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Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article describes three cases of rhegmatogenous retinal detachment associated with regressed retinoblastoma. Retinal breaks were found at the edge of the tumor scar. Conservative therapy was used for treatment. It notes that closure of the irregularly shaped retinal tear at the edge of tumor scar was contributed by vitrectomy and scleral buckling.

The article describes the case of a 62-year-old patient who underwent two 23-gauge vitrectomies. During the patient's presentation at the clinic, visual acuity was assessed, and other examinations include fundus biomicroscopy, retinal imaging by autofluorescence, and spectral domain optical coherence tomography. It notes that during the follow-up visit, his best-corrected visual acuity improved from 5 to 45 Early Treatment of Diabetic Retinopathy Study letters.

The article describes the case of an 80-year-old Spanish who woman who had 23-gauge transconjunctival sutureless vitrectomy. She was presented to the clinic for postoperative ocular examination with irreversible, refractory low intraocular pressure of unknown cause. It notes that following foreign body extraction, her pressure rose to normal. Three weeks following the surgery, her visual acuity did not improve.

The article focuses on diagnostic vitrectomy in inflamed eyes as an option when non-surgical approaches are inadequate. Topics discussed include indications for urgent vitrectomy, early surgery in acute retinal necrosis (ARN) to reduce detachment risk, and elective vitrectomy performed on eyes with intermediate uveitis. Also mentioned are principles applying to elective and therapeutic pars plana vitrectomy (PPV) for uveitis, indications for diagnostic vitrectomy, and chorioretinal biopsy.

The article discusses vital dyes used in chromodissection of the vitreoretinal interface. Topics addressed include the use of colored dyes to selectively visualize layers at the vitreoretinal interface, the occurrence of localized, partial or total posterior vitreous detachment (PVD), and challenges to effective membrane peeling. Also mentioned are fluorescein's staining of the vitreous, a dual membrane coloring agent released by Dutch Ophthalmic, and intraoperative staining techniques.

The article aims to explain the techniques for small-gauge pars plana vitrectomy in the management of retained lens material after cataract surgery. It discusses the improvements in small-gauge instrumentation, preoperative considerations for small and large fragments, trocar systems and sclerostomies including trocar positioning. Also discussed are fragmatome and intraoperative technique, new intraoperative techniques, and intraocular pressure and hypotony.

The article explores the performance of vitreoretinal surgery in a doctor's office. It offers information on the developments which studied the feasibility of office-based vitrectomy and its future. It also discusses the requirements for procedure room and equipment such as the vitrectomy unit, microscope and viewing system. Also discussed are three surgical cases performed by the authors. Cost-benefit analysis is also discussed.

The article presents a series of retrospective, interventional case report of patients diagnosed with Staphylococcus lugdunensis endophthalmitis after intravitreal injection. Information is given on the symptoms of endophthalmis developed by three patients after intravitreal injection. It also describes the treatment given to the patients, including vitreous tap and injection of endophthalmitis, vancomycin, and vitrectomy.

An interview with several experts in medicine about the functionality, efficiency and portability of VersaVIT machine for vitrectomy is presented. Doctors Derek Y. Kunimoto, Geeta A. Lalwani and Byron Ladd explain their primary considerations when purchasing a vitreoretinal surgery system for their facility. Doctors Rohit Ross Lakhanpal and Charles C. Wykoff discuss what is more important to them, capital or operating expense.

The article discusses the significance of the implementation of vitrectomy for the treatment of diabetic macular edema including an increase in the clearance of intravitreally injected medication, and remarkable results in macular thinning. The DRCR.net study stipulates the vitrectomy cases may differ due to patient selection. The therapy may prove to be more practical than anti-vascular endothelial growth factor injections as it is less expensive.

The article presents the innovation in cutter design employed in the vitrectomy system influencing the vitreous flow. The various characteristics of the cutter to be considered include its physical dimension, effect of the instrument size on tissue attraction, and the influence of the instrumentation gauge on rigidity. While there may be continuous development in the vitreoretinal operating room, the objective is the safest and most efficient elimination of the vitreous.

The article presents a comparison of portable vitrectors including the Intrector from Insight Instruments, Inc., VersaVit from Synergetics, and the ProCare Plus Vitrectomy System from VisionCare Devices, Inc.

The article highlights the criteria for pars plana vitrectomy which is done early in the course of a case of nonproliferative diabetic retinopathy with vision-compromising diabetic macular edema (DME). The proposed qualities of treatment for DME include efficacy, durability, availability, low cost, the need for frequent examinations, and safety. It also contrasts the important characteristics of anti-vascular endothelial growth factor (VEGF) therapy with those of vitrectomy.

The article focuses on the occurrence of postoperative vitreous cavity hemorrhage (POVCH) after diabetic delamination surgery. It states that persistent hemorrhage can occur from sclerostomies and clot lysis. It mentions preventive strategies to prevent POVCH including the removal of posterior vitreoretinal traction, ensuring that there is adequate hemostasis during vitrectomy and employing deep indentation to remove blood and reduce penetration of sequestered red blood cells.

Abstract: Complex retinal detachment includes proliferative vitreoretinopathy, traction retinal detachment, giant retinal breaks, and a subset of retinal detachments associated with trauma. These situations present a particular challenge to retinal reattachment procedures. Specific intraoperative and postoperative vitreoretinal techniques may facilitate effective repair of complex cases. The author present a review of vitrectomy techniques, microsurgical instrumentation, and postoperative management with intravitreal tamponade agents. Many techniques and tools are required to repair complex retinal detachments; a vitreoretinal surgeon must master all the described techniques and utilize flexible decision-making. A 25-gauge, sutureless vitrectomy without scleral buckling is the best option for complex retinal detachments. [Copyright &y& Elsevier]

The article presents a comprehensive review of the advances in illumination for modern vitreous surgery. Improved light sources, such as xenon light and mercury vapor light bulbs were introduced to compensate for the insufficient brightness of illumination through small-gauge light probes. Several new light probes have been developed to achieve wide angle endoillumination and to minimize wide-angle illumination-induced glare, such as the chandelier endoillumination.

The article focuses on closed eye pars plana vitrectomy pioneered by Robert Machemer. It mentions that recent advances have been made on pars plana vitrectomy with the three-port, 20 gauge system. It reveals that retina surgeons today prefer to use transconjunctival microincision vitrectomy surgery (MIVS) with 23-g or 25-g instrumentation on simple vitreoretinal pathologies and complex cases. The theoretical advantages of transconjunctival MIVS for diabetic retinopathy are also examined.

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article discusses the preoperative, intraoperative, and postoperative aspects of transconjunctival vitrectomy surgery techniques. It describes the complications involved in the technique and presents strategies for the risks' mitigation. It details the considerations involved in the entire procedure to help surgeons minimize the risks associated with transconjunctival/smaller-gauge vitrectomy surgery.

Abstract: Cataract surgery is routinely performed under local anaesthesia. With modern surgical techniques, adequate operating conditions can often be provided by topical anaesthesia alone. For more complex procedures and for prolonged operations such as vitreo-retinal surgery a local block is required. Historically, the sharp needle techniques of retrobulbar and peribulbar eye block have been used. However, the occurrence of rare but sight-threatening complications such as retrobulbar haemorrhage and globe perforation have led to the adoption of the technique of sub-Tenon’s block, which avoids the use of sharp needles. A thorough knowledge of ocular anatomy is essential before proceeding with any eye block technique. Patients who receive local anaesthesia for ocular surgery require careful preoperative assessment and stabilization of concomitant medical conditions. The intended procedure should be explained to the patient to ensure their cooperation and reduce anxiety. [ABSTRACT FROM AUTHOR]

Summary: Many patients presenting for V-R surgery are elderly with a high incidence of associated medical conditions. Thorough preoperative assessment is essential especially for those scheduled for general anaesthesia. Patients on anticoagulants and antiplatelet drugs scheduled for V-R surgery should continue their routine medication. However, where there are specific concerns, the anaesthetist, surgeon and patient should discuss the risks and benefits of continuing their routine medication to agree an acceptable approach. Local anaesthetic techniques are now far more commonly used than general anaesthesia for V-R surgery. Clinicians must recognize the limitations and contraindications of both approaches. Whenever local anaesthetic techniques are used, attention to small details can make a huge difference to patient comfort. This often entails meticulous patient positioning and clear lines of communication between patient and the theatre team. Sometimes, sedative drugs are beneficial to patient care. Careful patient monitoring is recommended during V-R surgery because of the darkened theatre environment, the age and associated medical conditions of many of these patients, and the risk of precipitating abnormal cardiac rhythms from drugs and the oculocardiac reflex. [Copyright &y& Elsevier]

The article presents a case study on a branch retinal artery occlusion with pars plana vitrectomy and removal of the retinal arterial embolus. A 70-year old diabetic and hypertensive woman was presented with retinal artery occlusion and laboratory evaluations revealed an acute lacunar infarcts. The case illustrated an experience with vitreous surgical techniques of embolus extraction with a branch retinal artery occlusion and ophthalmoscopically visible embolus.

The article presents a case study on the association of toxoplasmosis gondii in focal retinochoditis and vitritis in large B-cell and primary intraocular lymphoma. A 79-year old woman was presented for treatment of persistent vitritis and recurrent ocular toxoplasmosis through vitrectomy. The study found that T. gondii caused the lymphoproliferation and development of primary intraocular lymphoma.

Abstract: Background: Vitreous substitutes presently in use for intraoperative tamponade are perfluorocarbon liquids (PFCL) and for post operative tamponade are silicon oil (SO), sulphur hexafluoride (SF6) and perfluorocarbon gas (PFC). Several factors are important for a thorough understanding of each of these vitreous substitutes. The absorption or necessity for removal, indications for use (including clinical studies and special surgical methods), additives and complications of use have to be considered. Methods: Three port standard pars plana vitrectomy was performed in 60 consecutive cases requiring intra-vitreal intervention. PFCL was used intra-operatively in 30 cases (PFCL group and X group). The eyes were implanted with SO (silicon oil subgroup), PFC (C3F8 sub-group) and SF6 (SF6 sub-group) in twenty cases each. Apart from best corrected visual acuity (BCVA), the retinal status and the longevity of gas when used, changes and reaction in both the anterior and posterior segments were noted. Result: The difference of postoperative BCVA in the PFCL and non-PFCL groups was statistically significant with p<0.001. In both the PFCL and non-PFCL groups the difference between preoperative and postoperative BCVA was statistically significant with p<0.0001. All three vitreous substitutes studied are effective given the case where they had been utilised. Conclusion: PFCL is invaluable in the management of complicated retinal detachment (RD). Where a vitreous microsurgery is indicated, the visual outcome is good. SF6 is useful for short-term tamponade. Silicon oil and C3F8 are useful for longer tamponade. [Copyright &y& Elsevier]

The article evaluates a 27-gauge vitrectomy instrument used for microincision vitrectomy surgery (MIVS) aiding faster visual recovery and reduced postoperative inflammation form medical companies Alcon and Dutch Ophthalmic.

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article gives advice on how ophthalmologists make a decision about whether and when to adopt a novel idea or technique in ophthalmology. It relates the previous concern of ophthalmologists regarding the use of vitrectomy. It presents issues that ophthalmologists should keep in mind when they contemplate novel practices.

The article providers a historical overview of microincision surgery and tips for conducting sutureless microincisional vitrectomy. During a microincision vitrectomy procedure, sclerotomies are made through the conjuctiva without conjunctival suturing needed at the completion of surgery. When performing a microincision vitrectomy, angled sclerotomy is preferred over straight incision.

The article focuses on the PUREPOINT&reg 532 nanometer Thin Disc Laser feature of Alcon Laboratories Inc.'s CONSTELLATION® Vision System for vitrectomy surgery. The technology improves intra-operative laser delivery targeted to increase surgeon control and enhance patient safety. One of the main features that significantly enhance the employment of the laser system is the integration of a multi-function foot pedal shifts laser control from the circulating nurse to the surgeon.

The author relates the features of Alcon Laboratories Inc.'s CONSTELLATION® Vision System for vitrectomy surgery and his clinical experience in using the system. He highlights the key features and applications of the CONSTELLATION® Vision System. He believes the CONSTELLATION® Vision System's postsurgical V-LOCITY® Efficiency Components are most valuable and revolutionary.

The article summarizes an approach to managing postoperative vitreous hemorrhage (POVH), a complication of diabetic vitrectomy, and offers evidence-based tips that may help reduce the incidence of POVH. The importance of the diagnosis of fibrovascular ingrowth (FVI) in eye with nonclearing and later onset POVH is explained, as well as the use of bevacizumab in treating POVH. Bleeding from blood vessels is one of the causes of early POVH and mechanisl tamponade of the damaged vessels by injections of air has been attempted.

The article provides information on macular surgery and enzymatic manipulation of the vitreous cavity. Components needed for enzymatic manipulation of the vitreous include vitreous liquefaction and complete vitreoretinal interface separation. Plasmin and microplasmin are allegedly able to achieve these goals without causing damage to the retina. Implications of chemical vitrectomy include relief of vitreoretinal traction, alteration of the influx of molecules and change in the oxygen levels in the vitreous cavity.

The article presents a case report of bacterial endophthalmitis associated with a retained small-gauge vitrectomy trocar in a 66-year-old woman who underwent 25-gauge vitrectomy surgery for an epiretinal membrane.

The article presents a retrospective interventional case study of a 58-year-old pseudophakic female patient who reported the reopening of a macular hole 12 years after successful surgical closure. It describes the medical history of the patient and the procedures she underwent including pars plana vitrectomy (PPV), epiretinal membrane peeling gas-fluid exchange and seven days of face-down positioning. It discusses reasons macular holes can reopen so late after initial successful closure.

The article describes the case of an 85-year-old female patient diagnosed with macular hole-related retinal detachment. The patient initially complained of sudden loss of vision in the right eye. The administration of full ocular examination and spectral-domain optical coherence tomography revealed presence of subretinal fluid, macular hole, and vitreous traction. The treatment options administered include pars plana vitrectomy and internal limiting membrane (ILM) peel.

The article provides information on illumination as an element in vitreoretinal surgery with focus on the Stellaris PC (Procedural Choice) Vision Enhancement System. Aiming to provide safe light, Stellaris PC was created with attention to the fundamental and functional elements of the photopic responses of the eye. The system also considers versatility as it includes dual lamps and three filters.

The article discusses the case of a 26-year-old man with a 2-year history of gradually worsening vision in the right eye after a metal-on-metal hammering incident. The patient was taken for combined pars plana and transconjunctival sutureless vitrectomy with intraocular foreign body (IOFB) removal using a magnetized 25-gauge intraocular pick, without enlarging a sclerotomy wound. The said pick is a useful adjunct in the management of selected patients with a magnetic intraocular foreign body.

The article discusses the obstacles and advantages of converting from 20-gauge vitrectomy surgery to microincisional vitrectomy surgery (MIVS). Some of the original drawbacks to MIVS included flexible instruments, poor illumination and rudimentary special instruments which limited the number of cases to be treated with MIVS to simple indications. Meanwhile, switching to MIVS reportedly has advantages like quicker results, more efficient surgeries and faster healing.

The aim of this study is to evaluate vital dyes »Brilliant Blue G« (BBG) and »Membrane Blue Dual« (MBD) for intraoperative staining of the inner limiting membrane (ILM) during vitrectomy for macular hole (MH). Retrospective, comparative case series on 18 eyes with macular holes who underwent »23 and 25 gauge« pars plana vitrectomy. Main outcome measurements were staining intensity and characteristics, visual acuity, visual field, OCT measurements and complications over a period of 6 months. With the help of BBG and MBD succesfully was removed complete ILM in 14 eyes. Postoperative visual acuity was improved in 12 patients, unchanged in 2 patients and worse in 4 patients. Central retinal thickness showed significant postoperative reduction with closure of macular hole. OCT values range were from -10 to -250 mm. No visual field defects and no adverse effects were found. BBG and MBD sucesfully identificate internal limiting membrane during vitrectomy for MH. Good anatomical and functional results are achieved with the use of both vital dyes. [ABSTRACT FROM AUTHOR]

The article discusses the case of a 28-year-old woman with multiple and large retinal capillary hemangiomas who was subjected to pars plana vitrectomy (PPV) along with relaxing retinectomy in genotypically confirmed von Hippel-Lindau disease (VHL). Two years after her surgery, her retina remained reattached without tumor recurrence. Researchers saw a missence Arg167Trp mutation at exon 3 of the VHL gene in both blood and retina specimens.

The article presents a case study on histologic and immunohistochemical findings of an epiretinal membrane in hamartoma of the retina and retinal pigment epithelium. A 17-year old young woman was presented with a combined hamartoma of the retina and underwent vitrectomy and membranectomy. The study found that immunostains were suggestive of admixture of the retinal pigment epithelium and retinal elements.

The article presents a case study on neurosensory retinal detachment of the macula in retinal phototoxicity using optical coherence tomography. A 53-year old man was presented with pars plana lensectomy, core vitretomy, and intraocular lens implantation in the right eye. The case found that retinal phototoxicity in microscopic light induction may be associated with a neurosensory detachment.

The article presents a case study on endophthalmitis after 20-gauge vitrectomy caused by Serratia marcescens. An 86-year old woman was presented with chronic rhegmatogenous retinal detachment and treated with standard 20-gauge vitrectomy. The case found that endophthalmitis caused by S. marcescens resulted in poor visual prognosis with in vivo clinical resistance to antibiotic therapy despite the in vitro culture.

The article presents a case study on chronic hypotony and posterior uveal cleft associated with a fluocinolone acentonide implant following a vitrectomy and cryotherapy. A 57-year old woman with idiopathic uveitis was presented and treated with pars plana surgery and intravitreal triamcinolone acetonide. The case found that posterior uveal cleft may cause hypotony in a complicated fluocinolone acetonide implant and the researchers demonstrated the proper surgical techniques.

The article presents a comparison of two vitrectomy surgery procedures, transconjunctival sutureless vitrectomy (TSV) and traditional pars plana vitrectomy. Since the introduction of TSV in 2002, the procedure has evolved to be the technique used by a majority of vitreoretinal surgeons in the U.S. The 20-gauge three-port pars plana vitrectomy was introduced 30 years earlier, which remained the standard up until the introduction of the TSV.

The article discusses the advantages of using a transconjunctival sutureless microincision vitrectomy surgery (MIVS) for the repair of retinal detachment. These include the benefit of having a suture-less surgery and a shorter surgical time, less occurrence of inflammation, and a reduced risk of postoperative corneal astigmatism. According to the article, the acceptance of MIVS by vitreoretinal surgeons are prompted by advances in the technology of vitreous systems and the expanding array of small-gauge surgical instruments.

Abstract: Background: Chronic rhegmatogenous retinal detachment behaves like proliferative vitreo-retinopathy (PVR) even without evidence of the same. Surgery could be done either with conventional buckling procedures where the extent of buckling is determined by the number and location of the breaks or by primary vitreous surgery. In this study these cases were managed with primary 360°encircling broad buckle without a vitreous procedure. Methods: 210 eyes, with rhegmatogenous retinal detachment of more than six months duration and with PVR up to C3 (CP3 focal) were subjected to buckling surgery. Trans-scleral cryopexy of the breaks, 360°encircling buckle with a 276 – 279 tire and subretinal fluid drainage was performed. Result: Most (85.74%) of the eyes showed anatomical retinal re-attachment. Conclusion: Primary broad encircling buckling can be conducted successfully in cases of long standing retinal detachment. [Copyright &y& Elsevier]

The author offers his opinion on the benefits and disadvantages of sutureless small-gauge vitrectomy. He thinks that the most meaningful benefit of small-gauge vitrectomy is better instrument tip design to allow surgeons to cut and delaminate membranes without the need for scissors. Although he agrees that patients are more comfortable postop and recover vision faster with small-gauge surgery, this is only relevant for simple cases such as pucker removal.