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PURPOSE: The purpose of this study was to report an exceptional case of a postponed closure of a postoperative macular hole. METHODS: A 60-year-old woman received a diagnosis of idiopathic macular hole after she suffered decreased vision in her left eye for 3 weeks. She underwent a pars plana vitrectomy, fluid-air exchange, and room air tamponade with face down positioning for 5 days, without internal limiting membrane peeling. Optical coherence tomography scans were performed at 3 days, 3 months, and 6 months after surgery. RESULTS: Macular hole did not achieve closure until 6 months after surgery. CONCLUSION: Postponed closure in a case of a postoperative macular hole is rare. This report shows that idiopathic macular hole, which does not close immediately after surgery, still has the possibility to achieve closure.
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·AIM: To determine whether a combined scleral buckle and pars plana vitrectomy, as a primary surgery, owns any advantage over a single scleral buckling in pseudophakic and aphakic retinal detachments.·METHODS: Thirty consecutive pseudophakic/aphakic retinal deachments were included in this retrospective study. Each patient underwent combined scleral buckle and pars plana vitrectomy, and was followed up for 3 to 14 months. Patients were examined with respect to anatomic reattachment, visual acuity improvement, and surgical complications.·RESULTS: All eyes were anatomically reattached after the first operation. All patients had an increase in their visual acuity, and there were no complications attributable to the vitrectomy procedure.·CONCLUSION: A combined surgery for primary pseudophakic/aphakic retinal detachments offers significant benefits to scleral buckling alone. The improved uccess rate is contributing to the function of vitrectomy, which improves peripheral visibility and reduces the occurrence of proliferative vitreoretinopathy (PVR).
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AIM: To investigate the characteristics and surgical management of retinal detachment (RD) after laser-assisted in situ keratomileusis (LASIK) in myopia.METHODS: Documents of patients with RD observed in 18342 eyes (9 598 patients) who underwent LASIK were retrospectively reviewed. None of the patients had history of corneal or other diseases before LASIK and preoperative fundus examination was performed. Patients were followed for a mean of 20 months and the clinical features of the eyes which developed RD after LASIK were investigated.RESULTS: Six patients including 2 males and 4 females developed RD, and the incidence of RD after LASIK was 0.33‰. Mean pre-LASIK myopia in these 6 eyes was 9.33D.None of these eyes had prophylactic treatment history of any retinal lesions. Mean time interval between LASIK and RD development was 9.2 months. All RDs happened spontaneously and were managed with vitrectomy and other techniques.Retinal reattachment was achieved at the first retinal detachment surgery in all 6 eyes (100%) at mean follow-up of 9.3months.CONCLUSION: RD after LASIK is not common. The study suggests no cause-effect relationship between RD and LASIK procedure in myopic eyes. However, clinicians should still be aware of retinal pathology in patients undergoing LASIK.
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AIM: To assess the efficacy and safety of prophylactic laser photocoagulation for retinal breaks before laser in situ keratomileusis (LASIK) in myopic eyes.METHODS: From April 2000 to April 2004, totally 1 845 eyes ( 1 233 patients ) requesting LASIK had a fundus examination with indirect ophthalmoscopy before the surgery. They were divided into two groups according to the presence (Group 1) or absence of retinal breaks (Group 2). All patients with retinal breaks, though they were asymptomatic, underwent prophylactic laser photocoagulation to seal the breaks before LASIK.RESULTS: Patient age ranged from 18 to 43 ( 25.3±5.7) yaers old. Mean preoperative spherical equivalent refraction (PSER) was -7.44± 2.13 D (range, -1.50 to -14.50 D). Retinal breaks were identified and treated in 37eyes (2.05%) of 32 patients;1 808 eyes of 1 201 patients had no retinal breaks. No statistical difference was found in age ( P >0.05) or gender (P >0.05) between the two groups. Significant difference of PSER was noted between Group 1 (-9.41± 4.15D) and Group 2 (-7.52±3.71D) (P<0.05). During a mean 14mo follow-up, none of the patients developed retinal detachment.CONCLUSION: The efficacy and safety of prophylactic laser photocoagulation for retinal breaks was confirmed.Retinal breaks should be identified and treated by photocoagulation in eyes before LASIK for myopia.
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· AIM: To report the clinical results of vitrectomy for Terson syndrome.· METHODS: Twenty-one eyes of 15 patients with Terson syndrome underwent vitreous surgery with the mean follow-up of 19.1mo.· RESULTS: Incomplete posterior vitreous detachment(PVD) was found in 15 eyes (71.4 %), epiretinal membrane was formed in 7 eyes (33.3 %), and retinal detachment occurred in 4 eyes (19.0 %). Significant visual improvement occurred in all eyes after vitrectomy: visual acuity of 20/40 or better was achieved in 17 eyes (80.9 %)and 4 eyes (19.0 %) developed lens opacity.· CONCLUSION: Vitrectomy for Terson syndrome can provide good visual recovery, with low complication rate,including that of cataract.