Marco Coassin1, Lorenzo Braconi2, Giancarlo Sborgia3, Giuseppe Mangano2, Valentina Mastrofilippo4,5, Antonio Di Zazzo2, Luigi Fontana4, Luca Cimino5. 1. Ophthalmology, University Campus Bio-Medico, Rome, Italy. m.coassin@unicampus.it. 2. Ophthalmology, University Campus Bio-Medico, Rome, Italy. 3. Department of Medical Science, Neuroscience and Sense Organs, Eye Clinic, University of Bari, Bari, Italy. 4. Ophthalmology, AUSL-IRCCS of Reggio Emilia, Reggio Emilia, Italy. 5. Ocular Immunology, AUSL-IRCCS of Reggio Emilia, Reggio Emilia, Italy.
Abstract
PURPOSE: To compare the safety and the effectiveness of one-port vs. three-port diagnostic vitrectomy in undiagnosed cases of posterior segment inflammation. METHODS: We retrospectively collected data from 80 consecutive diagnostic vitrectomies performed using a one-port (n = 40) or a three-port approach (n = 40). Cases of suspected postoperative endophthalmitis were not included in the study. Several variables were compared among groups, including length of surgery, postoperative best-corrected visual acuity (BCVA), diagnostic success and surgical complications. RESULTS: The mean duration of surgery was shorter in the one-port group when compared to the three-port group (15 ± 8 min vs. 49 ± 30; p = 0.0001). The patients were observed for a mean follow-up of 19 months (range 1-84). In the one-port group, the mean BCVA improved from 1.31 ± 0.96 to 0.57 ± 0.59 logarithm of minimum resolution (LogMAR) (p = 0.0009). In the three-port group, BCVA improved from 0.98 ± 0.76 to 0.51 ± 0.76 LogMAR (p = 0.0005). The difference in mean postoperative BCVA between groups was not significative at the last follow-up. One-port vitrectomy yields to a final diagnosis in 80% of the cases, and three-port vitrectomy in 48%. Most of the one-port vitrectomies were carried out under topical anesthesia. After surgery, in both groups three eyes developed a retinal detachment. CONCLUSIONS: In this pilot study, the one-port diagnostic vitrectomy has proven to be as effective and safe as the three-port approach, allowing a reduction in surgical times. One-port diagnostic vitrectomy might be considered as the first option for those cases where more complex surgical procedures are not needed.
PURPOSE: To compare the safety and the effectiveness of one-port vs. three-port diagnostic vitrectomy in undiagnosed cases of posterior segment inflammation. METHODS: We retrospectively collected data from 80 consecutive diagnostic vitrectomies performed using a one-port (n = 40) or a three-port approach (n = 40). Cases of suspected postoperative endophthalmitis were not included in the study. Several variables were compared among groups, including length of surgery, postoperative best-corrected visual acuity (BCVA), diagnostic success and surgical complications. RESULTS: The mean duration of surgery was shorter in the one-port group when compared to the three-port group (15 ± 8 min vs. 49 ± 30; p = 0.0001). The patients were observed for a mean follow-up of 19 months (range 1-84). In the one-port group, the mean BCVA improved from 1.31 ± 0.96 to 0.57 ± 0.59 logarithm of minimum resolution (LogMAR) (p = 0.0009). In the three-port group, BCVA improved from 0.98 ± 0.76 to 0.51 ± 0.76 LogMAR (p = 0.0005). The difference in mean postoperative BCVA between groups was not significative at the last follow-up. One-port vitrectomy yields to a final diagnosis in 80% of the cases, and three-port vitrectomy in 48%. Most of the one-port vitrectomies were carried out under topical anesthesia. After surgery, in both groups three eyes developed a retinal detachment. CONCLUSIONS: In this pilot study, the one-port diagnostic vitrectomy has proven to be as effective and safe as the three-port approach, allowing a reduction in surgical times. One-port diagnostic vitrectomy might be considered as the first option for those cases where more complex surgical procedures are not needed.
Entities:
Keywords:
Diagnostic vitrectomy; Pars plana vitrectomy; Topical anesthesia; Uveitis
Authors: Ron Margolis; Oswaldo F M Brasil; Careen Y Lowder; Rishi P Singh; Peter K Kaiser; Scott D Smith; Victor L Perez; Christine Sonnie; Jonathan E Sears Journal: Ophthalmology Date: 2007-05-23 Impact factor: 12.079