ABSTRACT
We report a retrospective case series describing the feasibility and outcomes of combined 27-G minimally invasive vitrectomy surgery (MIVS) and Ahmed® Glaucoma Valve (AGV) placement. Four eyes of four patients underwent a combined MIVS using 27-G technology and AGV implantation with the tube placement in the vitreous cavity. Preoperative and postoperative data up to 12 months were collected including the type of glaucoma, intraocular pressure (IOP), glaucoma medications, and complications. All AGVs tubes were placed in the vitreous cavity using the same sclerotomy, although a slight wound enlargement was required. After one year, IOP and glaucoma medications were reduced (41.5⯱â¯19.1-14.5⯱â¯3.1â¯mmHg and from 3(3-3) to 1.5 (1.5-3.5). Three patients developed cystoid macular edema. The first-reported cases of combined MIVS-27-G and AGV showed a reduction of IOP and antiglaucoma medication. Placing the tube using the same sclerotomy location is feasible but a slight enlargement may be required.
Subject(s)
Glaucoma Drainage Implants , Glaucoma , Humans , Glaucoma Drainage Implants/adverse effects , Vitrectomy/adverse effects , Retrospective Studies , Treatment Outcome , Glaucoma/surgery , Glaucoma/etiology , Intraocular PressureABSTRACT
PurposeTo quantify the additional information provided by ultra-widefield fluorescein angiography, compared with 7-field standard imaging, in patients with retinal vasculitis (RV).Patients and methodsRetrospective case series of 106 patients.ResultsRetinal vascular pathology was identified by UWF FFA, but not by standard ETDRS 7-field area, in 62 patients (58.5%) and in 79 eyes (43.4%). The pathology included active RV (47 eyes, 25.8% of eyes); retinal ischaemia, or infarction (53 eyes, 29.1%); and retinal neovascularization (7 eyes, 3.8%). A change to management was made in 36 patients (34%). Of these, 21 (20% of all patients undergoing angiography) were made after the identification of retinal vascular pathology, which was found only on UWF FFA, outside the ETDRS area.ConclusionUltra-widefield fluorescein angiography has clear advantages over standard multi-field imaging. It is currently the standard method of assessment for RV in this centre.
Subject(s)
Fluorescein Angiography/instrumentation , Glucocorticoids/administration & dosage , Immunosuppressive Agents/administration & dosage , Laser Coagulation/methods , Retina/pathology , Retinal Vasculitis/diagnosis , Retinal Vessels/pathology , Adult , Disease Management , Equipment Design , Female , Fundus Oculi , Humans , Male , Middle Aged , Retinal Vasculitis/therapy , Retrospective Studies , Treatment OutcomeABSTRACT
Caso clínico: Ninguna técnica de biopsia intraocular es inocua y todas tienen posibilidad de falsos negativos por la dificultad para obtener una muestra suficiente. Paciente con sospecha de melanoma tras biopsia negativa con vitrectomía 25 G. Se realiza biopsia coriorretiniana modificada en la que además de extraerse un fragmento mediante cirugía bimanual, se obtiene material de la lesión con vitreotomo para realizar citología, confirmando el diagnóstico de sospecha de melanoma de coroides. Discusión: La asociación de una citología obtenida con vitreotomo de una lesión coroidea asociada a la escisión de un fragmento de la lesión puede mejorar la eficacia de la biopsia intraocular (AU)
Clinical case: No intraocular biopsy technique is free of risk and all have the possibility of giving false negatives due to the difficulty in obtaining a sufficient sample. A modified chorioretinal biopsy was performed on a patient with suspected choroidal melanoma after negative biopsy with 25G vitrectomy. In addition to removing a solid fragment of tumor material using bimanual surgery, material from the lesion was obtained with the vitreotome to perform cytology, which confirmed the diagnosis of melanoma. Discussion: Cytology obtained through the vitreotome in association with removing a solid sample of the choroidal lesion may improve the efficiency of intraocular biopsy (AU)
Subject(s)
Humans , Eye Neoplasms/surgery , Biopsy/methods , Vitrectomy/methods , Choroid Neoplasms/surgery , Eye Neoplasms/pathology , Melanoma/surgeryABSTRACT
CLINICAL CASE: No intraocular biopsy technique is free of risk and all have the possibility of giving false negatives due to the difficulty in obtaining a sufficient sample. A modified chorioretinal biopsy was performed on a patient with suspected choroidal melanoma after negative biopsy with 25G vitrectomy. In addition to removing a solid fragment of tumor material using bimanual surgery, material from the lesion was obtained with the vitreotome to perform cytology, which confirmed the diagnosis of melanoma. DISCUSSION: Cytology obtained through the vitreotome in association with removing a solid sample of the choroidal lesion may improve the efficiency of intraocular biopsy.
