Surgical Outcomes in Patients with Macular Pucker and Good Preoperative Visual Acuity After Vitrectomy with Membrane Peeling (original) (raw)
Related papers
Clinical Ophthalmology, 2011
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.
Surgical results of pars plana vitrectomy combined with phacoemulsification
Objectives: To evaluate the technical feasibility, safety, outcome, and incidence of complications after combined clear corneal phacoemulsification (PEA) with intraocular lens (IOL) implantation and vitreoretinal surgery. Methods: Combined operations of PEA and PPV were performed on 52 eyes of 52 patients with cataract and vitreoretinal diseases. Results: The mean follow-up time was (10.3±2.8) months. Postoperatively, visual acuity improved in 46 eyes (88.5%); was unchanged in 6 eyes (11.5%). The best-corrected visual acuities (BCVAs) Postoperative complications included posterior capsual opacification (7 eyes); secondary glaucoma (1 eye); and retinal detachment (2 eyes). Conclusion: Although further studies are indicated, our study suggests that the combined operation of PPV, PEA and IOL implantation is safe and effective for patients. The visual outcome and complications depended primarily on underlying posterior segment pathology and were not related to the combined procedure technique.
Pars Plana Vitrectomy for the Management of Retained Lens Material After Cataract Surgery
American Journal of Ophthalmology, 2007
PURPOSE: To evaluate the management and outcomes of patients undergoing pars plana vitrectomy (PPV) for retained lens material after cataract surgery; and to evaluate risk factors for poor visual outcome, retinal detachment, raised intraocular pressure (IOP), and cystoid macular edema (CME). • DESIGN: Retrospective interventional consecutive case series. • METHODS: SETTING: Institutional and Clinical practice. STUDY POPULATION: Patients with retained lens material after cataract surgery who underwent vitrectomy at Sydney Eye Hospital between July 1, 1998 and October 31, 2003. INTERVENTION: Standard three-port PPV/ lensectomy. MAIN OUTCOME MEASURES: Final best-corrected visual acuity (BCVA), retinal detachment, raised IOP, and CME. • RESULTS: A total of 223 eyes of 223 patients were included, with a mean follow-up of 20.5 months after vitrectomy. Final BCVA was 6/12 or better in 159 patients (71.3%).
Clinical Ophthalmology, 2019
The purpose of this study was to evaluate the functional and anatomical outcomes of combined phacovitrectomy with multifocal intraocular lens (mfIOL) implantation. Methods: Retrospective, interventional, non-comparative case series of six eyes that received a combined phacoemulsification surgery with apodized, diffractive mfIOL implantation for cataract and pars plana vitrectomy (PPV) with membrane peeling for epiretinal membrane (ERM). Outcome measures included distance and near visual acuities (DVA and NVA), central macular thickness (CMT), intraocular pressure (IOP), and disruption of external limiting membrane (ELM) or inner-segment outer-segment (IS/OS) junction. Results: Mean logMAR glare DVA improved from 0.40 (Snellen 20/50) preoperatively to a mean uncorrected DVA of 0.038 (Snellen 20/22) (P=0.004) at 6 months after surgery. All eyes achieved NVA of J2 or better by 12 months postoperatively. Median CMT improved by 10 µm and mean IOP increased by 1 mmHg at 12 months postoperatively. Percentage of patients with ELM or IS/OS disruptions decreased from 66.7% to 33.3%. Two eyes demonstrated residual metamorphopsia on Amsler grid testing postoperatively. Postoperatively, four eyes required laser capsulotomy and one required LASEK for refractive correction. Conclusion: Combined phacovitrectomy, membrane peeling, and mfIOL implantation improved VA in patients with idiopathic ERM. Multifocality was achieved, but final visual outcome was delayed due to posterior capsular opacification and macular healing.