Ultrasound-Guided Pars Plana Vitrectomy.
David Berrones1, Mariana Rivera-Cortes2, Luz Monroy-Esquivel2
1Ultrasound Department, Asociación para Evitar le Ceguera en México IAP, México City, México; and.
Retina (Philadelphia, Pa.)
|August 18, 2022
Summary
Ultrasound-guided vitrectomy is a feasible surgical technique for infectious keratitis endophthalmitis. Further research is needed to confirm its safety and optimize patient outcomes.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Medical Imaging
Background:
- Infectious keratitis endophthalmitis poses a significant challenge in ophthalmology.
- Pars plana vitrectomy is a standard treatment, but visualization can be difficult.
- Novel techniques are needed to improve surgical precision and outcomes.
Purpose of the Study:
- To evaluate the feasibility of a new surgical approach combining B-scan ultrasound with vitrectomy.
- To assess the utility of intraoperative ultrasound guidance during vitrectomy for endophthalmitis.
Main Methods:
- 12 patients with infectious keratitis endophthalmitis underwent ultrasound-guided pars plana vitrectomy.
- B-scan ultrasound was used to visualize vitreous movement and instrument position relative to the retina.
- Procedures were guided by at least four ultrasound projections.
- Patients were followed for three months, assessing visual acuity and adverse events.
Main Results:
- The mean age of patients was 56.2 years.
- Sixty-six percent of patients achieved inactivation of endophthalmitis.
- Visual acuity improved from baseline (2.3 logMAR) to follow-up (2.1 logMAR), though not statistically significant (P=0.5).
- Two patients required evisceration due to uncontrolled infection, and two experienced retinal detachment.
Conclusions:
- Ultrasound-guided vitrectomy demonstrates feasibility in treating infectious keratitis endophthalmitis.
- The technique shows potential for enhancing surgical visualization and precision.
- Further studies are warranted to establish the safety profile and optimize outcomes.
