"Delamination Plus": A Technique to Reduce Immediate Postoperative Diabetic Cavity Hemorrhage.

PURPOSE: To investigate the effectiveness of an intraoperative surgical technique to reduce the incidence of immediate postoperative cavity hemorrhage in patients undergoing vitrectomy for complications of proliferative diabetic retinopathy. METHODS: A single-center, prospective study of 20 consecutive patients who underwent vitrectomy for proliferative diabetic retinopathy-related complications. A standard 3-port pars plana vitrectomy with either 23 g or 25 g was performed. At the end of surgery, the infusion was switched off to create transient hypotony and endolaser photocoagulation with long-duration burns were applied to actively leaking blood vessel. RESULTS: The average age was 56.2 + 12.8 years. Eleven eyes had actively bleeding vessels at the end of surgery and received endolaser photocoagulation. No patients were found to have hypotony at Day 1 postoperative. Preoperative median visual acuity was 20/1,600 improving to 20/40 at a median of 2.3 weeks post-op (range 0.4-8.5 weeks). Two eyes (10%) had a small postoperative cavity hemorrhage with 20/40 vision, which did not require further intervention. CONCLUSION: The described technique was found to be effective in reducing the incidence of postoperative cavity hemorrhage from up to 75% reported in literature to 10% in our pilot study. Further study with a larger number of patients is required.

Diagnostic sensitivity of vitrectomy and vitreous biopsy for vitritis.

PURPOSE: To investigate sensitivity of diagnostic vitrectomy and vitreous biopsy for patients with vitritis of unknown aetiology. METHODS: Retrospective analysis of all vitrectomies and vitreous biopsies, performed at St Thomas' Hospital, London, UK, for vitritis between February 2001 and February 2019. Patients were identified using the VITREOR database and records were reviewed. Patients were categorised as infectious, non-infectious or masquerade based on final diagnosis. Sensitivity of both diagnostic pars plana vitrectomy (PPV) and vitreous cutter biopsy in each category was investigated. Furthermore, data on gender, age, and method of anaesthesia were also collected. RESULTS: In our cohort, 64 patients underwent PPV with a diagnostic sensitivity of 67% (43/64) overall and 60% (18/30), 56% (9/16) and 89% (16/18) for those with infectious, masquerade and non-infectious aetiologies, respectively. In comparison, 96 patients underwent a vitreous cutter biopsy with diagnostic sensitivity of 74% (71/96) overall and 71% (55/77), 67% (4/6) and 92% (12/13) for those with infectious, masquerade and non-infectious aetiologies, respectively. No statistically significant difference in sensitivity was identified between the vitrectomy and vitreous biopsy groups for either aetiology. Patients undergoing vitrectomy were noted to be older (p = 0.02) and more likely to undergo a general anaesthetic (p < 0.01). CONCLUSIONS: Herein we demonstrate similar diagnostic sensitivity of PPV and vitreous cutter biopsy in patients with vitritis of unknown aetiology.

Case report of a sarcoma botryoides of the uterine cervix in fertile age and literature review.

INTRODUCTION: The sarcoma botryoides of the cervix uteri occurs very rarely in fertile women. CASE: Here is a case of a 35-year-old fertile woman, who developed a sarcoma botryoides of the cervix uteri. The diagnosis required clinical examination, ecography, NMR, CT scan and a pathological examination of the surgical sample. Radical surgery and chemotherapy was performed. The patients is still living after more than 1 year after treatment. DISCUSSION: Although the combined modality approach has given, if not constant, acceptable outcomes, a larger investigation on all the cases of sarcoma botryoides of the cervix uteri is expected.