PURPOSE: We investigated the efficacy of fibrin glue for conjunctival closure in scleral buckling operations. METHODS: Thirty-seven eyes of 35 patients who underwent conjunctival closure for a scleral buckling operation with a minimum follow-up period of 3 months were evaluated. Postoperative discomfort (average score), presence of remnant adhesives, scleral buckle material infection, and wound dehiscence were evaluated prospectively in 35 eyes of 33 patients undergoing surgery with fibrin glue. RESULTS: The eyes showed decreasing conjunctival injection and hemorrhage over time and near to full recovered without any treatment after 1 month. With time, the average discomfort score decreased significantly (p < 0.05) and wound dehiscence was found in only 1 eye. There was no adhesive remnant in any of the eyes. CONCLUSIONS: The use of fibrin glue for conjunctival closure in scleral buckling operations is excellent as a cosmetic and functional method. The glue can reduce postoperative discomfort and is especially useful as a method to replace conventional conjunctival sutures.
Adhesives* ; Fibrin Tissue Adhesive ; Follow-Up Studies ; Hemorrhage ; Humans ; Methods ; Prospective Studies ; Scleral Buckling* ; Sutures ; Tissue Adhesives ; Wounds and Injuries

PURPOSE: To evaluate the clinical effectiveness of pneumatic retinopexy as a treatment method for pseudophakic retinal detachment. METHODS: A retrospective chart review was conducted of medical records of 38 patients who underwent pneumatic retinopexy using SF6 gas from January 2003 to December 2011 and who were observed during a follow-up period longer than 6 months. Primary and final success rates and final visual acuity were analyzed. Primary success was defined as retinal attachment at the last visit without additional surgery. Final success was defined as retinal reattachment at the last visit regardless of additional surgery. RESULTS: The mean patient age was 58.47 ± 17.00 years. All retinal tears were located in the upper retina (from 8 to 4 o'clock). Preoperative mean visual acuity was 1.17 ± 1.00 log MAR, and postoperative mean visual acuity was 0.42 ± 0.48 log MAR. The primary success rate was 61%, and patients with re-detached retina underwent repeat pneumatic retinopexy or other surgery such as scleral buckling or pars plana vitrectomy. At the final visit, all of the patients demonstrated successful results. CONCLUSIONS: Pneumatic retinopexy does not result in strabismus or refractive error, and the final success rate was 66% in our study. Therefore, pneumatic retinopexy can be considered as an effective management technique for some pseudophakic retinal detachment patients.
Follow-Up Studies ; Humans ; Medical Records ; Methods ; Refractive Errors ; Retina ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Retrospective Studies ; Scleral Buckling ; Strabismus ; Treatment Outcome ; Visual Acuity ; Vitrectomy

PURPOSE: To describe the results of lens-sparing vitrectomy for the correction of retinal detachment associated with retinopathy of prematurity (ROP) and its associated complications. METHODS: Seventeen patients who underwent a lens-sparing vitrectomy for stage 4 and stage 5 ROP with plus disease at Seoul National University Children's Hospital between 1999 and 2003 were enrolled in this study. The patients who had bilateral retinal detachment of ROP underwent a lens-sparing vitrectomy in one eye and a scleral buckling surgery or lensectomy-vitrectomy in the other eye. The patients who had a retinal detachment in one eye and a regressed ROP in the other eye underwent unilateral lens-sparing vitrectomies. A review of their preoperative clinical findings (including the status of retinal detachment and plus disease), post-operative results, and any complications encountered was performed. RESULTS: In 17 patients, the postoperative success rate of lens-sparing vitrectomy was 58.8%. However, lens-sparing vitrectomy as a treatment for stage 5 ROP (25.0%) produced more negative post-operative results than it did when used to treat either those for stage 4a (75,0%) or 4b (66.7%) ROP. Among the 10 eyes in which the retina was attached, form vision was shown in six eyes, light could be followed by three eyes, and no light perception was present in one eye. Intra- and post-operative complications included retinal break formation, cataracts, vitreous hemorrhages, and glaucoma in patients with stages 4b and stage 5 ROP. CONCLUSIONS: Lens-sparing vitrectomy resulted in encouraging surgical outcomes in the correction of retinal detachment of ROP, especially in stage 4 patients. Therefore, a lens-sparing vitrectomy for stage 4 ROP patient may be beneficial, although it is still associated with some intra- and post-operative complications.
Vitrectomy/*methods ; Treatment Outcome ; Severity of Illness Index ; Scleral Buckling/methods ; Retrospective Studies ; Retinopathy of Prematurity/complications/pathology/*surgery ; Retinal Detachment/etiology/pathology/surgery ; Retina/*pathology ; Male ; Lens, Crystalline/*surgery ; Infant, Newborn ; Infant ; Humans ; Follow-Up Studies ; Female ; Child, Preschool

OBJECTIVETo investigate corneal refractive changes after scleral buckling surgery.

METHODSIn a prospective self-controlled clinical study, we investigated the changes of refractive power, astigmatic power, astigmatic axis, and irregular astigmatic power of anterior corneal surface following scleral buckling surgery for retinal detachment in 30 patients (30 eyes). The corneal shapes were detected by Orbscan II topography at 1 day before surgery, and 1 week, 1 month, and 3 months after surgery. The effects of some surgical factors on the anterior corneal refractive changes were analyzed.

RESULTSAfter surgery, refractive power on corneal anterior surface decreased significantly in peripheral zone at 1 week (P < 0.01). Astigmatic power increased obviously in central zone. The direction of astigmatic axis matched the direction of the buckle, and changed obviously in central zone after 1 week (P < 0.05). Irregular astigmatic power did not change significantly. There was a significant correlation between the encircling length/the buckle width and the refractive changes of corneal anterior surface.

CONCLUSIONRefractive changes of corneal anterior surface following scleral buckling surgery was mainly temporary. Changes in the shape of corneal should be minimized to ensure a favorable postoperative visual acuity.

Adolescent ; Adult ; Aged ; Cornea ; pathology ; physiopathology ; Corneal Topography ; Female ; Humans ; Male ; Middle Aged ; Postoperative Period ; Prospective Studies ; Refraction, Ocular ; Refractive Errors ; etiology ; prevention & control ; Retinal Detachment ; physiopathology ; surgery ; Scleral Buckling ; adverse effects ; methods ; Time Factors