Search

Background: To evaluate the efficacy and safety of intravitreal injections of 4 mg (high dose) of aflibercept in treatment-naive patients with neovascular AMD(nAMD) with treat and extend(TREX) dosing regimens, and to determine the frequency of injections. Methods: In this interventional, retrospective study a total of 15 eyes of 14 patients (eight female and 9 male) with nAMD were included. All patients were examined and OCT imaging was performed at the time of initial presentation, on the day of each injection and at subsequent follow-up visits. Each eye received intravitreal injections of 4 mg/0.1 mL aflibercept at the dose of every 4 weeks for three months (loading phase) after that 4 mg high dose of aflibercept was applied as the TREX regime. The eyes with a minimum follow-up time of 12 months are included. Results: The mean age of the patients was 74.9 ± 7.3(61–85) years and the mean follow-up time was 20.33 ± 8.7(12–34) months. Total number of injections were 9.3 ± 3.0 (5–14) during the follow-up period. A statistically significant increase was found in terms of best-corrected visual acuity and central macular thickness between mean baseline values and at 1, 3, 6, 12 months, and the final examination(p < 0.05 for each comparison). No complication was observed during follow-up. Conclusions: High-dose Aflibercept of 4 mg/0.1 mL application with the TREX regimen was found to be efficient and safe. High-dose may also help to reduce the frequency of injections and visits in the follow-up period in eyes with nAMD. Prospective studies with large series are warranted. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to assess the frequency of smoking cessation and to identify the factors affecting smoking cessation success among individuals seeking assistance at a smoking cessation centre. Methods: This cross-sectional study included 1,570 individuals who applied to the smoking cessation centre in Izmir, Turkey, between 2009 and 2018, and completed three follow-ups. Data were obtained from the centre's records. Factors affecting smoking cessation success were analysed using logistic regression in multivariate analysis. Results: The median age to start smoking was 19 (17-22), and the median number of cigarettes consumed per day was 20 (20-30). Among the participants, 59.9% exhibited a high/very high level of nicotine dependence, and 79.6% had attempted to quit smoking previously. The median number of patient follow-ups was 7 (5-10). Of the patients, 34.0% successfully quit smoking for one year. According to the multivariate analysis results, smoking cessation success increased with being married by 2.26 times (95% CI: 1.51-3.38, p < 0.001), the absence of other smokers in the household by 1.38 times (95% CI: 1.01-1.88, p = 0.04), having a low level of nicotine dependence by 1.75 times (95% CI: 1.23-2.48, p = 0.002), and more patient follow-ups by 1.61 times (95% CI: 1.52-1.72, p < 0.001). Conclusions: Smoking cessation success is increased by the support and follow-up provided by healthcare professionals, the absence of other smokers in the household, and a low level of nicotine dependency. [ABSTRACT FROM AUTHOR]

In this study, 419 Turkish middle school students (203 girls, 216 boys) were surveyed on their exposure to and engagement in bullying, and their level of hopelessness. Our findings suggest that girls were victims of indirect (e.g. gossiping) bullying more than boys. Boys reported being victims of physical (e.g. damaging property) and verbal (e.g. teasing) bullying more than girls. While the level of hopelessness among victims of physical and verbal bullying was higher than non-victims, no difference was found between the victims of indirect bullying and non-victims. Students who never talked to their teachers and parents about bullying reported higher levels of hopelessness than others. The implications of the study for intervention and prevention programs are discussed. (Contains 4 tables.)

Background: Our purpose was to demonstrate if measuring lens autofluorescence (AF) with a scanning confocal biomicroscope may be used to identify subjects with undiagnosed type II diabetes mellitus (DM), and hence, for it to be used as a marker for the severity of diabetic retinopathy in diabetic patients. Patients and methods: In this cross-sectional, comparative study, lens AF was measured with scanning confocal lens fluorescence biomicroscope in diabetic and healthy groups. Full ophthalmological examination was performed. Blood tests of fasting plasma glucose, and glycosylated hemoglobin were also analyzed. The correlation between lens AF results and blood tests was evaluated in both groups. The cutoff value for the diagnosis of DM using lens AF was investigated. Results: The study included 191 subjects with a mean age of 52.09±6.75 years. One hundred and seven (56.0%) subjects were female, and 84 (44.0%) were male. Eighty-two (42.9%) patients had type II DM, and 109 (57.1%) subjects self-reported as normal. The fluorescence ratio (FR) values ranged from 0.09 to 0.46 (0.23±0.06) in the total group. Mean FR measurements of diabetic subjects were significantly higher (0.27±0.06) than those without DM (0.20±0.05), (p=0.001). A statistically significant correlation was found between glycosylated hemoglobin, fasting plasma glucose, and FR. The cutoff point for the FR according to the presence of DM was found to be 0.24 and above (p=0.001), with a sensitivity of 71.95% and a specificity of 80.73%. Conclusion: Measuring AF of human lens as an indirect evidence of increased advanced glycaton end products may helpful in detecting impaired glucose metabolism. Our results show highly significant correlation between possibility of DM and FR. [ABSTRACT FROM AUTHOR]

The article presents two case studies of a 9-year-old boy who had an open-globe injury to the right eye caused by an air gun pellet and a 9-year-old who had undergone primary corneal suturing because of a left eye wound caused by a tree branch. Both patients manifest posttraumatic retinal detachment and one has endophthalmitis. Intraocular foreign bodies (IFOB) were extracted from the eye using a suture loop and intraocular forceps.

Purpose: To compare anatomical and functional outcomes of 25 gauge sutureless pars plana vitrectomy (PPV) and 20 gauge PPV in eyes with diabetic vitreous hemorrhage (VH). Materials and Methods: IIn this interventional case series 15 eyes (Group 1) underwent 20-gauge PPV, and 29 eyes (Group 2) underwent 25 gauge sutureless PPV with oblique sclerotomies due to diabetic VH. Eyes with a minimum follow-up of 6 months were evaluated. The main outcome measures were changes in visual acuity (VA), intraocular pressure (IOP), and rates of complications. Results: In all eyes PPV was performed without complication. The mean follow-up period was 14±9.14 months. Mean VA in Group 1 increased significantly at postoperative week 1 and thereafter, whereas it increased in Group 2 at postoperative month 1 and thereafter (p<0.05). Mean log- MAR change, mean IOP levels, and rates of complications did not differ significantly between the two groups during follow-up (p>0.05). Transient hypotony was detected in 3 eyes in Group 2 only (p>0.05). Revitrectomy was performed in 1 (6.66%) and 3 (10.34%) eyes due to postoperative rehemorrhage in the two groups, respectively (p>0.05). Conclusions: In this study 25 gauge sutureless pars plana vitrectomy with oblique sclerotomies and 20 gauge vitrectomy were similarly effective and safe in the treatment of diabetic VH. Further prospective randomized and controlled studies with larger series and with longer follow-up are warranted. [ABSTRACT FROM AUTHOR]

To evaluate the efficacy of radial optic neurotomy (RON) with or without intravitreal triamcinolone in improving visual acuity in central retinal vein occlusion (CRVO). Materials and Methods: We performed vitrectomy and RON to 16 eyes of 16 patients with CRVO with a best corrected visual acuity (BCVA) of 20/200 or less. Eight of them received an injection of 4mg intravitreal triamcinolone (IVTA) at the completion of the surgery. The major outcome parameter was defined as an improvement of BCVA of 2 or more lines and final BCVA better than 20/200. Decrease in central macular thickness was our secondary outcome parameter. Intraoperative and postoperative complications were also evaluated. Results: Eleven (68.8%) of the eyes were evaluated as ischemic based on fluorescein angiography and presence of relative afferent pupillary defect. Only 2 (12.5%) patients had BCVA of better than 20/200 postoperatively. Central macular thickness was significantly reduced from 811±303 μ to 444±276 μ (p<0.01). Preoperative visual acuity and age were significant factors in affecting final BCVA of better than 20/200 (p=0.02 and p=0.05, respectively). One patient underwent trabeculectomy because of intractable open angle glaucoma. One additional patient developed neovascular glaucoma and was treated with diod laser cyclophotocoagulation. Conclusions: RON surgery with or without peroperative IVTA led to a significant decrease in central macular thickness but its functional success is very limited in eyes with preoperative BCVA of less than 20/200 and probably is not better than the natural history. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 2.5-year-old girl with type I osteogenesis imperfecta who underwent 25-gauge sutureless vitrectomy after being presented with intravitreal opacities. After nine months, the patient exhibited a healthy optic nerve and retina without detachment in her funduscopic examination. The study showed that 25-gauge sutureless vitrectomy can be used for pediatric patients with associated thin sclera to allow less surgical trauma and to avoid scleral suturing.

Purpose: To evaluate the efficacy and results of photodynamic therapy (PDT) in the treatment of chronic central serous chorioretinopathy (CSC) which persists longer than six months. Material and Methods: Fifteen eyes of 14 patients with subfoveal fluid which persisted longer than 6 months were included in the study. Visual acuities and contrast sensitivities of the patients were measured before and after the treatment. Infrared fundus photographies, fundus fluorescein and indocyanine green angiographies were performed. Central macular thickness and macular volume values were obtained with optical coherence tomography. Results: The mean age of the patients was 49±6.3 years. Mean follow-up period was 15.3±13.6 months. Visual acuity (VA) increased more than 2 lines in 12 (80%) eyes after PDT. Visual acuity decreased 1 line in 1 (6.6%) eye; remained unchanged in 1 (6.6%) eye and increased 1 line in 1 (6.6%) eye. The mean contrast sensitivity did not change significantly after PDT. A statistically significant decrease in the mean central macular thickness and total macular volume was observed after the treatment compared to pretreatment (p=0.001). Eleven (73.3%) eyes had complete resolution and 4 (26.7%) eyes had partial resolution of subretinal fluid in OCT. No complication was observed due to PDT. Conclusion: Photodynamic therapy reduced subretinal fluid and improved visual acuity in patients with chronic CSC of longer than six moths duration. Photodynamic therapy was considered as a safe and effective method in the treatment of chronic CSC. [ABSTRACT FROM AUTHOR]

Aim: To investigate the effect of pomegranate juice (PJ) intake on overall oxidation status in retinas of diabetic rats., Methods: Twenty-seven rats were divided into four groups as control (CO), diabetic (DM), control treated with PJ (CO-PJ), and diabetic treated with PJ (DM-PJ).The retina tissues were used to determine 8-hydroxy-2'-deoxyguanosine (8OHdG), malondialdehyde (MDA), reduced glutathione (GSH) levels, and the enzyme activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px)., Results: The levels of 8OHdG and MDA were significantly increased in the retina of DM group compared to CO group ( P =0.001, P <0.001 respectively). Both 8OHdG and MDA levels were decreased in PJ-DM group compared to DM group ( P =0.004, P <0.001 respectively). The activities of antioxidant enzymes GSH, SOD, and GDH-Px were significantly decreased in the retina of DM group compared to CO group ( P ≤0.01). GSH and GSH-Px activities were higher in PJ-DM group compared with DM group ( P =0.010, P =0.042, respectively) but SOD activity was not statistically different ( P =0.938)., Conclusion: PJ intake is found to be effective in decreasing oxidative end products, and in increasing the activities of antioxidant enzymes in diabetic retinas of rats, which suggests it may be effective against oxidative stress in diabetic retinas.

Purpose: The purpose of this study was to evaluate the safety and efficacy of iris claw intraocular lens implantation for correction of aphakia in vitrectomized eyes without capsular support., Methods: This was a prospective interventional case series. Twelve aphakic vitrectomized eyes without capsular support underwent iris claw intraocular lens implantation. The main outcome measures were changes in uncorrected visual acuity, best-corrected visual acuity, spheric equivalent, corneal endothelial cell density, corneal thickness, central macular thickness, and complications., Results: Mean follow-up was 15.58 +/- 3.80 months with no intraoperative complications. Postoperatively, uncorrected visual acuity increased significantly at all follow-up visits (P < 0.05). Mean best-corrected visual acuity increased 10 letters/2 lines at the final follow-up visit (P = 0.023). Mean postoperative spheric equivalent at the last visit was -1.68 +/- 063 D, and the spheric equivalent was within +/-2.00 D of emmetropia in 9 (75%) eyes. Mean central macular thickness increased only at postoperative Month 3 (P = 0.043). Mean endothelial cell density loss was 23.87% at the last visit. Mean corneal thickness did not change during follow-up (P > 0.05). No corneal edema was observed. Complications were transient intraocular pressure increase (n = 1), cystoid macular edema (n = 1), and haptic dislocation replaced by surgery (n = 1). Retinas remained attached in all eyes., Conclusion: Secondary iris claw intraocular lens implantation is clinically safe and effective to correct aphakia in vitrectomized eyes without capsular support. Larger studies with longer follow-up are warranted.

Purpose: To evaluate the success of initial treatment and the factors influencing the outcome in acute-onset endophthalmitis after cataract surgery., Methods: We retrospectively reviewed the medical records of all patients with acute postoperative endophthalmitis between 2000 and 2007. We performed pars plana vitrectomy (PPV) to all eyes with initial visual acuity of light perception. Eyes with visual acuity of hand motions or better underwent either intraocular antibiotic injection (IOAI) or PPV. Eyes that did not give a good clinical response to initial therapy within 60 hours underwent a second procedure. The main outcome measure was the rate of early reintervention after PPV and IOAI., Results: We evaluated 88 eyes of 88 patients. Thirty-seven patients underwent PPV and 51 patients underwent IOAI alone. Six of 37 (16.2%) patients required 1 or more procedures within 60 hours of the initial procedure in the PPV group. Twenty-eight of 51 eyes (54.9%) in the IOAI group underwent PPV within 60 hours. The rate of response to primary PPV was significantly higher than to primary IOAI (P < 0.001). Gram-negative organisms composed 35.1% of the isolates., Conclusion: Pars plana vitrectomy may be preferable to IOAI in postoperative endophthalmitis since the rate of early reintervention is lower with initial PPV.

Background: To determine the prognostic indicators of functional outcome in eyes with severe posterior segment trauma managed with pars plana vitrectomy., Methods: One hundred and six eyes of 101 patients were retrospectively reviewed to determine the accuracy of a number of factors in predicting functional outcome after surgery. These potential prognostic indicators included initial visual acuity (VA), retinal detachment (RD), type of trauma, presence of intraocular foreign body (IOFB), type of IOFB, posttraumatic endophthalmitis, hyphema, choroidal detachment, initial hypotonia, accompanying lens subluxation/dislocation, and severe vitreous hemorrhage. In our study, functional success was defined as VA > or =5/200. Fisher's exact and chi-square tests were used for statistical analysis., Results: The mean follow-up time was 12.8+/-0.52 (8-18) months. Thirty-three eyes (31.13%) had functional success. Forty-four (68.7%) of 64 eyes with preoperative RD had anatomical success (total retinal reattachment). Predictors of poor visual outcome (VA < or =5/200) were found to be poor initial VA (p<0.0001), presence of RD (p<0.001), and presence of endophthalmitis (p<0.05). No statistically significant correlation was found between the other predictors surveyed and visual outcome (p>0.05)., Conclusion: Vitreoretinal surgery can improve anatomical and functional success in eyes with severe posterior segment trauma. Poor initial VA, RD, and posttraumatic endophthalmitis are poor predictors of visual outcome.

Background: To determine the value of calculating an ocular trauma score (OTS) for patients with open-globe injuries. OTS evaluating system can provide valuable prognostic information, and its use may be an asset in counseling patients with open-globe injuries., Methods: This study was conducted as a retrospective review of 114 eyes of 114 patients who presented with open-globe injuries between January 2001 and July 2006. OTS variables (visual acuity, rupture, endophthalmitis, perforating injury, retinal detachment, and afferent pupillary defect) were determined and OTS was calculated in 114 eyes of 114 patients at the time of initial examination. In this study, presenting and final visual acuity were grouped (1 through 5) as > or = 20/40, 20/200 to 20/50, 1/200 to 19/200, light perception (LP)/hand motion (HM), and no light perception (NLP), similar to the OTS study group. Numerical values to the OTS variables were converted into OTS categories. Similarity of final visual acuities by groups was compared with those in the OTS study. Patients under the age of two and the ones with incomplete data for OTS variables were excluded., Results: When comparing the distribution of final visual acuity in all OTS categories, no statistically significant difference was found (p = 0.35) between the results of our study and the OTS study group. NLP ratio in category 1 and > or = 20/40 ratio in category 5 were statistically higher than in our study (p = 0.01). However, in our study, category 2 of LP/HM ratio (p < 0.0001) was statistically higher than in the OTS study. The likelihood of the final visual acuities (NLP, LP/HM, 1/200 to 19/200, 20/200 to 20/50, and > or = 20/40) in the other OTS categories in this group was similar to those in the OTS study group. The OTS showed positive correlation with final visual acuity (p < 0.001)., Conclusion: In open-globe injuries, a commonly accepted system for calculating ocular trauma score (OTS) can provide reliable prognostic information.

Purpose: The purpose of this article was to evaluate the outcomes and complications of transconjunctival sutureless 25-gauge vitrectomy using silicone oil tamponade in diabetic tractional retinal detachment., Materials and Methods: Patients were retrospectively evaluated. Main outcome measure was the feasibility of pars plana vitrectomy and silicone oil injection with 25-gauge system in eyes with diabetic tractional retinal detachment., Results: Fourteen eyes of 14 patients were included in the study. Tractional retinal detachment was accompanied by vitreous hemorrhage in 9 eyes and combined traction/rhegmatogenous retinal detachment was present in 1 eye. All patients underwent transconjunctival sutureless 25-gauge vitrectomy and 1,000 centistokes silicone oil injection. Angled insertion of the trocars was made in all eyes. Bimanual surgery was performed in 6 (42.8%) eyes. The median preoperative best-corrected visual acuities were 3.00 logarithm of the minimum angle of resolution; it increased to 1.60 logarithm of the minimum angle of resolution at last visit. Retinal tear formation occurred in 4 (28.5%) eyes. Retinal detachment developed in 2 (14.2%) eyes. Intraocular pressure of 5 mmHg or less was detected in 3 (21.4%) eyes. One patient lost light perception due to anterior hyaloidal fibrovascular proliferation., Conclusion: Pars plana vitrectomy and 1,000 centistokes silicone oil injection with 25-gauge system is feasible in diabetic tractional retinal detachment even in complex cases. Indications of 25-gauge surgery may be expanded toward this area.

Purpose: To evaluate the anatomic and functional outcomes of 25-gauge sutureless vitrectomy in primary treatment of noncomplex pseudophakic rhegmatogenous retinal detachments (RRD)., Methods: Prospective interventional institutional case series. Twenty-two eyes with pseudophakic RRD with proliferative vitreoretinopathy grade A or B underwent primary 25-gauge vitrectomy with oblique sclerotomies and gas endotamponade. Eyes with minimum follow-up of 6 months were evaluated. Main outcome measures were reattachment rate with single surgery, reoperation, complication rates, and changes in visual acuity (VA)., Results: Mean duration of visual loss was 14.68 +/- 12.87 days. Seventeen (77.27%) eyes had macular detachment. In all eyes 25-gauge sutureless vitrectomy was completed without complications. The mean follow-up period was 10.40 +/- 5.77 months. Retinal attachment was achieved in 21 (95.45%) eyes with single surgery and in all (100%) eyes with second vitrectomy. Mean preoperative VA of 1.61 +/- 1.18 improved to 0.50 +/- 0.53 at the last visit (P < 0.001). Transient hypotony was detected in 2 (9.09%) eyes with spontaneous resolution. No other postoperative complication was observed., Conclusions: Twenty-five-gauge sutureless vitrectomy with oblique sclerotomies in primary treatment of noncomplex pseudophakic RRDs resulted in reattachment in 95.45% with single surgery, and in 100% with reoperation in one eye, accompanied by an increase in visual acuity in 86% of eyes.

Purpose: To evaluate the rate, duration, and associated complications of postoperative hypotony after 25-gauge sutureless vitrectomy., Methods: In a retrospective, interventional, institutional case series, 25-gauge sutureless vitrectomy with straight incisions was performed on 111 eyes. Postoperative intraocular pressure (IOP) was measured routinely at 2 hours, 1 day, 1 week, and 1 month. Postoperative IOP, hypotony (IOP, <8 mmHg) rates, and complications associated with low IOP were assessed to determine outcome., Results: Mean follow-up +/- SD was 5.45 +/- 3.44 months. Mean IOP decreased significantly by 2 hours and on postoperative day 1 (P < 0.001) and increased to preoperative levels at week 1 (P = 0.48). Postoperative hypotony rates were 26.12%, 17.11%, and 8.10% at 2 hours, 1 day, and 1 week, respectively. The ratio of postoperative vitreous hemorrhage in eyes with and without hypotony on day 1 was 2:6 (P = 0.412). Two eyes with macular holes (MHs) filled inadequately with gas endotamponade that remained hypotonic for the first postoperative week underwent reoperation due to unsealed MHs., Conclusions: Twenty-five-gauge sutureless vitrectomy with straight incisions resulted in a hypotony rate of 26.12% at 2 hours that decreased to 17.11% on day 1 and to 8.10% at week 1 but did not increase the incidence of postoperative complications.

Purpose: To evaluate the efficacy of primary and secondary (following grid laser photocoagulation) intravitreal triamcinolone acetonide (IVTA) injection for the treatment of macular edema associated with branch retinal vein occlusion (BRVO)., Methods: Eyes with macular edema secondary to BRVO and best-corrected visual acuity (BCVA) worse than 20/40 were included. Eyes eligible for Branch Retinal Vein Occlusion Study (BVOS) guidelines received grid laser treatment first. Those that were not improved at least two lines following grid laser or that did not meet those guidelines received 4 mg IVTA injection. The efficacy of IVTA treatment was assessed by analyzing the change in BCVA and reduction in central macular thickness (CMT) measured by optical coherence tomography. Intraocular pressure (IOP) spikes and other complications were recorded., Results: The data from 37 eyes were included; in 12 of them IVTA injection was given after grid laser while 25 of them received IVTA as a primary treatment. Mean follow-up was 9.6 +/- 4.5 months. BCVA was 0.06 +/- 0.30 and 0.17 +/- 0.50 in the primary and secondary IVTA injection groups, respectively. In the primary injection group, there was a statistically significant gain in BCVA throughout the follow-up (P < 0.05), while a small increase in BCVA was noted only at the third month visit in the secondary IVTA injection group (P = 0.04). Average CMT were 434.8 +/- 122.1microm and 389.0 +/- 171.9 microm before IVTA injection in the two groups, respectively. In the primary IVTA injection group, CMT decreased at 1 month following IVTA injection and remained statistically significant until the sixth month visit (P < 0.05). In the secondary IVTA injection group, a slight reduction in CMT was noted only in the first month visit (P = 0.02). Pre-IVTA BCVA was found to be the single statistically significant predictor of BCVA gain following IVTA injection. In 8 patients (21.6%), the IOP increased above 25 mmHg postoperatively, and was successfully managed by medical treatment. Endophthalmitis did not develop in any of the patients., Conclusion: IVTA injection produced a significant reduction of macular edema in eyes with BRVO either with or without prior grid laser treatment. Reduction of CMT increased the BCVA in most of the eyes receiving IVTA primarily, while only a slight improvement of BCVA was found in eyes with prior grid laser. The IVTA effect was transient. Larger studies are necessary to find the best approach (either grid laser or IVTA) to patients with macular edema associated with BRVO.

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 institution to identify all patients who underwent PPV by any of the authors between January 1, 2005, and December 31, 2006, and were subsequently treated for endophthalmitis. In addition, all patients who underwent PPV and were subsequently treated for endophthalmitis at Pennsylvania State College of Medicine (Hershey, PA) and Bascom Palmer Eye Institute (Miami, FL) during the study period were included. The medical records of these patients were reviewed to confirm that the endophthalmitis was associated with PPV and to collect clinical data to meet the study objectives., Results: The incidence of endophthalmitis during the study period was 2 cases per 6,375 patients (or 1 case per 3,188 patients; 0.03%) for 20-gauge PPV compared with 11 cases per 1,307 patients (or 1 case per 119 patients; 0.84%) for 25-gauge PPV (P < 0.0001). Of 11 eyes that developed endophthalmitis after 25-gauge PPV, 9 received endophthalmitis prophylaxis with subconjunctival cefazolin after surgery. Median intraocular pressure on postoperative day 1 was 13 mmHg (range, 5-27 mmHg). Median time between PPV and endophthalmitis presentation was 3 days (range, 1-15 days). Presenting vision was hand motions or better in all eyes. Initial treatment included vitreous tap and injection of antibiotics in nine eyes and PPV and injection of antibiotics in two. All patients received intraocular treatment with vancomycin, and 10 received ceftazidime treatment. Eight patients had final visual acuity of >/=20/400, and four had visual acuity of >/=20/63. Cultures were negative in three cases; no culture specimens were obtained in one case. Six of the seven isolates were coagulase-negative staphylococci, and one was enterococcus. Five of six isolates tested for sensitivity to vancomycin were sensitive, and both isolates tested for sensitivity to ceftazidime were sensitive., Conclusions: The rate of endophthalmitis after 25-gauge PPV was significantly higher than that after 20-gauge PPV. Endophthalmitis after 25-gauge PPV occurred within 15 days of PPV, was usually due to coagulase-negative staphylococci sensitive to vancomycin, and was associated with variable visual outcomes.

Purpose: To report a new and simple technique for silicone oil removal from pars plana with 25-gauge (G) transconjunctival sutureless vitrectomy system (TSVS)., Methods: In this prospective, interventional clinical trial, 13 eyes underwent silicone oil (1000 centistokes) removal from pars plana passively, with 25-G TSVS, between January and May 2005. Main outcome measures were postoperative visual acuity, intraocular pressure (IOP), silicone oil removal time, complications, and number of sutured sites., Results: In all eyes silicone oil was removed successfully under sub-Tenon (n = 12) and topical (n = 1) anesthesia. The mean silicone oil removal time was 7.27 +/- 0.48 minutes. No intraoperative complications were reported. No suture placement was necessary. Mean postoperative follow-up period was 3.92 +/- 1.49 (range: 3-7) months. Visual acuity improved or stabilized in 11 (84.61%) eyes. Retinal redetachment occurred in 2 (15.38%) eyes resulting in a decrease in vision. Decrease in postoperative IOP was found only at 2 hours (P = 0.003). Postoperatively, transient hypotony at 2 hours (n = 1) and transient vitreous hemorrhage (n = 1) were noted. There were no cases of choroidal detachment, endophthalmitis, clinically significant corneal endothelial decompensation, or macular edema., Conclusion: Removal of silicone oil of 1000 centistokes with 25-G transconjunctival sutureless sclerotomies was effective and safe.