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.
Purpose:
To assess the feasibility of a novel surgical technique that combines B-scan ultrasound with modern vitrectomy techniques.
Methods:
Patients with a clinical diagnosis of infectious keratitis endophthalmitis, which were scheduled for pars plana vitrectomy and ruled out as candidates for transient keratoprosthesis, were enrolled. The ultrasound probe was placed over the eye to use the images to witness the vitreous movement around the cutter and to establish its position in relation to the retinal wall. The procedure was performed in at least four ultrasound projections (longitudinal-9,6, 3, and 12). All patients were followed for three months, and in each visit, the visual acuity and the presence of adverse effects were assessed.
Results:
Overall, 12 patients (mean age: 56.2 ± 18.4 years) were enrolled. Visual acuity at baseline was 2.3 ± 0.25 logarithm of the minimum angle of resolution. Sixty-six percent achieved inactivation of endophthalmitis. Two patients had evisceration caused by uncontrolled infection, and two more had retinal detachment during follow-up. Visual acuity at the end of follow-up was 2.1 ± 0.3 logarithm of the minimum angle of resolution ( P = 0.5).
Conclusion:
Ultrasound-guided vitrectomy is a feasible surgical technique. More studies are needed to assess its safety profile and optimize outcomes.
