eMedicine Specialties > Ophthalmology > Vitreous

Vitreous Wick Syndrome: Follow-up

Author: Manolette R Roque, MD, MBA, DPBO, FPAO, President and CEO, Chief of Service, Ocular Immunology and Uveitis, Consulting Staff, Cornea and Refractive Surgery, Eye Republic Ophthalmology Clinic; General Manager, Ophthalmic Consultants Philippines Co; Consulting Staff, CME Liaison, Section Chief of Ocular Immunology and Uveitis, Department of Ophthalmology, Asian Hospital and Medical Center
Coauthor(s): Barbara L Roque, MD, Full Partner, Ophthalmic Consultants Philippines Co, Chief of Service, Pediatric Ophthalmology and Strabismus, Consulting Staff, Orbit and Eye Plastics, EYE REPUBLIC Ophthalmology Clinic; C Stephen Foster, MD, FACS, FACR, FAAO, Clinical Professor of Ophthalmology, Harvard Medical School; Consulting Staff, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary; Founder and President, Ocular Immunology and Uveitis Foundation, Massachusetts Eye Research and Surgery Institution
Contributor Information and Disclosures

Updated: Dec 20, 2007

Follow-up

Further Outpatient Care

  • Arrange for follow-up care 1-2 days after surgery. If this initial follow-up examination is fine, schedule regular checkups for uneventful anterior segment surgeries.
  • An eye shield, especially at night, protects the globe from any untoward traumatic episodes.

Inpatient & Outpatient Medications

  • Discharge on broad-spectrum (or based on culture and sensitivity results) topical antibiotics. Steroid drops may be given, depending on the amount of inflammation.

Deterrence/Prevention

  • Meticulous surgical technique is essential for all ophthalmic surgery. Follow basic surgical techniques. Be sure all incisions are closed securely. In cases of broken capsules with vitreous presentation in the anterior segment, be sure all vitreous has been removed from the anterior segment by appropriate anterior vitrectomy technique. If this is not possible, consideration should be given to trans pars plana vitrectomy at a later date in consultation with a vitreoretinal surgeon.

Complications

  • Unnoticed and unmanaged vitreous wick syndrome may result in sight-threatening complications, such as sterile and infectious endophthalmitis.

Prognosis

  • Early identification and intervention lead to excellent results. The longer the vitreous wick is left unnoticed and unmanaged, the higher the risk for infection and inflammation.

Patient Education

  • Postoperative patients should report to their ophthalmologists,if the following are noted: delayed-onset eye redness, blurring of vision, and pain.

Miscellaneous

Medicolegal Pitfalls

  • Considering the ready availability of anterior vitrectomy capability, no eye should be left with vitreous in the anterior segment. Failure to at least attempt to clean prolapsed vitreous represents a departure from the standard of care.
  • Failure to consider the diagnosis may lead to severe infection and inflammation, which may result in blindness.
 
Acknowledgments

The author was a fellow and affiliated with the Ocular Immunology and Uveitis Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, HarvardMedicalSchool, while performing this work.



More on Vitreous Wick Syndrome

Overview: Vitreous Wick Syndrome
Differential Diagnoses & Workup: Vitreous Wick Syndrome
Treatment & Medication: Vitreous Wick Syndrome
Follow-up: Vitreous Wick Syndrome
Multimedia: Vitreous Wick Syndrome
References
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References

  1. Ruiz RS, Teeters VW. The vitreous wick syndrome. A late complication following cataract extraction. Am J Ophthalmol. Oct 1970;70(4):483-90. [Medline].

  2. Neetens A, Rubbens MC, Smets RM. Vitreous wick syndrome. Bull Soc Belge Ophtalmol. 1987;223 Pt 2:41-5. [Medline].

  3. Lindstrom RL, Doughman DJ. Bacterial endophthalmitis associated with vitreous wick. Ann Ophthalmol. Nov 1979;11(11):1775-8. [Medline].

  4. Srinivasan BD, Hofeldt A, Coleman DJ, DeVoe AG. Vitreous wick syndrome. Am J Ophthalmol. May 1979;87(5):662-4. [Medline].

  5. Rice TA, Michels RG. Current surgical management of the vitreous wick syndrome. Am J Ophthalmol. May 1978;85(5 Pt 1):656-61. [Medline].

  6. Chen SD, Mohammed Q, Bowling B, Patel CK. Vitreous wick syndrome--a potential cause of endophthalmitis after intravitreal injection of triamcinolone through the pars plana. Am J Ophthalmol. Jun 2004;137(6):1159-60; author reply 1160-1. [Medline].

  7. Sheets JH, Friedberg JG. Vitreous wick syndrome following discission of the posterior capsule. Arch Ophthalmol. Feb 1980;98(2):327. [Medline].

  8. Stainer GA, Binder PS. Vitreous wick syndrome following a corneal relaxing incision. Ophthalmic Surg. Aug 1981;12(8):567-70. [Medline].

  9. Venkatesh P, Verma L, Tewari H. Posterior vitreous wick syndrome: a potential cause of endophthalmitis following vitreo-retinal surgery. Med Hypotheses. Jun 2002;58(6):513-5. [Medline].

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Further Reading

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Keywords

vitreous wicks, vitrectomy, vitreous loss, vitreous prolapse, anterior segment surgery, vitreoretinal surgery, cataract surgery, endophthalmitis, intraocular inflammation, intraocular trauma, intraocular surgery, vision loss

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Contributor Information and Disclosures

Author

Manolette R Roque, MD, MBA, DPBO, FPAO, President and CEO, Chief of Service, Ocular Immunology and Uveitis, Consulting Staff, Cornea and Refractive Surgery, Eye Republic Ophthalmology Clinic; General Manager, Ophthalmic Consultants Philippines Co; Consulting Staff, CME Liaison, Section Chief of Ocular Immunology and Uveitis, Department of Ophthalmology, Asian Hospital and Medical Center
Manolette R Roque, MD, MBA, DPBO, FPAO is a member of the following medical societies: American Academy of Ophthalmic Executives, American Society of Cataract and Refractive Surgery, American Society of Ophthalmic Administrators, American Uveitis Society, International Ocular Inflammation Society, Philippine Medical Association, Philippine Ocular Inflammation Society, and Philippine Society of Cataract and Refractive Surgery
Disclosure: Nothing to disclose.

Coauthor(s)

Barbara L Roque, MD, Full Partner, Ophthalmic Consultants Philippines Co, Chief of Service, Pediatric Ophthalmology and Strabismus, Consulting Staff, Orbit and Eye Plastics, EYE REPUBLIC Ophthalmology Clinic
Disclosure: Nothing to disclose.

C Stephen Foster, MD, FACS, FACR, FAAO, Clinical Professor of Ophthalmology, Harvard Medical School; Consulting Staff, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary; Founder and President, Ocular Immunology and Uveitis Foundation, Massachusetts Eye Research and Surgery Institution
C Stephen Foster, MD, FACS, FACR, FAAO is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Association of Immunologists, American College of Rheumatology, American College of Surgeons, American Federation for Clinical Research, American Medical Association, American Society for Microbiology, American Uveitis Society, Association for Research in Vision and Ophthalmology, Massachusetts Medical Society, Royal Society of Medicine, and Sigma Xi
Disclosure: Nothing to disclose.

Medical Editor

Jerre Freeman, MD, Founder, Chairman, Memphis Eye and Cataract Associates; Clinical Professor, Department of Ophthalmology, University of Tennessee Health Science Center
Jerre Freeman, MD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Society of Cataract and Refractive Surgery, and Tennessee Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Managing Editor

J James Rowsey, MD, Former Director of Corneal Services, St Luke's Cataract and Laser Institute, Florida
J James Rowsey, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for the Advancement of Science, American Medical Association, Association for Research in Vision and Ophthalmology, Florida Medical Association, Pan-American Association of Ophthalmology, Sigma Xi, and Southern Medical Association
Disclosure: Nothing to disclose.

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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