Objective: To determine the sensivity and specify of ocular ultrasonography in detecting Vitreoretinal lesion prior to Deep Vitrectomy in patients with opaque media.Method: The hospital records of patients undergoing Deep Vitrectomy in a defined period at Shiraz Khalili hospital were reviewed. Sonographic reports given by a sinologist and operation reports Given by a vitreoretinal fellowship were compared regarding significant clinical problems in five groups: intraocular foreign bodies, retinal detachment, choroidal detachment, posterior globe rupture and significant vitreous opacities. Results: From 42 sonographic reports, sensitivity of sonography was 100% for detection of vitreous Opacity, posterior globe rupture, and intraocular foreign bodies; 90% for retinal detachment; and 71.4%for choroidal detachment. The specificity of sonography for all of the above mentioned Pathologies was over 80% except for determination of significant vitreous opacities that was 71.4%. Conclusion: In this five group of vitreoretinal lesions, sonographic reports were accurate and were reliable for surgical planning and decision making in our setting.

Purpose: To evaluate the efficacy of silicone oil injection after Deep Vitrectomy in infectious endophthalmitis regarding visual acuity.Methods: This single-blind randomized clinical trial was performed on 50 cases of infectious endophthalmitis undergoing Deep Vitrectomy. Patients were randomly assigned to two groups: in one group silicone oil was injected into the eye at the end of the operation (silicone group) and in the second group the eye was formed with balanced salt solution (non-silicone group). All patients were followed for more than six months.Results: The underlying cause of endophthalmitis was cataract surgery in 23 patients (46%), trauma in 20 patients (40%), bleb-associated endophthalmitis in 3 patients (6%), corneal graft in 2 patients (4%) and endogenous in 2 patients (4%). Mean visual acuity was 2.1 LogMAR in the silicone group and 4.0 LogMAR in the non-silicone group (p<0.0001).Conclusion: Silicone oil injection may be beneficial in terms of visual outcomes in Deep Vitrectomy for infectious endophthalmitis.

Background: Regardless of the exact reason, it is important to identify patients who are at greater risk for pain. There are few studies about the effects of age and gender in pain perception during and after Deep Vitrectomy; so, we performed this study to evaluate the effects of these two factors in this regard.Methods: In a descriptive study, 440 patients scheduled for Deep Vitrectomy were randomly allocated to three age groups, group 1: 17-34, group 2: 35-52, and group 3: 53-70 years old. General anesthesia was performed in the same manner in all the groups. Pain intensity [based on the visual analog scale (VAS)] and additional opioid consumption was assessed on entrance to the recovery room, and 30 and 60 minutes and 2, 4, 8, 16 and 24 hours after arrival it. Findings: Pain intensity in time of entrance to recovery room was 3.73±1.46, 3.05±1.08 and 4.19±2.03 in groups of 17-34, 35-52 and 53-70 years, respectively and the difference between the groups was significant (P<0.001). The patients aged 53-70 years had more pain intensity compared with the other age groups from arrival to the recovery room until 24 hours postoperatively (P<0.050 for all the times). In addition, the pain intensity was significantly higher in women compared to men from arrival to the recovery room until 4 hours postoperatively (P<0.05 for all the times). The number of patients requiring pethidine was not significantly different between the three groups all the times during 24 hours postoperatively (P>0.050 for all).Conclusion: Women and elder patients experience more intense pain after Deep Vitrectomy.

Purpose: To evaluate the effectiveness of pars plana Vitrectomy and posterior hyaloid stripping in decreasing macular thickness and improving vision in diabetic macular edema.Methods: This prospective interventional case series includes 30 eyes of25 diabetic patients with diabetic macular edema with macular thickness exceeding 170 microns and thickened posterior hyaloid. BCVA and macular thickness measured by OCT were evaluated preoperatively and 4-6 months postoperatively. Macular perfusion was evaluated by means of fluorescein angiography preoperatively. Treatment consisted of pars plana Vitrectomyand stripping of posterior hyaloid. Results: Mean preoperative macular thickness was 531.97±126.52 µm which decreased to 365.2±103.2, postoperatively (p<0.001). Mean preoperative BCVA (Log MAR) was 0.82±0.39 which improved to 0.65±0.34 postoperatively (P=0.006). According to Pearson correlation coefficient, macular perfusion and presurgical BCVA≤20/200 had statistically significant correlation with post surgical BCVA.Conclusion: Pars plana Vitrectomy and posterior hyaloid stripping lead to decrease in macular thickness and improvement of vision in patients with diabetic macular edema. All patients are legible to be exposed to the risks of surgery and it is rvandatory to select patients for this modality according to be exposed to the and after documenting the role of vitreousin the pathogenesis of the edema with OCT.

Purpose: To compare Deep Vitrectomy and scleral buckling for management of macula-off retinal detachment regarding the time course of foveal reattachment.Methods: This non-randomized clinical trial included 25 patients with spontaneous rhegmatogenous retinal detachments. Patients underwent Deep Vitrectomy (11 patients) or scleral buckling (14 eyes) based on the accepted indications. Patients underwent a complete ophthalmic examination as well as optical coherence tomography (OCT) pre- and 1, 6 and 12 months postoperatively.Results: OCT revealed that the fovea was completely attached with no subfoveal fluid in all cases of Deep Vitrectomy 1, 6 and 12 months postoperatively. However in the scleral buckling group there was a small subclinical area of subfoveal fluid on OCT in 8 eyes (57.2%) at one month, in 7 eyes (50%) at 6 months and in 3 eyes (21.4%) at 12 months postoperatively.Conclusion: Deep Vitrectomy for macula-off retinal detachment results in complete foveal reattachment without delay according to OCT results and therefore may be superior to scleral buckling.

Background & objectives: The aim of this study was to evaluate the effects of preventive administration of ketamine, fentanyl and paracetamol on pain intensity and hemodynamic parameters after Deep Vitrectomy. Methods: In this clinical trial, 80 candidates of Deep Vitrectomy surgery were randomly assigned into 4 groups (1-4) and received 0. 5 mg / kg ketamine, 2 μ, g / kg fentanyl, 10 mg/kg of paracetamol and equivolume of normal saline respectively intravenous infusion during the last 15 minutes of surgery. Pain intensity and hemodynamic parameters were recorded and analyzed. Results: Pain intensity was significantly higher in placebo group during the first 4 hours after operation (p<0. 01), but no significant differences were observed between the study groups at 8 and 24 hours after operation in this regard. There were no significant differences between the three intervention groups in terms of pain intensity during the study. Also there were no significant differences between the 4 study groups regarding to hemodynamic parameters. Conclusion: The use of each of the three intervention drugs significantly reduced the pain intensity compared to the control group without any hemodynamic derangement.

Background & Aims: Due to the high prevalence and importance of postoperative pain and opioid complications, we aimed to compare the prophylactic effect of intravenous injection of magnesium sulfate and paracetamol and their combination on pain intensity after Deep Vitrectomy in this study. Materials & Methods: In this clinical trial study, 140 candidates of Deep Vitrectomy randomly distributed in four groups of 35. in the first group, 7. 5 mg/kg magnesium sulfate was injected 20 minutes before the operation. In the second group, 15 mg/kg paracetamol, in the third group 10 mg/kg paracetamol plus 5 mg/kg magnesium sulfate within ten minutes, and in the fourth group, normal saline with the same volume was injected. The patients were then examined and compared in terms of hemodynamic parameters, pain intensity, amount of palliatives consumed, frequency of receiving palliatives, and occurrence of postoperative complications. Results: The mean postoperative pain intensity in the four groups of magnesium sulfate, paracetamol, magnesium sulfate-paracetamol, and control were 1. 32 ±,0. 9, 1. 42 ±,0. 34, 1. 05 ±,0. 38, and 1. 72 ±,0. 95, respectively, and the difference between the groups was significant (P = 0. 003). The number of patients received pethidine were significantly lower in the combination group than the other groups (P = 0. 018). The time interval between entering recovery and receiving analgesia in the group was significantly longer in the combination group than the other groups (P <0. 001). Conclusion: The use of magnesium sulfate-paracetamol combination reduces the postoperative pain intensity, prolongs the time of requesting analgesia, and reduces the use of analgesia within 24 hours after surgery, without any significant hemodynamic complication.