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Nick Mamalis - One of the best experts on this subject based on the ideXlab platform.
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diagnosis and management of opacified silicone intraocular lenses in patients with Asteroid Hyalosis
Journal of Cataract and Refractive Surgery, 2015Co-Authors: Ladan Espandar, Liliana Werner, Nick Mamalis, Nisha Mukherjee, Terry KimAbstract:We analyzed 3 calcified silicone IOLs from 2 patients with a history of Asteroid Hyalosis. In both cases, posterior capsule opacification had been diagnosed and a laser capsulotomy performed before referral. Subsequently, both IOLs were exchanged with hydrophobic acrylic IOLs that were placed in the sulcus. The IOL exchange was challenging due to the open capsule. Light microscopy demonstrated that the white deposits on the explanted IOLs formed an almost confluent crust in some areas, interspersed with clear areas on the posterior optic surfaces. The findings in our cases and in other reported cases may affect the choice of IOL in the presence of Asteroid Hyalosis. Also, ophthalmologists may consider deferring laser posterior capsulotomy treatment in a calcified silicone IOL to facilitate an IOL exchange procedure. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.
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calcification of different designs of silicone intraocular lenses in eyes with Asteroid Hyalosis
Ophthalmology, 2010Co-Authors: Jack Stringham, Liliana Werner, Bryan Monson, Raymond Theodosis, Nick MamalisAbstract:Purpose To describe the association between calcification of older and newer designs of silicone intraocular lenses (IOLs) and Asteroid Hyalosis. Design Case series with clinicopathologic correlation. Participants Sixteen silicone IOLs explanted because of decreased visual acuity associated with opacifying deposits on the posterior optic surface. Methods All 16 lenses underwent gross and light microscopic analyses. Selected lenses underwent alizarin red staining or scanning electron microscopy coupled with energy dispersive x-ray spectroscopy for elemental composition. Clinical data in each case were obtained by a questionnaire sent to the explanting surgeons. Clinical data in relation to 111 hydrophilic acrylic lenses explanted because of calcification also were assessed for comparison. Main Outcome Measures Deposit morphologic features and location were evaluated under gross and light microscopy. The calcified nature of the deposits was assessed by histochemical staining and surface analyses. Clinical data obtained included age at IOL implantation, gender, implantation and explantation dates, as well as history of neodymium:yttrium–aluminum–garnet laser treatment. The presence of Asteroid Hyalosis in the affected eye was investigated for the explanted silicone and hydrophilic acrylic lenses. Results The 16 lenses were of 8 designs manufactured from different silicone materials, which were explanted 9.21±3.66 years after implantation. Neodymium:yttrium–aluminum–garnet laser applications performed in 12 cases partially removed deposits from the lens, followed by a gradual increase in their density after the procedures. The presence of Asteroid Hyalosis was confirmed in 13 cases; no notes regarding this condition were found in patient charts in the other 3 cases. The deposits were only on the posterior optic surface of the silicone lenses and were composed of calcium and phosphate. A history of Asteroid Hyalosis was not found in relation to any of the 111 cases of postoperative calcification of hydrophilic acrylic lenses. Conclusions Including this current series, there are 22 cases of calcification of silicone lenses involving 8 designs manufactured from different silicone materials described in the literature. The presence of Asteroid Hyalosis was confirmed in 86.4% of cases. These findings may be added to the list of pros and cons surgeons consider when selecting or recommending an IOL. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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surface calcification of a 3 piece silicone intraocular lens in a patient with Asteroid Hyalosis a clinicopathologic case report
Ophthalmology, 2005Co-Authors: Liliana Werner, Nick Mamalis, Carol R Kollarits, Randall J OlsonAbstract:Objective To illustrate the laboratory findings in a patient with bilateral Asteroid Hyalosis who presented with calcified deposits on a 3-piece silicone intraocular lens (IOL). Design Observational case report. Methods A 76-year-old diabetic woman underwent uneventful cataract surgery in 1994 with implantation of a silicone-optic polypropylene-haptic IOL in the left eye. A neodymium:yttrium–aluminum–garnet (Nd:YAG) laser posterior capsulotomy was performed 2 years after cataract surgery, but persistent whitish deposits were observed on the posterior optic surface of the lens. Over the next 3 years, the opacification increased in the region corresponding to the capsulotomy. The IOL was explanted/exchanged. The right eye had cataract surgery in 1995. The acrylic lens implanted in this eye developed no opacities after 6 years. Main outcome measures Gross, microscopic, and surface analyses of the explanted IOL. Results Gross and light microscopic analyses revealed the presence of confluent crustlike deposits on the central area of the posterior optic surface, as well as Nd:YAG pits. Individual spherules exhibiting a Maltese-cross pattern under polarizing light were also observed. Energy dispersive x-ray spectroscopic analyses demonstrated the composition of the confluent deposits to be similar to hydroxyapatite. Conclusions An association between Asteroid Hyalosis and dystrophic calcification of IOLs has been reported only with silicone plate haptic designs. The material opacifying the 3-piece silicone lens probably was derived from the Asteroid bodies or from the process that results in this vitreous condition. Clinical evaluation of other pseudophakic patients with Asteroid Hyalosis will confirm if this phenomenon is restricted to silicone IOLs.
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surface calcification of silicone plate intraocular lenses in patients with Asteroid Hyalosis
American Journal of Ophthalmology, 2004Co-Authors: Laura M Foot, Liliana Werner, Nick Mamalis, James P Gills, David W Shoemaker, Paul S Phillips, Randall J Olson, David J AppleAbstract:Abstract Purpose To report three cases in which a silicone-plate lens was explanted because of whitish deposits on the posterior optic surface. Design Observational case series with clinicopathological correlation. Patients and methods In the three instances, the deposits were observed at least 2 years after uneventful cataract surgery. All of the patients had unilateral mild Asteroid Hyalosis in the concerned eye. After explantation of the lenses, gross and light microscopic analyses were performed. The posterior optic surfaces of the lenses also underwent scanning electron microscopy coupled with energy dispersive x-ray spectroscopy for analysis of the elemental composition of the deposits. Results Gross and light microscopic analyses revealed well-demarcated areas of whitish deposits on the posterior optic surface of the lenses, as well as multiple pits caused by Neodymium:yttrium aluminum garnet laser treatments. The deposits formed an amorphous layer with a “crustlike” appearance, which was confirmed by scanning electron microscopy. X-ray spectroscopy analyses demonstrated the composition of the deposits to be similar to hydroxyapatite. Conclusions The material opacifying the lenses was probably derived from the Asteroid bodies or from a similar process that results in this vitreous condition. We were unaware of this association between Asteroid Hyalosis and late postoperative dystrophic calcification of silicone lenses.
Liliana Werner - One of the best experts on this subject based on the ideXlab platform.
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diagnosis and management of opacified silicone intraocular lenses in patients with Asteroid Hyalosis
Journal of Cataract and Refractive Surgery, 2015Co-Authors: Ladan Espandar, Liliana Werner, Nick Mamalis, Nisha Mukherjee, Terry KimAbstract:We analyzed 3 calcified silicone IOLs from 2 patients with a history of Asteroid Hyalosis. In both cases, posterior capsule opacification had been diagnosed and a laser capsulotomy performed before referral. Subsequently, both IOLs were exchanged with hydrophobic acrylic IOLs that were placed in the sulcus. The IOL exchange was challenging due to the open capsule. Light microscopy demonstrated that the white deposits on the explanted IOLs formed an almost confluent crust in some areas, interspersed with clear areas on the posterior optic surfaces. The findings in our cases and in other reported cases may affect the choice of IOL in the presence of Asteroid Hyalosis. Also, ophthalmologists may consider deferring laser posterior capsulotomy treatment in a calcified silicone IOL to facilitate an IOL exchange procedure. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.
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calcification of different designs of silicone intraocular lenses in eyes with Asteroid Hyalosis
Ophthalmology, 2010Co-Authors: Jack Stringham, Liliana Werner, Bryan Monson, Raymond Theodosis, Nick MamalisAbstract:Purpose To describe the association between calcification of older and newer designs of silicone intraocular lenses (IOLs) and Asteroid Hyalosis. Design Case series with clinicopathologic correlation. Participants Sixteen silicone IOLs explanted because of decreased visual acuity associated with opacifying deposits on the posterior optic surface. Methods All 16 lenses underwent gross and light microscopic analyses. Selected lenses underwent alizarin red staining or scanning electron microscopy coupled with energy dispersive x-ray spectroscopy for elemental composition. Clinical data in each case were obtained by a questionnaire sent to the explanting surgeons. Clinical data in relation to 111 hydrophilic acrylic lenses explanted because of calcification also were assessed for comparison. Main Outcome Measures Deposit morphologic features and location were evaluated under gross and light microscopy. The calcified nature of the deposits was assessed by histochemical staining and surface analyses. Clinical data obtained included age at IOL implantation, gender, implantation and explantation dates, as well as history of neodymium:yttrium–aluminum–garnet laser treatment. The presence of Asteroid Hyalosis in the affected eye was investigated for the explanted silicone and hydrophilic acrylic lenses. Results The 16 lenses were of 8 designs manufactured from different silicone materials, which were explanted 9.21±3.66 years after implantation. Neodymium:yttrium–aluminum–garnet laser applications performed in 12 cases partially removed deposits from the lens, followed by a gradual increase in their density after the procedures. The presence of Asteroid Hyalosis was confirmed in 13 cases; no notes regarding this condition were found in patient charts in the other 3 cases. The deposits were only on the posterior optic surface of the silicone lenses and were composed of calcium and phosphate. A history of Asteroid Hyalosis was not found in relation to any of the 111 cases of postoperative calcification of hydrophilic acrylic lenses. Conclusions Including this current series, there are 22 cases of calcification of silicone lenses involving 8 designs manufactured from different silicone materials described in the literature. The presence of Asteroid Hyalosis was confirmed in 86.4% of cases. These findings may be added to the list of pros and cons surgeons consider when selecting or recommending an IOL. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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surface calcification of a 3 piece silicone intraocular lens in a patient with Asteroid Hyalosis a clinicopathologic case report
Ophthalmology, 2005Co-Authors: Liliana Werner, Nick Mamalis, Carol R Kollarits, Randall J OlsonAbstract:Objective To illustrate the laboratory findings in a patient with bilateral Asteroid Hyalosis who presented with calcified deposits on a 3-piece silicone intraocular lens (IOL). Design Observational case report. Methods A 76-year-old diabetic woman underwent uneventful cataract surgery in 1994 with implantation of a silicone-optic polypropylene-haptic IOL in the left eye. A neodymium:yttrium–aluminum–garnet (Nd:YAG) laser posterior capsulotomy was performed 2 years after cataract surgery, but persistent whitish deposits were observed on the posterior optic surface of the lens. Over the next 3 years, the opacification increased in the region corresponding to the capsulotomy. The IOL was explanted/exchanged. The right eye had cataract surgery in 1995. The acrylic lens implanted in this eye developed no opacities after 6 years. Main outcome measures Gross, microscopic, and surface analyses of the explanted IOL. Results Gross and light microscopic analyses revealed the presence of confluent crustlike deposits on the central area of the posterior optic surface, as well as Nd:YAG pits. Individual spherules exhibiting a Maltese-cross pattern under polarizing light were also observed. Energy dispersive x-ray spectroscopic analyses demonstrated the composition of the confluent deposits to be similar to hydroxyapatite. Conclusions An association between Asteroid Hyalosis and dystrophic calcification of IOLs has been reported only with silicone plate haptic designs. The material opacifying the 3-piece silicone lens probably was derived from the Asteroid bodies or from the process that results in this vitreous condition. Clinical evaluation of other pseudophakic patients with Asteroid Hyalosis will confirm if this phenomenon is restricted to silicone IOLs.
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surface calcification of silicone plate intraocular lenses in patients with Asteroid Hyalosis
American Journal of Ophthalmology, 2004Co-Authors: Laura M Foot, Liliana Werner, Nick Mamalis, James P Gills, David W Shoemaker, Paul S Phillips, Randall J Olson, David J AppleAbstract:Abstract Purpose To report three cases in which a silicone-plate lens was explanted because of whitish deposits on the posterior optic surface. Design Observational case series with clinicopathological correlation. Patients and methods In the three instances, the deposits were observed at least 2 years after uneventful cataract surgery. All of the patients had unilateral mild Asteroid Hyalosis in the concerned eye. After explantation of the lenses, gross and light microscopic analyses were performed. The posterior optic surfaces of the lenses also underwent scanning electron microscopy coupled with energy dispersive x-ray spectroscopy for analysis of the elemental composition of the deposits. Results Gross and light microscopic analyses revealed well-demarcated areas of whitish deposits on the posterior optic surface of the lenses, as well as multiple pits caused by Neodymium:yttrium aluminum garnet laser treatments. The deposits formed an amorphous layer with a “crustlike” appearance, which was confirmed by scanning electron microscopy. X-ray spectroscopy analyses demonstrated the composition of the deposits to be similar to hydroxyapatite. Conclusions The material opacifying the lenses was probably derived from the Asteroid bodies or from a similar process that results in this vitreous condition. We were unaware of this association between Asteroid Hyalosis and late postoperative dystrophic calcification of silicone lenses.
Tatsuro Ishibashi - One of the best experts on this subject based on the ideXlab platform.
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retinitis pigmentosa associated with Asteroid Hyalosis
Retina-the Journal of Retinal and Vitreous Diseases, 2010Co-Authors: Yasuhiro Ikeda, Toshio Hisatomi, Yusuke Murakami, Masanori Miyazaki, Ri Ichiro Kohno, Hiroshi Takahashi, Yasuaki Hata, Tatsuro IshibashiAbstract:Background:Asteroid Hyalosis (AH) is a condition in which cream-colored or white spherical particles are suspended in the vitreous body. Asteroid Hyalosis is considered not to cause decreased vision or any other visual symptoms except in rare cases. There have been a few reports of AH in patients wi
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anatomical findings of vitreoretinal interface in eyes with Asteroid Hyalosis
Graefes Archive for Clinical and Experimental Ophthalmology, 2009Co-Authors: Yasutaka Mochizuki, Ri Ichiro Kohno, Yasuaki Hata, Takeshi Kita, Yuhei Hasegawa, Shuhei Kawahara, Ryoichi Arita, Tatsuro IshibashiAbstract:Purpose To investigate the anatomical features of vitreoretinal interface in eyes with Asteroid Hyalosis (AH) with optical coherence tomography (OCT) and intravitreal triamcinolone acetonide (TA) during vitreous surgery.
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posterior vitreous cortex characteristics of an eye with Asteroid Hyalosis
Retinal Cases & Brief Reports, 2008Co-Authors: Yasutaka Mochizuki, Toshio Hisatomi, Yasuaki Hata, Shuhei Kawahara, Ryoichi Arita, Hiroshi Enaida, Akifumi Ueno, Tatsuro IshibashiAbstract:PURPOSE To describe both the clinical and the histological characteristics of the vitreoretinal interface of an eye with Asteroid Hyalosis (AH). METHODS A 76-year-old woman presented with a left eye with AH and an epiretinal membrane (ERM). Preoperative slit-lamp biomicroscopy revealed anatomical posterior vitreous detachment with a Weiss ring. Preoperative best-corrected visual acuity (BCVA) was 20/50. The patient underwent triamcinolone acetonide-assisted vitrectomy, along with peeling of the internal limiting membrane (ILM). The ERM and ILM were removed together with surgical ILM forceps. The excised ILM was analyzed with transmission electron microscopy (TEM). We also compared the histological characteristics of this tissue with those of tissue from a non-AH eye with idiopathic ERM. RESULTS A massive collagenous matrix with few cellular components, suggesting residual posterior vitreous but not ERM, was observed on the excised ILM of the AH eye. BCVA improved to 20/25 6 months after surgery. TEM of a non-AH eye with idiopathic ERM revealed a cellular rich component and extracellular matrix on the ILM. CONCLUSION We found evidence demonstrating a split in the posterior vitreous cortex, representing, to our knowledge, the first case report of this phenomenon in an eye with AH.
Tsunehiko Ikeda - One of the best experts on this subject based on the ideXlab platform.
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idiopathic macular hole with Asteroid Hyalosis two case reports
Medicine, 2018Co-Authors: Takakuni Kitagaki, Takaki Sato, Masanori Fukumoto, Ryohsuke Kohmoto, Takatoshi Kobayashi, Teruyo Kida, Hiroyuki Suzuki, Shou Oosuka, Tsunehiko IkedaAbstract:INTRODUCTION Asteroid Hyalosis (AH) is characterized by mild vitreous-body liquefaction and a reduced likelihood of posterior vitreous detachment (PVD). Here, we report the clinical features of 2 cases of macular hole (MH) in eyes with AH. The extent of retinal vitreous adhesion at the time of vitreous surgery, the presence or absence of iatrogenic retinal breaks, and the postoperative course was examined in regard to the association with AH. CASE PRESENTATION Case 1 involved a 67-year-old female with decreased visual acuity in her left eye. Although preoperative optical coherence tomography examination revealed complete PVD with operculum around the fovea central region, vitreoretinal adhesion was quite strong starting at the midperiphery of the fundus, and an iatrogenic retinal break was formed at the inferior site during vitreous surgery. Endophotocoagulation was performed, and no onset of retinal detachment (RD) postsurgery was observed. Case 2 involved a 74-year-old male with metamorphopsia in his right eye. Preoperative perifoveal PVD was observed, yet vitreoretinal adhesion was strong starting at the midperiphery of the fundus and multiple iatrogenic retinal breaks had formed on the inferior, superior, and temporal sites. Moreover, RD occurred during surgery. Endophotocoagulation and gas tamponade was performed; however, postoperative RD requiring multiple reoperations occurred. CONCLUSION As with normal MH, MH with AH is thought to be caused by perifoveal PVD, yet as the vitreoretinal adhesion was found to be quite strong starting at the midperiphery of the fundus, we decided to keep the artificial PVD within a range where adhesion was loose.
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Two Cases of Rhegmatogenous Retinal Detachment Associated with Asteroid Hyalosis
Karger Publishers, 2018Co-Authors: Yoshitaka Okuda, Keigo Kakurai, Takaki Sato, Seita Morishita, Masanori Fukumoto, Ryohsuke Kohmoto, Mai Takagi, Takatoshi Kobayashi, Teruyo Kida, Tsunehiko IkedaAbstract:Background: To report two cases of rhegmatogenous retinal detachment (RRD) associated with Asteroid Hyalosis (AH). Case Presentation: Two patients presented with RRD originating from a flap tear. Case 1 involved a 62-year-old male who was found to have bullous RRD in his left eye originating from a flap tear. During vitreous surgery, a thick vitreous cortex was found to have strongly adhered to the entire retinal surface, from the center to the periphery. A bimanual method was then used in conjunction with the vitrectomy to create an artificial posterior vitreous detachment. After surgery, the retina was successfully reattached, and his corrected visual acuity (VA) improved. Case 2 involved a 70-year-old male who was found to have localized RRD in his left eye originating from a flap tear. During vitreous surgery, a thick vitreous cortex was found to have strongly adhered to the entire retinal surface. After surgery, the retina was successfully reattached, and his corrected VA improved. Conclusions: RRD associated with AH presents with stronger vitreoretinal adhesion compared to typical RRD, thus requiring a more complicated surgical technique to properly treat the patient
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case of Asteroid Hyalosis that developed severely reduced vision after cataract surgery
BMC Ophthalmology, 2017Co-Authors: Ryosuke Ochi, Takaki Sato, Seita Morishita, Masanori Fukumoto, Takatoshi Kobayashi, Teruyo Kida, Bumpei Sato, Yukihiro Imagawa, Masashi Mimura, Tsunehiko IkedaAbstract:To report our findings in a patient with Asteroid Hyalosis (AH) who had a severe reduction of his visual acuity following cataract surgery. The vision was improved by vitreous surgery. The patient was an 81-year-old man. Following cataract surgery on his left eye, his decimal best-corrected visual acuity (BCVA) was markedly reduced from 0.2 to 0.02. A large number of Asteroid bodies (ABs) was observed to be concentrated on the posterior surface of the implanted intraocular lens. Ultrasound B-mode images showed turbidity of the vitreous that was denser in the anterior vitreous where the ABs were concentrated. During vitrectomy, the ABs were observed to be concentrated in the anterior vitreous cavity, and a complete posterior vitreous detachment (PVD) was present. After vitrectomy successfully removed the ABs, the visibility of the fundus improved and the BCVA recovered to 1.0. We suggest that the visual impairment after the cataract surgery was due to the concentrated ABs in the anterior vitreous cavity. The clustering of the ABs in the anterior vitreous cavity was most likely caused by the PVD that developed during the cataract surgery.
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vitrectomy for proliferative diabetic retinopathy with Asteroid Hyalosis
Retina-the Journal of Retinal and Vitreous Diseases, 1998Co-Authors: Tsunehiko Ikeda, Hiroshi Sawa, Kan Koizumi, Toru Yasuhara, Shigeru Kinoshita, Yasuo TanoAbstract:Purpose To characterize the clinical features of proliferative diabetic retinopathy (PDR) with Asteroid Hyalosis treated by pars plana vitrectomy. Methods Vitrectomy was performed in 26 eyes with PDR accompanied by Asteroid Hyalosis (7 eyes with vitreous hemorrhage, 6 eyes with tractional retinal detachment with vitreous hemorrhage, and 13 eyes with tractional retinal detachment without vitreous hemorrhage). We observed the occurrence of posterior vitreous detachment intraoperatively and evaluated the clinical characteristics retrospectively. Results In 24 eyes, posterior vitreous detachment was slight, necessitating artificial detachment. Of the 26 eyes, 20 experienced iatrogenic retinal breaks and 6 (23%) experienced postoperative retinal detachment due to iatrogenic breaks. Three cases worsened to anterior proliferative vitreoretinopathy and retinal reattachment could not be achieved. Conclusions In vitrectomy for PDR with Asteroid Hyalosis, and in cases of simple vitreous hemorrhage, surgery should be performed with full understanding of the anatomic characteristics. Notably, if posterior vitreous detachment is not present, the occurrence of iatrogenic retinal breaks is more likely.
Yasuo Tano - One of the best experts on this subject based on the ideXlab platform.
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vitrectomy for proliferative diabetic retinopathy with Asteroid Hyalosis
Retina-the Journal of Retinal and Vitreous Diseases, 1998Co-Authors: Tsunehiko Ikeda, Hiroshi Sawa, Kan Koizumi, Toru Yasuhara, Shigeru Kinoshita, Yasuo TanoAbstract:Purpose To characterize the clinical features of proliferative diabetic retinopathy (PDR) with Asteroid Hyalosis treated by pars plana vitrectomy. Methods Vitrectomy was performed in 26 eyes with PDR accompanied by Asteroid Hyalosis (7 eyes with vitreous hemorrhage, 6 eyes with tractional retinal detachment with vitreous hemorrhage, and 13 eyes with tractional retinal detachment without vitreous hemorrhage). We observed the occurrence of posterior vitreous detachment intraoperatively and evaluated the clinical characteristics retrospectively. Results In 24 eyes, posterior vitreous detachment was slight, necessitating artificial detachment. Of the 26 eyes, 20 experienced iatrogenic retinal breaks and 6 (23%) experienced postoperative retinal detachment due to iatrogenic breaks. Three cases worsened to anterior proliferative vitreoretinopathy and retinal reattachment could not be achieved. Conclusions In vitrectomy for PDR with Asteroid Hyalosis, and in cases of simple vitreous hemorrhage, surgery should be performed with full understanding of the anatomic characteristics. Notably, if posterior vitreous detachment is not present, the occurrence of iatrogenic retinal breaks is more likely.
