Rare Diseases Symptoms Automatic Extraction

Combined endoscopic vitrectomy with pars plana tube shunt procedure.


We report a case series of patients with limited fundus view due to advanced and complex anterior segment disease that underwent combined endoscopic vitrectomy and pars plana tube shunt for intraocular pressure (IOP) control.The records of 13 eyes of 11 patients operated at Cincinnati Eye Institute from 2006 to 2010 with combined endoscopic pars plana vitrectomy and pars plana tube shunt placement were retrospectively reviewed. Preoperative and postoperative IOP and visual acuity, clinical course and complications were noted.Nine eyes had aniridia, two had chemical burn injury, one had Axenfeld-Rieger syndrome and one had ocular trauma. Median follow-up was 18months. Preoperative and postoperative mean LogMAR visual acuities were 1.42±0.9 and 1.24±0.7 (p=0.55). Preoperative mean IOP was 23±9mmHg and improved to 12±5mmHg postoperatively (p<0.0003). No complications were noted.Endoscopic vitrectomy with pars plana glaucoma tube shunt implantation may be considered in the management of uncontrolled IOP in patients with media opacity. Achieving IOP control prior to attempted anterior segment reconstruction in these severely diseased eyes may increase the success rate and decrease the complexity of subsequent anterior reconstruction procedures.