@article {645, title = {COMBINED VITRECTOMY AND INTRAVITREAL DEXAMETHASONE (OZURDEX) SUSTAINED-RELEASE IMPLANT.}, journal = {Retina}, volume = {36}, year = {2016}, month = {2016 Nov}, pages = {2087-2092}, abstract = {

PURPOSE: To evaluate the safety and efficacy of combining intravitreal dexamethasone implantation (Ozurdex) with pars plana vitrectomy (PPV).

METHODS: A retrospective review was conducted on cases where Ozurdex injection was performed in the operating room in conjunction with pars plana vitrectomy. Our primary outcome measure was the presence of surgical complications in the perioperative and 3-month postoperative window. We also measured visual acuity, intraocular pressure (IOP), and macular edema at baseline, one, and 3 months after surgery.

RESULTS: Fifteen eyes in 14 cases were reviewed. There were no complications intraoperatively or at 1-month postoperatively. Two patients (2 eyes) with prior retinal detachment developed proliferative vitreoretinopathy and redetachment at 3 months. Visual acuity improved in 7 of 15 eyes, and an average improvement of 2 lines was achieved for the entire cohort. There was no overall change in intraocular pressure although 1 patient developed an increase in intraocular pressure \>5 mmHg. Five of 9 patients with baseline macular edema experienced improvement or resolution at 3 months.

CONCLUSION: Intraoperative Ozurdex in combination with PPV may be safe and effective in treating macular edema caused by many different underlying diseases.

}, keywords = {Adult, Aged, Aged, 80 and over, Combined Modality Therapy, Dexamethasone, Drug Implants, Female, Glucocorticoids, Humans, Intraocular Pressure, Intravitreal Injections, Macular Edema, Male, Middle Aged, Retinal Vein Occlusion, Retrospective Studies, Tomography, Optical Coherence, Uveitis, Posterior, Visual Acuity, Vitrectomy, Wet Macular Degeneration}, issn = {1539-2864}, doi = {10.1097/IAE.0000000000001063}, author = {Zheng, Andrew and Chin, Eric K and Almeida, David R P and Tsang, Stephen H and Mahajan, Vinit B} } @article {683, title = {ELEVATED INTRAOCULAR PRESSURE FOLLOWING PARS PLANA VITRECTOMY DUE TO TRAPPED GAS IN THE POSTERIOR CHAMBER.}, journal = {Retin Cases Brief Rep}, volume = {10}, year = {2016}, month = {2016 Fall}, pages = {334-7}, abstract = {

PURPOSE: Elevated intraocular pressure is relatively common following pars plana vitrectomy and intraocular gas tamponade. We discuss a series of patients who experienced elevated intraocular pressure from pupillary block and angle closure secondary to trapped gas in the posterior chamber.

METHODS: Case series.

RESULTS: Case 1 is a patient who underwent pars plana vitrectomy for retinal detachment repair. The intraocular pressure was elevated on postoperative Day 3 because of trapped gas in the posterior chamber, and it did not lower with prone positioning, maximal medical therapy, and laser peripheral iridotomies. Aspiration of the trapped gas was done with the patient sitting upright using a 27-gauge needle at the limbus, which was curative. Case 2 provides anterior-segment optical coherence tomography images that confirmed the location of the trapped gas resulting in angle closure. Case 3 demonstrates the unfortunate sequelae of a central retinal artery occlusion following delayed recognition of this entity. Case 4 highlights the challenges encountered when migratory gas is also seen elsewhere in the eye.

CONCLUSION: Clinicians should be aware of elevated intraocular pressure secondary to trapped gas in the posterior chamber, which may be recalcitrant to medical therapy. Aspiration of the trapped gas can alleviate both pupillary block and angle closure without compromising the gas tamponade.

}, keywords = {Aged, Endotamponade, Female, Gases, Humans, Intraocular Pressure, Male, Middle Aged, Ocular Hypertension, Posterior Eye Segment, Vitrectomy}, issn = {1937-1578}, doi = {10.1097/ICB.0000000000000256}, author = {Chin, Eric K and Almeida, David R P and Strohbehn, Austin L and Mahajan, Vinit B and Russell, Stephen R and Folk, James C} } @article {647, title = {Management of Pediatric Aphakic Glaucoma With Vitrectomy and Tube Shunts.}, journal = {J Pediatr Ophthalmol Strabismus}, volume = {53}, year = {2016}, month = {2016 Nov 01}, pages = {339-343}, abstract = {

PURPOSE: To review the impact of vitrectomy and tube shunts on mean intraocular pressure (IOP) and number of glaucoma medications in pediatric aphakic glaucoma.

METHODS: A retrospective review of pediatric patients who underwent combined vitrectomy and glaucoma tube shunt surgery for aphakic glaucoma was conducted. Inclusion criteria were: age 18 years or younger, diagnosis of aphakic glaucoma, preoperative IOP data, and postoperative IOP data for at least 6 months. Mean IOP lowering at 1 year, number of glaucoma medications at 1 year, and surgical complications, including tube occlusion in the postoperative period, were noted.

RESULTS: The mean \± standard deviation preoperative IOP was 33.9 \± 10.6 mm Hg (range: 18 to 57 mm Hg) with a mean of three topical IOP-lowering medications. A total of 5 (36\%) Ahmed and 9 (64\%) Baerveldt tube shunts were placed. One of the Baerveldt tube shunt procedures was combined with revision of a traumatically dislocated tube. The mean IOP at 12 months postoperatively was 16.6 \± 5.8 mm Hg (range: 6 to 28 mm Hg; P \< .01, t = 3.74, df = 13) with a mean of 2.3 glaucoma medications. There were no cases of tube occlusion, corneal decompensation, endophthalmitis, or retinal detachment over the 12 months of follow-up.

CONCLUSIONS: Combined vitrectomy and placement of a glaucoma tube shunt can be safe and effective in lowering IOP based on mean IOP values and number of glaucoma medications at 1 year. [J Pediatr Ophthalmol Strabismus. 2016;53(6):339-343.].

}, keywords = {Adolescent, Aphakia, Postcataract, Cataract, Cataract Extraction, Child, Child, Preschool, Female, Glaucoma, Glaucoma Drainage Implants, Humans, Infant, Intraocular Pressure, Male, Retrospective Studies, Visual Acuity, Vitrectomy}, issn = {1938-2405}, doi = {10.3928/01913913-20160818-01}, author = {Elshatory, Yasser M and Gauger, Elizabeth H and Kwon, Young H and Alward, Wallace L M and Boldt, H Culver and Russell, Stephen R and Mahajan, Vinit B} } @article {171, title = {Management of sympathetic ophthalmia with the fluocinolone acetonide implant.}, journal = {Ophthalmology}, volume = {116}, year = {2009}, month = {2009 Mar}, pages = {552-557.e1}, abstract = {

We examined whether implantation of the fluocinolone acetonide (Retisert) implant achieved control of inflammation and a reduced need for oral corticosteroids or immunosuppressives in patients with sympathetic ophthalmia (SO).

}, keywords = {Adult, Aged, Drug Implants, Female, Fluocinolone Acetonide, Follow-Up Studies, Glucocorticoids, Humans, Immunosuppressive Agents, Intraocular Pressure, Male, Middle Aged, Ophthalmia, Sympathetic, Retrospective Studies, Treatment Outcome, Visual Acuity}, author = {Mahajan, Vinit B and Gehrs, Karen M and Goldstein, Debra A and Fischer, David H and Lopez, Juan S and Folk, James C} }