Background: To evaluate the results of pars plana vitrectomy with peeling of the internal limiting membrane (ILM) in eyes with chronic macular oedema. Methods: PPV with indocyanine green (ICG) assisted peel ing of the...Background: To evaluate the results of pars plana vitrectomy with peeling of the internal limiting membrane (ILM) in eyes with chronic macular oedema. Methods: PPV with indocyanine green (ICG) assisted peel ing of the ILM was performed in 33 eyes with diabetic (21 eyes) or non- diabetic (12 eyes) macular oedema. Postoperatively, resolution of macular oedema, improvement of visual acuity (VA) and complications were documented. The peeled membranes were submitted for light and transmission electron microscopic evaluation. Results: The mean follow- up time was 12.2 month s. The macular oedema decreased or was resolved in 17 (81% ) eyes in the diabetic group and in 11 (92% ) eyes in the non- diabetic group. VA improved by at least 2 lines in 11 (52% ) eyes in the diabetic group and in 7 (58% ) eyes in the non- diabetic group. The difference between visual acuity improvements of the two groups was not statistically significant (P > 0.05). However, in the diabetic group the difference of visual improvement between cystoid and diffuse type of macular oedema eyes was statistically significant (14% versus 71% , P=0.02). Light and transmission electron microscopy showed the presence of ILM in all specimens. During the follow- up period no recurrence of macular oedema or epiretinal membrane formation was observed. Conclusion: Pars plana vitrectomy with peeling of the ILM and epiretinal membrane leads to the resolution of macular oedema in the majority of eyes. This however, is not always associated with VA improvement. In diabetic eyes, cystoid type of macular oedema appears to be a poor prognostic factor for improved VA.展开更多
BACKGROUND AND OBJECTIVE: The results and complications of posterior chamber i ntraocular lens (IOL) implantation by a 4-point scleral fixation technique are described. PATIENTS AND METHODS: Fifty eyes of 47 patients ...BACKGROUND AND OBJECTIVE: The results and complications of posterior chamber i ntraocular lens (IOL) implantation by a 4-point scleral fixation technique are described. PATIENTS AND METHODS: Fifty eyes of 47 patients who underwent scleral -fixated IOL implantation were retrospectively evaluated. Twenty-one (42%) ey es had a history of trauma and 29 (58%) eyes had previously undergone cataract surgery. In all cases, IOL implantation by 4-point scleral fixation was perform ed and the knots of fixation sutures were rotated and buried in the globe. The I OL position was adjusted by suture rotation for best centration. RESULTS: The me an follow-up time was 7 ±4 months. Four (8%) eyes had minimal corneal edema p reoperatively. Cystoid macular edema was noted in 2 (6.8%) eyes in the cataract surgery group and 8 (38%) eyes in the posttraumatic group. Two (9.5%) eyes in the posttraumatic group had atrophic macular changes and 1 (4.7%) had corneal scarring,which impaired vision. No complications such as knot exposure, tilting of the IOL, decentralization, or endophthalmitis were noted postoperatively. Pos toperative mean corrected visual acuity was 0.4 ±0.3 in the posttraumatic group and 0.4 ±0.2 in the cataract surgery group. CONCLUSION: The 4-point scleral f ixation technique resulted in no serious postoperative complications such as sut ure exposure and endophthalmitis. Because the knot can be rotated and buried in the globe, knot exposure is less likely to occur. This procedure ismore effectiv e than other techniques regarding IOL centralization.展开更多
BACKGROUND AND OBJECTIVE: To determine whether deep- topical anesthesia is suitable for small- incision manual extracapsular cataract extraction (ECCE). PATIENTS AND METHODS: Three hundred twenty- six eyes of 253 pati...BACKGROUND AND OBJECTIVE: To determine whether deep- topical anesthesia is suitable for small- incision manual extracapsular cataract extraction (ECCE). PATIENTS AND METHODS: Three hundred twenty- six eyes of 253 patients had small- incision manual ECCE under topical anesthesia with a 4% lidocaine- soaked sponge. The severity of the pain, eye movements, blepharospasm, and intraoperative complications were recorded. Patient and surgeon satisfaction levels were assessed. RESULTS: Operations on 323 eyes (99% ) were completed with topical anesthesia. Intraoperatively, topical anesthesia was converted to peribulbar anesthesia in 3 eyes (0.9% ) because of excessive eye movements. The cauterization of the scleral vessels and conjunctiva and the subconjunctival injection were the stages causing severe pain. The most frequent intraoperative complication was posterior capsule rupture in 6 eyes (1.8% ). The satisfaction level was 95% for the patients and 90% for the surgeon. CONCLUSION: Deep- topical, nerveblock anesthesia provides anesthesia with sufficient quality for small- incision manual ECCE.展开更多
文摘Background: To evaluate the results of pars plana vitrectomy with peeling of the internal limiting membrane (ILM) in eyes with chronic macular oedema. Methods: PPV with indocyanine green (ICG) assisted peel ing of the ILM was performed in 33 eyes with diabetic (21 eyes) or non- diabetic (12 eyes) macular oedema. Postoperatively, resolution of macular oedema, improvement of visual acuity (VA) and complications were documented. The peeled membranes were submitted for light and transmission electron microscopic evaluation. Results: The mean follow- up time was 12.2 month s. The macular oedema decreased or was resolved in 17 (81% ) eyes in the diabetic group and in 11 (92% ) eyes in the non- diabetic group. VA improved by at least 2 lines in 11 (52% ) eyes in the diabetic group and in 7 (58% ) eyes in the non- diabetic group. The difference between visual acuity improvements of the two groups was not statistically significant (P > 0.05). However, in the diabetic group the difference of visual improvement between cystoid and diffuse type of macular oedema eyes was statistically significant (14% versus 71% , P=0.02). Light and transmission electron microscopy showed the presence of ILM in all specimens. During the follow- up period no recurrence of macular oedema or epiretinal membrane formation was observed. Conclusion: Pars plana vitrectomy with peeling of the ILM and epiretinal membrane leads to the resolution of macular oedema in the majority of eyes. This however, is not always associated with VA improvement. In diabetic eyes, cystoid type of macular oedema appears to be a poor prognostic factor for improved VA.
文摘BACKGROUND AND OBJECTIVE: The results and complications of posterior chamber i ntraocular lens (IOL) implantation by a 4-point scleral fixation technique are described. PATIENTS AND METHODS: Fifty eyes of 47 patients who underwent scleral -fixated IOL implantation were retrospectively evaluated. Twenty-one (42%) ey es had a history of trauma and 29 (58%) eyes had previously undergone cataract surgery. In all cases, IOL implantation by 4-point scleral fixation was perform ed and the knots of fixation sutures were rotated and buried in the globe. The I OL position was adjusted by suture rotation for best centration. RESULTS: The me an follow-up time was 7 ±4 months. Four (8%) eyes had minimal corneal edema p reoperatively. Cystoid macular edema was noted in 2 (6.8%) eyes in the cataract surgery group and 8 (38%) eyes in the posttraumatic group. Two (9.5%) eyes in the posttraumatic group had atrophic macular changes and 1 (4.7%) had corneal scarring,which impaired vision. No complications such as knot exposure, tilting of the IOL, decentralization, or endophthalmitis were noted postoperatively. Pos toperative mean corrected visual acuity was 0.4 ±0.3 in the posttraumatic group and 0.4 ±0.2 in the cataract surgery group. CONCLUSION: The 4-point scleral f ixation technique resulted in no serious postoperative complications such as sut ure exposure and endophthalmitis. Because the knot can be rotated and buried in the globe, knot exposure is less likely to occur. This procedure ismore effectiv e than other techniques regarding IOL centralization.
文摘BACKGROUND AND OBJECTIVE: To determine whether deep- topical anesthesia is suitable for small- incision manual extracapsular cataract extraction (ECCE). PATIENTS AND METHODS: Three hundred twenty- six eyes of 253 patients had small- incision manual ECCE under topical anesthesia with a 4% lidocaine- soaked sponge. The severity of the pain, eye movements, blepharospasm, and intraoperative complications were recorded. Patient and surgeon satisfaction levels were assessed. RESULTS: Operations on 323 eyes (99% ) were completed with topical anesthesia. Intraoperatively, topical anesthesia was converted to peribulbar anesthesia in 3 eyes (0.9% ) because of excessive eye movements. The cauterization of the scleral vessels and conjunctiva and the subconjunctival injection were the stages causing severe pain. The most frequent intraoperative complication was posterior capsule rupture in 6 eyes (1.8% ). The satisfaction level was 95% for the patients and 90% for the surgeon. CONCLUSION: Deep- topical, nerveblock anesthesia provides anesthesia with sufficient quality for small- incision manual ECCE.
