Posterior Segment Complications after Vitrectomy for Macular Hole

Park, Susanna S.; Marcus, Dennis M.; Duker, Jay S.; Pesavento, Richard D.; Topping, Trexler M.; Frederick, Albert R.; D’Amico, Donald J.

doi:10.1016/s0161-6420(95)30956-6

Cited by 159 publications

(38 citation statements)

References 28 publications

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“…Postoperative complications in the posterior segment were noted in 23% of eyes in a study by Park et al (1995). Retinal breaks and retinal detachment developed in up to 25% as reported by Korobelnik et al (1996).…”

Section: Discussionmentioning

confidence: 69%

Preoperative measurements of macular hole with scanning laser ophthalmoscopy. Correlation with functional outcome

Byhr

Lindblom

1998

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: To measure the dimensions of macular holes before surgery and compare them with the functional outcome. Methods: A prospective study of ten consecutive patients scheduled for macular hole surgery. Macular holes were imaged with scanning laser ophthalmoscopy with different laser wavelengths. Computerized image analyses were used to measure the size of the hole and the surrounding rim. Results: Eyes were referred to three different groups preoperatively according to visual function. Measurements of the longest diameter and the area of the macular hole were found to correlate well with visual function tested before and after surgery. All holes closed after one operation. Eighty per cent of eyes improved two or more lines on the distance visual chart and all patients but one could read a newspaper six months after surgery. Conclusion: Preoperative size of macular hole can be used as a predictor of the functional outcome of macular hole surgery.

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Section: Discussionmentioning

confidence: 69%

Preoperative measurements of macular hole with scanning laser ophthalmoscopy. Correlation with functional outcome

Byhr

Lindblom

1998

Acta Ophthalmologica Scandinavica

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“…[1][2][3][4] The frequency of iatrogenic retinal breaks during PPV has been reported to range from 0 to 24%, 3,[5][6][7][8][9][10][11][12][13] with post PPV retinal detachment occurring in 0-15.8%. 3,[7][8][9][10][11][12][13][14][15][16][17] Unlike previous studies, in this study, the data are prospectively collected and the cases were matched to controls without iatrogenic breaks to establish the frequency, and risk factors for intraoperative iatrogenic retinal breaks in the largest reported series of patients undergoing PPV.…”

Section: Introductionmentioning

confidence: 99%

The incidence and the risk factors for iatrogenic retinal breaks during pars plana vitrectomy

Doğramacı

Lee

Williamson

2012

Eye

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Purpose To establish the frequency and the risk factors for iatrogenic retinal breaks during three-port pars plana vitrectomy (PPV). Methods A total of 2471 PPV operations were included in the study. The study period was between 2001 and 2010, all the data were entered in an electronic patient record database. All 270 consecutive eyes of 270 patients developing iatrogenic retinal breaks during primary PPV were matched to 270 controls. Univariate and multivariate analysis were performed to establish the risk factors. Results The median age of the patients with iatrogenic breaks was 60.06 years; male to female ratio was 140/130. The overall frequency of iatrogenic retinal breaks was 10.09%. The frequency of iatrogenic retinal breaks for eyes undergoing PPV for tractional retinal detachment (TRD) was 32.45%. The lens status was phakic in 79.6% of the eyes, with iatrogenic breaks compared with 34.4% of the eyes in control group (Po0.001). Posterior vitreous was attached in 58.9% of the eyes with iatrogenic breaks compared with 50.4% of the eyes in control group (P ¼ 0.04). Internal limiting, epiretinal, proliferative, or fibrovascular membrane removing manoeuvers were performed in 71.1% of the eyes with iatrogenic breaks compared with 61.9% of the eyes in control group (P ¼ 0.052). Conclusion Eyes undergoing PPV for TRD had significantly higher frequency of iatrogenic retinal breaks compared with other subgroups (P ¼ 0.0001). Phakia and absence of PVD were found to be risk factors for iatrogenic retinal breaks.

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“…Some of the breaks found in the present study were iatrogenic and created by the induced posterior vitreous detachment. It is a known complication Park et al 1995) difficult to avoid but easy to treat during operation. In spite of thorough peripheral vitrectomy, careful scleral depression of the pars plana as Freeman (1998), among others, recommended, treatment of a schisis with cryotherapy in one eye and of a retinal tear with endolaser in another eye, retinal detachments occurred 7 weeks postoperatively in these two eyes.…”

Section: Discussionmentioning

confidence: 99%

“…In both cases the macular hole remained closed. Retinal detachments have earlier been reported in up to 11-14% after macular hole surgery and usually secondary to peripheral retinal breaks (Park et al 1995;Banker et al 1997). The reason for the development of proliferative vitreoretinopathy in two eyes is unclear, but earlier described (Tornambe et al 1997).…”

Section: Discussionmentioning

confidence: 99%

Macular hole surgery without routine membrane excision or use of adjuvants

Byhr

Lindblom

2000

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: To present results of macular hole surgery without adjunctive treatment or routine membrane dissection, but with a long duration tamponade. Methods: Fifty-one consecutive eyes underwent surgery with vitrectomy. Membrane peeling was performed only when traction was obvious. Pure perfluoropropane gas was injected as a tamponade followed by prone positioning for two weeks. All eyes were examined with scanning laser ophthalmoscopy (SLO) before and after surgery. Results: The macular hole was closed successfully in 48 eyes (94%) after one procedure. Visual acuity improved to 0.50 or more in 18 eyes (35%). Improvement of two or more lines was achieved in 35 eyes (69%). Two eyes developed retinal detachments and two eyes showed post-operative visual field defects previously reported after macular hole surgery. Conclusion: In this series the results and complication rates compare favourably with other reports of macular hole surgery. However, in contrast to many previous studies, membrane peeling was not done. The extent and long duration of the gas tamponade was thought to be important for the surgical success.

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Posterior Segment Complications after Vitrectomy for Macular Hole

Cited by 159 publications

References 28 publications

Preoperative measurements of macular hole with scanning laser ophthalmoscopy. Correlation with functional outcome

Preoperative measurements of macular hole with scanning laser ophthalmoscopy. Correlation with functional outcome

The incidence and the risk factors for iatrogenic retinal breaks during pars plana vitrectomy

Macular hole surgery without routine membrane excision or use of adjuvants

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