RESUMEN
To evaluate the outcome of photodynamic therapy (PDT) and the factors influencing its outcome in patients with subfoveal choroidal neovascularization (CNV) due to pathologic myopia. Twenty-three eyes of 21 consecutive patients who received PDT for subfoveal CNV due to pathologic myopia and who were followed for >12 months were included in the study. The relationship between the factors that might affect the treatment outcome were evaluated. Mean age was 48.7 ± 16.0 years (23-74 years). Mean follow-up was 23.2 ± 7.7 months (15-41 months). Mean logMAR visual acuity was 0.85 ± 0.24 before treatment, 0.89 ± 0.37 at 12 months, and 0.92 ± 0.46 at the final visit. Mean logMAR visual acuity did not change significantly at 12 months or at the final visit (P = 0.47 and 0.36, respectively). The baseline visual acuity strongly correlated with the final visual acuity (P = 0.001). Age showed an inverse correlation with change in logMAR visual acuity at 12 months (P = 0.01). PDT prevented significant visual loss in eyes with subfoveal CNV due to pathologic myopia. Better initial visual acuity resulted in better final visual acuity. Younger age was correlated with better treatment outcome at 12 months.
Asunto(s)
Neovascularización Coroidal/tratamiento farmacológico , Miopía Degenerativa/complicaciones , Fotoquimioterapia , Adulto , Anciano , Neovascularización Coroidal/etiología , Neovascularización Coroidal/fisiopatología , Sensibilidad de Contraste/fisiología , Femenino , Angiografía con Fluoresceína , Humanos , Masculino , Persona de Mediana Edad , Miopía Degenerativa/fisiopatología , Fármacos Fotosensibilizantes/uso terapéutico , Porfirinas/uso terapéutico , Factores de Riesgo , Tomografía de Coherencia Óptica , Resultado del Tratamiento , Verteporfina , Agudeza Visual/fisiología , Adulto JovenRESUMEN
PURPOSE: The purpose of this article was to evaluate the outcomes and complications of transconjunctival sutureless 25-gauge vitrectomy using silicone oil tamponade in diabetic tractional retinal detachment. MATERIALS AND METHODS: Patients were retrospectively evaluated. Main outcome measure was the feasibility of pars plana vitrectomy and silicone oil injection with 25-gauge system in eyes with diabetic tractional retinal detachment. RESULTS: Fourteen eyes of 14 patients were included in the study. Tractional retinal detachment was accompanied by vitreous hemorrhage in 9 eyes and combined traction/rhegmatogenous retinal detachment was present in 1 eye. All patients underwent transconjunctival sutureless 25-gauge vitrectomy and 1,000 centistokes silicone oil injection. Angled insertion of the trocars was made in all eyes. Bimanual surgery was performed in 6 (42.8%) eyes. The median preoperative best-corrected visual acuities were 3.00 logarithm of the minimum angle of resolution; it increased to 1.60 logarithm of the minimum angle of resolution at last visit. Retinal tear formation occurred in 4 (28.5%) eyes. Retinal detachment developed in 2 (14.2%) eyes. Intraocular pressure of 5 mmHg or less was detected in 3 (21.4%) eyes. One patient lost light perception due to anterior hyaloidal fibrovascular proliferation. CONCLUSION: Pars plana vitrectomy and 1,000 centistokes silicone oil injection with 25-gauge system is feasible in diabetic tractional retinal detachment even in complex cases. Indications of 25-gauge surgery may be expanded toward this area.
Asunto(s)
Conjuntiva/cirugía , Retinopatía Diabética/cirugía , Desprendimiento de Retina/cirugía , Aceites de Silicona/administración & dosificación , Vitrectomía/instrumentación , Vitrectomía/métodos , Adulto , Anciano , Retinopatía Diabética/complicaciones , Retinopatía Diabética/fisiopatología , Estudios de Factibilidad , Femenino , Humanos , Inyecciones , Presión Intraocular , Masculino , Persona de Mediana Edad , Desprendimiento de Retina/complicaciones , Desprendimiento de Retina/etiología , Desprendimiento de Retina/fisiopatología , Perforaciones de la Retina/complicaciones , Perforaciones de la Retina/etiología , Estudios Retrospectivos , Resultado del Tratamiento , Agudeza Visual , Vitrectomía/efectos adversos , Hemorragia Vítrea/complicacionesRESUMEN
PURPOSE: To evaluate the rate, duration, and associated complications of postoperative hypotony after 25-gauge sutureless vitrectomy. METHODS: In a retrospective, interventional, institutional case series, 25-gauge sutureless vitrectomy with straight incisions was performed on 111 eyes. Postoperative intraocular pressure (IOP) was measured routinely at 2 hours, 1 day, 1 week, and 1 month. Postoperative IOP, hypotony (IOP, <8 mmHg) rates, and complications associated with low IOP were assessed to determine outcome. RESULTS: Mean follow-up +/- SD was 5.45 +/- 3.44 months. Mean IOP decreased significantly by 2 hours and on postoperative day 1 (P < 0.001) and increased to preoperative levels at week 1 (P = 0.48). Postoperative hypotony rates were 26.12%, 17.11%, and 8.10% at 2 hours, 1 day, and 1 week, respectively. The ratio of postoperative vitreous hemorrhage in eyes with and without hypotony on day 1 was 2:6 (P = 0.412). Two eyes with macular holes (MHs) filled inadequately with gas endotamponade that remained hypotonic for the first postoperative week underwent reoperation due to unsealed MHs. CONCLUSIONS: Twenty-five-gauge sutureless vitrectomy with straight incisions resulted in a hypotony rate of 26.12% at 2 hours that decreased to 17.11% on day 1 and to 8.10% at week 1 but did not increase the incidence of postoperative complications.