of 19 from group C, and none of 12 from group D. MCF of CD18 on granulocytes from groups A, B, and C were2.978 ±1.446, 3.201 ±0.692, and 4.072 ±0.837, respectively.The difference was significant(F =4.354, P =0.021).Subjects with more severe DR were more likely to have a higher level of CD18 MCF(trend test, 掊2=7.351, P =0.007).CD18 MCF was significantly associated with the development of DR(r =0.46, P =0.005 and β =0.147, P =0.035).CONCLUSION: Our results confirm the presence of granulocytes and the elevated levels of CD18 on the surface of them in the vitreous fluid from DR patients.These results may provide indirect evidence shown that granulocytes activation also has occurred in the retinal local compared to non-DR control.

Refractive shifts in four selected artificial vitreous substitutes based on Gullstrand-Emsley and Liou-Brennan schematic eyes.

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Gao, Qianying; Chen, Xiang; Ge, Jian; Liu, Yongji; Jiang, Zhaoxin; Lin, Zhi; Liu, Yaqin

2009-07-01

To determine and compare the refractive shifts based on Gullstrand-Emsley and Liou-Brennan schematic eyes after filling them with four selected artificial vitreous substitutes: silicone oil, heavy silicone oil, hydrogels, and encapsuled balanced salt solution. The optical constants of artificial vitreous body-filled eyes were calculated based on Gullstrand-Emsley and Liou-Brennan schematic eyes with accommodation relaxed. The theoretical refractive shifts in these two models were compared in pars plana vitrectomy (PPV), PPV plus lensectomized and PPV plus intraocular lens (IOL) eyes after four artificial vitreous tamponades. The Gullstrand-Emsley schematic eye shows refractive shifts of +8.710, -4.544, +1.136, and -0.338 D in PPV eyes; +11.044, +20.332, +16.351, and +17.413 D in PPV plus lensectomized eyes; and the need for IOL powers of +22.195, +22.366, +22.292, and +22.312 D in PPV plus IOL eyes in silicone oil, heavy silicone oil, hydrogels, and encapsuled balanced salt solution tamponade eyes, respectively. Similarly, the Liou-Brennan schematic eye induced shifts of +6.260, -3.266, +0.817, and -0.272 D in PPV eyes; +13.181, +20.654, +17.451, and +18.305 D in PPV plus lensectomized eyes; and the need IOL powers of +13.522, +23.767, +19.389, and +20.558 D in PPV plus IOL eyes, respectively. The Gullstrand-Emsley schematic eye is a convenient and accurate model for predicting refractive shifts for hydrogels and encapsuled balanced salt solution substitutes in PPV eyes. The Liou-Brennan schematic eye is recommended for silicone oil and heavy silicone oil in PPV eyes and for all four substitutes in PPV plus lensectomized eyes and PPV plus IOL eyes. In addition, the encapsuled balanced salt solution changes the refraction little in either schematic eye.

Assessment of the safety and efficacy of primary retropupillary fixation of iris-claw intraocular lenses in children with large lens subluxations.

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Rastogi, Anju; Goray, Apurva; Thacker, Prolima; Kamlesh; Babita

2017-08-17

To evaluate whether retropupillary fixation of the iris-claw intraocular lens (IOL) is a safe and effective treatment option in children with large lens subluxations. Fourteen eyes of children between the ages of 8-17 years with lens subluxations more than 7 clock hours underwent pars plana lensectomy-vitrectomy with implantation of the iris-claw IOL in the retropupillary position as a primary procedure. The best corrected visual acuity (BCVA), intraocular pressure (IOP), corneal endothelial count (EC) and the lens position using ultrasound biomicroscopy (UBM) were assessed pre- and postoperatively. Postoperatively, all patients had an increase in the BCVA with a mean of 0.351 ± 0.154 log MAR units which was statistically significant as compared to the preoperative value of 0.771 ± 0.132 log MAR units (p = 0.003). The difference between the mean preoperative IOP (13.642 ± 2.437 mmHg) and the mean postoperative intraocular pressure at the end of 6 months (13.5 ± 2.244 mmHg) was not statistically significant (p = 0.671). The mean EC decreased by 0.99% from 2838.42 ± 474.76 cells/mm 2 preoperatively to 2810 ± 461.24 cells/mm 2 at the end of 6 months postoperatively (p = 0.117). The lens position was analyzed using UBM and was found to be parallel to the iris plane in all cases at the end of 6 months. Our study shows that primary retropupillary iris-claw IOL implantation can be a safe and efficacious option for children with large (>7 clock hours) lens subluxations that is at least comparable to scleral-fixated PCIOLs.

Late in-the-bag intraocular lens dislocation in patients with uveitis.

Science.gov (United States)

Steeples, Laura R; Jones, Nicholas P

2015-09-01

Late in-the-bag intraocular lens (IOL) dislocation is an unusual complication of cataract surgery, being strongly associated with pseudoexfoliation, less so with previous vitreoretinal surgery, myopia and uveitis. We present the clinical features, management and outcomes of late spontaneous IOL dislocation in a series of patients with uveitis. A retrospective case series of IOL dislocation affecting patients in the Manchester Uveitis Clinic, UK. The uveitis diagnosis, IOL type, presentation and management are discussed. Six patients from out of 1056 undergoing cataract surgery (0.57%) were affected. Uveitis was the only identified risk factor for IOL dislocation, which occurred a mean 10.3 years following uncomplicated cataract surgery by phakoemulsification with endocapsular IOL implantation. The dislocation was in-the-bag in all six cases. Two patients presented with the IOL in the anterior chamber, and required removal of the IOL-bag complex, and are using aphakic refractive correction. Two patients with inferior IOL subluxation have been managed conservatively. Two patients underwent pars plana vitrectomy with sutureless scleral fixation of the existing IOL in one case, and IOL exchange with a scleral sutured IOL in the other. IOL dislocation is an uncommon late complication in patients with uveitis. Conservative management is appropriate in patients with tolerable symptoms, or in those with difficult uveitis. Otherwise, fixation of the existing IOL, or removal and implantation of a secondary IOL, may be necessary. Angle-supported, or iris-enclaved IOLs, are not of proven safety in this patient group; scleral-fixated posterior chamber IOLs are the favoured approach in our service. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Conjunctival inclusion cyst following repair of tube erosion in a child with aphakic glaucoma, leading to endophthalmitis.

Science.gov (United States)

Roy, Avik Kumar; Senthil, Sirisha

2015-01-01

Glaucoma in aphakia is a major long term complication following congenital cataract surgery. Implantation of glaucoma drainage device provides an effective approach to manage refractory paediatric glaucoma. However implant surgery in young individuals is not free of complications. The prompt detection and management of tube erosion is of utmost importance to prevent devastating sequel of endophthalmitis. Implantation cyst following repair of tube erosion has not been reported so far. This case illustrates the rare occurrence of inclusion cyst following repair of tube erosion, the possible causes and its consequences. A 2-year-old child with aphakia developed intractable glaucoma. Following a failed glaucoma filtering surgery he underwent sequential Ahmed Glaucoma Valve implantation in both the eyes. Six weeks following right eye surgery, the child presented with conjunctival erosion overlying the tube, which was treated with scleral patch graft and conjunctival advancement. One month after the repair of tube erosion, the child presented with implantation cyst under the scleral patch graft, which was treated by drainage with a 29G needle. The child presented with endophthalmitis of his right eye following an episode of bilateral conjunctivitis. This was managed by an emergency pars plana vitrectomy, intraocular antibiotics and tube excision. At the last follow up visit, the IOP was 20 mmHg with 2 topical antiglaucoma medications in the right eye following a trans scleral photocoagulation. Lifelong careful follow-up of paediatric eyes with implant surgery is mandatory to look for complication such as tube erosion. It is important to place additional sutures to secure the patch graft during implantation of glaucoma drainage devices in children to prevent graft displacement and consequent tube erosion. During repair of tube erosion, it is crucial to remove all the conjunctival epithelium around the tube, thus not to incorporate epithelial tissue within the surgical

Visual outcomes of macular hole surgery

International Nuclear Information System (INIS)

Khaqan, H.A.; Muhammad, F.J.

2016-01-01

To determine the mean visual improvement after internal limiting membrane (ILM) peeling assisted with brilliant blue staining of ILM in macular hole, and stratify the mean visual improvement in different stages of macular hole. Study Design: Quasi-experimental study. Place and Duration of Study: Eye outpatient department (OPD), Lahore General Hospital, Lahore from October 2013 to December 2014. Methodology: Patients with macular hole underwent measurement of best corrected visual acuity (BCVA) and fundus examination with indirect slit lamp biomicroscopy before surgery. The diagnosis of all patients was confirmed on optical coherence tomography. All patients had 23G trans-conjunctival three ports pars plana vitrectomy, ILM peeling, and endotamponade of SF6. The mean visual improvement of different stages of macular hole was noted. Paired t-test was applied. Results: There were 30 patients, 15 males and 15 females (50%). The mean age was 62 ± 10.95 years. They presented with low mean preoperative visual acuity (VA) of 0.96 ± 0.11 logMar. The mean postoperative VA was 0.63 ± 0.24 logMar. The mean visual increase was 0.33 0.22 logMar (p < 0.001). In patients with stage 2 macular hole, mean visual increase was 0.35 ± 0.20 logMar (p < 0.001). In patients with stage 3 macular hole, mean visual increase was 0.44 ± 0.21 logMar (p < 0.001), and in patients with stage 4 macular hole it was 0.13 ± 0.1 logMar (p = 0.004). Conclusion: ILM peeling assisted with brilliant blue is a promising surgery for those patients who have decreased vision due to macular hole, in 2 - 4 stages of macular hole. (author)

Vote par sondage uniforme incorruptible

OpenAIRE

Blanchard , Nicolas

2016-01-01

International audience; Introduit en 2012 par David Chaum, le vote par sondage uniforme (random-sample voting) est un protocole de vote basé sur un choix d'une sous-population représentative , permettant de limiter les coûts tout en ayant de nombreux avantages, principalement lorsqu'il est couplé a d'autres techniques comme ThreeBallot. Nous analysons un problème de corruptibilité potentielle où les votants peuvent vendre leur vote au plus offrant et proposons une variation du protocole reméd...

Vasculopatia polipoidal idiopática da coróide: aspectos extremos da evolução da doença em um paciente - Relato de caso Idiopathic polypoidal choroidal vasculopathy: its extreme aspects in one patient - Case report

Directory of Open Access Journals (Sweden)

Ieda Maria Alexandre Barreira

2005-04-01

indocyanine green angiographies in the right eye and with hemorrhagic detachment of the retinal pigment epithelium in the left eye. The patient was treated by pars plana vitrectomy in the right eye which was followed by retinal detachment and vision loss. In the left eye an involution of the hemorrhagic detachment of the retinal pigment epithelium with preservation of the vision was seen. The idiopathic polypoidal choroidal vasculopathy seems to be a distinct clinical entity that can and should be differentiated from age-related macular degeneration and the fluorescein and indocyanine green angiographies should be performed to evaluate the choroidal vasculature in an attempt to establish a more definitive diagnosis. Particularly in this case the entity had an extreme clinical course in the patient.

The double par locus of virulence factor pB171: DNA segregation is correlated with oscillation of ParA

DEFF Research Database (Denmark)

Ebersbach, G; Gerdes, K; Charbon, Gitte Ebersbach

2001-01-01

Prokaryotic plasmids and chromosomes encode partitioning (par) loci that segregate DNA to daughter cells before cell division. Recent database analyses showed that almost all known par loci encode an ATPase and a DNA-binding protein, and one or more cis-acting regions where the proteins act. All...

The role of pars flaccida in human middle ear sound transmission.

Science.gov (United States)

Aritomo, H; Goode, R L; Gonzalez, J

1988-04-01

The role of the pars flaccida in middle ear sound transmission was studied with the use of twelve otoscopically normal, fresh, human temporal bones. Peak-to-peak umbo displacement in response to a constant sound pressure level at the tympanic membrane was measured with a noncontacting video measuring system capable of repeatable measurements down to 0.2 micron. Measurements were made before and after pars flaccida modifications at 18 frequencies between 100 and 4000 Hz. Four pars flaccida modifications were studied: (1) acoustic insulation of the pars flaccida to the ear canal with a silicone rubber baffle, (2) stiffening the pars flaccida with cyanoacrylate cement, (3) decreasing the tension of the pars flaccida with a nonperforating incision, and (4) perforation of the pars flaccida. All of the modifications (except the perforation) had a minimal effect on umbo displacement; this seems to imply that the pars flaccida has a minor acoustic role in human beings.

Movement and equipositioning of plasmids by ParA filament disassembly

DEFF Research Database (Denmark)

Ringgaard, Simon; van Zon, Jeroen; Howard, Martin

2009-01-01

, plasmids consistently migrate behind disassembling ParA cytoskeletal structures, suggesting that ParA filaments pull plasmids by depolymerization. The perpetual cycles of ParA assembly and disassembly result in continuous relocation of plasmids, which, on time averaging, results in equidistribution...

PAR-1 contributes to the innate immune response during viral infection

Science.gov (United States)

Antoniak, Silvio; Owens, A. Phillip; Baunacke, Martin; Williams, Julie C.; Lee, Rebecca D.; Weithäuser, Alice; Sheridan, Patricia A.; Malz, Ronny; Luyendyk, James P.; Esserman, Denise A.; Trejo, JoAnn; Kirchhofer, Daniel; Blaxall, Burns C.; Pawlinski, Rafal; Beck, Melinda A.; Rauch, Ursula; Mackman, Nigel

2013-01-01

Coagulation is a host defense system that limits the spread of pathogens. Coagulation proteases, such as thrombin, also activate cells by cleaving PARs. In this study, we analyzed the role of PAR-1 in coxsackievirus B3–induced (CVB3-induced) myocarditis and influenza A infection. CVB3-infected Par1–/– mice expressed reduced levels of IFN-β and CXCL10 during the early phase of infection compared with Par1+/+ mice that resulted in higher viral loads and cardiac injury at day 8 after infection. Inhibition of either tissue factor or thrombin in WT mice also significantly increased CVB3 levels in the heart and cardiac injury compared with controls. BM transplantation experiments demonstrated that PAR-1 in nonhematopoietic cells protected mice from CVB3 infection. Transgenic mice overexpressing PAR-1 in cardiomyocytes had reduced CVB3-induced myocarditis. We found that cooperative signaling between PAR-1 and TLR3 in mouse cardiac fibroblasts enhanced activation of p38 and induction of IFN-β and CXCL10 expression. Par1–/– mice also had decreased CXCL10 expression and increased viral levels in the lung after influenza A infection compared with Par1+/+ mice. Our results indicate that the tissue factor/thrombin/PAR-1 pathway enhances IFN-β expression and contributes to the innate immune response during single-stranded RNA viral infection. PMID:23391721

Análisis energético de un sistema fotovoltaico integrado a una cubierta plana horizontal; Energetic analysis of a photovoltaic system integrated to a horizontal flatrooftop

Directory of Open Access Journals (Sweden)

Liomnis Osorio Laurencio

2015-12-01

Full Text Available En el presente trabajo se analiza el desempeño energético de un sistema fotovoltaico a base de silicio amorfo, integrado a la cubierta plana horizontal del Edificio Docente #2 del Instituto Superior Minero Metalúrgico de Moa.Con el software PV syst se determinó la producción anual de energía eléctrica del sistema de 3 kWp conectado a la red, así como las pérdidas por sombras, cableado, electrónica de potencia, modificación del ángulo deinclinación y por efecto de la irradiancia y temperatura. También se calcularon los parámetros característicos de la instalación, útiles para establecer perfiles mensuales para la planificación del consumo eléctrico. Los resultados demostraron que la energía anual generada, es equivalente al consumo eléctrico del Instituto durante dos días y además, constituye una alternativa para la generación de energía, a partir del aprovechamiento de espacios disponibles en azoteas de las áreas docentes y administrativas.In this research the energy performance of a photovoltaic system based on amorphous silicon is analyzed. It is integrated to the flat horizontal rooftop of Teaching Building # 2 of the Metallurgical Mining Institute of Moa. Withthe PVsyst software annual electricity production of 3 kWp system connected to grid, as well as losses shadows, wiring, power electronics, also, tilt angle and the effect of irradiance and temperature were determined. Thecharacteristic parameters of the installation, useful were calculated to establish monthly planning profiles for electrical consumption. The results showed that the annual energy generated is equivalent to the electricityconsumption of the Institute for two days and also an alternative for generation energy from the use of space available on rooftops of teaching and administrative areas.

Peptide-Based Optical uPAR Imaging for Surgery

DEFF Research Database (Denmark)

Juhl, Karina; Christensen, Anders; Persson, Morten

2016-01-01

Near infrared intra-operative optical imaging is an emerging technique with clear implications for improved cancer surgery by enabling a more distinct delineation of the tumor margins during resection. This modality has the potential to increase the number of patients having a curative radical...... tumor resection. In the present study, a new uPAR-targeted fluorescent probe was developed and the in vivo applicability was evaluated in a human xenograft mouse model. Most human carcinomas express high level of uPAR in the tumor-stromal interface of invasive lesions and uPAR is therefore considered...... an ideal target for intra-operative imaging. Conjugation of the flourophor indocyanine green (ICG) to the uPAR agonist (AE105) provides an optical imaging ligand with sufficiently high receptor affinity to allow for a specific receptor targeting in vivo. For in vivo testing, human glioblastoma xenograft...