The Efficacy of Pars Plana Vitrectomy on Recurrent or Remained Retinal Detachment After Primary Scleral Buckle

PURPOSE: To evaluate the efficacy of pars plana vitrectomy on the retinal reattachment for the patients who have suffered from recurrent or remained retinal detachment (RD) although they had undergone scleral buckling procedures for their rhegmatogenous retinal detachment. METHODS: With retrospective chart review of 14 patients with recurrent or persisted RD who underwent pars plana vitrectomy, the authors checked the reattachment rate, their visual recovery state, and complicated disorders during and after the surgeries. All eyes had undergone scleral buckling procedure during primary repair. RESULTS: Anatomic success was achieved after the initial reoperation in 10 (71.5%) eyes. With further surgery, the overall success rate was 85.1% (12 eyes). Visual acuity was improved in 4 eyes, worse in 8 eyes. CONCLUSIONS: These results suggest that pars plana vitrectomy may be an efficient surgical procedure for retinal reattachment in cases of recurrent or persisted RD after primary scleral buckle.

Comparison of Clinical Results between Hydroxyapatite and Medpor(R) Orbital Implant

PURPOSE: We compared orbital implants with hydroxyapatite and with Medpor (R) in operative group and observed clinical results by retrospective study. METHODS: We used hydroxyapatite implantation in 17 subjects(17 eyes) and Medpor(R) implantation in other 15 subjects (15 eyes) with enucleation and evisceration from April 1996 to May 2000. RESULTS: We observed clinical results for 10~34 month (average 20 month); Three cases of implant exposure, one case of peg extrusion, two cases of superficial conjunctival wound dehiscence, one case of granulation tissue overgrowth, and one case of implant self-infection after hydroxyapatite implantation; Two cases of implant exposure and one case of superficial conjunctivial wound dehiscence after Medpor(R) implantation. In measurement at 6 months after operation, fibrovascular ingrowth pattern after hydroxyapatite implantation was slightly better than Medpor R implantation, and prothesis motility was not different. CONCLUSIONS: We found high frequency of complication with implant exposure, superficial conjunctival wound dehiscence, granulation tissue formation after Hydroxyapatite implantation than Medpor(R) implantation, and that no different complication with the exception of noise of prosthesis movement in Medpor(R) implantation, which is better useful for peg drilling & enucleation. So it is thought to be Medpor(R) is more useful clinical materials for orbital implants than Hydroxyapatite.

The Effect of Silicone Tube Intubation in Pediatric Nasolacrimal Duct Obstruction

PURPOSE: To evaluate the results of silicone tube intubation in pediatric patients whose tearing was not relieved by probing method. OBJECTS AND METHODS: We intubated Crawford type and Monoka type silicone tube from 1995 to 2000 in forty eyes which had persistent tearing in spite of conservative treatment and probing method, and inferior turbinate was fractured if necessary. RESULTS: The mean follow-up period was 16.9 months. The successful results were obtained in 80% of Crawford type, and in 85% of Monoka type. Especially, in cases of the inferior turbinate fracture, success rate was 100% regardless of the type of silicone tube. There was no significant difference in complications in the two types. Monoka type was easier to proceed and less irritant to eyes than Crawford type but there were some cases in which the tube was extruded during the follow-up period. CONCLUSION: Monoka type silicone tube intubation in pediatric nasolacrimal duct obstruction was as successful as Crawford type and the procedure was easier than Crawford type. In addition, silicone tube intubation could be performed more simply with inferior turbinate fracture.

Ocular Perforation During Reattachment Surgery for Recurrent Retinal Detachment

Ocular perforation during retinal reattachment surgery is very uncommon intraoperative complication.If globe rupture occurs, intraocular fluid leakage, ocular hypotony, and vitreous hemorrhage follow. Authors made an intraoperative ocular perforation inadvertently by scleral depressor on our patient who had a recurrent retinal detachment on his right eye. However, immediate scleral suture of the ruptured wound and balanced salt solution injection by pars plana route, and effective scleral exoplant maintained his retina anatomically flat. So, we present the case with a brief literatures review.