Anatomic outcome of scleral buckling surgery in primary rhegmatogenous retinal detachment.

PURPOSE: To evaluate the factors affecting the anatomic success of treatment of retinal detachments (RD) by scleral buckling surgery. METHODS: One-hundred and two eyes of 102 patients with rhegmatogenous RD operated on by scleral buckling surgery were included in the study. Results were analyzed according to the anatomic status of the retina at the most recent follow-up examination. The chi-squared test was used to determine the relationship between preoperative and intraoperative variables and anatomic results, and the relative risk of failure was determined for each variable. RESULTS: Retinal reattachment was achieved in 85 of 102 eyes (82.5%) after initial surgery. The success rate for anatomic reattachment was 95% after two operations. After three operations reattachment was achieved for 98 eyes (96%). Predictive factors for anatomic failure (P<0.05) were the presence of grade C(1) PVR and multiple breaks. CONCLUSION: Grade C(1) PVR and multiple breaks were found to be significant risk factors for anatomic failure in rhegmatogenous RD treated by conventional buckling surgery.

A novel suture technique in stellate corneal lacerations.

A novel suture technique for regular stellate corneal lacerations, called a star-shaped suture is described. The suturing begins from inside any of the wound lips in a clockwise direction. Suture placement proceeds in a counterclockwise direction by the adjacent wound limb, while the suture passes are all in clockwise direction. Finally, a star-shaped suture is achieved with the knot self-buried in the corneal stroma at the initial entry site. This is a continuous suture, of which tractional forces direct to the center of the wound providing good apical apposition for stellate lacerations. This suture technique can be an alternative for the reconstruction of stellate corneal lacerations.

A simple closed chamber technique for repair of traumatic iridodialysis in phakic eyes.

A surgical technique was developed for traumatic iridodialysis repair using a small partial-thickness scleral flap and a 24-gauge disposible hypodermic needle. This procedure is a "direct iridodialysis-site approach" closed chamber technique with minimal surgical trauma that can be used in phakic, pseudophakic, or aphakic eyes.

An alternative technique in (1) determining the placement of scleral buckles in (2) retinal detachment surgery.

We have developed a simple technique to verify the final and exact position of the explant on the retinal break before placing the radial or circumferential scleral buckles during the retinal detachment surgery. For this purpose, we used the back end of a dismantled blade holder which is essentially the same size as a sponge.

A simple "lasso" for intraocular foreign bodies.

Three patients had foreign bodies in their anterior chambers following penetrating ocular injuries. These foreign bodies were removed by a closed chamber technique using a simple loop. The loop was created by a 22-gauge intravenous cannula and a 7-0 polypropylene suture. Retained cilia in one patient and metallic foreign bodies in two patients were removed using this intraocular "lasso." Sutures were not placed at the incision sites at the end of the surgery. This is an inexpensive and easy to prepare technique that introduces minimal surgical trauma. In addition, two hands are not needed for loop manipulation. This technique may be an excellent alternative for removal of small intraocular foreign bodies.

Electrocardiographic changes during subconjunctival injections.

Electrocardiographic changes were investigated in 53 patients during subconjunctival drug injections. Decrease in heart-rate of more than 10% or arrhythmia was observed in 25 (47.2%) of the patients, who were considered to have a positive oculocardiac reflex. In the control group of 35 patients, only 3 (8.6%) were found to have a significant decrease in heart rate during blood sampling from antecubital vein (p = 0.000). Young age was a significant risk factor for oculocardiac reflex during injections (p = 0.01). Patient gender, verbal pain score, satiety, experience of periocular injections, injected drug type were not found to be risk factors. All patients with oculocardiac reflex were asymptomatic; however, it is still wise to have emergency supplies ready for any circulatory derangement during subconjunctival injections.

The influence of religious fasting on basal tear secretion and tear break-up time.

Muslims abstain from food and drink from dawn to sunset during the holy month of Ramadan. An extended strict fasting may influence tear secretion and quality. We investigated changes in basal tear secretion (BTS) and tear break-up time (BUT) at the beginning and at the end of fasting on 32 healthy male patients with a mean age of 22.3 +/- 2.9 years. Body weight and urine specific gravity were also determined to assess the extent of dehydration due to fasting. Each case lost 0.1-1.25 kg of body weight while urine specific gravity changes were statistically insignificant. Mean BTS amount was 19.9 +/- 10.9 mm at the initial examination and 19.7 +/- 11.5 mm at the end of fasting (p = 0.9). BUT values were 20.1 +/- 9.3 sec at the beginning of fasting and 23.5 +/- 14.9 sec at the end of fasting (p = 0.19). We found that religious fasting in the winter season does not seem to affect BTS and BUT values in healthy individuals.

Clinical results of implantation of the Medevec mini-loop haptic anchor plate foldable lenses.

PURPOSE: To evaluate the surgical performance and postoperative outcomes of 50 consecutive implantations of the Medevec VS 2 UV(TM) mini-loop silicone plate lenses. SETTING: Ege University Hospital, Eye Department, Izmir, Turkey. METHODS: Forty-three patients of either sex, aged 49 years, or older, were included in the study. Clear corneal incision, circular curvilinear capsulorhexis, phacoemulsification and implantation of the Medevec VS 2 UV(TM) mini-loop silicone plate lenses using the injector-cartridge system was performed in all cases. The mean outcome measures were ease of implantation, intraoperative and postoperative complications, postoperative centration and visual acuity. RESULTS: The mean follow-up was 10.2 months (range 8-11 months). Twenty-two lenses (44 required two or more manoeuvers). In 6 cases, the lens was implanted into a bag with torn anterior capsule and in 3 patients (6 implanted into the sulcus because of a torn posterior capsule during phacoemulsification). Best corrected visual acuity was > or =7/10 in 48 eyes (96%) and > or =10/10 in 42 eyes (84%) at 8 months. The examination of the lenses after 8 months showed no sign of haze, discoloration or tilt. Mean decentration of the lenses was 0.32 mm +/- 0.19 (SD). There were no cases of cystoid macular edema or retinal detachment. YAG capsulotomy was performed in one eye. CONCLUSIONS: Medevec VS 2 UV(TM) mini-loop silicone plate lenses appeared to have some learning curve for the implantation. They provided -- even in the sulcus -- excellent centration, good visual acuity and minimal postoperative complications.