Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 14.991
Filtrar
1.
Zhonghua Yan Ke Za Zhi ; 57(11): 819-824, 2021 Nov 11.
Artigo em Chinês | MEDLINE | ID: mdl-34743466

RESUMO

Intraocular foreign body injury, as a special type of eye trauma, threatens visual function seriously via mechanical damage and a series of pathological changes to the eyeball due to the presence of a foreign body in the eye. Recently, the diagnosis of intraocular foreign body injury has been distinctly improved attributing to the advancement of medical imaging technology. Moreover, the ophthalmic microsurgery technology has been promoted and popularized, especially the technology of vitrectomy, which enhances the success rate of intraocular foreign body removal remarkably. In order to further standardize the principles and strategies for treatment of intraocular foreign body, China Ocular Trauma Society has reached a consensus based on serious discussions, which can be applied to ophthalmologists' daily clinical work as a reference. (Chin J Ophthalmol, 2021, 57: 819-824).


Assuntos
Corpos Estranhos no Olho , Ferimentos Oculares Penetrantes , China , Consenso , Corpos Estranhos no Olho/diagnóstico , Corpos Estranhos no Olho/cirurgia , Ferimentos Oculares Penetrantes/diagnóstico , Ferimentos Oculares Penetrantes/cirurgia , Humanos , Vitrectomia
2.
Ann Palliat Med ; 10(10): 10922-10929, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34763454

RESUMO

BACKGROUND: To investigate the clinical safety and efficacy of foldable capsular vitreous body (FCVB) in the treatment of severe silicone oil-dependent eyes. METHODS: Five patients (5 eyes) of severe silicone oil-dependent eyes underwent FCVB implantation from December 2019 to July 2020. The preoperative and postoperative visual acuity, intraocular pressure, corneal conditions, postoperative retinal reattachment, and FCVB status were observed. The patients were followed up for 12-15 months. RESULTS: A total of 5 patients (5 eyes) with severe silicone oil-dependent eyes were included, including 3 males and 2 females, with an average age of 32±14 years. The longest silicone oil tamponade time was 8 years, and the shortest was 2 years, with an average of 5±3 years. All patients were safely and successfully implanted with FCVB without severe intraoperative or postoperative complications. Up to the last follow-up, there was no significant change between preoperative and postoperative visual acuity. Before surgery, 4 patients had normal intraocular pressure while 1 patient had ocular hypotension; after surgery, the latter was still at a low level, and the other patients had intraocular pressure in the normal range. CONCLUSIONS: The FCVB is a safe, feasible, and effective vitreous substitute to maintain ocular morphology and intraocular pressure without aggravating silicone oil emulsification, retinal displacement, or corneal degeneration during the implantation period of 12-15 months.


Assuntos
Descolamento Retiniano , Óleos de Silicone , Adolescente , Adulto , Feminino , Humanos , Pressão Intraocular , Masculino , Pessoa de Meia-Idade , Descolamento Retiniano/cirurgia , Vitrectomia , Corpo Vítreo , Adulto Jovem
3.
Br J Hosp Med (Lond) ; 82(10): 1-11, 2021 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-34726948

RESUMO

Retinal detachments are a potentially sight-threatening ophthalmic emergency that may result in significant, irreversible vision loss. The risk of developing retinal detachment increases with advancing age, myopia and trauma. Pre-existing retinal degenerations can precipitate a pre-detachment symptomatic period of photopsia or floaters, allowing clinicians to intervene early and prevent detachments. Novel imaging techniques, such as spectral-domain optical coherence tomography, and well-established topographic modalities, such as B scan, can help to elucidate the type of detachment and any underlying causes, and help with surgical management. The overarching goal of treatment is to identify and seal all retinal holes, relieve vitreoretinal traction and prevent further recurrence. Prompt prophylactic retinopexy of retinal holes and tears is crucial in preventing retinal detachment, the main treatments of which are pars plana vitrectomy, tamponading agents and silicone scleral buckle.


Assuntos
Descolamento Retiniano , Perfurações Retinianas , Humanos , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/etiologia , Descolamento Retiniano/terapia , Perfurações Retinianas/diagnóstico , Perfurações Retinianas/etiologia , Perfurações Retinianas/terapia , Recurvamento da Esclera , Resultado do Tratamento , Vitrectomia
4.
BMC Ophthalmol ; 21(1): 392, 2021 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-34781932

RESUMO

PURPOSE: To investigate the macular vessel density and thickness in macular-on rhegmatogenous retinal detachment (RRD) after vitrectomy with gas and silicone oil (SO) tamponade. METHODS: Patients with macular-on RRD eyes, treated with a single successful vitrectomy with gas or SO tamponade and a minimum 30 months follow-up, were reviewed. Best-corrected visual acuity (BCVA), macular vessel density and retinal thickness by using optical coherence tomography angiography, were compared to the contralateral eyes. RESULTS: Sixteen eyes with gas tamponade and 17 eyes with SO tamponade were included in the study. LogMAR best-corrected visual acuity (BCVA) slightly improved from 0.25 ± 0.18 (Snellen 20/36) to 0.17 ± 0.23 (Snellen 20/30) in eyes with gas tamponade, and decreased from 0.30 ± 0.22 (Snellen 20/40) to 0.49 ± 0.28 (Snellen 20/62) in eyes with SO tamponade. The parafoveal vessel densities in superficial vascular complex (SVC) and the corresponding inner retinal thickness (IRT) were similar between the affected eyes and the contralateral eyes in gas tamponade group (P = 0.578, P = 0.943), while significantly reduced in the affected eyes, compared to the contralateral eyes in SO tamponade group (P < 0.001, P < 0.001). CONCLUSION: Eyes in SO tamponade group had worse BCVA, lower SVC vessel densities and thinner corresponding IRT after vitrectomy for macular-on RRD, than those in gas tamponade group.


Assuntos
Macula Lutea , Descolamento Retiniano , Tamponamento Interno , Humanos , Descolamento Retiniano/cirurgia , Óleos de Silicone , Vitrectomia
5.
J Pak Med Assoc ; 71(11): 2570-2575, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34783739

RESUMO

OBJECTIVE: To report outcomes of 27 gauge pars plana vitrectomy for the management of a variety of simple to complex posterior segment disorders. METHODS: This retrospective cohort study was conducted at the Shifa International Hospital, Islamabad, Pakistan, and comprised data of all patients who underwent 27 gauge pars plana vitrectomy between July 1, 2015, and June 30, 2019, for a variety of indications. Data noted included age, gender, laterality, diagnosis, pre-operative visual acuity, date of surgery and surgical details, including operating time and complications. Best corrected visual acuity at 3 months was also recorded. Data was analysed using SPSS 21. RESULTS: Of the 574 patients, 355(62%) were males and 219(38%) were females. The overall mean age was 55±16.9 years. There were total 665 eyes as 91(15.8%) patients underwent bilateral surgeries. The most common surgical indications were diabetic tractional retinal detachment 196(29.5%) and vitreous haemorrhage 191(28.7%). Mean operating time was 62± 37 minutes. With the exception of 0.34% cases where 20 gauge fragmatome was used, no case required conversion to 20 gauge system, while 25 gauge trocar was used for silicon oil injection. Per-operative complications included iatrogenic retinal tear 2(0.3%) eyes and supra choroidal silicon oil migration 1(0.15%) eye. Post-operative complications were raised intraocular pressure 7(1.05%), endophthalmitis 1(0.15%) eye, haemorrhagic occlusive retinal vasculitis 1(0.15%) eye and rhegmatogenous retinal detachment 2(0.3%) eyes. Mean best corrected visual acuity improved from 1.62± 0.68 to 0.4± 0.38 logarithm of minimum angle of resolution (p<0.001). CONCLUSIONS: The 27 gauge pars plana vitrectomy was found to be a safe and effective procedure for both simple and complex retinal pathologies requiring significant surgical manipulation.


Assuntos
Descolamento Retiniano , Vitrectomia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Descolamento Retiniano/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Hemorragia Vítrea/cirurgia
6.
BMC Ophthalmol ; 21(1): 398, 2021 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-34789189

RESUMO

BACKGROUND: The aim of this retrospective study was to evaluate commonly used clinical and OCT-morphological parameters, including perifoveal pseudocysts, as prognostic factors for postoperative outcome after macular hole surgery in a retinal referral clinic in North Rhine-Westphalia, Germany. METHODS AND MATERIAL: This was a retrospective analysis of all patients who underwent surgery because of idiopathic MH between 2011 and 2017 in Augenklinik Tausendfensterhaus, Duisburg, Germany. Statistical evaluation of clinical and OCT-based parameters, including the areas of intraretinal pseudocysts, was conducted. The main statistical outcomes were surgical success and visual acuity. Only parameters with a highly significant correlation to the outcome parameters (postoperative visual acuity (VA); surgical success) in univariate analysis were entered in linear and logistic regression analyses. RESULTS: A total of 189 eyes of 178 patients (71.4% female; mean age 67.5 ± 8.2 a) who underwent surgery because of MH were included. The overall closure rate was 86.8%. The mean best corrected VA increased from 0.7 ± 0.3 logMAR before surgery to 0.5 ± 0.3 logMAR (p < 0.0001). While several clinical and OCT-based parameters as well as calculated indices showed a significant correlation with the outcome measures, the regression analysis showed that the minimum linear diameter was the only parameter that both predicted surgical success (p = 0.015) and was correlated with postoperative VA (p < 0.001). CONCLUSION: The minimum linear diameter serves as an easily assessed prognostic factor with the best predictive properties. This result is of great importance for clinical practice, as it simplifies the postsurgical prognosis.


Assuntos
Perfurações Retinianas , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Perfurações Retinianas/cirurgia , Estudos Retrospectivos , Tomografia de Coerência Óptica , Resultado do Tratamento , Vitrectomia
7.
Arch Soc Esp Oftalmol (Engl Ed) ; 96(11): 615-617, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34756286

RESUMO

We present the case of an 81-year-old woman who developed a bilateral spontaneous suprachoroidal hemorrhage while under treatment with sodium enoxaparin. Temporal suspension of anticoagulant therapy led to an improvement of the choroidal hemorrhage. After three months follow-up, there was a complete reabsorption of the choroidal detachments, but there was a persistent vitreous hemorrhage in the right eye, which had been more severely affected. Pars plana vitrectomy with air tamponade was successfully performed in the right eye. Vision improved to 20/50 in the right eye and 20/20 in the left eye. Suprachoroidal hemorrhage is a rare condition with a poor visual prognosis. Reports on the development of suprachoroidal hemorrhage in patients with no predisposing ocular conditions are scarce, and in none were both eyes affected. The case reported herein is, to the best of our knowledge, the first case of bilateral, simultaneous suprachoroidal hemorrhage without predisposing ocular factors due to treatment with anticoagulants, with a favourable visual outcome.


Assuntos
Hemorragia da Coroide , Idoso de 80 Anos ou mais , Hemorragia da Coroide/induzido quimicamente , Olho , Feminino , Heparina de Baixo Peso Molecular , Humanos , Acuidade Visual , Vitrectomia
8.
Middle East Afr J Ophthalmol ; 28(2): 65-70, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34759662

RESUMO

PURPOSE: The purpose of this study is to compare the anatomical and visual outcomes of scleral buckle (SB) surgery with the pars plana vitrectomy (PPV) in the management of chronic rhegmatogenous retinal detachment. METHODS: This cohort study included patients who underwent surgical repair SB group and PPV group for chronic retinal detachment during 2014-2018 at the King Khalid Eye Specialist Hospital, Riyadh. The anatomical and functional success rate at 12 months after surgery was compared in two groups. Cox regression and linear regression analysis were performed to identify the predictor of anatomical and functional outcomes, respectively. Need for second surgery was also evaluated. RESULTS: Our cohort had 68 eyes in SB and 64 eyes in PPV group. Eyes that underwent PPV were more likely to develop retinal detachment over 12 months than those that underwent SB surgery (adjusted heart rates 2.11, 95% confidence interval [CI], 0.95-4.64 P = 0.065). A multivariable linear regression analysis did not reveal a significant association between the surgery type and change in visual acuity (beta coefficient, 0.002; 95% CI,-0.184, 0.189 for specific bread volume; P = 0.979). A higher percentage of eyes in the PPV group compared with those in the SB surgery group required secondary surgery (39.1% vs. 22.1%; P = 0.034). CONCLUSION: Scleral buckling surgery showed a better single surgery anatomic success rate as compared to PPV in the management of chronic primary rhegmatogenous retinal detachment. The functional outcome of the two procedures was comparable.


Assuntos
Descolamento Retiniano , Recurvamento da Esclera , Estudos de Coortes , Humanos , Descolamento Retiniano/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Vitrectomia
9.
Middle East Afr J Ophthalmol ; 28(2): 137-139, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34759673

RESUMO

In aqueous misdirection, the interval between diagnosis and surgical intervention is inversely proportional to the success of the surgery. Here, we report a successful outcome of pars plana vitrectomy (PPV) with irido-zonulo-hyaloidectomy 4 years after the onset of the disease. A 34-year-old female, known to have primary angle closure glaucoma, underwent trabeculectomy with mitomycin C in the right eye for uncontrolled intraocular pressure (IOP). Six weeks after the surgery, the patient presented with a shallow anterior chamber centrally and peripheral iridocorneal touch along with a patent peripheral iridectomy. Ultrasound biomicroscopy showed a shallow AC centrally with peripheral iridocorneal touch, and the ciliary body was rotated forward confirming the diagnosis of aqueous misdirection. The patient refused surgical management and was managed medically, which was unsuccessful. Four years after the diagnosis, the patient underwent PPV with irido-zonulo-hyaloidectomy because of progressive shallowing of the AC and corneal edema. One month postoperatively, visual acuity improved from 20/200 to 20/60, and the AC maintained appropriate depth. In conclusion, PPV with irido-zonulo-hyaloidectomy may result in a complete resolution of a chronic low-grade form of aqueous misdirection.


Assuntos
Glaucoma de Ângulo Fechado , Glaucoma , Adulto , Feminino , Glaucoma/cirurgia , Humanos , Pressão Intraocular , Iridectomia , Vitrectomia
10.
Cesk Slov Oftalmol ; 77(5): 232-241, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34666492

RESUMO

AIMS: Present the use of Optical Coherence Tomography Angiography (OCTA) in vitreoretinal interface diseases and results of macular capillary network evaluation before and after idiopathic macular hole surgery (IMD). METHODOLOGY: Prospective evaluation of functional results, anatomical and OCTA findings before and after IMD surgery. The group consists of 8 eyes of eight patients. Preoperatively and 1, 3 and 6 months after surgery, the best corrected visual acuity (BCVA) was examined, fundus photography was performed, examination of the macula by spectral-domain optical coherence tomography (SD OCT), determination of the stage of IMD according to Gases and also OCTA examination. The area of the foveal avascular zone (FAZ) and vascular density (VD) were evaluated by using of the OCTA. The operation was performed in all cases by transconjunctival suture 25G vitrectomy by one surgeon, always peeling the inner limiting membrane. An expansive gas, 7x 20% SF6, 1x 15% C3F8, was used for vitreous tamponade. RESULTS: In all 8 cases, the primary closure of the IMD occurred after the operation. The mean BCVA improved statistically significantly from 0.74 to 0.48 logMAR (p = 0.0023). The average FAZ area decreased from 0.345 mm² to 0.25 mm² after surgery (p = 0.0458). The mean VD increased from 7.93 mm-1 to 8.38 mm-1 (p = 0.2959). CONCLUSIONS: Assessment of the macular capillary network in patients with diseases of the vitreoretinal interface offers new findings and important details that can lead to prognostic information and a better understanding of the pathogenesis of the disease. We demonstrated a statistically significant reduction in FAZ in the eyes after successful IMD surgery and an indirect relationship between the improvement of BCVA and the change in FAZ area in our cohort.


Assuntos
Membrana Epirretiniana , Perfurações Retinianas , Angiografia , Membrana Epirretiniana/cirurgia , Humanos , Estudos Retrospectivos , Tomografia de Coerência Óptica , Acuidade Visual , Vitrectomia
11.
Cesk Slov Oftalmol ; 77(5): 242-247, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34666493

RESUMO

AIMS: To analyse the changes in endothelial cell density (ECD) after pars plana vitrectomy (PPV) and to identify the factors implicated. PATIENTS AND METHODS: This was a prospective, consecutive, and non-randomised, case-control study. All 23-gauge vitrectomies were performed by a single surgeon at a tertiary centre. ECD was measured at baseline before surgery and on postoperative Days 30, 90, and 180. The fellow eye was used as the control eye. The primary outcome was a change in ECD after PPV. RESULTS: Seventeen patients were included in this study. The mean age of the patients was 65 years. The mean ECD count at baseline was 2340 cells/mm2. The median ECD loss in the vitrectomised eye was 3.6 %, 4.0 %, and 4.7 % at Days 30, 90, and 180, respectively, compared to +1.94 %, +0.75 %, +1.01 %, respectively, in the control eye. The relative risk of ECD loss after PPV was 2.48 (C.I. 1.05-5.85, p = 0.0247). The pseudophakic eyes lost more ECD than the phakic eyes, but this was not statistically significant. There were no significant differences in diagnosis, age, surgical time, or tamponade used after surgery. CONCLUSIONS: Routine pars plana vitrectomy had an impact on the corneal endothelial cells until Day 180 post-op. The phakic status was slightly protective against ECD loss after PPV, although it was not statistically significant. The pathophysiology of corneal cell damage after routine PPV remains unclear. Further studies are required to confirm these findings.


Assuntos
Células Endoteliais , Vitrectomia , Idoso , Estudos de Casos e Controles , Humanos , Estudos Prospectivos , Estudos Retrospectivos , Acuidade Visual , Vitrectomia/efeitos adversos
12.
Vestn Oftalmol ; 137(5. Vyp. 2): 181-188, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34669326

RESUMO

PURPOSE: To evaluate the structure of vitreous body in asteroid hyalosis by low vacuum scanning electron microscopy. MATERIAL AND METHODS: The material of the study was samples of the vitreous body obtained from 7 patients aged from 62 to 72 years with vitreomacular traction syndrome during vitrectomy. In all cases, clinical manifestations of asteroid hyalosis (the presence of multiple point-like echo-positive inclusions) were identified during the preoperative examination. Samples for scanning electron microscopy and chemical microanalysis were prepared without using fixation elements, total dehydration, staining or centrifugation, and according to the so-called principle of bougienage, which consists in partial separation of fractions of the gel-like tissue with a stream of saline. RESULTS: The conducted examinations made it possible to identify various types of local accumulations of mineral elements in the vitreous body in asteroid hyalosis - called asteroid bodies - that is, multiple complex rounded formations consisting of needle-shaped crystals of a radial fibrous structure. CONCLUSION: The developed algorithm, which includes intraoperative sampling of the vitreous body in conditions of its minimal hydration and a special technique for preparing samples for scanning electron microscopy and chemical microanalysis, provides the capability for the in vivo assessment of morphological changes in hyaloid elements of the vitreous body. With that, asteroid bodies can be considered as markers of the vitreous structures that are difficult to visualize.


Assuntos
Oftalmopatias , Doenças Retinianas , Oftalmopatias/diagnóstico , Oftalmopatias/cirurgia , Humanos , Microscopia Eletrônica de Varredura , Transtornos da Visão , Vitrectomia , Corpo Vítreo
13.
BMC Ophthalmol ; 21(1): 372, 2021 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-34666710

RESUMO

BACKGROUNDS: To describe changes in rhegmatogenous retinal detachment (RRD) surgical procedures in Beijing during the COVID-19 Pandemic. METHODS: A retrospective cohort of RRD patients was analyzed. Patients were divided into the COVID-19 pandemic group and pre-COVID-19 group according to their presentation. The presurgery characteristics, surgical procedures, and surgery outcomes were collected. The potential factors related to the choice of pars plana vitrectomy (PPV) or scleral buckling (SB) were analyzed using logistic regression. The differences in the procedure choice under specific conditions were compared. Surgery outcomes were compared between the two groups. RESULTS: In the COVID-19 pandemic group, less patients received SB (27.8, 41.3%, p = 0.02) while more patients received PPV (72.2, 58.6%, p = 0.02); in patients who received SB, fewer patients received subretinal fluid drainage (45.4,75.7%, p = 0.01); in patients who received PPV, fewer patients received phacovitrectomy (7.0, 21.0%, p = 0.02). The choice of PPV was related to older age (1.03, p = 0.005), the presence of RRD with choroidal detachment (RRD-CD) (2.92, p = 0.03), pseudophakia (5.0, p = 0.002), retinal breaks located posterior to the equator (4.87, p < 0.001), macular holes (9.76, p = 0.005), and a presurgery visual acuity (VA) less than 0.02 (0.44, p = 0.03). Fewer phakia patients with retinal breaks located posterior to the equator (1/28, 11/30, p = 0.01) and fewer patients with chronic RRD and subretinal strand (1/9, 9/16, p = 0.03) received SB in the COVID-19 pandemic group. There were more patients with improved VA (55.7, 40.2%, p = 0.03) in the COVID-19 pandemic group. The overall single-surgery retinal attachment rate was similar in the two groups (94.9, 94.5%, p = 0.99). CONCLUSIONS: During the COVID-19 Pandemic, the main reason for the increased number of PPV in RRD treatment was that more complicated cases were presented. However, the surgeons were conservative in procedure choice in specific cases. The adjustments on RRD treatments lead to comparable surgery outcomes.


Assuntos
COVID-19 , Descolamento Retiniano , Idoso , Humanos , Pandemias , Descolamento Retiniano/epidemiologia , Descolamento Retiniano/cirurgia , Estudos Retrospectivos , SARS-CoV-2 , Recurvamento da Esclera , Resultado do Tratamento , Vitrectomia
14.
Adv Clin Exp Med ; 30(10): 1099-1103, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34610225

RESUMO

BACKGROUND: The implementation of the 27-gauge (G) sutureless vitrectomy technique is associated with a marked shortening of surgery time, faster healing of scleral and conjunctival wounds, less severe conjunctival scarring, limited postoperative corneal astigmatism, and marked improvement in the postoperative comfort of patients. The traditional methods of anesthesia for vitrectomy surgery are quite varied and each has its own potential for complications. OBJECTIVES: To assess the feasibility and safety of 27G pars plana vitrectomy (PPV) performed under local topical anesthesia for diabetic maculopathy, asteroid hyalosis and vitreomacular traction syndrome associated with high myopia. MATERIAL AND METHODS: Three carefully selected patients with various vitreoretinal disorders underwent primary 27G PPV performed by a single surgeon under local topical anesthesia. Patients were analyzed in regard to best corrected visual acuity, intraocular pressure, intraoperative/postoperative complications, intraoperative/postoperative pain, and surgery time. RESULTS: All patients showed postoperative improvement in visual acuity. No decrease in intraocular pressure below 10 mm Hg was documented on postoperative day 1. Furthermore, no postoperative complications were recorded during the six-month follow-up, and evident improvement in the anatomical status was confirmed using ophthalmic coherence tomography in all cases. CONCLUSION: Our findings support that 27G PPV performed solely under local topical anesthesia is safe and effective for treating selected vitreoretinal disorders.


Assuntos
Anestesia , Doenças Retinianas , Humanos , Projetos Piloto , Doenças Retinianas/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Acuidade Visual , Vitrectomia
15.
BMC Ophthalmol ; 21(1): 384, 2021 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-34715824

RESUMO

BACKGROUND: Acute postoperative endophthalmitis is one of the most severe complications of modern ophthalmic procedures including cataract surgeries, vitrectomy and intravitreal injection (IVI). We evaluated the treatment outcomes of acute postoperative infectious endophthalmitis. METHODS: In this retrospective study, we collected data from 82 patients with acute infectious endophthalmitis within 6 weeks after intraocular surgeries, including cataract surgeries, vitreoretinal surgeries, and IVI, from January 2010 to December 2019. We analyzed the pre-treatment, treatment-related and post-treatment factors that affected visual outcomes. RESULTS: The mean age was 67.65 ± 9.52 years, the proportion of male patients was 56.1%. The mean baseline vision was 1.92 (Snellen Equivalent SE], counting finger [CF]) ± 0.54 logarithm of the minimum angle of resolution (log MAR) and the mean final vision was 0.71 (SE, 39/200) ± 0.80 logMAR. Visual improvement was significant (P < 0.001). The pre-treatment factors affecting final visual outcomes were diabetes, hemodialysis, baseline vision, signs of vitreous opacity, and different surgeries before endophthalmitis; the treatment-related factors affecting visual outcomes were the choice factors between IVI of antibiotics alone and vitrectomy combined with IVI of antibiotics, and the injection numbers of antibiotics; post-treatment factors affecting visual outcomes were complications such as retinal detachment (RD), glaucoma and macular pucker. Furthermore, prior cataract surgery was associated with a better mean final vision of 0.57 (SE, 54/200) ± 0.67 logMAR while prior vitrectomy resulted in the worst mean final vision of 1.38 (SE, 21/500) ± 0.75 logMAR. CONCLUSIONS: The important factors that affected the final visual prognosis, included diabetes, hemodialysis, baseline vision, severity of vitritis, treatment strategies and complications. The treatment outcomes revealed better final vision in prior cataract surgery than vitrectomy.


Assuntos
Endoftalmite , Infecções Oculares Bacterianas , Idoso , Antibacterianos/uso terapêutico , Endoftalmite/epidemiologia , Endoftalmite/etiologia , Endoftalmite/terapia , Infecções Oculares Bacterianas/tratamento farmacológico , Humanos , Injeções Intravítreas , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/tratamento farmacológico , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Resultado do Tratamento , Vitrectomia
19.
Indian J Ophthalmol ; 69(11): 3297-3301, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34708792

RESUMO

Purpose: To study and compare the outcomes of pars plana vitrectomy (PPV) with the internal limiting membrane (ILM) peeling in the eyes with recalcitrant diabetic macular edema (DME) with and without vitreomacular traction. Methods: A comparative prospective interventional study was undertaken in which group 1 included 45 eyes of 45 patients with DME with vitreomacular tractional component and group 2 included 45 eyes of 45 patients with recalcitrant DME without a tractional component. Both groups underwent standard PPV with ILM peeling. All the patients were followed up for a minimum of 6 months. The parameters evaluated were changes in the best-corrected visual acuity (BCVA), central macular thickness (CMT), multifocal electroretinogram (mfERG) parameters, and occurrence of any intraoperative/postoperative surgical complication. Results: The mean CMT improved significantly from 540.6 and 490.2 µm at the baseline to 292.5 and 270.6 µm at 6 months in groups 1 and 2, respectively (P < 0.001). The mean BCVA logMAR improved from 0.78 ± 0.21 to 0.62 ± 0.22 in group 1 and 0.84 ± 0.19 to 0.65 ± 0.21 in group 2 at 6 months follow-up which was not statistically significant. The improvement in the mfERG was seen in group 2 as a significant increase in P1 wave amplitude in ring 2 (2-5°) (P < 0.004) and a significant decrease in P 1 wave implicit time in ring 1 (central 2°) (P < 0.001). None of the eyes suffered from the loss of BCVA or any major surgical complication in either group. Conclusion: PPV in recalcitrant DME provides good anatomical outcomes and the results are comparable in DME with and without a tractional component.


Assuntos
Diabetes Mellitus , Retinopatia Diabética , Membrana Epirretiniana , Edema Macular , Membrana Basal/cirurgia , Retinopatia Diabética/complicações , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/cirurgia , Membrana Epirretiniana/cirurgia , Humanos , Edema Macular/diagnóstico , Edema Macular/cirurgia , Estudos Prospectivos , Retina , Estudos Retrospectivos , Tomografia de Coerência Óptica , Tração , Acuidade Visual , Vitrectomia
20.
Indian J Ophthalmol ; 69(11): 3302-3307, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34708793

RESUMO

Purpose: To evaluate the surgical outcome of full-thickness macular hole (FTMH) secondary to active fibrovascular proliferation (FVP) and tractional retinal detachment (TRD) in eyes with proliferative diabetic retinopathy (PDR), and factors influencing the outcome. Methods: This retrospective study included the patients who underwent vitrectomy for FTMH secondary to PDR TRD from 2016 to 2020. Anatomical and visual outcomes were analyzed after six months along with the factors predicting the final outcome and duration of subretinal fluid (SRF) resolution. Results: Group A (macula-off combined RD, i.e., tractional and rhegmatogenous) included 10 eyes, while group B (macula-threatening TRD) included eight eyes. The mean best-corrected visual acuity improved from logMAR 1.21 (Snellen equivalent: 20/324) to logMAR 0.76 (Snellen equivalent: 20/115) (P = 0.008). Seventeen patients gained ≥1 line(s) of vision. Mean visual gain in groups A and B was 3.7 ± 1.9 and 1.9 ± 1.1 lines, respectively (P = 0.051). MH closed in 88.9% eyes. Type 1 anatomical closure was achieved in 88.9% of eyes. At 6 months, SRF and central macular thickness reduced from 479.6 ± 512.5 µm to 11.4 ± 23.5 µm (P = 0.002) and 874.3 ± 422.6 µm to 207.6 ± 81.7 µm (P = 0.0002), respectively. Finally, macular SRF resolved in all the patients. The mean duration for complete SRF resolution was 4.9 ± 3.2 months. Eyes with a shorter duration of diabetes mellitus (rho = -0.49, P = 0.040) and macula-off combined RD (P = 0.048) took a longer time for complete SRF resolution. Conclusion: Good anatomical and visual outcomes can be achieved in eyes with PDR TRD-associated FTMH. The residual macular SRF resolves slowly after the surgery and extra intervention is not required. Macula-off combined RD is associated with worse outcome and a slower SRF resolution rate.


Assuntos
Diabetes Mellitus , Retinopatia Diabética , Macula Lutea , Descolamento Retiniano , Perfurações Retinianas , Retinopatia Diabética/complicações , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/cirurgia , Humanos , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/etiologia , Descolamento Retiniano/cirurgia , Perfurações Retinianas/complicações , Perfurações Retinianas/diagnóstico , Estudos Retrospectivos , Resultado do Tratamento , Vitrectomia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...