The effect of adjunctive Mitomycin C in Ahmed glaucoma valve implantation.

PURPOSE: To evaluate the effectiveness and safety of adjunctive mitomycin C (MMC) in Ahmed glaucoma valve (AGV) implantation for refractory glaucoma. METHODS: Twenty-two eyes of 22 patients who underwent AGV implantation with adjunctive MMC (0.5 mg/ml) for 3 minutes (Group A) were compared to a control group of 26 eyes of 26 patients (Group B) who received AGV implantation without MMC. Nine patients were female and 13 patients were male in Group A and 11 patients were female and 15 patients were male in Group B. The mean age was 56 years ranging from 13 to 77 in Group A and 58 ranging from 14 to 71 years in Group B. Success was defined as an intraocular pressure (IOP) between 4 and 21 mmHg with or without glaucoma medication and with no additional glaucoma surgery, phthisis, or loss of light perception. RESULTS: The probability of success at 1 year was 86.36% and 80.76% in Group A and Group B, respectively. The number of glaucoma medications decreased from 2.82 to 0.56 in Group A and from 2.65 to 0.73 in Group B. Postoperative hypotony as an early complication was higher in Group A (31.81% in Group A and 15.38% in Group B). As a late postoperative complication, tube exposure developed in 3 patients (13.63%) in Group A and no such complication was seen in Group B. There was no statistically significant difference in success and complication rates between the two groups (p>0.05). CONCLUSIONS: Although adjunctive MMC in AGV implantation is safe and effective, it may not offer a better chance of surgical success compared with AGV implantation without MMC.

Closed chamber iridodialysis repair using a needle with a distal hole.

We describe a closed-system technique of iridodialysis repair using a 22.0 mm, plastic handled, 27 gauge straight needle with a hole 1.0 mm proximal to the tip. The distal hole is suitable for passage of 9-0 or 10-0 mm polypropylene or nylon sutures. The technique was effective in 8 patients with traumatic iridodialysis in the upper and inferior temporal quadrants.

Effect of melatonin against oxidative stress in ultraviolet-B exposed rat lens.

PURPOSE: To investigate the defensive effect of melatonin against oxidative stresses in ultraviolet-B (UVB) radiation induced cataract development. METHODS: Young rats received 8 kJ/m(2) UVB for 15 min. For the intervention of cataract development intraperitoneal injection of melatonin (4 mg/kg daily for 1 week) following UVB exposure was performed. Lenticular glutathione peroxidase (GSHPx), catalase (CAT), superoxide dismutase (SOD) activities and glutathione (GSH), malondialdehyde (MDA) levels were determined in UVB-melatonin, UVB, and control groups. RESULTS: One week after exposure in the UVB group, lens opacities were observed and CAT, SOD, and GSHPx activities, and GSH level were lower than control and MDA level was higher than control (p < 0.05). In the UVB-melatonin group CAT and SOD activities were lower than control (p < 0.05), and the MDA level was lower than the UVB group (p < 0.05). CONCLUSIONS: These results suggest that melatonin may protect against the UVB-induced cataract development by directly quenching lipid peroxides and indirectly by enhancing the production of the endogenous antioxidant GSH.

An unusual complication of retinal reattachment surgery.

The authors report a case with an unusual late extraocular complication of scleral buckling and local silicone sponge implant. Four years after the reattachment surgery, a ptotic upper eyelid perforated by local silicone sponge implant and fistula between upper eyelid and sclera were detected. Primary repair of upper eyelid and removal of silicone sponge were performed. One year later, the retina was attached and there was no problem with the upper eyelid. Cryotherapy, episcleral explant (scleral buckling), and local implant (sponge) are frequently used and effective methods for retinal reattachment surgery. Postoperative early and late complications have been reported. To our knowledge, there is no report of upper eyelid perforation, ptosis and fistula formation caused by silicone sponge implant rejection.

Vitreoretinal surgery in Behçet's disease with severe ocular complications.

PURPOSE: To investigate effects of vitreoretinal surgery in Behçet's disease. MATERIALS AND METHOD: Vitreoretinal surgery was applied to 26 eyes of 21 patients with Behçet's disease. Preoperative and postoperative visual acuities, number and duration of attacks, anterior and posterior segment pathologies were evaluated. RESULTS: The mean age of the patients was 33 years and female/male ratio was 6/15. The mean follow-up was 23 months. Visual acuity increased in 15 eyes (58%), did not change in 11 eyes (42%). In the postoperative period, there was a significant decrease in mean number of uveitis attacks compared to the preoperative period (p=0.001), as well as a significant decrease in the mean duration of uveitis attacks (p=0.001). In the postoperative follow-up, intravitreal haemorrhage in 2 eyes (8%), posterior subcapsular cataract in 5 eyes (19%) and corticonuclear cataract in 2 eyes (8%) were observed. Posterior capsular opacification (PCO) developed in 5 of 16 eyes (31%) having ECLE-IOL. CME continued in 3 eyes (12%). CONCLUSION: Vitreoretinal surgery has favourable effect on the visual and anatomic prognosis in Behçet's patients with severe ocular complications.