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Advances in Vitreoretinal Interventions for Eye Diseases
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Advances in Vitreoretinal Interventions for Eye Diseases

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: closed (20 December 2023) | Viewed by 8931

Special Issue Editor

Dr. Paolo Mora

E-Mail Website
Guest Editor
Ophthalmology Unit, University Hospital of Parma, 43126 Parma, Italy
Interests: vitrectomy; vitreoretinal intervention; retina; retinal detachment; macular degeneration

Special Issue Information

Dear Colleagues,

Few fields experience constant innovative development in the same way as the field of vitreoretinal interventions. The aim of this Special Issue is to consider original approaches to diagnostics, surgical management, and the post-operative assessment of the treatment results in related ocular pathologies.

Additionally, the search for parameters that are potentially useful in planning a proper surgical strategy as well as to predict prognosis will be considered carefully. In fact, several technological advances have addressed anatomical or functional issues that could be useful in supporting treatment plans and in evaluating cost-effectiveness. Topics of interest include genetics, artificial intelligence, biomarkers, current technologies extended to uncommon clinical settings, or the development of investigation tools.

Both the indication and the intraoperative and postoperative management of the various vitreoretinal pathologies require adequate know-how. We hope that the articles included in this Special Issue will assist in the choice of the most appropriate strategies in relation to the type and degree of the disease.

Dr. Paolo Mora
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • vitreous
  • retina
  • surgery
  • diagnostics
  • results
  • follow up
  • advances

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Published Papers (6 papers)

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Research

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14 pages, 2442 KiB  
Article
Visual Outcomes of Traumatic Lens Dislocations and Subluxations Managed by Pars Plana Vitrectomy and Lensectomy
by Mădălina-Claudia Hapca, George-Adrian Muntean, Iulia-Andrada Nemeș-Drăgan, Ștefan Cristian Vesa and Simona-Delia Nicoară
J. Clin. Med. 2023, 12(22), 6981; https://doi.org/10.3390/jcm12226981 - 8 Nov 2023
Cited by 1 | Viewed by 1138
Abstract
Aim: The aim of this study was to evaluate the visual outcome of lens dislocation and subluxation managed by pars plana vitrectomy (PPV) and lensectomy in patients with open (OGIs) or closed globe injuries (CGIs). Methods: Medical records of 70 consecutive patients treated [...] Read more.
Aim: The aim of this study was to evaluate the visual outcome of lens dislocation and subluxation managed by pars plana vitrectomy (PPV) and lensectomy in patients with open (OGIs) or closed globe injuries (CGIs). Methods: Medical records of 70 consecutive patients treated by PPV and lensectomy over a period of 11 years (1 January 2010–31 December 2020) were retrospectively reviewed. We collected demographic data, best corrected visual acuity (BCVA) using a Snellen Chart pre- and postoperatively, associated ocular injuries and treatment strategy. Visual outcome was evaluated according to the final BCVA which was defined as poor <0.1 or good ≥0.1. Results: The mean age was 57.9 ± 17.6 years. CGIs were present in 49 (70.0%) cases and open OGIs in 21 (30.0%) cases. The dislocation mechanism was zonular lysis in 59 cases (84.3%) and capsular rupture in 11 cases (15.7%). The intraocular lens implant (IOL) was sutured to the sclera in 51 (72.9%) cases or positioned in the capsular bag or in the sulcus in 3 (4.3%) cases and 1 (1.4%) case, respectively, whereas 15 (21.4%) patients remained aphakic. A good BCVA ≥ 0.1 was achieved in 45.71% of the eyes. The presence of retinal detachment (RD) (p = 0.014), iridodonesis (p = 0.011) and initial BCVA (p = 0.000) achieved statistical significance in predicting visual outcome. After treatment, 45.71% of patients achieved a final BCVA ≥ 0.1. Conclusion: RD, iridodonesis and initial BCVA were risk factors for poor visual outcome in our series. Full article
(This article belongs to the Special Issue Advances in Vitreoretinal Interventions for Eye Diseases)
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10 pages, 4583 KiB  
Article
Multimodal Assessment of the Prognostic Role of Ectopic Inner Foveal Layers on Epiretinal Membrane Surgery
by Carlo Gesualdo, Settimio Rossi, Clemente Maria Iodice, Andrea Rosolia, Paolo Melillo, Michele Della Corte and Francesca Simonelli
J. Clin. Med. 2023, 12(13), 4449; https://doi.org/10.3390/jcm12134449 - 2 Jul 2023
Cited by 1 | Viewed by 1127
Abstract
Background: To perform a multimodal assessment of the ectopic inner foveal layers’ (EIFL) prognostic role on idiopathic epiretinal membrane (ERM) surgery. Methods: We retrospectively followed-up for 12 months 27 patients who underwent ERM surgery and stratified them based on EIFL presence (group 1) [...] Read more.
Background: To perform a multimodal assessment of the ectopic inner foveal layers’ (EIFL) prognostic role on idiopathic epiretinal membrane (ERM) surgery. Methods: We retrospectively followed-up for 12 months 27 patients who underwent ERM surgery and stratified them based on EIFL presence (group 1) or absence (group 2) at baseline. Central Retinal Thickness (CRT) and best-corrected visual acuity (BCVA) were compared pre- and post-operatively at 1, 4 and 12 months, whereas fixation stability (FS), macular sensitivity (MS) and multifocal electroretinogram (mfERG) responses were confronted at baseline and 12 months. Results: In group 1, BCVA improved at 4 and 12 months (MD = 0.14 (SE = 0.04); MD = 0.13 (SE = 0.05), respectively) as well as in group 2 (MD = 0.31 (SE = 0.07); MD = 0.41 (SE = 0.08), respectively). CRT did not change in group 1, whereas it decreased in group 2 at 4 and 12 months (MD = −73.13; SE = 23.56; MD = −76.20; SE = 23.56). MS showed no changes in both groups after surgery. FS did not change in group 1, whereas group 2 improved FS 2° (+8.91 ± 13.97) and FS 4° (+4.33 ± 3.84). MfERG P1 wave did not change in group 1, while in group 2 αP1-2, αP1-3 and αP1-4 improved postoperatively (27.97 ± 27.62; 12.51 ± 17.36; 10.49 ± 17.19, respectively). Conclusions: Multimodal assessment confirmed that EIFL negatively affected ERM surgery outcomes. Full article
(This article belongs to the Special Issue Advances in Vitreoretinal Interventions for Eye Diseases)
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7 pages, 920 KiB  
Article
Open Globe Injury (OGI) with a Presence of an Intraocular Foreign Body (IOFB)—Epidemiology, Management, and Risk Factors in Long Term Follow-Up
by Michał Jabłoński, Mateusz Winiarczyk, Katarzyna Biela, Paweł Bieliński, Monika Jasielska, Joanna Batalia and Jerzy Mackiewicz
J. Clin. Med. 2023, 12(1), 190; https://doi.org/10.3390/jcm12010190 - 26 Dec 2022
Cited by 4 | Viewed by 1187
Abstract
The purpose of the study was to evaluate visual outcomes and consider management strategies in the eyes with an intraocular foreign body (IOFB). In a single-center, retrospective case-control study, 36 eyes of 36 patients who suffered from open globe injury (OGI) with IOFB [...] Read more.
The purpose of the study was to evaluate visual outcomes and consider management strategies in the eyes with an intraocular foreign body (IOFB). In a single-center, retrospective case-control study, 36 eyes of 36 patients who suffered from open globe injury (OGI) with IOFB were admitted to the Department of Vitreoretinal Surgery of Medical University of Lublin, Poland from January 2015 to December 2020. Most frequent primary procedure was the pars plana vitrectomy (PPV) with IOFB removal (n = 28). Retinal detachment (RD) developed in nine eyes soon after injury or as a further complication. Recurrent retinal detachment occurred in eight of these nine cases. Final VA 0.1 or better was observed in 21 eyes (58%). Fifteen patients had BCVA of less than 0.1. One eye was not included in the final VA assessment due to the short follow-up period. In 25 out of 28 patients who underwent any kind of pars plana vitrectomy (ppV) a BCVA of <0.4 was observed. The prognosis after an IOFB injury is uncertain due to multiple factors in a peri- and postoperative period. Factors predisposing to poor visual outcomes are: IOFB localization in the posterior segment, retinal detachment, vitreous hemorrhage and prolonged silicone oil tamponade. Full article
(This article belongs to the Special Issue Advances in Vitreoretinal Interventions for Eye Diseases)
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Review

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10 pages, 271 KiB  
Review
Pars Plana Vitrectomy Alone or Combined with Phacoemulsification to Treat Rhegmatogenous Retinal Detachment: A Systematic Review of the Recent Literature
by Carlo Bellucci, Alessandra Romano, Francesca Ramanzini, Salvatore Antonio Tedesco, Stefano Gandolfi and Paolo Mora
J. Clin. Med. 2023, 12(15), 5021; https://doi.org/10.3390/jcm12155021 - 30 Jul 2023
Cited by 4 | Viewed by 1740
Abstract
Pars plana vitrectomy is today a common first-line procedure for treatment of rhegmatogenous retinal detachment (RRD). Removal or preservation of the natural lens at the time of vitrectomy is associated with both advantages and disadvantages. The combination of cataract extraction (i.e., phacoemulsification) with [...] Read more.
Pars plana vitrectomy is today a common first-line procedure for treatment of rhegmatogenous retinal detachment (RRD). Removal or preservation of the natural lens at the time of vitrectomy is associated with both advantages and disadvantages. The combination of cataract extraction (i.e., phacoemulsification) with pars plana vitrectomy (PPVc) enhances visualization of the peripheral retina and the surgical management of the vitreous base. However, PPVc prolongs the surgical time and is associated with iatrogenic loss of the accommodation function in younger patients, possible postoperative anisometropia, and unexpected refractive results. Performance of pars plana vitrectomy alone (PPVa) requires good technical skills to minimize the risk of lens damage, and quickens cataract development. We retrieved all recent papers that directly compared PPVc and PPVa using parameters that we consider essential when choosing between the two procedures (the success rate of anatomical RRD repair, postoperative refractive error, intra- and postoperative complications, and costs). PPVa and PPVc were generally comparable in terms of RRD anatomical repair. PPVc was associated with fewer intraoperative, but more postoperative, complications. Macula-off RRD PPVc treatment was often associated with undesirable myopic refractive error. PPVa followed by phacoemulsification was the most expensive procedure. Full article
(This article belongs to the Special Issue Advances in Vitreoretinal Interventions for Eye Diseases)

Other

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16 pages, 649 KiB  
Systematic Review
Early versus Late Pars Plana Vitrectomy in Vitreous Hemorrhage: A Systematic Review
by Filippo Confalonieri, Gianmaria Barone, Vanessa Ferraro, Giacomo Ambrosini, Alessandro Gaeta, Beáta Éva Petrovski, Xhevat Lumi, Goran Petrovski and Alessandra Di Maria
J. Clin. Med. 2023, 12(20), 6652; https://doi.org/10.3390/jcm12206652 - 20 Oct 2023
Cited by 2 | Viewed by 1571
Abstract
Background: Vitreous hemorrhage (VH) is a common vitreoretinal condition causing impairment of vision due to various etiologies. No consensus exists on the best timing for performing pars plana vitrectomy (PPV) in fundus-obscuring VH. Materials and Methods: Following the Preferred Reporting Items [...] Read more.
Background: Vitreous hemorrhage (VH) is a common vitreoretinal condition causing impairment of vision due to various etiologies. No consensus exists on the best timing for performing pars plana vitrectomy (PPV) in fundus-obscuring VH. Materials and Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards, we conducted a systematic review of the timing of PPV in VH. We assessed the strength of the evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach for all the included publications, in accordance with the 2011 Oxford Centre for Evidence-Based Medicine (OCEBM) recommendations. Results: A total of 1731 articles were identified. Following the removal of duplicates and screening of abstracts, 1203 articles remained. Subsequently, a comprehensive full-text review of 30 articles was conducted. Ultimately, 18 articles met the predefined inclusion criteria. Conclusions: Despite the small number of studies on the timing of treatment for VH, the advantage of early over late PPV seems to be a reasonable approach in selected cases, and it might be considered modern standard care. Full article
(This article belongs to the Special Issue Advances in Vitreoretinal Interventions for Eye Diseases)
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9 pages, 1063 KiB  
Brief Report
Role of Vitrectomy in Nontractional Refractory Diabetic Macular Edema
by Stefano Ranno, Stela Vujosevic, Manuela Mambretti, Cristian Metrangolo, Micol Alkabes, Giovanni Rabbiolo, Andrea Govetto, Elisa Carini, Paolo Nucci and Paolo Radice
J. Clin. Med. 2023, 12(6), 2297; https://doi.org/10.3390/jcm12062297 - 15 Mar 2023
Cited by 3 | Viewed by 1569
Abstract
Background: Currently, the gold standard of diabetic macular edema (DME) treatment is anti-vascular endothelial growth factor (VEGF) injections, although a percentage of patients do not respond optimally. Vitrectomy with or without internal limiting membrane (ILM) peeling is a well-established treatment for DME cases [...] Read more.
Background: Currently, the gold standard of diabetic macular edema (DME) treatment is anti-vascular endothelial growth factor (VEGF) injections, although a percentage of patients do not respond optimally. Vitrectomy with or without internal limiting membrane (ILM) peeling is a well-established treatment for DME cases with a tractional component while its role for nontractional cases is unclear. The aim of this study is to evaluate the role of vitrectomy with or without ILM peeling in nontractional refractory DME. Methods: We performed a retrospective review of twenty-eight eyes with nontractional refractory DME treated with vitrectomy at San Giuseppe Hospital, Milan, between 2016 and 2018. All surgeries were performed by a single experienced vitreoretinal surgeon. In 43.4% of cases, the ILM was peeled. Best corrected visual acuity and optical coherence tomography (OCT) scans were assessed preoperatively and at 6, 12, and 24 months post-vitrectomy. Results: The mean central macular thickness improved from 413.1 ± 84.4 to 291.3 ± 57.6 μm at two years (p < 0.0001). The mean logarithm of the minimum angle of resolution logMAR best-corrected visual acuity (BCVA) improved after two years, from 0.6 ± 0.2 to 0.2 ± 0.1 (p < 0.0001). We found no difference between ILM peeling vs. no ILM peeling group in terms of anatomical (p = 0.8) and visual outcome (p = 0.3). Eyes with DME and subfoveal serous retinal detachment (SRD) at baseline had better visual outcomes at the final visit (p = 0.001). Conclusions: We demonstrated anatomical and visual improvement of patients who underwent vitrectomy for nontractional refractory DME with and without ILM peeling. Improvement was greater in patients presenting subretinal fluid preoperatively. Full article
(This article belongs to the Special Issue Advances in Vitreoretinal Interventions for Eye Diseases)
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