Endotamponades in pars plana vitrectomy for metallic intraocular foreign body associated with endophthalmitis

AIM: To study the criterion-reference of endotamponades in pars plana vitrectomy for metallic intraocular foreign body (MIOFD) associated with endophthalmitis. METHODS:Thirty-six patients of MIOFD with endophthalmitis accorded with Exclusion and inclusion criteria were retrospectively analyzed. A detailed analysis of the patients' natural factors, preoperative examinations, intraoperative endotamponades choice, postoperative complications and therapeutic effects was performed. RESULTS: BSS was used in 4 eyes without obvious retinal damage. There was no postoperative complication and their visual acuity (VA) was improved. Sixteen eyes that had mild retinal damage filled with C3F8 gas. The postoperative VA improved in 10 eyes (62.5%), 4 eyes (25.0%) remained unchanged and 2 eyes (12.5%) decreased. Only 2 cases occurred postoperative retinal detachment in gas group. Another 16 eyes with serious retinal damage were treated with silicone oil. Postoperative VA of 9 eyes (56.3%) improved, 3 eyes (18.8%) remained unchanged and 4 eyes (25.0%) decreased. The silicone oil group had higher incidence of postoperative complications, but the incidence of secondary treatment had no significant different between silicone oil and gas group. CONCLUSION: An appropriate choice of endotamponades in vitrectomy surgery for MIOFB with endophthalmitis is important for prognosis.

The outcomes of pars plana vitrectomy without endotamponade for tractional retinal detachment secondary to proliferative diabetic retinopathy

AIM:To evaluate the outcomes of pars plana vitrectomy(PPV) without the use of an ocular tamponade in patients having tractional retinal detachment(TRD) secondary to proliferative diabetic retinopathy(PDR).METHODS:It was an interventional study conducted at the Department of Ophthalmology,B.V.Hospital,Bahawalpur,Pakistan,from July 2011 to July 2012.A total of 75 patients(84 eyes) having TRD secondary to PDR were treated by PPV without using an ocular tamponade.All patients included in the study had a tractional retinal detachement secondary to proliferative diabetic retinopathy but didn’t have or develop retinal breaks before or during the study period.The surgical procedure included a PPV combined with the removal of the tractional retinal membranes and the application of endolaser photocoagulation to the retina.The mean follow-up period was 12 months. RESULTS:Successful retinal reattachement was observed in 78 of the operated eyes(92.8%).In these patients,the retina remained attached till the end of the one year follow-up period.Improvement in best corrected visual acuity(BCVA) was seen in 63 eyes(75%).The visual acuity remained unchanged in 9 eyes(10.7%).Mean improvement in BCVA was 2.00 +1.24 at baseline to 1.24+1.22(P【0.05) at the end of the followup period.CONCLUSION:In the absence of the retinal breaks,a TRD secondary to PDR can be successfully treated by pars plana vitrectomy without the use of an ocular tamponade.

A novel approach for 25-gauge transconjunctival sutureless vitrectomy to evaluate vitreous substitutes in rabbits

AIM:To improve the standard three-port vitrectomy for establishing and evaluating an endotamponade model in rabbits.METHODS:Three ports were prepared near the third eyelid of rabbits,and the infusion port was placed at the inferior nasal quadrant with the inserted cannula linking with a self-designed handheld rigid infusion catheter.All right eyes of rabbits underwent a modified 25-gauge vitrectomy and were subsequently filled with balanced salt solution,silicone oil,and eight-arm polyethylene glycols(8-arm PEGs)hydrogel separately for comparison.Ophthalmic examinations were performed regularly to record the changes after the surgery.RESULTS:Successful vitrectomy was achieved among 44 chinchilla rabbits.The mean operation time was 4.51±1.25min.Four eyes(9.1%)presented limited lens touch and two eyes(4.5%)showed retinal touch during surgery.Incision leakage was found in three eyes(6.8%)after surgery.There was no endophthalmitis,hemorrhage,or retinal detachment during the observation period and ophthalmic examinations after the implantation of vitreous substitutes.CONCLUSION:The modified technique of the standard vitrectomy applied in the endotamponade model in rabbits shows excellent safety and practicality.