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Case Reports in Ophthalmology 2016To report a case of endophthalmitis following 27-gauge pars plana vitrectomy for symptomatic vitreous floaters.
PURPOSE
To report a case of endophthalmitis following 27-gauge pars plana vitrectomy for symptomatic vitreous floaters.
METHODS
The clinical course and imaging findings, including fundus optomap, and spectral domain optical coherence tomography of a 24-year-old male patient were documented.
RESULTS
The patient, with a preoperative best-corrected visual acuity (BCVA) of 1.0, developed endophthalmitis following 27-gauge pars plana vitrectomy for symptomatic vitreous floaters. After a series of treatments, including emergent vitreous tap and silicone oil injection, antibiotic treatment, and silicone oil removal, the patient regained a BCVA of 0.6.
CONCLUSION
Although rare, the potential risk of endophthalmitis should be explicitly discussed with patients considering surgical intervention for vitreous floaters.
PubMed: 28101041
DOI: 10.1159/000452733 -
Retina (Philadelphia, Pa.) Jun 2014To determine the safety, efficacy, and quality of life improvement following sutureless 25-gauge pars plana vitrectomy for symptomatic floaters.
PURPOSE
To determine the safety, efficacy, and quality of life improvement following sutureless 25-gauge pars plana vitrectomy for symptomatic floaters.
METHODS
Patients with symptomatic vitreous floaters who underwent sutureless vitrectomy between January 2008 and January 2011 were included. Data were collected regarding baseline preoperative characteristics, postoperative outcomes, complications, and a nine-item quality-of-life survey completed by each patient.
RESULTS
One hundred and sixty-eight eyes (143 patients) underwent sutureless 25-gauge pars plana vitrectomy for symptomatic vitreous floaters. Mean Snellen visual acuity was 20/40 preoperatively and improved to 20/25 postoperatively (P < 0.0001). Iatrogenic retinal breaks occurred in 12 of 168 eyes (7.1%). Intraoperative posterior vitreous detachment induction was not found to increase the risk of retinal breaks (P = 1.000). Postoperative complications occurred in three eyes, of which one had transient cystoid macular edema and two had transient vitreous hemorrhage. Approximately 88.8% of patients completed a quality-of-life survey, which revealed that 96% were "satisfied" with the results of the operation, and 94% rated the experience as a "complete success."
CONCLUSION
Sutureless 25-gauge pars plana vitrectomy for symptomatic vitreous floaters improved visual acuity, resulted in a high patient satisfaction quality-of-life survey, and had a low rate of postoperative complications. Sutureless pars plana vitrectomy should be considered as a viable means of managing patients with symptomatic vitreous floaters.
Topics: Adult; Aged; Aged, 80 and over; Eye Diseases; Humans; Male; Middle Aged; Patient Satisfaction; Postoperative Complications; Quality of Life; Suture Techniques; Visual Acuity; Vitrectomy
PubMed: 24384616
DOI: 10.1097/IAE.0000000000000063 -
International Ophthalmology Oct 2023To demonstrate the methodology and efficacy of using scanning laser ophthalmoscopy (SLO) and dynamic optical coherence tomography (OCT) to identify and treat symptomatic...
PURPOSE
To demonstrate the methodology and efficacy of using scanning laser ophthalmoscopy (SLO) and dynamic optical coherence tomography (OCT) to identify and treat symptomatic vitreous floaters using yttrium-aluminum garnet laser vitreolysis (YLV).
METHODS
This is a case series highlighted from a cross sectional retrospective study conducted at the Vitreous Retina Macula Specialists of Toronto. Forty eyes from thirty-five patients were treated with YLV between November 2018 and December 2020 for symptomatic floaters and imaged with SLO and dynamic OCT. Patients were re-treated with YLV if they reported ongoing significant vision symptoms during follow-up which correlated to visible opacities on exam and or imaging. Three cases will be highlighted to present the practical applications of SLO and dynamic OCT imaging for YLV treatment.
RESULTS
Forty treated eyes were enrolled in this study, with twenty-six eyes (65%) requiring at least one repeat YLV treatment following the first treatment due to ongoing symptomatic floaters. Following the first YLV, there was a significant improvement in overall mean best corrected visual acuity compared to before treatment (0.11 ± 0.20 LogMAR units vs. 0.14 ± 0.20 LogMAR units, p = 0.02 (paired t test)). Case 1 demonstrates a dense, solitary vitreous opacity that has been localized with dynamic OCT imaging to track its movements and retinal shadowing with the patient's eye movements. Case 2 shows the utility of adjusting the fixation target to monitor the movement of vitreous opacities in real-time. Case 3 exhibits an association between decreased symptom burden and vitreous opacity density after YLV.
CONCLUSION
Image-guided YLV facilitates the localization and confirmation of vitreous opacities. SLO and dynamic OCT of the vitreous can provide a real-time evaluation of floater size, movement, and morphology, to help clinicians target treatment and monitoring of symptomatic floaters.
Topics: Humans; Retrospective Studies; Cross-Sectional Studies; Vitrectomy; Eye Diseases; Vitreous Body; Vision Disorders; Tomography, Optical Coherence
PubMed: 37402010
DOI: 10.1007/s10792-023-02765-4 -
Expert Opinion on Drug Safety Sep 2016Pharmacologic vitreolysis is a strategy used to treat anomalous posterior vitreous detachment, by weakening vitreoretinal adhesion with an intravitreal drug.... (Review)
Review
INTRODUCTION
Pharmacologic vitreolysis is a strategy used to treat anomalous posterior vitreous detachment, by weakening vitreoretinal adhesion with an intravitreal drug. Pharmacologic vitreolysis facilitates surgery, and abnormalities of the vitreoretinal interface including vitreomacular traction (VMT) and early stage macular hole (MH) could be resolved. Ocriplasmin is a recombinant protease, active against fibronectin and laminin, which are important components of the vitreoretinal interface. Ocriplasmin has been approved for symptomatic treatment of VMT and MH with visible traction, and it functions by dissolving the proteins that link the vitreous to the macula, thereby creating a complete posterior vitreous detachment (PVD).
AREAS COVERED
This paper reviews the current knowledge and status of investigations regarding the use of ocriplasmin for pharmacologic vitreolysis and its safety.
EXPERT OPINION
Ocriplasmin is a non-specific enzyme; therefore, it dissolves vitreal proteins as well as possibly proteins associated with visual function in the retina, choroid, and lens. Ocular adverse events (OAEs) of ocriplasmin include transient visual loss, intraocular inflammation, vitreous floaters, lens opacification, zonular instability of the lens, and intraocular hemorrhage. The prevalence of the OAEs is very low; however, on rare occasions, they can result in widespread retinal dysfunction. Research into the acute and long-term safety of ocriplasmin is required.
Topics: Animals; Fibrinolysin; Humans; Intravitreal Injections; Peptide Fragments; Retina; Retinal Perforations; Tissue Adhesions; Treatment Outcome; Vitreous Body; Vitreous Detachment
PubMed: 27388220
DOI: 10.1080/14740338.2016.1208169 -
Bulletin de La Societe Belge... 2001Ten eyes of nine patients were treated for very disturbing vitreous floaters with the technique of Nd-YAG laser vitreolysis. The Scanning Laser Ophthalmoscope (SLO) was...
Ten eyes of nine patients were treated for very disturbing vitreous floaters with the technique of Nd-YAG laser vitreolysis. The Scanning Laser Ophthalmoscope (SLO) was used to objectivate the position, the size and the motility of the vitreous floaters with respect to the patient's visual axis, which can be precisely located with the SLO. With this technique it was possible to define more precisely some eligibility criteria for Nd-YAG laser treatment of vitreous floaters and to classify the vitreous floaters in ill-suspended and well-suspended floaters in the vitreous body, the well-suspended floaters responding better to treatment compared to the ill-suspended vitreous floaters. The treatment was performed using the Q-Switched Nd-YAG Laser type Nanolas 15S of Alcon.
Topics: Eligibility Determination; Eye Diseases; Humans; Laser Therapy; Treatment Outcome; Visual Acuity; Vitrectomy; Vitreous Body; Vitreous Detachment
PubMed: 11486460
DOI: No ID Found -
BMC Ophthalmology Apr 2020Modern laser surgery uses Nd:YAG laser capsulotomy for posterior capsule opacification (PCO) and Nd:YAG laser vitreolysis for symptomatic vitreous floaters (VF). We...
BACKGROUND
Modern laser surgery uses Nd:YAG laser capsulotomy for posterior capsule opacification (PCO) and Nd:YAG laser vitreolysis for symptomatic vitreous floaters (VF). We report a case of acute retinal detachment seven days after Nd:YAG laser capsulotomy combined with Nd:YAG laser vitreolysis and analyze the cause of this complication.
CASE PRESENTATION
A 58-year-old myopic woman complained of decreased visual acuity and symptomatic floaters with her left eye for 3 months. We found she had significant PCO and VF in the posterior vitreous. She underwent neodymium-doped yttrium aluminum (Nd:YAG) laser vitreolysis immediately after Nd:YAG capsulotomy. After 7 days, she complained of rapid vision decline and dark shadows in her treated eye. We found she had a acute severe rhegmentogenous retinal detachment (RD) involving the macula. Then she underwent vitrectomy, retinal reattchment and silicone oil tamponade surgery immediately. Six months later, silicone oil was removed and the best corrected visual acuity (BCVA) of her left eye gradually improved to 10/20 and maintained during a 1-year follow-up period.
CONCLUSION
As myopic patients are at risk of developing retinal detachment, Nd:YAG vitreolysis and capsulotomy should be performed with caution. The laser energy should be as low as possible and careful focus is necessary to reduce interference to the retina.
Topics: Capsule Opacification; Female; Humans; Laser Therapy; Lasers, Solid-State; Middle Aged; Postoperative Complications; Retinal Detachment; Visual Acuity; Vitrectomy; Vitreous Body
PubMed: 32306922
DOI: 10.1186/s12886-020-01428-7 -
Trials Jan 2024Vitreous floaters are a common ocular condition that affects individuals of all ages. Although vitreous floaters are typically benign, they can significantly impair...
BACKGROUND
Vitreous floaters are a common ocular condition that affects individuals of all ages. Although vitreous floaters are typically benign, they can significantly impair visual acuity and quality of life. Laser vitreolysis, which uses an Nd: YAG laser to vaporize collagenous vitreous opacities, is increasingly being used as a treatment option. However, there is currently a lack of evidence regarding its efficacy and the appropriate timing of its application. This study aims to evaluate the efficacy and safety of early intervention with YAG laser vitreolysis in treating symptomatic vitreous floaters.
METHODS
The present study is a randomized, controlled, double-blind clinical trial. A total of 70 participants with symptomatic floaters for 1 month were prospectively recruited. These participants will be randomly assigned to two groups, with 35 individuals in each group: the early treatment group and the delayed treatment group. Participants assigned to the early treatment group will undergo YAG laser vitreolysis immediately, followed by a sham laser treatment 3 months later. On the other hand, participants assigned to the delayed treatment group will receive a sham laser treatment and then undergo YAG laser vitreolysis 3 months later. The follow-up time points will be 1, 3, 6, and 12 months from randomization. Primary outcomes will be participants' self-reported improvement in visual disturbance on a scale of 1 to 10 and their scores on the National Eye Institute Visual Functioning Questionnaire 25 (NEI VFQ-25). Secondary outcomes will be an objective evaluation of the effectiveness of the treatment in reducing vitreous floaters through OCT and fundus photography and tracking any adverse events related to the eyes or overall health.
DISCUSSION
This clinical trial aims to evaluate the effectiveness of YAG laser vitreolysis in treating symptomatic vitreous floaters and assess the safety of performing early intervention with YAG laser vitreolysis.
TRIAL REGISTRATION
ClinicalTrials.gov NCT05800353 . Registered on 10 March 2023.
Topics: Humans; Vitreous Body; Vitrectomy; Lasers, Solid-State; Quality of Life; Laser Therapy; Randomized Controlled Trials as Topic; Vision Disorders
PubMed: 38218919
DOI: 10.1186/s13063-024-07924-1 -
Case Reports in Ophthalmology 2017Traditionally acceptable methods of anesthesia for vitrectomy surgery are quite varied. However, each of these methods has its own potential for complications that can...
PURPOSE
Traditionally acceptable methods of anesthesia for vitrectomy surgery are quite varied. However, each of these methods has its own potential for complications that can range from minor to severe. The surgery procedure of vitrectomy for symptomatic vitreous floaters is much simpler, mainly reflecting in the nonuse of sclera indentation, photocoagulation, and the apparently short surgery duration. The use of 27-gauge cannulae makes the puncture of the sclera minimally invasive. Hence, retrobulbar anesthesia, due to its rare but severe complications, seemed excessive for this kind of surgery.
METHOD
Three cases of 27-gauge, sutureless pars plana vitrectomy for symptomatic vitreous floaters with topical anesthesia are reported.
RESULTS
The vitrectomy surgeries were successfully performed with topical anesthesia (proparacaine, 0.5%) without operative or postoperative complications. Furthermore, none of the patients experienced apparent pain during or after the surgery.
CONCLUSION
Topical anesthesia can be considered for 27-guage vitrectomy in patients with symptomatic vitreous floaters.
PubMed: 28203195
DOI: 10.1159/000453332 -
Ophthalmology. Retina Jul 2019
Re: Thompson: Much Ado about Nothing (or Something)-What Is the Role of Vitrectomy and Yttrium-Aluminum-Garnet Laser for Vitreous Floaters? (Ophthalmol Retina. 2018;2:879-880).
PubMed: 31277804
DOI: 10.1016/j.oret.2019.01.025 -
American Journal of Ophthalmology Nov 1956
Topics: Chlorobutanol; Disease; Drug Combinations; Eye Diseases; Hemorrhage; Humans; Iodides; Niacin; Niacinamide; Retina; Retinal Hemorrhage; Sodium Iodide; Vitreous Body; Vitreous Hemorrhage
PubMed: 13372702
DOI: No ID Found