OBJECTIVETo evaluate the therapeutic effects and complications of hydroxyapatite (HA) orbital implantation on patients after trauma-related surgeries.

METHODSRetrospective analysis was made from 211 cases (211 eyes) who underwent HA orbital implant placement after trauma-related enucleation or evisceration, including 68 cases of evisceration and primary HA implant placement, 77 cases of enucleation and HA implant placement wrapped with multi-windowed sclera, 66 cases of enucleation and HA implant placement free of wrapping. All the cases were followed up for 1-5 years to observe the therapeutic effects and major complications.

RESULTSFive of 211 cases had wound dehiscence. Ten cases had HA implants exposure, including 1 case suffering severe orbital infection and requiring HA implant removal. The implants exposure incidences by the three surgical methods were from 1.30% to 10.06% and averaged 4.74%. Significant difference was found in late exposure incidence and total incidence from the three methods (chi(2)=13.372, P < 0.01 and chi(2)=7.540, P < 0.05). Two cases had shrinkage of the lower fornix. Enophthalmos occurred in 1 case treated by method 1 and was corrected by implanting porous polyethylene (Medpor) plate into the bottom of orbit. In 210 cases, the artificial eye moved well and the cosmetic results were satisfactory.

CONCLUSIONSDifferent surgical methods have their own merit and disadvantage. Enucleation and placement of HA implant wrapped with multi-windowed sclera has corroborated fewer complications than others.

Adult ; Durapatite ; Eye Enucleation ; methods ; Eye Evisceration ; methods ; Eye Injuries, Penetrating ; surgery ; Female ; Humans ; Male ; Middle Aged ; Ophthalmologic Surgical Procedures ; methods ; Orbital Implants ; Prosthesis Implantation ; methods ; Retrospective Studies

PURPOSE: To analyze trends in rhegmatogenous retinal detachment (RRD) surgery among the members of the Korean Retina Society from 2001 to 2013. METHODS: In 2013, surveys were conducted by email and post to investigate the current practice patterns regarding RRD treatment. Questions included how surgeons would manage six cases of hypothetical RRD. Results were compared to those reported in 2001. RESULTS: A total of 133 members (60.7%) in 2013 and 46 members(79.3%) in 2001 responded to the survey. Preference for pneumatic retinopexy has decreased in uncomplicated primary RRD (p = 0.004). More respondents in 2013 selected vitrectomy as the primary procedure when mild vitreous hemorrhage (p = 0.001), myopia (p = 0.044) and history of successful scleral buckling on the fellow eye (p = 0.044) were added to the primary scenario. Vitrectomy was over twice as popular in cases of pseudophakic, macula-off RRD with posterior capsular opacity (p = 0.001). CONCLUSIONS: For RRD with myopia, pseudophakia and media opacity, surgical interventions over the last decade have drastically shifted from scleral buckling and pneumatic retinopexy to vitrectomy.
Endotamponade/trends ; Female ; Health Care Surveys ; Humans ; Male ; Middle Aged ; Ophthalmologic Surgical Procedures/*trends ; Ophthalmology/organization & administration ; Practice Patterns, Physicians'/*trends ; Republic of Korea ; Retinal Detachment/*surgery ; Scleral Buckling/trends ; Societies, Medical ; Surveys and Questionnaires ; Vitrectomy/trends

We report a case of possible venous air embolism (VAE) during trans pars plana vitrectomy with air-fluid exchange of the vitreous cavity. Shortly after initiation of air-fluid exchange, decreases in end-tidal CO2, oxygen saturation, and blood pressure were observed. The patient rapidly progressed to cardiac arrest unresponsive to cardiopulmonary resuscitation, and recovered after the application of percutaneous cardiopulmonary support. Prompt termination of air infusion is needed when VAE is suspected during air-fluid exchange, and extracorporeal life support should be considered in fatal cases. Although the incidence is rare the possibility of VAE during ophthalmic surgery clearly exists, and therefore awareness and vigilant monitoring seem critical.
Blood Pressure ; Cardiopulmonary Resuscitation ; Embolism, Air* ; Heart Arrest* ; Humans ; Incidence ; Ophthalmologic Surgical Procedures ; Oxygen ; Vitrectomy

Cataract surgery is the commonest ophthalmic surgical procedure and a local anaesthetic technique is usually preferred but the provision of anaesthesia in terms of skills and resources varies worldwide. Intraconal and extraconal blocks using needles are commonly used. The techniques are generally safe but although rare, serious sight- and life-threatening complications have occurred following the inappropriate placement of needles. Sub-Tenon's block was introduced as a safe alternative to needle techniques but complications have arisen following this block as well. Currently, there is no absolutely safe ophthalmic regional block. It is essential that those who are involved in the care of these patients have a thorough knowledge of the techniques used. This review article outlines the relevant anatomy, commonly used techniques and their safe performance and perioperative care.
Cataract Extraction ; Humans ; Nerve Block ; adverse effects ; methods ; Ophthalmologic Surgical Procedures

Senile ptosis is a disease often seen in ophthalmology. If not treated timely, this condition can result in unwanted consequences both cosmetic and functional terms. This paper addressed to clinical features of senile ptosis and the efficiency of surgical correcting procedures. Subjects: Target groups of the study consist of over sixty years old patients suffering senile ptosis who were treated at the National Institute of Ophthalmology between 2002 - 2005. Method: the author had investigated senile ptosis clinical features and its correction surgery with three ways: excision of excessive skin, frontalis suspension operation, aponeurotic resection and resection of Muller's muscles (by Tyers A. G.). Results and conclusion: References drawn from the study on senile ptosis clinical features are as follows: Senile ptosis is often seen in patients aged between 60 and 65, the highest rate of ptosis (56.25%) at the over 70-years-old group, 100% of such patients have excessive skin; These surgeries are highly efficient for correction of senile ptosis. Our series of 55 eyes, 70,59, per cent (36 eyes) achieved a good results, 25.49 per cent (13 eyes) achieved an average results and 3.92 percent (2 eyes) achieved a poor results with an average follow up of 12 months. Though preliminary results are very encouraging, further study is still needed to optimized the treatment.
Eye Diseases, Ophthalmologic Surgical Procedures, Blepharoptosis, Therapeutics

OPHTHALMOLOGY ; OPHTHALMOLOGIC SURGICAL PROCEDURES/HISTORY ; PHILIPPINES

The management of vitreous opacities varies from case to case. Successful treatment depends on identifying the specific cause of the opacity. In general, opacities which do not reduce vision are left alone; however, the condition producing the opacities is treated. Most congenital opacities seldom requires treatment, since they are usually asymptomatic and innocuous. In case of vitreous opacity caused by uveitis, specific therapy or steroid therapy is needed. The management of hemorrhagic vitreous opacity depends on whether the hemorrhage is recent or long-standing. A patient with a recent vitreous hemorrhage of unknown etiology should be placed on strict bed rest at least 72 hours. Retinal break or vascular lesions causing vitreous hemorrhages should be treated with photocoagulation, cryoapplication or scleral buckling procedure. When vitreous hemorrhage does not clear in 6 months, a closed vitrectomy may be indicated. Dense, organized intravitreous opacities of hemorrhagic or inflammatory origin are permanent and these opacities can be removed through a closed vitrectomy.
Bed Rest ; Hemorrhage ; Humans ; Light Coagulation ; Retinal Perforations ; Scleral Buckling ; Uveitis ; Vitrectomy ; Vitreous Hemorrhage

The management of vitreous opacities varies from case to case. Successful treatment depends on identifying the specific cause of the opacity. In general, opacities which do not reduce vision are left alone; however, the condition producing the opacities is treated. Most congenital opacities seldom requires treatment, since they are usually asymptomatic and innocuous. In case of vitreous opacity caused by uveitis, specific therapy or steroid therapy is needed. The management of hemorrhagic vitreous opacity depends on whether the hemorrhage is recent or long-standing. A patient with a recent vitreous hemorrhage of unknown etiology should be placed on strict bed rest at least 72 hours. Retinal break or vascular lesions causing vitreous hemorrhages should be treated with photocoagulation, cryoapplication or scleral buckling procedure. When vitreous hemorrhage does not clear in 6 months, a closed vitrectomy may be indicated. Dense, organized intravitreous opacities of hemorrhagic or inflammatory origin are permanent and these opacities can be removed through a closed vitrectomy.
Bed Rest ; Hemorrhage ; Humans ; Light Coagulation ; Retinal Perforations ; Scleral Buckling ; Uveitis ; Vitrectomy ; Vitreous Hemorrhage

Pars plana vitrectomy with encircling scleral buckling was performed for 30 eyes of 30 patients with complicated retinal disorders, and the changes of axial length, refractive power, and corneal curvature were analyzed. Significant axial length elongations were observed after encircling procedures. Mean elongation was 0.93+/-0.48mm after 3 months and 0.91+/-0.54mm after 6 months. These spherical equivalent of refraction showed myopic shift of -2.26+/-1.51 diopters(D) after 3 months and -2.19+/-1.39D after 6 months. These changes seem to be less prominent in the eyes with preoperative axial length of 24.50mm or longer(0.68+/-0.46mm after 3 months, 0.60+/-0.49mm after 6 months) than in the eyes with axial length of 24.49mm or shorter(1.18+/-0.35mm 1.23+/-0.38mm). Slight increase in astigmatism was observed, 0.80+/-1.35D after 3 months and 0.64+/-1.01D after 6 months. The mean keratometric readings showed no significant changes, 0.00+/-0.95D after 3 months and 0.26+/-0.95D after 6 months. The result of this study may give an important information when combined procedure of encircling scleral buckling and IOL implantation be planned.
Astigmatism ; Humans ; Reading ; Retinaldehyde ; Scleral Buckling* ; Vitrectomy

PURPOSE: To evaluate the effect of scleral buckling and pars plana vitrectomy on accommodative power. METHODS: The study groups consisted of 30 eyes after buckling and 30 eyes after pars plana vitrectomy. Each control group comprised 30 eyes. Accommodative power, pupil diameter and anterior chamber depth were measured and the correlation coefficient to accommodative power was calculated. RESULTS: There was no statistical significance in the buckling group. In the pars plana vitrectomy and control groups, the accommodative powers were 4.03 +/- 2.30D and 2.26 +/- 2.70D (p<0.05), and the pupil diameters were 3.07 +/- 1.06 mm and 3.99 +/- 2.71 mm (p<0.05), respectively. Age and pupil diameter had a significant correlation coefficient in all groups (r>0.8 or r<-0.8). CONCLUSIONS: After pars plana vitrectomy, the accommodative power was increased, which suggested that the anatomical and structural change of the vitreous after pars plana vitrectomy influences the accommodative power.
Anterior Chamber ; Pupil ; Scleral Buckling* ; Vitrectomy*