Trans Pars Plana Vitrectomy Research Articles

Platelet derived growth factor and fibroblast growth factor basic levels in the vitreous of patients with vitreoretinal disorders

AIMTo determine the potential role of basic fibroblast growth factor (bFGF) and platelet derived growth factor (PDGF) in the pathogenesis of proliferative vitreoretinopathy (PVR).METHODSAn enzyme linked immunosorbent assay technique was...

Rhegmatogenous Retinal Detachments in HIV-Positive Patients With Ocular Syphilis

The purpose of this study is to report retinal manifestations of lues in human immunodeficiency virus (HIV)-positive patients and to suggest a method for treatment of rhegmatogenous retinal detachments in these patients. Two HIV-positive patients with bilateral retinitis were examined and treated at the authors' institution for a period of 14 months. Ocular syphilis was diagnosed clinically, confirmed by cerebrospinal fluid serologic testing, and treated with intravenous penicillin. Both patients experienced bilateral rhegmatogenous retinal detachments complicated by proliferative vitreoretinopathy after resolution of the active retinitis. All four eyes underwent surgical repair with trans pars plana vitrectomy, epiretinal membrane delamination, gas-fluid exchange, endolaser, scleral buckle, and silicone oil instillation. The recognition of ocular syphilis as a cause of retinal detachment in HIV-positive patients is important. Prompt intervention with the appropriate medical and surgical treatments may result in the preservation of vision in these patients.

Combined endocapsular phacoemulsification, pars plana vitrectomy, and intraocular lens implantation

Objective: To determine whether a combined vitrectomy and phacoemulsification is a safe and feasible approach in patients requiring a vitrectomy who have a concomitant significant lens opacity.Setting: Royal Victoria Eye and Ear Hospital, Dublin, Ireland.Methods: This retrospective study comprised five patients with significant lens opacities who had combined trans pars plana vitrectomy and phacoemulsification with intraocular lens implantation. Main outcome measures were visual acuity and intraoperative and postoperative complications.Results: The combined surgical approach resulted in minimal complications, and postoperative visual acuity was satisfactory.Conclusion: In the hands of experienced phacoemulsification and vitrectomy surgeons, combined trans pars plana vitrectomy and phacoemulsification can be a safe approach in treating patients requiring a vitrectomy who have significant lens opacities precluding a view of the posterior segment.

Trans-pars plana vitrectomy in conjunction with scleral buckling procedures for complicated retinal detachment.

Trans-pars plana vitrectomy in conjunction with scleral buckling procedures for complicated retinal detachment.

Vitrectomy Retinotomy Aspiration Biopsy of Choroidal Tumors

We used an investigational technique for the biopsy of intraocular tumors to aid in the diagnosis of three choroidal tumors. A three-port trans-pars plana vitrectomy was performed in conjunction with retinotomy, tumor biopsy, endophotocoagulation, and air-fluid exchange. Vitrectomy was used to decrease the amount of traction secondary to retained vitreous after intraocular surgery. Retinotomy sites were chosen under microscopic control to avoid large caliber retinal vessels. Then a modified tumor-aspiration technique, together with endophotocoagulation and aspiration of intraoperative vitreous hemorrhages, provided an opportunity to sample tumor tissue continually at varied depths. We have added standard vitreous surgery concepts, techniques, and instrumentation to produce vitrectomy retinotomy aspiration biopsy of choroidal tumors.

Ciliary Sulcus Suturing of a Posterior Chamber Intraocular Lens

We describe a method for ciliary sulcus fixation of a posterior chamber intraocular lens (PC-IOL) in the absence of an intact posterior capsule. This method, which combines a lens fixation procedure with trans pars plana vitrectomy techniques to ensure safe manipulation of the lens implant in the absence of an intact anterior hyaloid face, is ideally suited for retrieval and repositioning of PC-IOLs dislocated into the vitreous. It also permits closed system repositioning and fixation of the implant, thereby avoiding the complications of vitreous loss and the need for reopening the limbal incision.

Vitreous Microsurgery

When Robert Machemer, MD, designed his vitreous infusion suction cutter (VISC) in 1970, he was seeking an instrument to replace cellulose sponge vitrectomy popularized by David Kasner, MD. It soon became apparent that trans-pars plana vitrectomy, first used by Machemer to clear chronic vitreous hemorrhage, was a major revolution in posterior segment surgery. "Dr Charles' engineering background elegantly comes through..." The VISC, called a multifunction probe because it combines infusion, suction, cutting, and illumination in one instrument, was subsequently replaced by the O'Malley ocutome, which separated the infusion, endoillumination, and suction-cutting functions of the VISC into trans-pars plana infusion sutured to the sclera, and separate openings for the endoilluminator and the suction cutter. However, it was Steve Charles, MD, who took an innovative systems approach to the O'Malley instrumentation by providing vitreoretinal surgeons with such techniques as vacuum cleaning of preretinal hemorrhage, fluid-air exchange, internal drainage of subretinal fluid, endophotocoagulation,

Endophthalmitis After Strabismus Surgery With a Good Visual Result

A 78-year-old woman underwent recession-resection surgery for longstanding exotropia. A scleral perforation occurred at the time of surgery and was treated with transscleral retinocryopexy. Three days after surgery the patient experienced light perception vision, pain, and hypopyon. She underwent a trans pars plana vitrectomy with intravitreal and periocular antibiotics. Three months after vitrectomy, visual acuity returned to the preoperative level of 20/50. Six months after vitrectomy she underwent an uneventful cataract extraction with posterior chamber lens implant. Visual acuity 5 months after cataract surgery was 20/20.

Vitrectomy Without Scleral Buckling for Primary Rhegmatogenous Retinal Detachment

Trans pars plana vitrectomy with air-fluid exchange was performed on 29 selected cases of primary rhegmatogenous retinal detachment in which scleral buckling would be the usual surgical approach. The group contained 20 phakic eyes, two aphakic eyes, and seven pseudophakic eyes; the macula was detached preoperatively in 17 eyes (66%). The reattachment rate after one operation was 79% (23 of 29 eyes); after two operations this increased to 93% (27 of 29 eyes). Visual acuities of 20/50 or better were achieved in 22 of 27 successfully treated cases (81%). Vitrectomy without scleral buckling may allow retinal reattachment with excellent visual results in selected cases of primary rhegmatogenous retinal detachment.

Surgical outcome of pars plana vitrectomy: a retrospective study in a peripheral tertiary eye care centre of Nepal

Trans-pars plana vitrectomy (TPPV) is an effective surgical procedure to retain the useful vision in vitreoretinal diseases. To evaluate the surgical outcome of pars plana vitreoretinal surgery. Retrospective non-comparative interventional case series. A hospital-based retrospective interventional study of series of cases was carried out in retina clinic of Lumbini Eye Institute, Nepal, over a period of one-and-a-half years. Records of 64 patients who underwent vitreo-retina surgeries were reviewed. Demography, duration of symptoms, risk factors and indications, preoperative and post-operative visual acuity, intra-operative and post-operative complications were analyzed. The parameters studied were post-operative visual acuity and complications. Of 64 patients, 61% presented 2 months after the onset of symptoms. Preoperatively, 65.5% had visual acuity of hand motions to 3/60 followed by perception of light only in 26.6%. The main indication for TPPV was vitreous haemorrhage (VH), in 53%. The visual acuity improved to better than 6/60 in patients with VH (68%), whereas, overall, in 72% of the subjects, it improved by 2 lines postoperatively. The commonest intra-operative complications were iatrogenic retinal break (5, 7.8%) at the sclerostomy site. The main indication for TPPV is vitreous haemorrhage. Useful vision can be restored by pars plana vitrectomy in the majority of the patients. Retinal break is the commonest complication of TPPV.