Search

Introduction: The aim of this study was to evaluate the incidence of pseudophakic retinal detachment (RD) recurrence after primary vitrectomy., Patients and Methods: This was a prospective nonrandomized consecutive case series study, evaluating two series presenting to our clinic with pseudophakic RD from 1998 to 2004 (103 eyes of 97 patients). The study included 24 consecutive pseudophakic eyes treated with gas vitrectomy surgery with placement of an encircling band from January 1998 to December 2000 (group A) and 79 consecutive pseudophakic eyes treated with gas vitrectomy surgery with no encircling band from January 2001 to December 2004 (group B). Pre- and postoperative characteristics were analyzed in both groups. In the cases of postoperative RD recurrence, we particularly analyzed the pre- and postoperative risk factors, as well as the anatomic and functional outcome., Results: Visual acuity improved in 74/103 (71.8%) eyes from both groups postoperatively. Recurrence of RD after primary vitrectomy occurred in eight of 103 (7.8%) eyes in both groups. More specifically, two of 24 (8.3%) eyes in group A and six of 79 (7.6%) eyes in group B presented a recurrence after gas vitrectomy with encircling band and gas vitrectomy alone, respectively. Among these eight eyes, four eyes (50%) presented proliferative vitreoretinopathy (PVR) at the time of initial vitrectomy, while all eyes presented PVR at the time of recurrence (one grade B, seven grade C). These eyes required two additional interventions on average. Five eyes (62.5%) required silicone-oil tamponade for a good anatomic reapplication., Discussion: These results show that recurrence after primary vitrectomy for pseudophakic RD is most often related to the presence of PVR before or after the first intervention. This series reports a success rate of 91.7% and 92.4%, respectively, for group A and B, thus demonstrating the efficacy of vitrectomy in the treatment of pseudophakic RD. This study also shows a nonsignificant difference in the recurrence rate among patients treated by gas vitrectomy and those undergoing gas vitrectomy in association with encircling band placement, which raises the question of the usefulness of an additional encircling band in pseudophakic RD.

Introduction: Panretinal photocoagulation proved to be effective in preventing complications related to vasoproliferative diabetic retinopathy. Surgery is most often a last resort in cases of recurrent or persistent vitreous hemorrhage or retinal detachment. The aim of our study is to point out that eyes requiring surgery for complications related to vasoproliferative diabetic retinopathy are often insufficiently photocoagulated., Patients and Methods: Retrospective analysis of operating protocols and surgical results for a series of 39 eyes of 36 patients with complications of vasoproliferative diabetic retinopathy., Results: The mean age at the intervention was 57 years. Eighty-five percent of the eyes had a vitreous hemorrhage, 17% a retinal detachment. Eighty-five percent of the eyes had undergone a partial retinal photocoagulation before surgery. All eyes underwent a vitrectomy with segmentation of fibrovascular membranes. In 85% of the eyes studied, endolaser photocoagulation was necessary, sometimes even in the mid-periphery. After 39+/-26 months of postoperative follow-up, 97% of eyes showed improvement of the anatomical state of the retina and improvement or stabilization of visual acuity., Conclusion: Our results confirm the benefit of vitreoretinal surgery in complications related to vasoproliferative diabetic retinopathy. Moreover, it should be emphasized that complications requiring surgery often result from incomplete preoperative photocoagulation. To be effective, photocoagulation has to destroy more than 35% and up to 50% of photoreceptors. An intraoperative laser extension can reduce the risk of regrowth of fibrovascular membranes.

We present the case of a 54-year-old man with a previous history of central retinal vein occlusion in the right eye, who developed an idiopathic polypoidal choroidal vasculopathy in the right eye and an epiretinal membrane in the left eye. The patient's medical history disclosed arterial hypertension controlled with medical treatment. Although idiopathic polypoidal choroidal vasculopathy has been associated with several conditions, this is the first time that this entity has been described in the literature in association with central retinal vein occlusion.

Purpose: We conducted a prospective study to determine the effect of topical administration of brimonidine tartrate 0.2% on postoperative intraocular pressure (IOP) spikes during the first 24 hours after an extracapsular cataract extraction., Material and Methods: In a placebo-controlled study, we randomized 40 consecutive normotensive eyes undergoing extracapsular cataract surgery into two treatment modalities. Twenty eyes (group A) received placebo and 20 eyes (group B) were given brimonidine tartate 0.2% drops twice the day before and twice on the day of the operation. IOP was measured at baseline (prior to surgery) and then 4, 6, 12 and 24 hours postoperatively., Results: Mean postoperative IOP was higher in the placebo group than in the brimonidine group at every time point studied. In both groups, peak elevation of mean IOP was recorded 6 hours after surgery. At that time, mean IOP was significantly higher in the placebo group (36.2+/-4.0 mmHg) than in the brimonidine group (24.7+/-3.8 mmHg) (p<0.001). A gradual reduction in IOP followed, yet with significantly higher values than those found preoperatively, even 12 hours after surgery (p<0.001). It was only the brimonidine group that achieved a near-to-normal mean IOP 24 hours after surgery (p>0.05). Four of the placebo group patients compared to 1 of the brimonidine group patients had an IOP higher than 40 mmHg 6 hours after surgery and therefore received additional therapy., Conclusion: Prophylactic treatment with brimonidine tartrate 0.2% drops twice a day for 2 days is effective in reducing IOP spikes throughout the first 24 hours after an extracapsular cataract extraction.