Changes in the anterior segment of the eye following uncomplicated pars plana vitrectomy. A review

Kopecký, A; Němčanský, Jan

doi:10.5507/bp.2019.014

Cited by 5 publications

(5 citation statements)

References 41 publications

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“…In particular, Friberg et al mentioned an ECD reduction of 14.1% in patients who underwent vitrectomy with concurrent lensectomy and scleral buckle, while the percentage declined to 7.7% in those who experienced solely vitrectomy and lensectomy (11). Furthermore, in diabetic patients, ECD deterioration was 16.5% in cases who underwent vitrectomy along with lensectomy as opposed to 9.4% in those who experienced only vitrectomy (12). It is a speculation that the ECD depletion might have been higher in the former studies on account of the more sizable instruments and obsolete vitrectomy machines.…”

Section: Discussionmentioning

confidence: 99%

25G Pars Plana Vitrectomy-Lensectomy and Sulcus IOL Implantation for Patients with Cataract and Cornea Guttata

GOTZARIDIS,

CHRISTOU,

PATEL

et al. 2024

Maedica

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Introduction: Corneal guttata is a non-inflammatory progressive decline of endothelial cell density (ECD)which represents an early clinical feature of Fuch's dystrophy. In patients with corneal guttata, the relative risk for corneal transplantation after phacoemulsification has been found to be 68.2 times higher than in those without it. In the present study, five patients with corneal guttata underwent 25G pars plana vitrectomy (PPV) with concurrent lensectomy and intraocular lens (IOL) implantation in the sulcus. The aim of the present study is to investigate whether this technique has a less damaging effect on endothelial cells as compared to standard phacoemulsification.Methods: This retrospective case series study was conducted at "My Retina" Athens Eye Centre, Greece. Five patients with moderate to dense cataract and clinical signs of corneal guttata were included. All patients had ECD measurement prior to and after surgery. The operation included 25-gauge pars plana vitrectomy (PPV) with subsequent lensectomy and a three-piece IOL implanted in the sulcus with intact anterior capsule.Results: The mean value of ECD was 1157.8±237.51 cells/mm 2 preoperatively and 1118.2±227.42 cells/mm 2 postoperatively, indicating a 3.4% reduction from initial values. Retinal detachment was not observed on any of the operated patients after surgery. The IOL was well centered to the sulcus in all patients. Iatrogenic retinal tears were identified in one patient and were treated with laser retinopexy and SF6 gas tamponade.Conclusions: Our results show that PPV along with lensectomy through fragmatome may cause less corneal decompensation than femtosecond laser-assisted cataract surgery (FLACS) or phacoemulsification, especially in patients with corneal guttata. Therefore, reducing the risk for possible future corneal transplantation.

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Section: Discussionmentioning

confidence: 99%

25G Pars Plana Vitrectomy-Lensectomy and Sulcus IOL Implantation for Patients with Cataract and Cornea Guttata

GOTZARIDIS,

CHRISTOU,

PATEL

et al. 2024

Maedica

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“…To the authors' knowledge, this is the first description of this complication after PPV. 2 Significant corneal opacities may necessitate excision before retinal detachment repair. In this case, the pigmented opacity persisted despite the cessation of face-down positioning, and pathology revealed that the pigment was located intracellularly within RPE cells, precluding removal by aspiration.…”

Section: Discussionmentioning

confidence: 99%

Corneal Pigment Opacity From Face-Down Positioning After Pars Plana Vitrectomy, Treated With Descemet Stripping Only Technique

Yung

Lee

Chow

et al. 2022

Cornea

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The purpose of this study was to report a case of corneal opacity resulting from pigment deposition after face-down positioning, which was treated with Descemet stripping only (DSO) to enable concurrent pars plana vitrectomy (PPV) for retinal detachment repair. Methods:A 79-year-old man with a history of Fuchs endothelial dystrophy and retinal detachment presented for the repair of recurrent retinal detachment and evaluation of a central corneal opacity. Results:The patient was found to have significant corneal endothelial pigment deposition obscuring the view to the fundus. A repeat macula-involving retinal detachment was visualized on limited fundoscopic examination and confirmed using ultrasonography. The patient subsequently underwent combination scleral buckle, DSO, and PPV. DSO achieved corneal clarity for the entire duration of the PPV and allowed for the necessary postoperative face-down positioning. Immunohistochemistry of the corneal specimen revealed deposition of retinal pigment epithelium as the origin of the pigment opacity. The corneal edema cleared at postoperative month 4, and the retina remained attached, resulting in an improvement of visual acuity from counting fingers preoperatively to 20/70.Discussion: This is, to the best of our knowledge, the first case describing the formation of a corneal endothelial opacity because of retinal pigment epithelium deposition associated with face-down positioning after PPV for retinal detachment. DSO is a minimally invasive, viable alternative to endothelial keratoplasty or temporary keratoprosthesis placement for the clearance of focal corneal endothelial opacities for PPV.

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“…In general, surgery can be considered a form of trauma, which naturally leads to an inflammatory reaction [ 13 ]. This suggests that changes to the eye surface may occur after PPV, although we know that PPV does not affect the anterior segment in the long term [ 11 ]. However, we know from clinical practice that even uncomplicated PPV causes, for example, chemosis and conjunctival hyperaemia.…”

Section: Discussionmentioning

confidence: 99%

“…Possible eye changes following the operation (e.g. intraocular pressure, corneal thickness or other anterior segment changes) are reported as temporary [ 11 ]. Osmolarity examinations were carried out with the TearLab® instrument on both eyes always before surgery (on the day of the surgery or the preceding day), then after 10 days (± 2 days) and after 30 days (± 3 days).…”

Section: Methodsmentioning

confidence: 99%

Changes in tear film osmolarity after 25G+ PPV

2020

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Background The aim of our study was to assess changes of tear film osmolarity after micro-incision 25G+ pars plana vitrectomy (PPV) in a prospective study. Methods The group consisted of 21 patients (17 women, 4 men) with an average age of 70,52 years [48; 85]. All patients underwent 25G + PPV surgery due to a disorder of the vitreomacular interface (macular hole or epimacular membrane). Only patients who did not use artificial tears before the surgery and who had not been diagnosed with dry eye syndrome at ours or another institution were included in the study. Except cataract surgery, all ocular surface diseases, intraocular diseases, trauma or surgery were exclusion criterias. Tear film osmolarity was measured in both eyes in every patient before surgery, 10 days after surgery and 30 days after surgery. A paired test was used for statistical evaluation. Results No statistically significant change in osmolarity was found in the operated eyes (p > 0.05). No statistically significant changes in time (p > 0.05) were found when both eyes were compared. There were no postoperative complications or failure to observe the study protocol. Conclusion Micro-incision 25G + PPV does not affect the osmolarity of the tear film.

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Changes in the anterior segment of the eye following uncomplicated pars plana vitrectomy. A review

Cited by 5 publications

References 41 publications

25G Pars Plana Vitrectomy-Lensectomy and Sulcus IOL Implantation for Patients with Cataract and Cornea Guttata

25G Pars Plana Vitrectomy-Lensectomy and Sulcus IOL Implantation for Patients with Cataract and Cornea Guttata

Corneal Pigment Opacity From Face-Down Positioning After Pars Plana Vitrectomy, Treated With Descemet Stripping Only Technique

Changes in tear film osmolarity after 25G+ PPV

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