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Purpose: The purpose of the study was to evaluate anatomical and functional results of pars plana vitrectomy in giant retinal tears., Materials and Methods: Ten eyes with giant retinal tears underwent pars plana vitrectomy. The time of observation after surgical intervention was 3 months to 2.5 years., Results: Retinal reattachment was obtained in 9 eyes (90%). In one eye, despite second vitrectomy, there was no positive effect due to massive vitreo-retinal proliferation., Conclusions: Surgical treatment of giant retinal tear yields good anatomical and functional results. Rarely massive vitreo-retinal proliferation may cause the redetachment. Perfluorodecalin used during surgery facilitates unfolding and flattening of the retina.

The authors present results of the treatment of retinal detachment with giant tear in 12 eyes in 11 patients. The encirclement of the eyeball, vitrectomy and endo-tamponade with gas in 3 cases and silicone oil in 9 were applied. In 4 cases, perfluorocarbon liquid was used to unroll the retina. After 6-15 months follow-up retina was completely attached in 8 eyes (66%); in 3 eyes (25%) residual detachment was observed in the inferior part of the fundus and in 1 eye retina remained detached. In 8 eyes, visual acuity was above 5/50, in 3 above 1/50. The type of endo-tamponade and the role of perfluorocarbon liquid in this kind of retinal detachment are discussed.

The methods and results of surgery in 6 cases of retinal detachment with macular hole are presented. In all 6 cases pars plana vitrectomy was performed, in 4 with subsequent SF6 and in 2 with silicone oil tamponade. Retinal attachment was achieved in 4 eyes. Visual acuity 1/50-2/50 was found after surgery in 5 cases. The follow-up ranged from 6 to 9 months.

The authors presented results of pars plana vitrectomy performed in 80 eyes of 70 patients with proliferative diabetic retinopathy. Endo-tamponade with silicone oil was applied in cases complicated by intraocular haemorrhages and tractional or rhegmatogenous retinal detachment. A complete attachment of the retina was achieved in 70 eyes, in 5 a limited area of flat retinal detachment persisted and in 5 the results were negative. The functional results were evaluated in two groups: 1) 26 eyes in which silicone oil was not used or was removed after several months, 2) with permanent silicone oil tamponade. Statistically significant better visual acuity was achieved in the first group. The authors concluded that for better results vitrectomy should be performed in less advanced stages of proliferative diabetic retinopathy, in which permanent silicone oil tamponade is not necessary.

The authors presented their experiences concerning the treatment of 26 eyes (in 25 patients) with retinal detachment complicated by PVR in which pars plana vitrectomy and silicone oil tamponade were applied. The patients have been previously operated with traditional methods however without success. Positive results, it is retinal attachment completely or in the superior and central part of the fundus with residual detachment inferiorly were achieved in 19 eyes (73%). An useful visual acuity (> 1/50) was achieved in 12 eyes and in 7 (27%) it was better than 5/50. Our results confirmed that this method (pars plana vitrectomy with silicone oil tamponade) is a method of choice in complicated retinal detachment, in which traditional methods failed.

The authors analyse the results of 146 operations of vitrectomy through the pars plana executed in cases of complications of diabetic retinopathy. In 50 eyes with prognostically very severe conditions (tractional retinal detachment, presence of central retinal holes, recurrent intraocular haemorrhages) vitrectomy was connected with an intra-bulbar injection of silicone oil. In the period of 6 months to 3 years after surgery the improvement of the visual acuity was attained in 96 eyes (66 p.c.). Intravitreal injection of the silicone oil increased the chance of reattachment of the retina and reduced the incidence of a postsurgical recurrent intraocular haemorrhage.

Silicone oil is being used with increased frequency for retinal tamponade during vitreous surgery for complicated retinal detachments. Though it is now possible to reattach most detached retinas, the visual outcome of the silicone oil procedure is often disappointing. This is due to the well known complications of silicone oil (i.e. cataract, glaucoma, corneal opacification), and the necessity to remove the silicone oil in a second surgical procedure with a certain risk of redetachment. Possible toxicity to retina and optic nerve has not yet get been completely evaluated. An alternative method is the use of expanding gases for internal retinal tamponade. Expanding gases are not as effective as silicone oil in advanced stages of proliferative vitreoretinopathy (PVR), but are afflicted with much less complications. We reviewed the charts of our patients, operated on for retinal detachment, to analyse the anatomical and functional results with silicone oil versus gas tamponade. Regarding the last 421 consecutive surgical procedures for retinal detachment (368 eyes), silicone oil has been used in 5%, expanding gases in 14%. The silicone oil procedure was restricted to the most advanced cases of PVR. The anatomic success rate with silicone was 72%, with gas tamponade 87%. Visual acuity of 0.05 and better achieved 19% of the eyes treated with silicone oil versus 61% of the eyes with gas tamponade. These results confirm the findings of other investigators: despite of the high anatomic success rate with silicone oil, the functional results are poor. Because many complicated cases of retinal detachment can also be treated successfully with gas tamponade, silicone oil should remain the last step in retinal detachment surgery.

The purpose of the investigation was to evaluate the efficiency of two protective creams elaborated in my laboratory, devised for protection of skin exposed to aqueous solution of chromium and nickel compounds. The creams were tested by the measurement of Cr2O7(2-) and Ni2+ absorption rate through the skin in rats and excretion of these metals in urine after termination of exposure. It was found that absorption rate both ions through the skin and their excretion in urine decreased in presence of creams. However, correlation between absorption rate and excretion of these metals in urine was not found.