Endoscope-assisted pars plana vitrectomy in severe ocular trauma

Abstract

Purpose To report the results of pars plana vitrectomy (PPV) assisted by ophthalmic endoscope (OE) in severe ocular trauma cases which are unsuitable for PPV using wide-angle contact/non-contact lens due to media haze and/or disorganised anterior segment. Methods Prospective, non-comparative, interventional case series. Main outcome measured was anatomic status of the retina postoperatively, secondary outcome measured was functional status regarding vision, intraocular pressure and control of inflammation in cases of endophthalmitis. Results Fifty trauma cases were included in the study. Out of these, 43 eyes had open globe injuries (32 eyes without intraocular foreign body (IOFB), and 11 eyes with retained IOFB), and seven eyes had post-traumatic endophthalmitis. In the open globe injury group, 36 (83.7%) eyes reported improvement in vision. In endophthalmitis group, five eyes showed improvement in vision. Conclusions OE provided a clear view to conduct PPV in select trauma cases where delay in surgery due to hazy media or due to non-availability of donor cornea for simultaneous penetrating keratoplasty can lead to severe proliferative vitreoretinopathy changes.

Comparison of endoscopic-assisted and temporary keratoprosthesis-assisted vitrectomy in combat ocular trauma: experience at a tertiary eye center in Turkey

“…The high cost of the instruments, limited field of view, and difficulty of bimanual surgery are other limitations. 16 Nonetheless, previous studies have shown that endoscopic vitrectomy improves anatomical and functional outcomes with the capability of earlier intervention and lower rates of proliferative vitreoretinopathy and postoperative retinal detachment. 7,9 Endoscopic-assisted vitrectomy is an effective method for treating the sequelae of COT.…”

“…Moreover, surgical implantation of the TKP prolongs the operative period, and the open-sky stage is associated with a risk of suprachoroidal hemorrhage. 16 Loss of transparency of the corneal graft is another problem when performing combined keratoplasty and vitrectomy. In the present study, 75% of eyes (n = 6) in the TKP group had BCVA worse than 20/200, two cases of which were due to corneal graft failure.…”

Combined endoscopic vitrectomy with pars plana tube shunt procedure

“…Endoscopic visualisation for vitreoretinal surgery was first described in 1986 by Lecoq et al 6. Although rarely used, endoscopic PPV techniques have been described for vitrectomy in eyes with poor fundus view,6–8 including for the management of retained lens fragments and posteriorly dislocated intraocular lens,9 endophotocoagulation for vitreo-retinal diseases,10 management of proliferative vitreoretinopathy,11 12 transscleral suture fixation,13 ciliary body photocoagulation,14 removal of intraocular foreign body,15 retinal detachment repair,16 17 endophthalmitis,18 ocular trauma19 20 and as a diagnostic tool for intraocular devices 21…”

Endoscopy-Assisted Vitrectomy and Membrane Dissection of Anterior Proliferative Vitreoretinopathy for Chronic Hypotony After Previous Retinal Detachment Repair

“…6 Endoscopy-assisted vitreoretinal surgery has been described in cases of eyes with RDs and anterior segment opacities, such as corneal blood staining or band keratopathy, hypotony, ocular trauma with penetrating or perforating injuries, intraocular foreign bodies, retained lens fragments or intraocular lens, complex RD with PVR, subretinal surgery, sulcus fixation of an intraocular lens, and endophthalmitis. [7][8][9][10][11][12][13][14][15][16][17][18][19][20] To the best of our knowledge, outcomes for endoscopy-assisted dissection of anterior PVR for the treatment of hypotony have not been previously reported. Herein, we report a series of patients with hypotony secondary to anterior PVR after previous RD repair who were treated using endoscopic visualization and dissection of anterior membranes.…”