Peeling of internal limiting memberane in the management of full-thickness idiopathic macular hole

Purpose: To evaluate the effectiveness of removal of the internal limiting membrane [ILM] in the treatment of full-thickness idiopathic macular hole [MH]. 13 consecutive eyes of 11 patients with full-thickness idiopathic macular hole were recruited for a non-comparative retrospective study. All eyes underwent pars plana vitrectomy, staining of ILM with indocyanine green [ICG], ILM maculorhexis, fluid-air exchange, intravitreous gas tamponade and positioning face down. The outcome measures were disappearance of the submacular fluid, anatomical closure of the hole, visual acuity, associated findings and complications. All patients had postoperative follow up period of >/= 6 months. Primary closure of the macular hole was successfully achieved in 11[84.6%] of the 13 eyes with one operation. Of the 2 macular holes that were open, one underwent repeat surgery. Ultimately, 12 [92.3%] eyes had closure of the macular holes. Nine [69%] of 13 eyes had improvement in the visual acuity of at least two Snellen lines. Complications attributed to removal of ILM were minor hemorrhages and retinal edema that resolved spontaneously. Postoperative ICG staining of the lens capsule and papillary borders had been observed in 2 [15%] eyes. Complications related to the operations included retinal tears and retinal detachment in one [7.6%] eye. Conclusions: peeling of ILM is an important development in successful management of macular hole. To overcome the poor visibility of the ILM, staining of the ILM with ICG is helpful to allow easier and atraumatic removal of ILM

Deep sclerectomy versus trabeculectomy in management of primary open angle glaucoma

Aim of the work: This work aims to evaluate the efficacy of deep sclerectomy in management of primary open angle glaucoma, with its possible complications through a comparative study with the traditional filtering surgery trabeculectomy. Patient and methods: Thirty eyes of 28 glaucoma patients, whom were diagnosed as primary open angle glaucoma, were randomly divided into two groups each of 15 eyes, group I: Patients were subjected to trabeculectomy operation. Group II: Patients were subjected to deep sclerectomy operation. The two groups were followed postoperatively for detection of any complications Results and discussion: The deep sclerectomy as non penetrating glaucoma surgery lowers the intraocular pressure as good as the standard trabeculectomy. Its complication rate is very low during the early postoperative weeks