Human ; Female ; Middle Aged ; RETINAL NEOVASCULARIZATION ; RETINAL NEOVASCULARIZATION/SURGERY ; RETINAL PERFORATIONS ; RETINAL PERFORATIONS/SURGERY ; HUMAN ; FEMALE

Perfluorocarbon liquids have been used to facilitate surgery in complicated retinal detachments or giant retinal tears which were difficult to manage. The results of perfluorophenanthrene usage in 26 eyes that had been taken vitreoretinal surgery were analyzed.The causes of retinal detachments were giant retinal tears in five eyes[19%], pseudophakia or aphakia in three[12%]and trauma in three.As tamponades, C3F8 gas was used in 11 eyes and silicone oil in 15 eyes. Overall, anatomical success rate was 73%and functional success rate was 58%.All of the giant retinal tears were successfully reattached and four eyes[80%]were functionally successful.The rates of anatomical success were 75%in eyes with grade C proliferative vitreoretinopathy, and 64%in grade D.Regarding postoperative tamponade materials, there was no significant difference between C3F8 gas and silicone oil.Releasing retinectomy was perfomed in four eyes and there was no functional success. In conclusion, perfluorocarbon liquid is a useful instrument that improves the result of operation of complicated retinal detachment if used selectively.
Aphakia ; Pseudophakia ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Silicone Oils ; Vitrectomy ; Vitreoretinal Surgery ; Vitreoretinopathy, Proliferative

Humans ; Epiretinal Membrane/surgery* ; Retinal Perforations/surgery* ; Vitrectomy ; Tomography, Optical Coherence ; Retrospective Studies

PURPOSE: To evaluate the effects of laser photocoagulation on reopened macular holes. METHODS: This study involved 9 eyes from 9 patients who underwent laser photocoagulation coupled with fluid-gas exchange for reopened macular holes. The photocoagulation was performed at the center of the macular hole. Closure of the reopened hole was categorized by optical coherence tomography (OCT) according to the presence (type 1 closure) or absence (type 2 closure) of continuity in the foveal tissue. Best corrected visual acuity (BCVA), closure types, and complications were assessed. RESULTS: Upon final examination, all macular holes were found to have closed. Six eyes were classified as type 1 closure, and three were classified as type 2 closure. The mean BCVAs, before and after laser photocoagulation, were 0.11 and 0.31, respectively (P< .05). The eyes with type 1 closure were associated with shorter symptom durations and greater visual improvement than those with type 2 closure (P< .05). CONCLUSIONS: The combination of laser photocoagulation and fluid-gas exchange appears to be a safe and effective treatment for reopened macular holes. Early intervention should be encouraged to ensure complete hole closure and improved visual outcomes.
*Tomography, Optical Coherence ; Retinal Perforations/*pathology/*surgery ; Recurrence ; Middle Aged ; Male ; *Laser Coagulation ; Humans ; Female ; Aged

PURPOSE: To evaluate long-term outcome of foveal tissue elongation after macular hole (MH) surgery. METHODS: This retrospective, observational case series was performed on patients who underwent MH surgery and were followed-up more than 12 months. Distance between the parafoveal edge of the outer plexiform layer (OPL) was defined as the inter-OPL distance and measured using optical coherence tomography images at 5 to 8 months postoperatively and at the last follow-up. The horizontal and vertical inter-OPL distances were compared between the 2 defined time points. In addition, further elongation of the foveal tissue in certain directions was defined as asymmetric elongation and was compared between the defined time points. RESULTS: The early and late postoperative examination was performed at 6.3 +/- 1.1 (mean +/- standard deviation) months and 22.7 +/- 7.8 months, respectively. The horizontal inter-OPL distance was 552.3 +/- 130.5 microm and 502.8 +/- 139.3 microm at the defined time points, respectively and the vertical inter-OPL distance was 478.9 +/- 107.2 microm and 447.5 +/- 107.1 microm, respectively. Both horizontal and vertical inter-OPL distances were significantly shortened at the last postoperative examination (p < 0.001, p = 0.002, respectively). The degree of asymmetric elongation was 10.8 +/- 6.5% and 11.8 +/- 7.9% at the defined time points, respectively, and was not different between the defined time points (p = 0.426). CONCLUSIONS: The long-term shortening of foveal tissue after MH surgery without progression of asymmetry may partially contribute to the long-term recovery of visual function after MH surgery.
Follow-Up Studies ; General Surgery* ; Humans ; Retinal Perforations* ; Retrospective Studies ; Tomography, Optical Coherence

OBJECTIVETo identify the characteristics of and evaluate surgical impact on idiopathic macular hole (IMH) by using an optical coherence tomography (OCT) scanner.

METHODSSixty-five cases (70 eyes) experiencing IMH were examined using OCT, then graded by their clinical characteristics. Nineteen cases (19 eyes) were scanned and measured using OCT before and after surgery.

RESULTSOf the 70 eyes,the number of stage I-IV macular holes were 11, 12, 36 and 11, respectively. For stage I holes, the OCT images revealed flattened or nonexistent fovea and minimally reflective space within or beneath the neurosensory retina; stage II holes appeared to be full-sized with attached operculum and surrounding edema; stage III holes were also full-sized with surrounding edema; finally, stage IV holes were full-sized and completely separated the posterior hyaloid membrane from the retina. Through quantitative measurements, OCT determined that the values for mean hole diameter, mean halo diameter and mean thickness of the hole's edge were reduced from 570.95 +/- 265.59 to 337.05 +/- 335.95 microm, 1043.53 +/- 278.8 to 695.00 +/- 483.00 microm and 389.78 +/- 60.58 to 298.78 +/- 109.80 microm, respectively in 19 IMH cases after surgery. In 17 eyes, the holes or halos eventually closed or were reduced in size, or the edges of the holes thinned out. The anatomic successful rate of the surgery was 89%.

CONCLUSIONOCT can exhibit the characteristics of IMH and measure the diameter of holes quantitatively. This method can also judge the surgical impacts of IMH objectively, accurately and effectively.

Adult ; Aged ; Female ; Humans ; Macula Lutea ; pathology ; Male ; Middle Aged ; Retinal Perforations ; pathology ; surgery ; Tomography ; methods

OBJECTIVES: To assess the inadvertent intraocular retention of perfluorocarbon liquid (PFCL) after vitreoretinal surgery and their complications. METHODS: We retrospectively reviewed the medical records of 108 patients who underwent vitreoretinal surgeries using intraoperative PFCL (perfluoro-n-octane (C8F18), 0.69 centistoke at 25degrees C, PERFLUORN(R), Alcon, USA) and the removal of PFCL through fluid-air exchange. The analysis was focused on the occurrence of intraocular retained PFCL, diagnoses,surgicalprocedures,andcomplications. RESULTS: Retinal detachment (51 cases, 47%) was the most common surgery which used PFCL intraoperatively. Other causes were vitreous hemorrhage (24 cases, 22%), posteriorly dislocated lens (22 cases, 21%), and trauma (11 cases, 10%). Intraocular PFCL was found in a total of 9 (8.3%) eyes. PFCL bubbles remained in anterior chamber and vitreous cavity were observed in 4 cases and subretinal retained PFCL was observed in 5 cases. Three of 5 cases of subretinal PFCL exhibited in subfoveal space. Among the three subfoveal cases, macular hole developed after PFCL removal in 1 case, epiretinal membrane in the area where had been PFCL bubble. However, we observed no complications in 1 case of subfoveal PFCL that was removed by surgery. PFCL in anterior chamber and vitreous cavity were in 4 cases. CONCLUSIONS: The presence of subfoveal PFCL might affect visual and anatomic outcomes. However, subfoveal PFCL may induce visual complications, and therefore requires special attention.
Anterior Chamber ; Epiretinal Membrane ; Humans ; Medical Records ; Retinal Detachment ; Retinal Perforations ; Retrospective Studies ; Vitrectomy* ; Vitreoretinal Surgery ; Vitreous Hemorrhage

Changes in the scotopic electroretinogram (ERG) and oscillatory potentials (Ops) were examined in patients who had rhegmatogenous retinal detachment within 3 days before and also at regular intervals after a successful reattachment operation. Electroretinograms were recorded in 38 patients (age 10 to 62 years) for the recent 5 year period. The amplitudes of the scotopic a-wave and b-wave in the detached eye were significantly decreased compared to the fellow normal eye preoperatively. Statistically significant differences were found between the preoperative and the postoperative recordings of the diseased eye. However, postoperative interocular differences in the amplitude of the a-wave between the reattached and normal fellow eye were not statistically significant. The amplitudes of the a-wave and b-wave were inversely related to the extent of the retinal detachment area, the duration of the detachment, and the extent of the buckles that were applied. Significant interocular differences in the b/a wave amplitude ratio and the Ops amplitude were observed. These results strongly suggest that the retinal function, even after successful reattachment surgery, might be compromised mainly by an inner retinal malfunction rather than from a photoreceptor dysfunction.
Adolescent ; Adult ; Child ; *Electroretinography ; Human ; Middle Age ; Oscillometry ; Postoperative Period ; Retinal Detachment/etiology/*physiopathology/*surgery ; Retinal Perforations/*complications

PURPOSE: To analyze retinal tears and to compare the clinical outcomes between retinal tear and rhegmatogenous retinal detachment (RRD) as the cause of dense non-diabetic vitreous hemorrhage in patients who underwent vitreoretinal surgery. METHODS: In a retrospective case series, the medical records of patients who presented dense non-diabetic vitreous hemorrhage and who underwent vitreoretinal surgery between January 2005 and June 2009 were reviewed. Among the 134 patients, 27 patients had dense vitreous hemorrhage caused by retinal tears. The first group had retinal tears only and the second group had accompanying RRD. A comparison of clinical features and postoperative prognoses between the two groups was performed. RESULTS: Among the 27 eyes with non-traumatic retinal tear and RRD, 18 were categorized into the retinal tear group and 9 to the RRD group. The demographic findings between the two studied groups exhibited no significant differences except for time between onset of symptoms and diagnosis. However, the time to diagnosis was significantly delayed in the group with RRD (22.67 +/- 37.47 days) compared to the retinal tear group (5.00 +/- 3.41 days) (p = 0.035). The amount of visual improvement was also greater in the retinal tear group than the RRD group (p = 0.002). CONCLUSIONS: Retinal tears are a major cause of non-diabetic vitreous hemorrhage. Vitreous hemorrhage caused by retinal detachment may result in delayed diagnosis and poor visual recovery. Therefore, early examinations in suspicion of RRD and appropriate treatments are needed in non-diabetic vitreous hemorrhage.
Delayed Diagnosis ; Eye ; Humans ; Medical Records ; Prognosis ; Retinal Detachment ; Retinal Perforations ; Retinaldehyde ; Retrospective Studies ; Vitreoretinal Surgery ; Vitreous Hemorrhage

Cryotherapy is implicated for inducing or aggravating proliferative vitreoretinopathy (PVR) by releasing retinal pigment epithelial (RPE) cells. These are based on the fact that PVR rarely occurs in a non-operated eye, and many of the PVR patients have received cryotherapy during surgery. Nonetheless, eyes with diathermy also developed PVR, and although there have been many experiments, the effect of cryotherapy on inducing PVR has not been proven experimentally in the living eye. We made retinal tears in living rabbit eyes, and applied cryotherapy on one eye of each rabbit. The result was compared histologically with the contralateral noncryothermized control eye. There was no statistically significant difference between the two groups concerning the migration of RPE, and the proliferation of RPE. Although the formation of an epiretinal membrane was more obvious in the cryothermized group, the difference was not statistically significant.
Animals ; Cell Division ; *Cryosurgery/adverse effects ; Rabbits ; Retinal Detachment/*pathology ; Retinal Perforations/*pathology ; Vitreous Body/*pathology/surgery