Combined endoscopic vitrectomy with pars plana tube shunt procedure

Shaikh, Adeel H.; Khatana, Anup K.; Zink, Jeffrey M.; Miller, Daniel M.; Petersen, Michael R.; Corrêa, Zélia M.; Riemann, Christopher D.

doi:10.1136/bjophthalmol-2013-304283

Cited by 8 publications

(7 citation statements)

References 26 publications

(18 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the two previously published studies in adult eyes, not surprisingly the underlying diagnoses differed from our pediatric cohort [ 12 , 13 ]. In Tarantola et al, the majority of the 19 eyes (68%) had corneal opacification due to corneal graft failure while the remainder had corneal edema or scar, band keratopathy, or fibrosed pupil.…”

Section: Discussionmentioning

confidence: 62%

“…However, in these eyes limited view from the corneal opacification can preclude standard wide-angle vitrectomy, requiring an endoscopic approach. While endoscopic vitrectomy and GDD placement has been described in adult eyes, there is minimal information in the literature regarding the pediatric population [ 12 , 13 ]. We present, to the best of our knowledge, the largest study of children undergoing this combined approach.…”

Section: Discussionmentioning

confidence: 99%

“…Endoscopy has previously been demonstrated as a viable alternative, allowing for visualization of the posterior segment despite anterior opacities in both children and adults [ 9 – 11 ]. While endoscopic vitrectomy combined with GDD placement has been described in adults, there is a paucity of data regarding this technique in children [ 12 , 13 ]. Thus, we report our experience with this surgical technique, which to the best of our knowledge, is the largest cohort of pediatric patients to date.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Outcomes of combined endoscopic vitrectomy and posteriorly placed glaucoma drainage devices in pediatric patients

2022

View full text Add to dashboard Cite

Background This study aims to describe outcomes of posteriorly-placed glaucoma drainage devices (GDD) with concurrent endoscopic vitrectomy in pediatric patients with glaucoma and corneal opacification. Methods This retrospective case series identified patients under 18 years of age who underwent posteriorly-placed GDD implantation with concurrent endoscopic vitrectomy between 2012 and 2021. Data collected included ocular diagnoses, prior intraocular surgeries, type and position of GDD, surgical complications, and additional surgeries. Preoperative and final visual acuity, intraocular pressure (IOP), number of glaucoma medications, and exam findings were also recorded. Surgical data included type and position of GDD, Success was defined as IOP between 5-21 mmHg without visually devastating complication or need for additional glaucoma surgery. Results Ten patients (14 eyes) with sclerocornea (6), Peters Anomaly (4), corneal decompensation from increased IOP (3), and corneal scar (1) underwent combined endoscopic vitrectomy with posteriorly-placed GDD (Baerveldt (10 eyes), Ahmed (4 eyes)) at 4.6 ± 5.8 years of age. Four eyes of 3 patients remained successful at final follow-up, while 10 eyes of 7 patients required 2.4 ± 1.3 additional surgeries for glaucoma (7) or hypotony (3). Kaplan Meier analysis demonstrated 1- and 2-year survival rates of 36% and 18%, respectively. At final follow-up (3.7 ± 2.4 years), after an average of 4.4 ± 2.4 glaucoma surgeries, 13 of 14 eyes had obtained IOP control on significantly fewer (p<0.0001) IOP-lowering medications. Additional complications included retinal detachment (2), chronic corneal graft failure (2), phthisis (1) and band keratopathy (1). Conclusions Management of glaucoma in pediatric eyes with corneal opacification is challenging and often requires multiple surgeries. A combined endoscopic vitrectomy and posteriorly placed GDD is a viable technique to establish aqueous humor outflow. Although the success rate is low, this surgical approach may be useful in ultimately obtaining IOP control and preserving vision in these complex eyes.

show abstract

Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Outcomes of combined endoscopic vitrectomy and posteriorly placed glaucoma drainage devices in pediatric patients

2022

View full text Add to dashboard Cite

show abstract

“…48 And has been suggested to offer better long-term visual outcomes for placement of a pars plana tube shunt in the setting of complex anterior segment disease. 49 A recent report describes the successful hybridization of ocular endoscopy with a 3D visualization system to manage vitreoretinal disease. 50 Despite clearly defined advantages, ocular endoscopy utilization remains low in part due to the ergonomic challenges of multiscreen off-axis viewing away from the main surgical field.…”

Section: Discussionmentioning

confidence: 99%

<p>Consolidation of Imaging Modalities Utilizing Digitally Assisted Visualization Systems: The Development of a Surgical Information Handling Cockpit</p>

Brooks

Kitchens

Stone

et al. 2020

OPTH

Self Cite

View full text Add to dashboard Cite

The management of vitreoretinal cases is ever-evolving, paralleled by rapid advancements in operative imaging modalities. In this article, we describe an advanced application of digitally assisted vitreoretinal surgery (DAVS) that involves the consolidation of pre-existing ancillary imaging technology into a single same-screen viewing platform. Forty-four eyes of 44 patients were operated using same screen simultaneous viewing of the primary three-dimensional high definition (3DHD) surgical field and simultaneous auxiliary video feed viewing of all currently approved ocular endoscopy (n=12), intraoperative optical coherence tomography (iOCT) units (n=24), or computer feeds from the EHR/image management software (n=8). All surgeries were successful with excellent functional and anatomic outcomes. DAVS facilitated same screen viewing of multiple video/information feeds was notable for improved ergonomics, surgical efficiency, and precision when compared to viewing the surgical field and auxiliary video feeds separately. We describe a new concept for the vitreoretinal operating rooma DAVS-based surgical information handling cockpitintegrating FDA approved ocular endoscopy (n=1), microscope-integrated iOCT units (n=3), and one EHR/Image management solution with the primary surgical field 3DHD feed. We suggest same screen viewing of multiple video and other clinical information feeds is a promising modality that may be considered in the management of patients with surgical vitreoretinal disease and should be purposefully incorporated into future iterations of DAVS technology platforms.

show abstract

“…Advantages of endoscopy in cases of media opacity are well established (endophthalmitis, trauma); [19][20][21][22][23] nonetheless, a broader number of indications for endoscopy exists when used as "endoscopy-assisted" vitrectomy. 6,18,[24][25][26][27][28][29] We propose the use of endoscopy to perform a detailed endoscopic revision during SO extraction in complex RDs. In the current era of small-gauge, high-resolution, and digitally-assisted vitrectomy, the potential advantages of endoscopy clearly outweigh the added costs, offering significant advantages, including complete SO removal, lowering of redetachment rates, and improvement of anatomical outcomes in this complex subset of patients.…”

Section: Discussionmentioning

confidence: 99%

Endoscopy-Assisted Vitrectomy Outcomes During Silicone Oil Removal After Complex Retinal Detachment Repair

Vilà

Rampakakis

Rezende

2019

Journal of VitreoRetinal Diseases

View full text Add to dashboard Cite

Purpose: This retrospective study recorded intraoperative findings during silicone oil removal and postoperative anatomical outcomes comparing endoscopy-assisted pars plana vitrectomy (E-PPV) vs pars plana vitrectomy (PPV) alone after proliferative vitreoretinopathy (PVR)-related retinal detachment (RD) repair. Methods: This single-center retrospective study included patients who underwent PPV for silicone oil removal after RD with PVR from July 2009 to January 2017. Patients with diabetic tractional RD, history of trauma, uveitis, or endophthalmitis were excluded. After 2013, an endoscopic visualization system (E2 MicroProbe; Endo Optiks) was used in a nonrandomized fashion. Data collection included reattachment rate, intraoperative endoscopic findings and phthisis rate. Results: Fifty-four eyes of 54 patients were included. The mean participant age was 58.4 ± 12.9 years and 36 (65.5%) participants were male. The mean (± SD) follow-up duration after oil removal was 24.3 ± 20.1 months. E-PPV combined with wide-angle visualization system was performed in 26 (48.1%) of the patients; the surgical management was modified after endoscopic examination in 17 (65.4%) of the cases. Reattachment rate in the E-PPV group was 96.2% compared with 76.0% in the PPV-alone group ( P = .04). Conclusions: E-PPV for silicone oil removal appears to be advantageous for prevention of RD recurrence, thus achieving better reattachment rates. A thorough examination is facilitated by endoscopic visualization and contributory factors for anterior PVR can be identified and treated.

show abstract

Combined endoscopic vitrectomy with pars plana tube shunt procedure

Cited by 8 publications

References 26 publications

Outcomes of combined endoscopic vitrectomy and posteriorly placed glaucoma drainage devices in pediatric patients

Outcomes of combined endoscopic vitrectomy and posteriorly placed glaucoma drainage devices in pediatric patients

<p>Consolidation of Imaging Modalities Utilizing Digitally Assisted Visualization Systems: The Development of a Surgical Information Handling Cockpit</p>

Endoscopy-Assisted Vitrectomy Outcomes During Silicone Oil Removal After Complex Retinal Detachment Repair

Contact Info

Product

Resources

About