Diplopia and strabismus following ocular surgeries.

Postoperative diplopia and strabismus may result from a variety of ocular surgical procedures. Common underlying mechanisms include sensory disturbance, scarring, direct extraocular muscle injury, myotoxicity from injections of local anesthesia or antibiotics, and malpositioning of extraocular muscles by implant materials. The most common patterns are vertical and horizontal motility disturbance. Treatment options include prisms, botulinum, occlusion, or surgery.

Diabetic macular edema: pathogenesis and treatment.

Diabetic macular edema is a major cause of visual impairment. The pathogenesis of macular edema appears to be multifactorial. Laser photocoagulation is the standard of care for macular edema. However, there are cases that are not responsive to laser therapy. Several therapeutic options have been proposed for the treatment of this condition. In this review we discuss several factors and mechanisms implicated in the etiology of macular edema (vasoactive factors, biochemical pathways, anatomical abnormalities). It seems that combined pharmacologic and surgical therapy may be the best approach for the management of macular edema in diabetic patients.

A comparison of the effectiveness of four biostains in enhancing visualization of the vitreous.

PURPOSE: To compare the effectiveness of four biostains in vitreous staining as a means to facilitate clean anterior vitrectomy. MATERIALS AND METHODS: Four biostains (fluorescein, indocyanine green, trypan blue, and triamcinolone acetonide) were used to stain the transparent vitreous of human cadaver and monkey cadaver eyes. Results were compared and recorded by digital photography and videography. RESULTS: Of the four biostains, triamcinolone acetonide best highlighted the vitreous. Although fluorescein, indocyanine green, and trypan blue also produced acceptable vitreous staining, the surrounding ocular structures were slightly stained as well. CONCLUSION: All four biostains enhanced visualization of the vitreous. However, triamcinolone acetonide best highlighted the vitreous.

Pars plana vitrectomy for refractory diabetic macular edema.

OBJECTIVE: The aim of this study is to describe the results of pars plana vitrectomy (PPV) for refractory diabetic macular edema (DME). METHODS: Review of the relevant peer-reviewed scientific literature identified using Medline. MAIN OUTCOME MEASURES: The anatomical and functional outcome of surgery. RESULTS: Vitrectomy with or without internal limiting membrane (ILM) peeling can be beneficial for the treatment of DME that is resistant to laser photocoagulation or sub-Tenon's steroid injection. Visual improvement has been reported in approximately 40-90% of patients, with approximately 85-100% experiencing either improvement or stabilization of vision. Retinal edema decreases or resolves in approximately 70-100% of patients. Complications range in severity with approximately 5-20% of patients developing peripheral retinal breaks, approximately 1-2% developing retinal detachment, approximately 2% developing macular hole, and approximately 10-60% developing cataract. Severe complications such as rubeosis iridis and the fibrinoid syndrome have also been reported. CONCLUSION: Pars plana vitrectomy can be an effective treatment for diabetic macular edema refractory to laser therapy and/or sub-Tenon's capsule steroid injection.