Perfluorocarbon liquids(PFCLs) have recently been used to facilitate surgery in a variety of condition, including proliferative vitreoretinopathy, giant retinal tears, diabetic tractions, retinal detachment with a rhegmatous component, dislocated crystalline lenses. Although the ocular toxicity of PFCLs has been evaluated in a number of animal studies, few reports have focused on ocular complications associated with their clinical use. We evaluated complications of PFCLs as an intraoperative tool in a series of 55 patients. We had used two kinds of PFCLs, Vitreon(perfluorophenanthrene) and DK-line(perfluorodecaline) intraoperatively. 10 eyes had intraoperative complications. Subretinal PFCLs(6 eyes), subretinal hemorrhage(3 eyes), subretinal hemorrhage with subretinal PFCLs(1 eye) were observed. Postoperative complications of PFCLs as an only intraoperative tool were preretinal small dreplets(4 eyes), subretinal small droplets(4 eyes) and small dreplets in anterior chamber(2 eyes). In case of posterior retinal break, careful injection should be considered. Postoperative small residual droplet of perfluorocarbon in sub- and preretinal space did not cause any toxic effects in these patients. But remained droplet in anterior chamber should be removed to avoid significant corneal toxity.
Animals ; Anterior Chamber ; Hemorrhage ; Humans ; Intraoperative Complications ; Lens, Crystalline ; Postoperative Complications ; Retinal Detachment ; Retinal Perforations ; Traction ; Vitreoretinopathy, Proliferative

PURPOSE: To determine the clinical effect of radial optic neurotomy (RON) in central retinal vein occlusion (CRVO). METHODS: The retinal findings, visual acuity and complications were analyzed in patients who had undergone RON for the treatment of CRVO and were followed up 10 months or more after surgery. RESULTS: Of all 16 patients (16 eyes), the mean age was 55 years and the follow-up period was 14 months. Preoperative anterior segment and retinal neovascularization was observed in each three eyes. All eyes showed improvement in the retinal findings within two weeks after RON. The postoperative complications included vitreous hemorrhage in 1 eye, chorioretinal collateral circulation in 1 eye, neovascular glaucoma in 1 eye, vitreous hemorrhage and neovascular glaucoma in 1 eye. The visual acuity was counting fingers or less in 8 eyes preoperatively and in 2 eyes finally, and was less than 0.1 in 13 eyes preoperatively and in 10 eyes finally. The mean visual improvement in the 3.8 lines was in 11 eyes and a loss of 2.5 lines in 2 eyes. The maximum velocity of the blood flow of CRV improved with 1.95 +/- 0.93 cm/sec on the average in the 7 eyes examined by color doppler. CONCLUSIONS: RON appears to be safe and effective for improving the retinal findings, visual acuity and blood flow of CRV in CRVO. However, the visual recovery is limited.
Collateral Circulation ; Fingers ; Follow-Up Studies ; Glaucoma, Neovascular ; Humans ; Postoperative Complications ; Retinal Neovascularization ; Retinal Vein* ; Retinaldehyde ; Visual Acuity ; Vitreous Hemorrhage

PURPOSE: To investigate the visual recovery and complications of vitrectomy in Terson's syndrome. METHODS: A retrospective study was carried out on 11 eyes in 9 patients who had undergone pars plana vitrectomy for Terson's syndrome from October 2004 to June 2006. The factors assessed were age, gender, presence of hypertension, type of intracranial hemorrhage, preoperative and final visual acuity, time interval from intracranial hemorrhage (ICH) to vitrectomy, and any intraoperative and postoperative complications. RESULTS: The average age of the subjects and the Interval from ICH to vitrectomy were 43.0+/-11.0 years and 3.25+/-3.48 months respectively. Binocular involvement was found in two of the nine patients, and fundus findings were severe vitreous opacity in all cases, while sub-ILM hemorrhage at the posterior pole was seen in five eyes. Intraoperative retinal break was recorded at the 10 o'clock sclerotomy site in five eyes, and four of these five eyes were associated with sub-ILM hemorrhage. One patient underwent a scleral buckling operation four months postoperatively due to rhegmatogenous retinal detachment associated with a retinal tear at the 2 o'clock sclerotomy site. Visual acuity improved in all cases postoperatively, and the final visual acuity was over 0.6 in seven eyes. CONCLUSIONS: We can expect from early surgery a relatively good prognosis of visual acuity and prevention of complications. Due to the possibility of retinal breaks at the sclerotomy sites, we should keep in mind that cautious handling of intraocular instrument and complete removal of vitreous base may be necessary.
Hemorrhage ; Humans ; Hypertension ; Intracranial Hemorrhages ; Postoperative Complications ; Prognosis ; Retinal Detachment ; Retinal Perforations ; Retrospective Studies ; Scleral Buckling ; Telescopes ; Visual Acuity ; Vitrectomy*

PURPOSE: To investigate the visual recovery and complications of vitrectomy in Terson's syndrome. METHODS: A retrospective study was carried out on 11 eyes in 9 patients who had undergone pars plana vitrectomy for Terson's syndrome from October 2004 to June 2006. The factors assessed were age, gender, presence of hypertension, type of intracranial hemorrhage, preoperative and final visual acuity, time interval from intracranial hemorrhage (ICH) to vitrectomy, and any intraoperative and postoperative complications. RESULTS: The average age of the subjects and the Interval from ICH to vitrectomy were 43.0+/-11.0 years and 3.25+/-3.48 months respectively. Binocular involvement was found in two of the nine patients, and fundus findings were severe vitreous opacity in all cases, while sub-ILM hemorrhage at the posterior pole was seen in five eyes. Intraoperative retinal break was recorded at the 10 o'clock sclerotomy site in five eyes, and four of these five eyes were associated with sub-ILM hemorrhage. One patient underwent a scleral buckling operation four months postoperatively due to rhegmatogenous retinal detachment associated with a retinal tear at the 2 o'clock sclerotomy site. Visual acuity improved in all cases postoperatively, and the final visual acuity was over 0.6 in seven eyes. CONCLUSIONS: We can expect from early surgery a relatively good prognosis of visual acuity and prevention of complications. Due to the possibility of retinal breaks at the sclerotomy sites, we should keep in mind that cautious handling of intraocular instrument and complete removal of vitreous base may be necessary.
Hemorrhage ; Humans ; Hypertension ; Intracranial Hemorrhages ; Postoperative Complications ; Prognosis ; Retinal Detachment ; Retinal Perforations ; Retrospective Studies ; Scleral Buckling ; Telescopes ; Visual Acuity ; Vitrectomy*

A retrospective study was performed in 180 eyes (173 patients) with rhegmatogenous retinal detachment which underwent primary scleral buckling operations. One hundred and sixteen patients (67.1 %) were men. The most common age group was the seventh decade (34 patients, 19.6%). Moderate- to high- degree myopia were the most numerous (65 eyes, 38.0%) as the associated ocular findings and the peripheral retinal degenerations were next (44 eyes. 257%). One hundred and fifty eyes had retinal breaks preoperatively, 129 eyes (76.8%) had breaks distributed in the superior and/or inferior temporal quadrants, 84 eyes (56.0%) had breaks located in the equator and 82 eyes (54.7%) had atrophic holes. Among 180 eyes studied, 141 eyes (78.3%) achieved retinal reattachment by primary scleral buckling operations. Preoperative and/or postoperative proliferative vitreoretinopathy as causes of failure were presented in 18 eyes. Ten eyes had intraocular hemorrhage as intraoperative complications and the other 10 eyes developed cataract as postoperative ones. Fourty-seven eyes (33.3%) had corrected visual acuity below 0.1 in spite of successful retinal reattachment and 23 eyes had macular degenerations as the most common causes of poor vision.
Cataract ; Hemorrhage ; Humans ; Intraoperative Complications ; Macular Degeneration ; Male ; Myopia ; Retinal Degeneration ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Retrospective Studies ; Scleral Buckling ; Visual Acuity ; Vitreoretinopathy, Proliferative

PURPOSE: To report the effects and complications of conjunctival fixation to the sclera in conjunctivochalasis patients with inferior punctal occlusion. METHODS: The authors of the present study evaluated the degree of conjunctivochalasis and performed Fluorescein Dye Disappearance Test (FDT) in 15 eyes of 8 patients diagnosed with conjunctivochalasis with inferior punctal occlusion. Under topical anesthesia, the inferior bulbar conjunctiva was attached to the sclera with 3 8-0 vicryl stitches 8 mm posterior from the limbus. After surgery, the relief of symptoms, postoperative complications and improvement of conjunctivochalasis were observed. RESULTS: One week after the surgery, all 15 eyes achieved a subjective improvement of symptoms and the degree of conjunctivochalasis and FDT showed statistical difference after surgery (p = 0.000, 0.000, respectively). A complication occurred in 1 eye which was a retinal hemorrhage due to scleral puncture. CONCLUSIONS: Conjunctival fixation to the sclera could improve epiphora in conjunctivochalasis patients with inferior punctal occlusion. However, this procedure should be performed with caution.
Anesthesia ; Conjunctiva ; Eye ; Fluorescein ; Humans ; Lacrimal Apparatus Diseases ; Polyglactin 910 ; Postoperative Complications ; Retinal Hemorrhage ; Sclera

Penetrating ocular injuries with intraretinal foreign body(IRFB) are increasing and may result in significant visual morbidity. We evaluated retrospectively 22 eyes of 22 patients who had undergone pars plana vitrectomy for removal of IRFB at Dong-a University Hospital from July 1990 to June 1996. The majority of patients were adult male(95.5%). The nature of all IRFB was magnetic property and the causes of injury were hammering and cutting work(77.3%). Preoperatively, eyes were complicated with vitreous hemorrhage and opacity(59.1%), traumatic cataract(45.%), retinal detachment(36.4%), and corneal opacity(22.7%). Postoperative complications included vitreous hemorrhage and opacity(36.4%), retinal detachment(22.7%), and proliferative vitreoretinopathy(18.2%). In our study, poor visual prognosis was obtained in cases of corneal entrance site, IRFB larger than 2mm in size, IRFB located posterior to equator and IRFB associated with retinal detachment.
Adult ; Foreign Bodies* ; Humans ; Postoperative Complications ; Prognosis ; Retinal Detachment ; Retinaldehyde ; Retrospective Studies ; Vitrectomy* ; Vitreous Hemorrhage

The branch retinal vein occlusion is the second most common retinal vascular disease after diabetic retinopathy. Complications such as macular edema, retinal neovascularization, vitreous hemorrhage, epiretinal membrane may be associated. But, the retinal detachment may occur rarely in BRVO patients. We studied the clinical features of retinal detachment associated with branch retinal vein occlusion. We reviewed the medical records of 15 retinal detachment patients associated with branch retinal vein occlusion. Mean age was 54.7 years old and 10 patients(66.7%) were female. Hypertension was associated in 13cases(86.7%). The duration between the development of BRVO and the development of retinal detachment was shorter than 4 years in all cases and shorter than 2 years in 9 cases(60.0%). Retinal break was identified in 14 cases(93.3%), among which 13 cases(92.2%) were located inside the lesion of branch vein occlusion. The epiretinal membrane was frequently combined 8 cases(53.3%). The preoperative laser photocoagulation was done in 4 cases(26.7%). The primary surgical procedures included scleral buckling in 8 cases(53.3%), pars plana vitrectomy in 6 cases(40.0%), and scleral buckling with pars plana vitrectomy in 1 case(6.7%). Three cases(20.0%) required reoperations. The postoperative complications included the progression of cataract in 6 cases(40.0%), iatrogenic retinal tear in 3 cases(20.0%), epiretinal membrane in 2 cases(13.3%), and proliferative vitreoretinopathy in 1 case(6.7%). The anatomic retinal reattachment was achieved in 14 cases(93.5%) and the visual recovery in 11 cases(73.3%).
Cataract ; Diabetic Retinopathy ; Epiretinal Membrane ; Female ; Humans ; Hypertension ; Light Coagulation ; Macular Edema ; Medical Records ; Postoperative Complications ; Retinal Detachment* ; Retinal Neovascularization ; Retinal Perforations ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Scleral Buckling ; Vascular Diseases ; Veins ; Vitrectomy ; Vitreoretinopathy, Proliferative ; Vitreous Hemorrhage

PURPOSE: To evaluate the clinical efficacy for primary application of the silicone oil tamponade in vitrectomy for severe proliferative diabetic retinopathy. METHODS: We did retrospective clinical analysis on the preoperative and postoperative fundus findings, visual results, postoperative complications in 26 patients (30 eyes) with severe proliferative diabetic retinopathy who vitrectomy and intravitreal silicone oil injection were performed simultaneously as initial operation. RESULTS: Vitrectomy with silicone oil injection was performed in 14 eyes (46.7%) with severe traction retinal detachment involving macula, 10 eyes (33.3%) showed severe intraoperative hemorrhage among the cases that iatrogenic retinal tear was developed in the eyes with traction retinal detachment and 6 eyes (20.0%) with combined tractional and rhegmatogenous retinal detachment, and silicone oil was removed postoperatively on mean 2.7months (1.4~6.0 months) in 28 eyes of the total of 30 eyes. Final anatomic success was obtained in 26 eyes (86.7%) and functional success in 23 eyes (76.7%), and there was visual improvement of mean 2.8, 1.9 lines and improvement over 2 lines in 17 (56.7%), 11 (36.7%) eyes for best and final visual acuity comparing to preoperative visual acuity, respectively. Postoperative complications included cataract formation and aggravation in 24 or 25 phakic eyes(96.0%), recurrent preretinal membrane in 10 eyes (33.3%), retinal detachment in 10 eyes (33.3%), neovascular glaucoma in 5 eyes (16.7%), vitreous hemorrhage in 3 eyes (10.0%), and phthisis, band keratopathy, endophthalmitis in 1 eye (3.3%) respectively. CONCLUSIONS: In the proliferative diabetic retinopathy that difficulty in the retinal reattachment is predicted or that has high risk of the rebleeding, early application of the silicone oil tamponade is expected to be a useful tool for primary vitrectomy.
Cataract ; Diabetic Retinopathy* ; Endophthalmitis ; Glaucoma, Neovascular ; Hemorrhage ; Humans ; Membranes ; Postoperative Complications ; Retinal Detachment ; Retinal Perforations ; Retinaldehyde ; Retrospective Studies ; Silicone Oils* ; Traction ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage

Operation on vitreous body has been almost forbidden till the past few years. However, after the report on pars plana vitrectomy in early 1970's, it has been received favorably as effective operation for treatment of many diseases of vitreous body. So, the clinical and statistical evaluation of the 60 pars plana vitrectomies using a device of VISC X which were operated at the Dept. of Ophth. St. Mary's Hospital, Catholic Medical College from July, 1977 to April 1979 was done. The follow up period ranged from 2 wks to 21 months. The results were as follows; 1. Among the four major causes requiring pars plana vitrectomy, the highest percentage was occupied by Trauma (33 cases-55.0%) followed by diabetic retinopathy (11 cases-18.3%), hypertensive retinopathy (3 cases-5.0%) and central retinal vein occlusion (3 cases-5.0%). 2. Postoperative improvement of visual acuity was seen in 26 cases (43.3%). There was no change in vision in 17 cases (28.3%) and decrease of visual acuity occured in 17 cases (28.3%). Vitreous opacity and hemorrhage patients without proliferative changes showed improvement in 55.2% where as patients with proliferative changes showed improvement in only 32.3% of cases. 3. The complications during operation were vitreous hemorrhage (7 cases-11.7%), hyphema (4 cases-6.7%), retinal detachment (3 cases-5.0%) and traumatic cataract (2 cases-3.3%). The postoperative complications were ocular hypotonY(11 cases-18.3%), vitreous hemorrhage (9 cases-15.0%) and retinal detachment (9-cases-13.3%). We found that pars plana vitrectomy using a device of VISC X is effective method in rarious cases of vitreous diseases with or without proliferative change which has not been able to treat effectively before.
Cataract ; Diabetic Retinopathy ; Follow-Up Studies ; Hemorrhage ; Humans ; Hypertensive Retinopathy ; Hyphema ; Postoperative Complications ; Retinal Detachment ; Retinal Vein ; Visual Acuity ; Vitrectomy* ; Vitreous Body ; Vitreous Hemorrhage