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Purpose: We report clinical characteristics, risk factors, treatment outcomes, and prognostic predictors of post?vitrectomy secondary macular holes (MHs). Methods: This was a retrospective observational case series from November 2014 to December 2020. Eyes that developed secondary MH, two weeks and beyond after primary vitrectomy for non?MH indications, were enrolled. Pre? and intraoperative records were screened to exclude pre?existence of MH. Eyes with multiple vitreoretinal surgeries prior to MH detection and tractional myopic maculopathy were excluded. Results: A total of 29 eyes of 29 patients with a mean age of 52 years developed secondary MH post?vitrectomy. The most common indications for primary vitrectomy were rhegmatogenous retinal detachment (RRD, 48.2%) and tractional retinal detachment (TRD, 24.1%). Time to MH detection after primary vitrectomy was 91.5 ± 117.6 days. The mean minimum hole diameter was 530 ± 298 microns. Epi?retinal membrane and cystoid degeneration was noted in 6 (20.7%) and 12 (41.3%) eyes, respectively (p = 0.088). The mean time from MH detection to MH repair was 34 ± 42 days. The surgical intervention included internal limiting membrane peeling with tamponade in 25 eyes. Overall, 80% showed anatomic hole closure, 90.9% versus 57.1% in the RRD and TRD (p = 0.092), respectively. The mean best?corrected visual acuity (BCVA) at the final visit was 0.71 logarithm of the minimum angle of resolution. Thirteen eyes (52%) had a BCVA of 20/100 or better. Minimal hole diameter (p = 0.029) only predicted final visual acuity. The interval between MH diagnosis and repair did not affect hole closure significantly (p = 0.064). Conclusion: Secondary MH post?vitrectomy closed successfully with limited visual improvement and trails behind idiopathic MH.
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@#AIM: To evaluate the refractive errors after phacoemulsification combined with intraocular lens(IOL)implantation in previously vitrectomized eyes.<p>METHODS: Thirty-eight patients(40 eyes)with cataract who had undergone vitrectomy were divided into two groups: vitrectomy alone as group A(22 eyes), vitrectomy combined with inert gas(C<sub>3</sub>F<sub>8</sub>)tamponade as group B(18 eyes). In addition, normal eyes(20 eyes)without vitrectomy history who required cataract surgery were included as a control group C. Axial length(AL), keratometric value(K), anterior chamber depth(ACD), and white-to-white(W-W)were measured with IOL Master 500 before the surgery. The power of IOL was calculated with the online Barrett Universal Ⅱ formula. Phacoemulsification combined with IOL implantation by an iris hook assistance technique was used to treat groups A and B, group C was treated only with phacoemulsification and IOL implantation. There were no complications, such as posterior capsule rupture. The postoperative refraction was obtained three months after surgery. The prediction error(PE), absolute prediction error(AE), and median absolute error(MedAE)among the three groups were compared.<p>RESULTS: There was no significant difference among the three groups in AL, K value, and IOL power. A significantly deep ACD was noted in groups A and B compared with group C(<i>P</i><0.01). There was a significant difference in the prediction error among the three groups(<i>P</i>=0.042). Group B showed a significant hyperopic shift compared with group C. AE and MedAE among groups showed no significant difference.<p>CONCLUSION: There was no significant difference in the refractive results of patients with phacoemulsification sequential to vitrectomy alone compared with the normal control group. However, a hyperopic shift was found in patients with phacoemulsification sequential to vitrectomy with inert gas tamponade comparing with the normal eyes. Undercorrection should be avoided when selecting IOL power.
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The incidence of endophthalmitis after vitrectomy is extremely low,especially lower in silicone oil-filled eyes.Silicone oil exerts a toxic effect on the cell membranes of microorganisms and leads to the lack of nutrients.It is thus believed to inhibit the growth of bacteria and fungi.Endophthalmitis induced by mixed bacteria in silicone oil-filled eye has been rarely reported.We reviewed the clinical manifestations,diagnosis,and treatment of a patient with endophthalmitis caused by mixed infection of
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Humans , Bacteria , Coinfection , Endophthalmitis , Silicone Oils/adverse effects , VitrectomyABSTRACT
@#AIM: To evaluate the clinical efficacy and safety of transscleral cyclophotocoagulation(TSCP)for glaucoma secondary to vitrectomy. <p>METHODS: A retrospective review was performed within 20 patients(20 eyes)with glaucoma secondary to vitrectomy underwent TSCP in our hospital from October 2014 to October 2016. The follow-up time was 3mo. The postoperative visual acuity, intraocular pressure(IOP)and complications were observed. <p>RESULTS: One month after operation, the postoperative IOP increased in 9 cases. Another 4 eyes were performed TSCP again, and three of them got the normal IOP recovery. At the last follow-up, visual acuity had no significant changes(<i>P</i>=0.655); IOP was effectively controlled in 14(70%)patients. Meanwhile, the mean postoperative IOP(24.6±11.4mmHg)was statistically reduced than the mean preoperative IOP(42.3±5.9mmHg, <i>P</i><0.05). No serious complications, like hypotony and suprachoroidal hemorrhage, had been observed during 3-month follow-up. <p>CONCLUSION: TSCP procedure is a safe, effective, repeatable surgery for patients with glaucoma secondary to vitrectomy.