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Harry W Flynn - One of the best experts on this subject based on the ideXlab platform.

  • endophthalmitis following Pars Plana Vitrectomy a literature review of incidence causative organisms and treatment outcomes
    Clinical Ophthalmology, 2014
    Co-Authors: Vivek Dave, Stephen G Schwartz, Avinash Pathengay, Harry W Flynn
    Abstract:

    Endophthalmitis following Pars Plana Vitrectomy is a very uncommon cause of endophthalmitis. Cases reported over the last decade show a decrease in incidence over time. To optimize visual outcome, early diagnosis and treatment are essential. In this review we report a summary of the incidence of endophthalmitis following Vitrectomy, various risk factors for their occurrence, the microbiological profile and the visual outcomes post treatment.

  • Pars Plana Vitrectomy with internal limiting membrane peeling for diabetic macular edema
    Retina-the Journal of Retinal and Vitreous Diseases, 2008
    Co-Authors: Kristen L Hartley, William E. Smiddy, Harry W Flynn, Timothy G Murray
    Abstract:

    Purpose To evaluate anatomic and visual acuity (VA) results of Pars Plana Vitrectomy (PPV) with internal limiting membrane (ILM) peeling for diffuse diabetic macular edema (DME), and to review the literature on the topic. Methods Retrospective noncomparative case series of patients who underwent PPV with ILM peeling for diffuse DME between January 1, 2000, and December 1, 2005, performed by three surgeons at Bascom Palmer Eye Institute. Main outcome measures included pre- and postoperative optical coherence tomography (OCT) and visual acuity. Mean follow-up period was 8 months (range, 43 days-2 years). Results Twenty-four eyes of 23 patients meeting the criteria were evaluated. Duration of DME ranged from 1 to 93 months. Mean preoperative logMAR vision was 0.782 (range, 0.30-1.82). Mean logMAR visual acuity at final follow-up was 0.771 (range, 0.10-2.00). At last follow-up, 25% of eyes had > or =2 line increase in VA from baseline, 54% of eyes had no improvement in VA, and 21% of eyes had > or =2 line decrease in VA. Of 9 eyes with pre- and postoperative OCT, there was an overall reduction in central macular thickness of 141 microm at postoperative month 3 and 120 microm at last follow-up. Postoperative complications included progression of cataract in 6 (60%) of 10 phakic eyes, postoperative intraocular pressure > or =30 mmHg in 6 (24%) eyes, and postoperative vitreous hemorrhage in 2 (8%) eyes. Conclusions Pars Plana Vitrectomy with ILM peeling was associated with a reduction in DME when measured by OCT in the majority of eyes, but visual acuity outcomes showed minimal improvement compared to baseline. These results suggest the efficacy of PPV with ILM peeling for eyes with DME has not been well established and should be reserved for therapy with selected cases.

  • endophthalmitis after 25 gauge and 20 gauge Pars Plana Vitrectomy incidence and outcomes
    Retina-the Journal of Retinal and Vitreous Diseases, 2008
    Co-Authors: Ingrid U Scott, Harry W Flynn, Sundeep Dev, Saad Shaikh, Robert A Mittra, Fernando J Arevalo, Andres Kychenthal, Nur Acar
    Abstract:

    Purpose:To compare the rates of endophthalmitis after 20-gauge versus 25-gauge Pars Plana Vitrectomy (PPV) and to investigate clinical features of, and visual acuity outcomes, for patients with endophthalmitis after PPV.Methods:A computerized database search was performed at each author’s institutio

  • primary retinal detachment scleral buckle or Pars Plana Vitrectomy
    Current Opinion in Ophthalmology, 2006
    Co-Authors: Stephen G Schwartz, Harry W Flynn
    Abstract:

    Purpose of reviewThere remains no consensus among vitreoretinal surgeonsregarding the optimal management of primaryrhegmatogenous retinal detachment. In this article,fundamental principles are discussed and applied torecent clinical reports.Recent findingsThe consensus of the peer-reviewed literature appears tobe that scleral buckling and primary Pars Plana Vitrectomymay yield comparable single-operation success rates andvisual acuity outcomes for a wide variety ofrhegmatogenous retinal detachments.SummaryNo definitive prospective, randomized, multicenter trialcompares scleral buckling with Pars Plana Vitrectomy. Theupcoming Scleral Buckling versus Primary Vitrectomy inRhegmatogenous Retinal Detachment study may yielduseful information in this regard. Even when this study iscompleted, the choice of surgical modality is complex andmay be individualized for specific patients.KeywordsPars Plana Vitrectomy, pneumatic retinopexy, proliferativevitreoretinopathy, rhegmatogenous retinal detachment,scleral buckling, single-operation success rate

  • endophthalmitis after Pars Plana Vitrectomy incidence causative organisms and visual acuity outcomes
    American Journal of Ophthalmology, 2004
    Co-Authors: Charles W G Eifrig, William E. Smiddy, Ingrid U Scott, Harry W Flynn, Jean Newton
    Abstract:

    Purpose To investigate the incidence, causative organisms, and visual acuity outcomes associated with endophthalmitis after Pars Plana Vitrectomy. Design Retrospective, noncomparative, consecutive case series. Methods The medical records were reviewed of all patients who developed acute-onset postoperative endophthalmitis (within 6 weeks of surgery) after Pars Plana Vitrectomy at Bascom Palmer Eye Institute between January 1, 1984 and December 31, 2003. Results During the 20-year study interval, the overall incidence rate of postVitrectomy endophthalmitis was 0.039% (6/15,326). Cultured organisms were Staphylococcus aureus (n = 3), Proteus mirabilus (n = 1), and Staphylococcus epidermidis / Pseudomonas aeruginosa (n = 1); one case was culture-negative. Visual acuity after treatment for endophthalmitis ranged from 2/200 to no light perception, with a final vision of light perception or no light perception in four of six (67%) eyes. Conclusion The incidence of endophthalmitis after Pars Plana Vitrectomy is low but the visual acuity outcomes after treatment are generally poor.

Nived Moonasar - One of the best experts on this subject based on the ideXlab platform.

  • surgical outcomes of 27 gauge Pars Plana Vitrectomy for symptomatic vitreous floaters
    Journal of Ophthalmology, 2017
    Co-Authors: Zhong Lin, Rui Zhang, Qi Hua Liang, Ke Lin, Yu Shu Xiao, Nived Moonasar
    Abstract:

    Purpose. To report the surgical outcomes of 27-gauge Pars Plana Vitrectomy (PPV) for symptomatic vitreous floaters. Methods. 47 eyes of 47 patients (39 males, 83.0%) with symptomatic vitreous floaters who underwent 27-gauge PPV and followed up for more than 6 months were included. The mean age was 34.7 ± 13.5 years. Results. No operative complication occurred. At first day postoperatively, the intraocular pressure (IOP) was significantly lower than that at other time points (8.6 ± 2.7 mmHg, ). 28 (59.6%) eyes had transient hypotony (IOP  NCT03049163 .

  • Surgical Outcomes of 27-Gauge Pars Plana Vitrectomy for Symptomatic Vitreous Floaters
    Hindawi Limited, 2017
    Co-Authors: Zhong Lin, Rui Zhang, Qi Hua Liang, Ke Lin, Yu Shu Xiao, Nived Moonasar
    Abstract:

    Purpose. To report the surgical outcomes of 27-gauge Pars Plana Vitrectomy (PPV) for symptomatic vitreous floaters. Methods. 47 eyes of 47 patients (39 males, 83.0%) with symptomatic vitreous floaters who underwent 27-gauge PPV and followed up for more than 6 months were included. The mean age was 34.7 ± 13.5 years. Results. No operative complication occurred. At first day postoperatively, the intraocular pressure (IOP) was significantly lower than that at other time points (8.6 ± 2.7 mmHg, p

  • endophthalmitis following 27 gauge Pars Plana Vitrectomy for vitreous floaters
    Case Reports in Ophthalmology, 2016
    Co-Authors: Zhong Lin, Nived Moonasar
    Abstract:

    Purpose: To report a case of Staphylococcus epidermidis endophthalmitis following 27-gauge Pars Plana Vitrectomy for symptomatic vitreous floaters. Methods: The clinical course and imaging findings, including fundus optomap, and spectral domain optical coherence tomography of a 24-year-old male patient were documented. Results: The patient, with a preoperative best-corrected visual acuity (BCVA) of 1.0, developed endophthalmitis following 27-gauge Pars Plana Vitrectomy for symptomatic vitreous floaters. After a series of treatments, including emergent vitreous tap and silicone oil injection, antibiotic treatment, and silicone oil removal, the patient regained a BCVA of 0.6. Conclusion: Although rare, the potential risk of endophthalmitis should be explicitly discussed with patients considering surgical intervention for vitreous floaters.

Camiel J. F. Boon - One of the best experts on this subject based on the ideXlab platform.

  • Pars Plana Vitrectomy for disturbing primary vitreous floaters clinical outcome and patient satisfaction
    Graefes Archive for Clinical and Experimental Ophthalmology, 2013
    Co-Authors: Karlijn F. De Nie, Niels Crama, M.a.d. Tilanus, Jeroen B Klevering, Camiel J. F. Boon
    Abstract:

    Background Primary vitreous floaters can be highly bothersome in some patients. In the case of persistently bothersome floaters, Pars Plana Vitrectomy may be the most effective treatment. The aim of this study is to evaluate the incidence of complications, and patient satisfaction, after Pars Plana Vitrectomy for disabling primary vitreous opacities.

  • Pars Plana Vitrectomy for disturbing primary vitreous floaters: clinical outcome and patient satisfaction
    Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2012
    Co-Authors: Karlijn F. De Nie, Niels Crama, M.a.d. Tilanus, B. Jeroen Klevering, Camiel J. F. Boon
    Abstract:

    Primary vitreous floaters can be highly bothersome in some patients. In the case of persistently bothersome floaters, Pars Plana Vitrectomy may be the most effective treatment. The aim of this study is to evaluate the incidence of complications, and patient satisfaction, after Pars Plana Vitrectomy for disabling primary vitreous opacities. We included a total of 110 eyes that underwent Pars Plana Vitrectomy between February 1998 and August 2010. Fifty-seven eyes (51.8%) underwent 20-gauge Vitrectomy, whereas 53 eyes (48.2%) underwent 23-gauge Vitrectomy. In a retrospective manner, we assessed intraoperative and postoperative complications. There was a considerable range of time between surgery and questionnaire (range: 4-136 months). Patient satisfaction was assessed by a questionnaire based on a modified NEI VFQ-25 questionnaire. A retinal detachment occurred in 10.9% of cases, and the incidence did not differ significantly between the 20-gauge and 23-gauge Vitrectomy groups. In 4.5% of the eyes, a retinal detachment developed within the first 3 months, and 6.4% occurred later in the postoperative period. Cystoid macular edema occurred in 5.5%, and an epiretinal membrane was seen postoperatively in 3.6% of cases. Development of glaucoma requiring glaucoma surgery, a macular hole, and postoperative scotoma, each occurred in 0.9% of cases. No cases of endophthalmitis occurred. Eighty-five percent of patients were satisfied or very satisfied with the results of the Vitrectomy. Eighty-four percent of all patients were completely cured from their troublesome vitreous floaters, and an additional 9.3% of patients were less troubled by vitreous floaters. Ten patients (9.3%) were dissatisfied, and six of these patients (5.6%) had a serious complication that resulted in permanent visual loss. Pars Plana Vitrectomy is an effective approach to treat primary vitreous floaters, resulting in a high rate of patient satisfaction. Postoperative complications may be more frequent than previously reported, so patients should be well-informed about the complication rate before reaching informed consent about this surgical intervention. Additional preventive measures should be considered to reduce this complication rate.

Ingrid U Scott - One of the best experts on this subject based on the ideXlab platform.

  • small gauge Pars Plana Vitrectomy a report by the american academy of ophthalmology
    Ophthalmology, 2010
    Co-Authors: Franco M Recchia, Ingrid U Scott, Gary C Brown, Melissa M Brown
    Abstract:

    Objective To review available peer-reviewed publications to evaluate the safety profile and visual outcomes associated with small-gauge Pars Plana Vitrectomy. Methods Literature searches of the PubMed and the Cochrane Library databases were last conducted on August 5, 2009, with no date restrictions. The searches were limited to articles published in English. These searches retrieved 328 articles, of which 76 were deemed topically relevant and rated according to strength of evidence. Results On the basis of level II and level III evidence, the overall safety profile of small-gauge Pars Plana Vitrectomy is similar to that established for conventional 20-gauge Pars Plana Vitrectomy and provides comparable visual acuity results. An increased incidence of infectious endophthalmitis after 25-gauge Vitrectomy was reported in 2 comparative studies, but this was not found in multiple, larger, more recent studies, perhaps due to modifications in case selection and surgical technique over time. Compared with 20-gauge Vitrectomy, small-gauge Vitrectomy is associated with significantly lower levels of patient discomfort and ocular inflammation, and the time required for improvement in visual acuity is shorter. Conclusions The technological advances of small-gauge Vitrectomy seem to afford visual benefit comparable with that seen with traditional 20-gauge surgery, with more rapid healing, less discomfort, and an acceptably low incidence of adverse events comparable with those observed with conventional 20-gauge Vitrectomy. As surgical techniques evolve and clinical experience grows, continued close surveillance is necessary for an accurate assessment of complications. Financial Disclosure(s) Proprietary or commercial disclosure may be found after the references.

  • endophthalmitis after 25 gauge and 20 gauge Pars Plana Vitrectomy incidence and outcomes
    Retina-the Journal of Retinal and Vitreous Diseases, 2008
    Co-Authors: Ingrid U Scott, Harry W Flynn, Sundeep Dev, Saad Shaikh, Robert A Mittra, Fernando J Arevalo, Andres Kychenthal, Nur Acar
    Abstract:

    Purpose:To compare the rates of endophthalmitis after 20-gauge versus 25-gauge Pars Plana Vitrectomy (PPV) and to investigate clinical features of, and visual acuity outcomes, for patients with endophthalmitis after PPV.Methods:A computerized database search was performed at each author’s institutio

  • endophthalmitis after Pars Plana Vitrectomy incidence causative organisms and visual acuity outcomes
    American Journal of Ophthalmology, 2004
    Co-Authors: Charles W G Eifrig, William E. Smiddy, Ingrid U Scott, Harry W Flynn, Jean Newton
    Abstract:

    Purpose To investigate the incidence, causative organisms, and visual acuity outcomes associated with endophthalmitis after Pars Plana Vitrectomy. Design Retrospective, noncomparative, consecutive case series. Methods The medical records were reviewed of all patients who developed acute-onset postoperative endophthalmitis (within 6 weeks of surgery) after Pars Plana Vitrectomy at Bascom Palmer Eye Institute between January 1, 1984 and December 31, 2003. Results During the 20-year study interval, the overall incidence rate of postVitrectomy endophthalmitis was 0.039% (6/15,326). Cultured organisms were Staphylococcus aureus (n = 3), Proteus mirabilus (n = 1), and Staphylococcus epidermidis / Pseudomonas aeruginosa (n = 1); one case was culture-negative. Visual acuity after treatment for endophthalmitis ranged from 2/200 to no light perception, with a final vision of light perception or no light perception in four of six (67%) eyes. Conclusion The incidence of endophthalmitis after Pars Plana Vitrectomy is low but the visual acuity outcomes after treatment are generally poor.

William E. Smiddy - One of the best experts on this subject based on the ideXlab platform.

  • Pars Plana lensectomy combined with Pars Plana Vitrectomy for dislocated cataract
    Journal of Cataract and Refractive Surgery, 2010
    Co-Authors: Jae Ryung Oh, William E. Smiddy
    Abstract:

    Purpose To assess the prognosis and complications after Pars Plana Vitrectomy (PPV) combined with lensectomy as a primary procedure for visual correction of complicated cataract. Setting Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA. Methods This retrospective study reviewed the preoperative, intraoperative, and postoperative clinical features in eyes that had PPV combined with lensectomy as a primary procedure for complicated cataract without severe posterior segment pathology (study group). The corrected distance visual acuity (CDVA), reoperations, retinal detachment (RD), and cystoid macular edema (CME) were ascertained. Results were compared with those in a control group of eyes having combined PPV and lensectomy for uncomplicated cataract. Results In the study group (40 patients), 23 eyes had traumatic lens dislocation, 12 had Marfan syndrome, 7 had idiopathic lens dislocation, and 4 had pseudoexfoliation syndrome. The median corrected distance visual acuity improved from 20/185 (range 20/20 to hand motions) preoperatively to 20/30 (range 20/20 to hand motions) 3 months postoperatively ( P P = .018). Complications included RD (6.5%), transient vitreous hemorrhage (13.0%), choroidal detachment (4.3%) and CME (13.0%), which occurred more frequently in eyes with a history of trauma ( P = .022). The control group (43 eyes; 42 patients) had 1 (2.3%) RD. Conclusions Pars Plana Vitrectomy with lensectomy yielded favorable visual outcomes in eyes with complicated cataract in which standard anterior segment techniques were prohibitive or risky. However, preexisting conditions and postoperative complications may limit visual outcomes. Financial Disclosure Neither author has a financial or proprietary interest in any material or method mentioned.

  • Pars Plana Vitrectomy with internal limiting membrane peeling for diabetic macular edema
    Retina-the Journal of Retinal and Vitreous Diseases, 2008
    Co-Authors: Kristen L Hartley, William E. Smiddy, Harry W Flynn, Timothy G Murray
    Abstract:

    Purpose To evaluate anatomic and visual acuity (VA) results of Pars Plana Vitrectomy (PPV) with internal limiting membrane (ILM) peeling for diffuse diabetic macular edema (DME), and to review the literature on the topic. Methods Retrospective noncomparative case series of patients who underwent PPV with ILM peeling for diffuse DME between January 1, 2000, and December 1, 2005, performed by three surgeons at Bascom Palmer Eye Institute. Main outcome measures included pre- and postoperative optical coherence tomography (OCT) and visual acuity. Mean follow-up period was 8 months (range, 43 days-2 years). Results Twenty-four eyes of 23 patients meeting the criteria were evaluated. Duration of DME ranged from 1 to 93 months. Mean preoperative logMAR vision was 0.782 (range, 0.30-1.82). Mean logMAR visual acuity at final follow-up was 0.771 (range, 0.10-2.00). At last follow-up, 25% of eyes had > or =2 line increase in VA from baseline, 54% of eyes had no improvement in VA, and 21% of eyes had > or =2 line decrease in VA. Of 9 eyes with pre- and postoperative OCT, there was an overall reduction in central macular thickness of 141 microm at postoperative month 3 and 120 microm at last follow-up. Postoperative complications included progression of cataract in 6 (60%) of 10 phakic eyes, postoperative intraocular pressure > or =30 mmHg in 6 (24%) eyes, and postoperative vitreous hemorrhage in 2 (8%) eyes. Conclusions Pars Plana Vitrectomy with ILM peeling was associated with a reduction in DME when measured by OCT in the majority of eyes, but visual acuity outcomes showed minimal improvement compared to baseline. These results suggest the efficacy of PPV with ILM peeling for eyes with DME has not been well established and should be reserved for therapy with selected cases.

  • retinal breaks observed during Pars Plana Vitrectomy
    American Journal of Ophthalmology, 2007
    Co-Authors: Jeffrey K Moore, William E. Smiddy, John W Kitchens, Elias C Mavrofrides, Giovanni Gregorio
    Abstract:

    Purpose To quantitate the frequency and features of retinal breaks discovered at the time of Vitrectomy and to evaluate the outcomes with prophylactic treatment. Design A consecutive, single-surgeon, retrospective, observational case series from a two-year period. Methods Medical records were reviewed for all patients who underwent primary, standard, three-port Pars Plana Vitrectomy (PPV) between January 1, 2000, and December 31, 2001. Intraoperative findings recorded included the number, location, and categorization of retinal breaks and their method of management. Postoperative features recorded included the presence or absence of a retinal detachment (RD). Results There were 65 retinal breaks found in 48 (11.6%) of 415 eyes and included 30 (7.2%) eyes with definite breaks, nine (2.2%) with suspicious breaks, and nine (2.2%) with probably preexisting breaks. Breaks that were described as being large (n = 5) were more commonly associated with the right-hand sclerotomy (P = .041), although other categories of breaks were not. After surgery, the overall incidence of RD was 2.2% (nine of 415 eyes). The rate of RD among the 48 eyes with retinal breaks (of any category) was also 2.1% (one eye). All RDs in this series occurred more than three months after initial Vitrectomy and, accordingly, were probably unrelated to retinal breaks that occurred during surgery. Conclusions Recognition of retinal breaks and intraoperative treatment with retinopexy and air–fluid exchange during Vitrectomy reduces the postoperative risk of RD to that among eyes without observed intraoperative retinal breaks.

  • endophthalmitis after Pars Plana Vitrectomy incidence causative organisms and visual acuity outcomes
    American Journal of Ophthalmology, 2004
    Co-Authors: Charles W G Eifrig, William E. Smiddy, Ingrid U Scott, Harry W Flynn, Jean Newton
    Abstract:

    Purpose To investigate the incidence, causative organisms, and visual acuity outcomes associated with endophthalmitis after Pars Plana Vitrectomy. Design Retrospective, noncomparative, consecutive case series. Methods The medical records were reviewed of all patients who developed acute-onset postoperative endophthalmitis (within 6 weeks of surgery) after Pars Plana Vitrectomy at Bascom Palmer Eye Institute between January 1, 1984 and December 31, 2003. Results During the 20-year study interval, the overall incidence rate of postVitrectomy endophthalmitis was 0.039% (6/15,326). Cultured organisms were Staphylococcus aureus (n = 3), Proteus mirabilus (n = 1), and Staphylococcus epidermidis / Pseudomonas aeruginosa (n = 1); one case was culture-negative. Visual acuity after treatment for endophthalmitis ranged from 2/200 to no light perception, with a final vision of light perception or no light perception in four of six (67%) eyes. Conclusion The incidence of endophthalmitis after Pars Plana Vitrectomy is low but the visual acuity outcomes after treatment are generally poor.

  • endophthalmitis after Pars Plana Vitrectomy
    Ophthalmology, 1995
    Co-Authors: Steven M Cohen, Harry W Flynn, Timothy G Murray, William E. Smiddy
    Abstract:

    Purpose: To describe the clinical course and incidence of culture-proven PostVitrectomy endophthalmitis in 18 patients from five academic centers and three private practices. Methods: Patients undergoing Pars Plana Vitrectomy for recent trauma or endophthalmitis were excluded. The average age was 58 years (range, 21–85 year). Sixty-one percent of the patients (11/18) had diabetes mellitus. The indication for initial Vitrectomy was vitreous hemorrhage (n = 10), macular epiretinal membrane (n = 3), recurrent retinal detachment with proliferative vitreoretinopathy (n = 2), retinal detachment with retinoschisis (n =1), proliferative diabetic retinopathy with tractional retinal detachment (n =1), and dislocated intraocular lens (n =1). None of these eyes received prophylactic intraocular antibiotics during the Vitrectomy. Results: All eyes were treated with intraocular antibiotics after the diagnosis of PostVitrectomy endophthalmitis was made. Final visual acuity ranged from 20/20 to no light perception and included five eyes with 20/50 or better visual acuity and 11 eyes with less than 5/200 visual acuity. Nine eyes had a final visual acuity of no light perception. Of the 16 eyes infected with a single organism, 71 % (5J7) of eyes infected with coagulasenegative staphylococci retained 20/50 or better final visual acuity compared with no eyes (0/9) infected with other organisms ( P = 0.005). Two eyes infected with both coagulase-negative Staphylococcus and Streptococcus had a final visual acuity of 20/ 400. Three eyes with a total hypopyon later had enucleation or evisceration. Based on the data from four medical centers, the incidence of endophthalmitis after Pars Plana Vitrectomy performed over the last 10 years was 9/12,216 (0.07%). Conclusion: Endophthalmitis after Vitrectomy is rare. PostVitrectomy bacterial endophthalmitis caused by organisms other than coagulase-negative staphylococci has a poor visual prognosis.