Perfluorocarbon liquids have been used as vitreous substitutes for the complicated vitreoretinal surgery. Some authors have reported that perfluorophenanthrene(C14, F24) liquid could be left in the eye for extended term without ocular toxicity. We reviewed 37 eyes that had undergone surgery using perfluorophe-nanthrene(C14, F24) liquid at our hospital since June, 1991 to March, 1996. It was used as intraoperative tool in 20 eyes(Group I), and as postoperative tamponade material in 17 eyes for variable period from 24 hours to 45 days(Group II). Group III includes 11 anatomically successful eyes among group II. Follow up periods were from 111 to 1763(mean 341) days. The rate of anatomical success was 100, 64.7% in group I and II, and the rate of functional success was 70, 70.6, 90.9% in group I, II, III, respectively. Postoperatively, proliferative vitreoretinopathy, recurrent retinal detachment, and elevation of intraocular pressure were observed in both group I and II. According to the above results, it would be better that perflourophenanthrene liquid be used as an intraoperative tool than as a postoprative extended period tamponade.
Follow-Up Studies ; Intraocular Pressure ; Retinal Detachment ; Vitreoretinal Surgery* ; Vitreoretinopathy, Proliferative

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

To investigate the usefulness of large relaxing retinectomies in the management of selected complicated retinal detachments. The charts of 25 consecutive patients who underwent large relaxing retinectomy during vitrectomy were reviewed. Penetrating injury(10 eyes) and chronic retinal detachment(11 eyes) were the leading etiologic diagnoses. 22 eyes showed extensive PVR, 14 of them had a PVR Grade C P 12 and 3 eyes had extensive vitreoretinal incarceration. Most eyes (22 eyes) had undergone one or more previous ocular procedures and four eyes were early phthisical preoperatively. Extended tamponade was achieved with either silicone oil(23 eyes) or C3F8 gas (2 eyes). Retinectomy size was larger than 180 degrees in 20 eyes, ranging from 90 degrees to 360 degrees. Total retinal reattachment was achieved in 15 eyes(60%) and subtotal attachment including the macula in 6 eyes(24%). 10 eyes(40%) achieved 5/200 or better. The size of retinectomy or etiologic diagnosis did not influence the anatomic results. Hypotony was seen in 3 eyes and corneal decompensation in 8 eyes. Large retinectomy in selected cases of vitreoretinal surgery seemed to be an effective procedure in eyes otherwise unsuccessful.
Diagnosis ; Humans ; Retinal Detachment* ; Retinaldehyde* ; Silicone Oils ; Vitrectomy* ; Vitreoretinal Surgery ; Vitreoretinopathy, Proliferative

To investigate the usefulness of large relaxing retinectomies in the management of selected complicated retinal detachments. The charts of 25 consecutive patients who underwent large relaxing retinectomy during vitrectomy were reviewed. Penetrating injury(10 eyes) and chronic retinal detachment(11 eyes) were the leading etiologic diagnoses. 22 eyes showed extensive PVR, 14 of them had a PVR Grade C P 12 and 3 eyes had extensive vitreoretinal incarceration. Most eyes (22 eyes) had undergone one or more previous ocular procedures and four eyes were early phthisical preoperatively. Extended tamponade was achieved with either silicone oil(23 eyes) or C3F8 gas (2 eyes). Retinectomy size was larger than 180 degrees in 20 eyes, ranging from 90 degrees to 360 degrees. Total retinal reattachment was achieved in 15 eyes(60%) and subtotal attachment including the macula in 6 eyes(24%). 10 eyes(40%) achieved 5/200 or better. The size of retinectomy or etiologic diagnosis did not influence the anatomic results. Hypotony was seen in 3 eyes and corneal decompensation in 8 eyes. Large retinectomy in selected cases of vitreoretinal surgery seemed to be an effective procedure in eyes otherwise unsuccessful.
Diagnosis ; Humans ; Retinal Detachment* ; Retinaldehyde* ; Silicone Oils ; Vitrectomy* ; Vitreoretinal Surgery ; Vitreoretinopathy, Proliferative

We reviewed the records of 23 patients who underwent repeat operation after initial vitreoretinal surgery in Chungnam National University Hospital between January 1993 and December 1993. Of 193 eyes who underwent vitreoretinal surgery in that period, 23(12%) had undergone reoperation. The most common cause of initial anatomic failure and reoperation was either new or recurrent proliferative vitreoretinopathy(10 eyes). Other causes included iatrogenic retinal tears(5 eyes), hidden retinal breaks(4 eyes), vitreous traction(1 eye), inappropriate chorioretinal adhesion(1 eye), and new break(1 eye). We performed vitreous base dissection on all 9 eyes with anterior proliferative vitreoretinopathy. With additional surgery and after a mean follow-up period of 10.4 months, 21(91%) of 23 retinas were reattached. The final cause of anatomic failure was anterior proliferative vitreoretinopathy. Of the 23 reoperated eyes, 20(87%) had postoperative visual acuity of 0.05 or better.
Chungcheongnam-do ; Follow-Up Studies ; Humans ; Reoperation ; Retina ; Retinaldehyde ; Visual Acuity ; Vitreoretinal Surgery* ; Vitreoretinopathy, Proliferative

Proliferative vitreoretinopathy is the principal cause of failure in rhegmatogenous retinal detachment surgery. The final cause of anatomic failure is anterior proliferative vitreoretinopathy. Surgical outcome of anterior proliferative vitreoretinopathy is poorer than that of posterior proliferative vitreoretinopathy. Of 147 cases which underwent vitreoretinal surgery from January through December 1993, 16 eyes(l6 patients) had anterior proliferative vitreoretinopathy. Seven eyes had anterior proliferative vitreoretinopathy at initial surgery(group 1). Remaining 9 eyes developed anterior proliferative vitreoretinopathy after primary vitrectomy(group 2). Of 16 eyes, 3 were aphakic, 2 were pseudophakic, and remaining 11 were phakic. Lens was removed in 11 phakic eyes. Meticulous vitreous base dissection and removal of anterior epiretinal membrane were performed. After minimal follow-up of 6 months, retina reattached in 11 eyes(69%) including all nine eyes of group 2. Nine eyes(56%) had postoperative visual acuity of 0.025 or better. These results suggest that both vitreous base dissection and meticulous removal of anterior and posterior epiretinal membrane should be crucial in improving surgical success rate of anterior proliferative vitreoretinopathy.
Epiretinal Membrane ; Follow-Up Studies ; Retina ; Retinal Detachment ; Visual Acuity ; Vitreoretinal Surgery ; Vitreoretinopathy, Proliferative*

PURPOSE: Epiretinal membrane in proliferative vitreoretinopathy (PVR) may cause tractional retinal detachment after vitreoretinal surgery. It has been thought that the proliferative membrane is mainly composed of choroidal fibroblasts and retinal pigment epithelial cells. Inspite of the technical advances, the treatment of PVR is still difficult. Therefore, the need for phamarcologic treatment of proliferative vitreoretinopathy is increasing. METHODS: In vitro models of proliferative vitreoretinopathy allow to identify the factors which may inhibit proliferation and contraction of collagen matrix by choroidal fibroblast and retinal pigment epithelial cells. Cultured choroidal fibroblasts and the RPE cells were plated to the collagen matrix and antiproliferative drugs was tested. RESULTS: Each antiproliferative drug showed the inhibition of collagen matrix contraction at following concentration: colchicine(0.1 microgram/ml), puromycin(1~10 microgram/ml), cytochalasin B(0.05 microgram/ml). Transmission electron micrograph of collagen matrices showed dense collagen fibers surrounding choroidal fibroblast and fine collagen fibers surrounding RPE cell. Scanning electron micrograph of collagen matrices contaning colchicine, puromycin, or cytochalasin B showed that collagen fibers were well preserved without distortion. All collagen matrices containing RPE cells showed more fine collagen fibers than those containing choroidal fibroblasts. CONCLUSION: Colchicine, puromycin, cytochalasin B showed inhibitory effect on cell mediated contraction in addition to potent antiproliferative effect. Retinal pigment epithelial cell played less significant role in causing PVR than choroidal fibroblast.
Choroid* ; Colchicine ; Collagen* ; Cytochalasin B ; Epiretinal Membrane ; Epithelial Cells* ; Fibroblasts* ; Membranes ; Puromycin ; Retinal Detachment ; Retinaldehyde* ; Traction ; Vitreoretinal Surgery ; Vitreoretinopathy, Proliferative

We analyzed the surgical result of pars plana vitrectomy using silicone oil tamponade and evaluated the effect of different silicone oil viscosity on the result. Of all 66 patients, 48 were male and their mean age was 45.9 years. The most common underlying disease was proliferative vitreoretinopathy (29 patients) and 54 patients (81.9%) had visual acuity of 5/200 or less. Mean follow-up period was 8.94 months. Twenty eight patients had undertaken two or more vitreoretianl surgeries. Anatomical and functional success was achieved in 57 (86.4%) and 31 patients (47.0%), respectively. Complications included hypotony (7 patients), increased intraocular pressure (6 patients), keratopathy (4 patients) and closure of inferior iridectomy (3 patients) on the last follow-up. There was statistically significant correlation between preoperative and final visual acuity (p=0.0001), anatomical success and improvement of visual acuity (p=0.0057), and frequency of vitreoretinal surgery and final visual acuity (p=0.0143). There was no statistically significant difference in the surgical result between eyes using 1,000 cSt and 5,000 cSt silicone oil. This result suggests silicone oil injection may effectively support the surgical treatment of intractible retinal detachment. However, difference of its viscosity seems to make little effect on the surgical result.
Follow-Up Studies ; Humans ; Intraocular Pressure ; Iridectomy ; Male ; Retinal Detachment ; Silicone Oils* ; Viscosity* ; Visual Acuity ; Vitrectomy* ; Vitreoretinal Surgery ; Vitreoretinopathy, Proliferative

Adolescent ; Adult ; Aged ; Humans ; Middle Aged ; Pupil Disorders ; diagnosis ; etiology ; Refraction, Ocular ; Retina ; physiopathology ; Retinal Detachment ; surgery ; Scleral Buckling ; Visual Acuity ; Vitreoretinopathy, Proliferative ; surgery

PURPOSE: Using a temporary keratoprosthesis(TKP), earlier surgical treatment became amenable in eyes with coexisting vitreoretinal and corneal disease. We analysed our experience with this type of surgery. METHOD: Medical records of patients who had undergone pars plana vitrectomy(PPV) using Eckardt TKP from 1994 to 2000 were reviewed. Analysis was focused on preoperative conditions, surgical outcome and complications. RESULT: Of 34 eyes of consecutive 34 patients, 25(73.5%) showed trauma-related indications and 4 had IOFB. Retinal detachments were present in 24(70.6%) eyes, proliferative vitreoretinopathy in 8(23.5%) and vitreous hemorrhage in 10(29.4%) eyes. Penetrating keratoplasty(PKP) with donor corneas were performed in only 3 patients at the time of surgery and patient's excised corneas were sutured to 31 patients, 9 of whom underwent PKP later. After mean follow up period of 14 months, retinas remained attached in 27(79.4%) eyes and 3 eyes were phthisical. Visual acuity improved in 18(53%) eyes and worsened in 5 eyes. CONCLUSIONS: In cases with coexisting corneal and vitreoretinal pathology, PPV using TKP was effective for preserving vision and globe. Timing of grafting clear cornea might be delayed when donor cornea was not available.
Cornea ; Corneal Diseases ; Follow-Up Studies ; Humans ; Keratoplasty, Penetrating* ; Medical Records ; Pathology ; Retina ; Retinal Detachment ; Tissue Donors ; Transplants ; Visual Acuity ; Vitreoretinal Surgery* ; Vitreoretinopathy, Proliferative ; Vitreous Hemorrhage