Macular epiretinal membranes.

Epiretinal membranes (ERM) are a common finding in older patients. Although they may be associated with numerous clinical conditions, most epiretinal membranes occur in the absence of ocular pathology. Patients symptoms range from asymptotic to complaints of severe vision loss and metamorphopsia. Epiretinal membranes are commonly classified according to their density, to the severity of retinal distortion and to associated biomicroscopic changes. Pars plana vitrectomy has been found to be effective in removing ERM from the macula, improving the visual acuity and decreasing metamorphopsia. Both idiopathic and secondary ERMs do well after surgery, although secondary ERMs showed a greater amount of improvement than idiopathic ones. Complications are frequent including accelerated postoperative nuclear sclerosis, retinal breaks and RD, macular edema, RPE and, occasionally, macular hole and hypotony. However only RD involving the macula have a worsening prognosis on final outcome.

Preoperative ocular disinfection by the use of povidone-iodine 5%.

Numerous disinfective methods have been proposed in order to prevent intraocular infections during eye operations. In a clinical-laboratory study we evaluated the effectiveness of povidone-iodine solution 5% as a preventive - preoperative means of conjunctival antisepsis prior to ocular surgery. Conjunctival cultures were performed on 100 patients. Group A (50 patients) had their fornices washed with normal saline immediately before surgery. In Group B (50 patients) one drop of povidone-iodine solution 5% was applied prior to preoperative wash of the fornices with normal saline. Thirty-three out of 50 eyes from Group A had positive cultures (66%). Only 15 out of 50 eyes from Group B had positive cultures (30%). Bacteria flora differed in the two groups, with Group A exhibiting more dangerous strains. Preoperative-preventive disinfection with povidone-iodine 5% may prove to be advantageous to ocular surgery.

Management of pseudophakic retinal detachment with various intraocular lens types.

In the last five years, 25 cases of retinal detachment (RD) after intraocular lens implantation were treated in the University Eye Clinic of Thessaloniki. The incidence of RD was lower with posterior chamber intraocular lens (PC-IOL, 0.46%) implantation than in the cases with anterior chamber IOL (AC-IOL, 2.6%) implantation. The successful reattachment rate was higher with PC-IOL (100%) than in cases with AC-IOL where the low success (87%) rate was caused by proliferative vitreoretinopathy. Therefore, the eyes with AC-IOL required reoperation more frequently, and the ultimate failure rate (despite multiple operations) was higher in the AC-IOL group. Conventional surgical techniques were used in the first procedure. In the reoperated cases, the most advanced techniques were used, such as vitrectomy combined with gas or silicone oil injection.