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Ultrasound-guided pars plana vitrectomy.

PURPOSE
To assess the feasibility of a novel surgical technique that combines b-scan ultrasound with modern vitrectomy techniques.


METHODS
We enrolled patients with a clinical diagnosis of infectious keratitis endophthalmitis, that were scheduled for pars plana vitrectomy and ruled out as candidates for transient keratoprosthesis. The ultrasound probe was placed over the eye in order 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, we assess the visual acuity and the presence of adverse effects.


RESULTS
We enrolled 12 patients (mean age: 56.2 ± 18.4 years). Visual acuity at baseline was 2.3 ± 0.25 logMAR. Sixty-six percent achieved inactivation of endophthalmitis. Two patients had evisceration due to uncontrolled infection and two more had retinal detachment during follow-up. Visual acuity at the end of follow-up was 2.1 ± 0.3 logMAR (p=0.5).


CONCLUSION
Ultrasound-guided vitrectomy is a feasible surgical technique. More studies are needed to assess its safety profile and optimize outcomes.