Vitreo-retinal surgery in sickle cell disease [abstract]

Sickle cell disease is the commonest haemo-globinopathy. The gene is present in about 8 percent of Afro-American and 10 percent of Afro-Jamaican. Severe ocular complications of this condition include proliferative retinopathy, vitreous haemorrhages, and retinal detachment ultimately leading to blindness in a number of cases. There are not many reports of vitreo-retinal surgery in the literature dealing with cases. This is a report of 28 vitero-retinal surgeries in 20 eyes of 19 patients with sickle cell eye disease. Four eyes had surgery for viterous haemorrage, 16 for retinal detachment. All four eyes with vitreous haemorrage had successful pars plana vitrectomy (PPV) with full restoration of full potential vision. Eight of 16 eyes had successful retinal detachment surgery. Four eyes had pneumatic retinopexy with one unsuccessful result. Five eyes had scleral buckles with four having successful results, and six had bad results and one was unchanged. Six of ten eyes that had pars plana virectomy for retinal detachment had bad results. The unsuccessful cases were difficult ones with extensive proliferative vitero-retinopathy and long-standing retinal detachment. (AU)

Management of the dropped nucleus in phaco-emulsification [abstract]

Posterior capsular rupture is a common complication of phaco-emulsification of cataracts. This often results in vitreous prolapse and sometimes loss of cataract fragments into the vitreous cavity. Depending on the amount of lens material retained, inflammation can cause severe proliferative vitreo-retinopathy and also severe glaucoma. Both problems can result in the loss of eye. Timely intervention with vitreo-retinal surgery can reduce the morbidity and save sight. Newer instrumentation will now allow the safe removal of the entire lens by phaco-fragmentation in the vitreous cavity. The ability to safely carry out the manoevres required to remove the lens material is an important part of the armamentarium of the vitreo-retinal surgeon. Complications of the procedure include retinal detachment, choroidal haemorrhage, secondary glaucoma, endophthalmitis, macular scarring and corneal decompensation. (AU)