曲安奈德和吲哚青绿双染法辅助下玻璃体切除术治疗特发性黄斑孔

目的 探讨曲安奈德(TA)和吲哚青绿(ICG)双染法辅助下玻璃体切除联合内界膜剥除术治疗特发性黄斑孔的疗效.方法 26例(26眼)均行玻璃体切除联合内界膜剥除术,术中应用TA和ICG辨认玻璃体后皮质和内界膜,术毕填充16％C3F8气体.结果 随访3～18个月,2例失访,23例黄斑孔完全闭合,1例未闭合者伴近锯齿缘处小裂孔后以硅油填充后闭合.随访患者24例中,21眼视力提高,2眼不变,1眼视力稍下降.结论 术中应用TA可以更清晰地辨认玻璃体后皮质,ICG的应用则有助于内界膜的剥除.TA和ICG双染法辅助下玻璃体切除术治疗特发性黄斑孔安全有效.     

Pars plana cysts

Pars plana cysts are found in up to 18 per cent of eyes and are more prevalent in the older population. These cysts typically appear as ovoid elevations with a smooth, taut surface. Pars plana cysts are usually acquired, representing a normal ocular senescent change. While the cysts themselves are benign they may occur secondary to ocular or systemic pathology, most notably retinal detachment, posterior uveitis and multiple myeloma. Two cases of pars plana cysts are presented.     

Intraocular Carbon Dioxide Laser Photocautery: Indications and Contraindications at Vitrectomy

The indications and contraindications for the use of carbon dioxide laser photocautery at the time of vitrectomy have been reviewed. Indications include posterior retinal tears either in flat or elevated sensory retina; elevated fibrovascular fronds on the optic nerve or elsewhere; flat neovascularization elsewhere, bleeding rubeotic iris vessels. It is also used as a means of panretinal endophotocoagulation. Contraindications include flat disc neovascularization and areas within one disc diameter of the macula and nerve. The advantages and disadvantages of the 10.6 micrometer infrared wavelength of carbon dioxide laser photocautery are discussed.     

The Effect of Vitreous and Retinal Surgery on Corneal Endothelial Cell Density

The effect of vitreoretinal surgery on corneal endothelial cell density was studied prospectively in 69 eyes by comparing preoperative endothelial cell densities to postoperative data. The mean cell loss in eyes of diabetic patients did not differ significantly from those of non-diabetics. The mean endothelial cell loss in 30 phakic eyes which underwent pars plana vitrectomy without lens removal was 1.3 ± 1.4%. In aphakic eyes, vitrectomy and scleral buckling led to a mean cell loss of 12.6 ± 2.3%. When vitrectomy was combined with lentectomy and scleral buckling, the mean cell loss was 8.5 ± 1.8%, but eyes undergoing fluid-gas exchange in addition to these procedures suffered a mean cell loss of 16.9 ± 1.9%. The presence of the lens protects the corneal endothelium during pars plana vitrectomy, while fluid-gas exchange in aphakic eyes appears to have a detrimental effect.     

Long-term diabetic vitrectomy results. Report of 10 year follow-up

Ten year follow-up examinations were obtained on 72 cases having pars plana vitrectomies for diabetic retinopathy complications from 1970 to 1973. Forty-two percent of the cases maintained 6/60 or better visual acuities through the tenth year. The visual results were quite stable, with 53% of the cases having the same or better visual acuities at ten years compared with six months. Neovascular glaucoma developed in 11 eyes, usually during the first six months, and open-angle glaucoma developed in 16 eyes, usually after the five-year follow-up examination. Both types of glaucoma occurred almost exclusively in aphakic eyes. Cataracts developed in 75% of retained clear lenses. The vitreous cavities remained clear in 67% of the eyes, and the maculas were attached in 65% of the eyes 10 years following vitrectomy. Fundus neovascularization did not recur.     

Pars plana vitrectomy in aphakic retinal detachments

Thirty-three cases of aphakic retinal detachment have been treated by pars plana vitrectomy and retinopexy. This procedure allowed us to lower the incidence of postoperative massive periretinal proliferation from 15,4%, in a series that was performed by a classical method, to 6% in the pars plana treated group.Presented at the XIIIth Meeting of the Jules Gonin Club, Córdoba, 29 March–2 April 1982.     

Osteochondritis (Calvé’s disease) of a vertebral body—a rare form of vertebra plana

In 1925, Calvé described vertebra plana as an aseptic necrosis of bone involving a single vertebral body of the spinal column. This theory was set aside in 1954 by Compere, who concluded that vertebra plana is caused by eosinophilic granuloma and not by osteochondritis as suggested by Calvé. It has been well documented in literature that many factors other than eosinophilic granuloma can cause vertebra plana-like destruction of the vertebral body. However, the definition of the terms was not clear, and there was no consensus on whether to call these cases vertebra plana or not. Some authors did, some did not. Anyhow, no publication so far has reported on osteochondritis as a rare cause of vertebra plana. The case of a 12-year-old girl, presented here by the authors, suggests this explanation. Some important conclusions can be drawn from this regarding the nomenclature, the diagnosis, and the therapy.     

Pars Plana Lensectomy by Ultrasonic Fragmentation: Results of a Retrospective Study

The results of a retrospective study of pars plana lensectomy by ultrasonic fragmentation are reviewed. More than 93% of the 284 eyes achieved 20/20–20/40 vision. Complications in 284 operations included retinal detachment (1.7%) and chronic cystoid macular edema (3.9%). In the last 100 operations performed, 98% of the eyes achieved 20/20–20/40 vision, with one retinal detachment, one macular hole, and no chronic cystoid macular edema.     

Pars plana lensectomy by ultrasonic fragmentation: I. A versatile and simple technique for cataract removal

A comparison has been made between pars plana lensectomy and intracapsular cataract extraction. Pars plana lensectomy has been shown to have many advantages. It is applicable to any age, while intracapsular cataract extraction is restricted to patients over 30 years old. It can be used in any type of cataract, whereas intracapsular cataract extraction is restricted to senile cataracts. It requires less patient preparation, less instrumentation, and less surgical dexterity than does intracapsular cataract extraction. It allows intraocular examination at the time of surgery. It can be combined with other surgical procedures (intraocular lens implantation, vitrectomy, cryoretinopexy, scleral buckle, etc.). It leaves the eyes in better condition postoperatively with fewer postoperative complications, and it gives good or better visual results than intracapsular cataract extraction.It is now unnecessary to learn (and teach) multiple techniques to handle different ages and types of cataracts since pars plana lensectomy manages them all with fewer complications.