Manufactured soil: A new use for bauxite residue.

Bauxite processing residue produced at an Alumina refinery was used to produce manufactured soil. The residue was first acidified and then leached to remove excess salts. Green waste compost was added at rates of 5 and 10 % w/w, with or without the addition of 20 % w/w dune sand. The products were dried, crushed and sieved and the chemical, physical and microbial properties of the materials characterized. Products had an electrical conductivity and pH of 1.0-1.1 dS m-1 and 8.0-8.1 respectively in 1:5 soil:water extracts and corresponding values in saturation paste extracts were 5.4-5.7 dS m-1 and 7.4-7.5. The effective cation exchange capacity was 202-351 mmolc kg-1, exchangeable Na percentage was 41-46 %, Colwell-extractable P was 108-119 mg kg-1 and the Toxicity Characteristic Leaching Procedure showed that extractable metal concentrations were an order of magnitude below regulatory limits so the material can be considered as non-hazardous. Diethylenetriaminepentaacetic acid-extractable Cu, Zn and Mn were below reported critical levels. Addition of compost lowered concentrations of extractable Cr, As and V and drying the material further reduced extractable levels. When the material was dried it shrunk and solidified and the aggregates produced had a low macroporosity and high microporosity and water holding capacity compared with dune sand. Aggregates were very stable as measured by wet sieving. Compost addition increased organic C content, and the size (microbial biomass C) and activity (basal respiration and the activity of enzymes involved in C, N, S and P mineralization) of the soil microbial community. It was concluded that the materials produced had soil-like chemical, physical and microbial properties and could potentially be used as a soil substitute.

Potential use of two filter media in constructed wetlands for simultaneous removal of As, V and Mo from alkaline wastewater - Batch adsorption and column studies.

The potential to use water treatment sludge and bauxite as active filter media in constructed wetlands to remove As, V and Mo from alkaline drainage originating from seawater-neutralized bauxite processing residue was evaluated in laboratory batch and column studies. Batch adsorption studies showed that increasing the electrolyte concentration from 0.01 to 0.30 M NaCl (the typical electrolyte strength of the drainage) increased adsorption of all three oxyanions onto both media while increasing initial pH from 6.7 to 8.3 (the typical pH of drainage) and using granules (1-2 mm dia.) rather than ground material (<0.2 mm) both decreased adsorption. Kinetic studies showed that while ionic strength had little effect on the contact time required to reach maximum adsorption, increased initial pH increased the time to reach maximum adsorption for Mo on both media and increased particle size increased the time required for maximum adsorption of all three oxyanions onto both media. In batch experiments, at initial elemental concentrations of 1 and 50 mg L-1, adsorption from multi-element solutions (compared with single element ones) was reduced in the order: Mo ¼â€¯As > V. In continuous flow column studies from single element solutions (1 mg L-1), breakthrough curves for Mo occurred first and greater than three times more eluent passed through the columns before breakthrough of V and then As occurred. When multi-element solutions were used, less volume of eluent was required for breakthrough of all three anions and the volume required before breakthrough of As was greatly reduced compared to that for V. The possibility that the strong ability of V to compete with As and particularly Mo could cause desorption of previously adsorbed Mo and As and their movement through a wetland filter needs to be further investigated. It was concluded that molybdate is the least strongly held oxyanion and that a decrease in solution pH within the wetland would greatly improve Mo removal efficiency.

Real world outcomes of ocriplasmin use by members of the British and Eire Association of Vitreoretinal Surgeons.

PurposeTo describe a survey of the use of ocriplasmin by members of the British and Eire Association of VitreoRetinal Surgeons (BEAVRS) for VitreoMacular Traction (VMT) and Full Thickness Macular Hole (FTMH) and compare it to published MIVI TRUST trial data.MethodsAll 173 BEAVRS members were contacted by email in October 2014 requesting data on all cases treated with ocriplasmin up to that date. The total number of cases, FTMH closure rate, VMT release rate and the frequency of adverse events were recorded. Results were compared with trial data.Results48 members responded reporting results from 241 eyes. The respective BEAVRS and MIVI TRUST trial closure rates for small FTMHs were 42.1 and 58.3% (P=0.09) and for medium FTMH 12.7 and 36.7% (P=0.01). The respective VMT release rates were 34.1 and 37.4% (P=NS). Retinal detachment was observed in 3.3% of the BEAVRS cohort compared with 0.4% in MIVI TRUST. Reduction in visual acuity to <6/60 was observed in 5.8% of the BEAVRS cohort and 0.6% in MIVI TRUST. Other complications not reported in the MIVI TRUST trial included an increase in FTMH basal diameter following unsuccessful ocriplasmin use in 46.9% of BEAVRS cases and zonular instability at the time of subsequent phacoemulsification in 2.4%.ConclusionMacular hole closure rates were lower in the BEAVRS survey than published in the MIVI TRUST trial data. The incidence of adverse events was greater than previously reported. The reasons for these disparities are unknown but could include positive reporting bias inherent to retrospective surveys, treatment and population differences.

Comparison of the chemical, physical and microbial properties of composts produced by conventional composting or vermicomposting using the same feedstocks.

The chemical, physical and microbial properties of thermophilic composts and vermicomposts were compared using the same municipal green waste-based feedstocks: (i) municipal green waste alone, (ii) 75 % municipal green waste/25 % green garden waste and (iii) 75 % municipal green waste/25 % cattle manure. Temperatures reached 37 °C during composting of municipal green waste alone but when garden waste or cattle manure were added, temperatures reached 47 and 52 °C, respectively. At the end of vermicomposting (using Eisenia fetida), the number of earthworms present was greater than that added for the cattle manure-amended feedstock but much less for both the garden waste and municipal green waste alone treatments. The products formed in all treatments generally fell within suggested maturity indices for composts. Greater organic matter decomposition occurred during composting than vermicomposting resulting in composts having a significantly lower organic C content and a greater content of total N, extractable Mg, K, Na, P, and mineral N, a higher EC and a lower C/N ratio than the vermicomposts. For all three feedstocks, vermicomposts had a lower bulk density and greater total porosity and macroporosity than composts. For the garden waste- and cattle manure-amended feedstocks, vermicomposts had a higher microbial biomass C than the composts and for all three feedstocks, basal respiration and metabolic quotient were greatest for vermicomposts. It was concluded that composting is a robust process suitable for treatment of a range of organic wastes but, because of the nutritional requirements of the earthworms, vermicomposting is a much less robust and was only suitable for the cattle manure-amended feedstock.

Use of alum water treatment sludge to stabilize C and immobilize P and metals in composts.

Alum water treatment sludge is composed of amorphous hydroxyl-Al, which has variable charge surfaces with a large Brunauer-Emmett-Teller (BET) surface area (103 m(-2) g(-1)) capable of specific adsorption of organic matter molecules, phosphate, and heavy metals. The effects of adding dried, ground, alum water treatment sludge (10% w/w) to the feedstock for composting municipal green waste alone, green waste plus poultry manure, or green waste plus biosolids were determined. Addition of water treatment sludge reduced water soluble C, microbial biomass C, CO2 evolution, extractable P, and extractable heavy metals during composting. The decrease in CO2 evolution (i.e., C sequestration) was greatest for poultry manure and least for biosolid composts. The effects of addition of water treatment sludge to mature green waste-based poultry manure and biosolid composts were also determined in a 24-week incubation experiment. The composts were either incubated alone or after addition to a soil. Extractable P and heavy metal concentrations were decreased by additions of water treatment sludge in all treatments, and CO2 evolution was also reduced from the poultry manure compost over the first 16-18 weeks. However, for biosolid compost, addition of water treatment sludge increased microbial biomass C and CO2 evolution rate over the entire 24-week incubation period. This was attributed to the greatly reduced extractable heavy metal concentrations (As, Cr, Cu, Pb, and Zn) present following addition of water treatment sludge, and thus increased microbial activity. It was concluded that addition of water treatment sludge reduces concentrations of extractable P and heavy metals in composts and that its effect on organic matter stabilization is much greater during the composting process than for mature compost because levels of easily decomposable organic matter are initially much higher in the feedstock than those in matured composts.

Potential for use of industrial waste materials as filter media for removal of Al, Mo, As, V and Ga from alkaline drainage in constructed wetlands--adsorption studies.

The potential to remove Al, Mo, V, As and Ga from alkaline (pH 8.0-8.6) drainage originating from seawater neutralized bauxite processing residue storage areas using constructed wetland technology was studied in a laboratory study. Bauxite processing residue sand, bauxite, alum water treatment sludge and blast furnace slag were investigated as potential active filter materials. Al was shown to precipitate as Al(OH)3 in the pH range 7.0-8.0 in aqueous solution and 6.0-8.5 in the presence of silica sand particles that provided a surface for nucleation. For V As Mo and Ga, adsorption to the surfaces of the adsorbents decreased greatly at elevated pH values (>pH 6-9). Water treatment sludge and bauxite had a greater ability to adsorb V, As and Mo at high pH (As and V at pH 7-9 and Mo at pH 5-7) than processing sand and slag. Adsorption isotherm data for As and V onto all four adsorbent than processing sand and slag. Adsorption isotherm data for As and V onto all four adsorbent materials fitted equally well to the Langmuir and Freundlich equations but for Ga, and to a lesser extent Mo, the Freundlich equation gave higher R(2) values. For all four ions, the maximum adsorption capacity (Langmuir value qmax) was greatest for water treatment sludge. Bauxite adsorbed more Mo, Ga and V than residue sand or slag. The pseudo-second order equation gave a better fit to the experimental kinetic data than the pseudo-first order model suggesting that chemisorption rather than diffusion/exchange was the rate limiting step to adsorption. It was concluded that water treatment sludge and bauxite were the most effective adsorbents and that for effective removal of the target ions the pH of the drainage water needs to be decreased to 6.0-7.0.

Particle size fractionation as a method for characterizing the nutrient content of municipal green waste used for composting.

In order to better characterize mechanically shredded municipal green waste used for composting, five samples from different origins were separated into seven particle size fractions (>20mm, 10-20mm, 5-10mm, 2-5mm, 1-2mm, 0.5-1.0mm and <0.5mm diameter) and analyzed for organic C and nutrient content. With decreasing particle size there was a decrease in organic C content and an increase in macronutrient, micronutrient and ash content. This reflected a concentration of lignified woody material in the larger particle fractions and of green stems and leaves and soil in the smaller particle sizes. The accumulation of nutrients in the smaller sized fractions means the practice of using large particle sizes for green fuel and/or mulch does not greatly affect nutrient cycling via green waste composting. During a 100-day incubation experiment, using different particle size fractions of green waste, there was a marked increase in both cumulative CO2 evolution and mineral N accumulation with decreasing particle size. Results suggested that during composting of bulk green waste (with a high initial C/N ratio such as 50:1), mineral N accumulates because decomposition and net N immobilization in larger particles is slow while net N mineralization proceeds rapidly in the smaller (<1mm dia.) fractions. Initially, mineral N accumulated in green waste as NH4(+)-N, but over time, nitrification proceeded resulting in accumulation of NO3(-)-N. It was concluded that the nutrient content, N mineralization potential and decomposition rate of green waste differs greatly among particle size fractions and that chemical analysis of particle size fractions provides important additional information over that of a bulk sample.

Influence of different acid and alkaline cleaning agents on the effects of irrigation of synthetic dairy factory effluent on soil quality, ryegrass growth and nutrient uptake.

The aim of this study was to examine the effects of replacement of phosphoric acid with nitric or acetic acid, and replacement of NaOH with KOH, as cleaning agents in dairy factories, on the effects that irrigation of dairy factory effluent (DFE) has on the soil-plant system. A 16-week greenhouse study was carried out in which the effects of addition of synthetic dairy factory effluent containing (a) milk residues alone or milk residues plus (b) H(3)PO(4)/NaOH, (c) H(3)PO(4)/HNO(3)/NaOH or (d) CH(3)COOH/KOH, on soil's chemical, physical and microbial properties and perennial ryegrass growth and nutrient uptake were investigated. The cumulative effect of DFE addition was to increase exchangeable Na, K, Ca, Mg, exchangeable sodium percentage, microbial biomass C and N and basal respiration in the soil. Dry matter yields of ryegrass were increased by additions of DFE other than that containing CH(3)COOH. Plant uptake of P, Ca and Mg was in the same order as their inputs in DFE but for Na; inputs were an order of magnitude greater than plant uptake. Replacement of NaOH by KOH resulted in increased accumulation of exchangeable K. The effects of added NaOH and KOH on promoting breakdown of soil aggregates during wet sieving (and formation of a < 0.25 mm size class) were similar. Replacement of H(2)PO(4) by HNO(3) is a viable but CH(3)COOH appears to have detrimental effects on plant growth. Replacement of NaOH by KOH lowers the likelihood of phytotoxic effects of Na, but K and Na have similar effects on disaggregation.

Chemical, physical and microbial properties and microbial diversity in manufactured soils produced from co-composting green waste and biosolids.

The effects of adding biosolids to a green waste feedstock (100% green waste, 25% v/v biosolids or 50% biosolids) on the properties of composted products were investigated. Following initial composting, 20% soil or 20% fly ash/river sand mix was added to the composts as would be carried out commercially to produce manufactured soil. Temperatures during composting reached 50 °C, or above, for 23 days when biosolids were included as a composting feedstock but temperatures barely reached 40 °C when green waste alone was composted. Addition of biosolids to the feedstock increased total N, EC, extractable NH(4), NO(3) and P but lowered pH, macroporosity, water holding capacity, microbial biomass C and basal respiration in composts. Additions of soil or ash/sand to the composts greatly increased the available water holding capacity of the materials. Principal component analysis (PCA) of PCR-DGGE 16S rDNA amplicons separated bacterial communities according to addition of soil to the compost. For fungal ITS-RNA amplicons, PCA separated communities based on the addition of biosolids. Bacterial species richness and Shannon's diversity index were greatest for composts where soil had been added but for fungal communities these parameters were greatest in the treatments where 50% biosolids had been included. These results were interpreted in relation to soil having an inoculation effect and biosolids having an acidifying effect thereby favouring a fungal community.

Use of inorganic wastes as immobilizing agents for soluble P in green waste-based composts.

PURPOSE: The study examines the effectiveness of red mud, blast furnace (BF) slag, and alum-derived water treatment sludge as immobilizing agents for excessive soluble P that had accumulated in three green waste-based composts. METHODS: The three wastes were applied at 0%, 5%, 10%, and 20% w/w to three different composts, all containing extremely high concentrations of extractable P, and were incubated for 60 days. Water-soluble P was measured regularly throughout the incubation period, and at the end, P extractable with resin, 0.05 M NaHCO(3), and 0.005 M H(2)SO(4) were also measured. RESULTS: In the water extracts, inorganic P made up more than 85% of the total P present. All three materials had the ability to adsorb P and thus lowered water-soluble P concentrations. Water treatment sludge was clearly the most effective material, and this was attributed to its amorphous nature (thus, large Brunauer-Emmett-Teller surface area) and its acid pH (6.8) compared with the alkaline pH (10-11) of the other two materials. Water treatment sludge was also the most effective at lowering resin- and NaHCO(3)-extractable P. When H(2)SO(4) was used as the extractant, BF slag tended to be the most effective material at lowering extractable P, followed by water treatment sludge, and red mud. That is, the P immobilized by water treatment sludge was extractable with acid but not with water, resin, or NaHCO(3). CONCLUSIONS: Water treatment sludge has the potential to be used as an effective immobilizing agent for soluble P in composts, and it should be trialed under field conditions.

Addition of an organic amendment and/or residue mud to bauxite residue sand in order to improve its properties as a growth medium.

The effects of addition of carbonated residue mud (RMC) or seawater neutralized residue mud (RMS), at two rates, in the presence or absence of added green waste compost, on the chemical, physical and microbial properties of gypsum-treated bauxite residue sand were studied in a laboratory incubation study. The growth of two species commonly used in revegetation of residue sand (Lolium rigidum and Acacia saligna) in the treatments was then studied in a 18-week greenhouse study. Addition of green waste-based compost increased ammonium acetate-extractable (exchangeable) Mg, K and Na. Addition of residue mud at 5 and 10% w/w reduced exchangeable Ca but increased that of Mg and Na (and K for RMS). Concentrations of K, Na, Mg and level of EC in saturation paste extracts were increased by residue mud additions. Concentrations of cations in water extracts were considerably higher than those in saturation paste extracts but trends with treatment were broadly similar. Addition of both compost and residue mud caused a significant decrease in macroporosity with a concomitant increase in mesoporosity and microporosity, available water holding capacity and the quantity of water held at field capacity. Increasing rates of added residue mud reduced the percentage of sample present as discrete sand particles and increased that in aggregated form (particularly in the 1-2 and >10mm diameter ranges). Organic C content, C/N ratio, soluble organic C, microbial biomass C and basal respiration were increased by compost additions. Where compost was added, residue mud additions caused a substantial increase in microbial biomass and basal respiration. L. rigidum grew satisfactorily in all treatments although yields tended to be reduced by additions of mud (especially RMC) particularly in the absence of added compost. Growth of A. saligna was poor in sand alone and mud-amended sand and was greatly promoted by additions of compost. However, in the presence of compost, addition of carbonated mud had a marked depressive effect on both top and root growth. The significant positive effect of compost was attributed to substantial inputs of K and marked reductions in the Na/K ratio in soil solution while the depressive effect of RMC was attributed to its greater alkalinity and consequently higher concentrations of HCO(3)(-) in solution.

Cation and anion leaching and growth of Acacia saligna in bauxite residue sand amended with residue mud, poultry manure and phosphogypsum.

PURPOSE: To examine (1) the effect of organic (poultry manure) and inorganic (residue mud and phosphogypsum) amendments on nutrient leaching losses from residue sand and (2) whether amendments improve the growth of plants in residue sand. METHODS: Leaching columns were established using residue sand. The phosphogypsum-treated surface layer (0-15 cm) was amended with poultry manure and/or bauxite residue mud and the subsurface layer (15-45 cm) was either left untreated or amended with phosphogypsum. RESULTS: Much of the Na⁺, K⁺, Cl⁻ and SO4²â» was lost during the first four leachings. Additions of phosphogypsum to both surface and subsurface layers resulted in partial neutralization of soluble alkalinity. Mean pH of leachates ranged from 8.0 to 8.4, the major cation leached was Na⁺ and the major balancing anion was SO4²â» . Where gypsum was not applied to the subsurface, mean pH of leachates was 10.0-10.9, the main cation leached was still Na⁺ and the main balancing anions were a combination of SO4²â» and HCO3⁻/CO3²â». At the end of the experiment, concentrations of exchangeable Na⁺ in the subsurface layers were similar regardless of whether gypsum had been applied to that layer or not. Yields of Acacia saligna were promoted by additions of poultry manure to the surface layer but unaffected by gypsum incorporation into the subsurface layer. CONCLUSIONS: Lack of reaction of phosphogypsum with the subsurface layer is unlikely to be a major factor limiting revegetation of residue sand since in the absence of phosphogypsum the excess Na⁺ leaches with the residual alkalinity (HCO3⁻/CO3²â») rather than SO4²â».

Use of inorganic and organic wastes for in situ immobilisation of Pb and Zn in a contaminated alkaline soil.

PURPOSE: This study aims to examine whether addition of immobilising agents to a sandy, alkaline (pH = 8.1) soil, which had been contaminated with Pb and Zn by airborne particles from a Pb/Zn smelter, would substantially reduce metal bioavailability. METHODS: The effectiveness of five waste materials (blast furnace (BF) slag, alum water treatment (WT) sludge, red mud, sugar mill mud and green waste compost) as metal immobilising agents was evaluated by incubating them with a contaminated soil for a period of 12 months at rates of 5% and 10% (w/w), after which, Rhodes grass was grown in the soils in a greenhouse study. RESULTS: Additions of WT sludge, BF slag and red mud reduced CaCl(2), CH(3)COOH, HCl and EDTA-extractable Zn but compost and mill mud had no appreciable immobilising effects. Additions of all amendments reduced levels of CaCl(2), CH(3)COOH and HCl-extractable Pb although concentrations of EDTA-extractable Pb remained unchanged. A sequential extraction procedure showed that additions of mill mud and compost increased the percentage of total Pb and Zn present in the oxidisable fraction whilst additions of the other materials increased the percentage present in the residual fraction. Rhodes grass yields were promoted greatly by additions of red mud, compost and particularly mill mud, and yields were negatively correlated with tissue Pb concentrations and extractable Pb. CONCLUSIONS: Red mud was the most effective material for lowering extractable Pb and Zn levels simultaneously while mill mud and compost were notably effective for Pb. A field evaluation in the study area is justified.

Effect of amendment of bauxite processing sand with organic materials on its chemical, physical and microbial properties.

The effects of addition of a range of organic amendments (biosolids, spent mushroom compost, green waste compost and green waste-derived biochar), at two rates, on some key chemical, physical and microbial properties of bauxite-processing residue sand were studied in a laboratory incubation study. Levels of exchangeable cations were not greatly affected by additions of amendments but extractable P was increased significantly by mushroom and green waste composts and massively (i.e. from 11.8 to 966 mg P kg(-1)) by biosolids applications. Levels of extractable NO(3)(-)-N were also greatly elevated by biosolids additions and there was a concomitant decrease in pH. Addition of all amendments decreased bulk density and increased mesoporosity, available water holding capacity and water retention at field capacity (-10 kPa), with the higher rate having a greater effect. Addition of biosolids, mushroom compost and green waste compost all increased soluble organic C, microbial biomass C, basal respiration and the activities of beta-glucosidase, L-asparaginase and alkali phosphatase enzymes. The germination index of watercress grown in the materials was greatly reduced by biosolids application and this was attributed to the combined effects of a high EC and high concentrations of extractable P and NO(3)(-). It was concluded that the increases in water storage and retention and microbial activity induced by additions of the composts is likely to improve the properties of bauxite-processing residue sand as a growth medium but that allowing time for soluble salts, originating from the organic amendments, to leach out may be an important consideration before sowing seeds.

Chemical, microbial and physical properties of manufactured soils produced by co-composting municipal green waste with coal fly ash.

Increasing proportions of coal fly ash were co-composted with municipal green waste to produce manufactured soil for landscaping use. Only the 100% green waste treatment reached a thermophilic composting phase (50 degrees C) which lasted for 6 days. The 25% and 50% ash treatments reached 36-38 degrees C over the same period while little or no self-heating occurred in the 75% and 100% ash treatments. Composted green waste had a low bulk density and high total and macro-porosity. Addition of 25% ash to green waste resulted in a 75% increase in available water holding capacity. As the proportions of added ash in the composts increased, the organic C, soluble C, microbial biomass C, basal respiration and activities of beta-glucosidase, L-asparaginase, alkali phosphatase and arylsulphatase enzymes in the composted products all decreased. It could be concluded that addition of fly ash to green waste at a proportion higher than 25% did not improve the quality parameters of manufactured soil.

Reclamation and revegetation of fly ash disposal sites - Challenges and research needs.

Coal-fired power generation is a principal energy source throughout the world. Approximately, 70-75% of coal combustion residues are fly ash and its utilization worldwide is only slightly above 30%. The remainder is disposed of in landfills and fly ash basins. It is desirable to revegetate these sites for aesthetic purposes, to stabilize the surface ash against wind and water erosion and to reduce the quantity of water leaching through the deposit. Limitations to plant establishment and growth in fly ash can include a high pH (and consequent deficiencies of Fe, Mn, Cu, Zn and P), high soluble salts, toxic levels of elements such as B, pozzalanic properties of ash resulting in cemented/compacted layers and lack of microbial activity. An integrated organic/biotechnological approach to revegetation seems appropriate and should be investigated further. This would include incorporation of organic matter into the surface layer of ash, mycorrhizal inoculation of establishing vegetation and use of inoculated legumes to add N. Leaching losses from ash disposal sites are likely to be site-specific but a sparse number of studies have revealed enriched concentrations of elements such as Ca, Fe, Cd, Pb, and Sb in surrounding groundwater. This aspect deserves further study particularly in the longer-term. In addition, during weathering of the ash and deposition of organic matter during plant growth, a soil will form with properties vastly different to that of the parent ash. In turn, this will influence the effect that the disposal site has on the surrounding environment. Nevertheless, the effects of ash weathering and organic matter accumulation over time on the chemical, physical and biological properties of the developing ash-derived soil are not well understood and require further study.

Vitreoretinal surgery for retinal detachment in retinochoroidal colobomata.

PURPOSE: To report the management and outcome of retinal reattachment surgery in retinochoroidal coloboma. METHODS: Four patients with retinochoroidal colobomata presented to the Bristol Eye Hospital (a UK tertiary referral center for vitreoretinal surgery) with retinal detachment. INTERVENTION: All were type II colobomatous detachments (three patients with type IIB, one patient with type IID). All eyes underwent vitrectomy with endolaser and/or cryotherapy and three eyes underwent scleral buckling. Two eyes had internal tamponade with gas (SF6, C3F8) while the other two had silicone oil. Endolaser was applied over healthy retinal pigment epithelium. RESULTS: At last follow-up, all (100%) remained attached, with no recurrences. Three patients achieved visual acuity of 6/120 or better and were able to perform satisfactory near work with appropriate magnifiers. The last patient began with hand movement vision and retained similar vision but subjectively felt more navigational. CONCLUSIONS: Good anatomic and functional outcomes can be achieved in this patient group with combined vitrectomy with or without scleral buckling surgery. Endolaser retinopexy is effective over healthy RPE at the margin of the coloboma combined with either gas or oil internal tamponade.

Emulsification of Densiron-68 used in inferior retinal detachment surgery.

PURPOSE: To report the clinical features of eight patients presenting with emulsification of the heavier than water vitreous substitute, Densiron-68. METHODS: Two patients underwent primary inferior retinal detachment (RD) surgery, two patients underwent giant retinal tear repair, three patients had repair of inferior RD complicated by proliferative vitreoretinopathy and one patient had inferior RD surgery following repair of a scleral rupture. All patients had insertion of Densiron-68. RESULTS: Significant emulsification of Densiron-68 was seen within 12 weeks of surgery in eight cases out of a total of 40 patients receiving Densiron-68. CONCLUSION: Despite adequate Densiron fills, emulsification necessitated its removal. Emulsified Densiron may have contributed to significant intraocular inflammation, epiretinal membrane formation and cystoid macular oedema. Without removal, prolonged presence of emulsified Densiron may lead to keratopathy, secondary glaucoma and retinal toxicity secondary to partitioning of perfluorohexyloctane. This has potentially significant implications on the indications for Densiron-68 use and warrants consideration before deciding on the optimal surgical intervention for inferior RDs.