Clinical Characteristics and Surgical Outcomes of Pseudophakic and Aphakic Retinal Detachments

We retrospectively evaluated the clinical characteristics and surgical outcomes of 20 pseudophakic retinal detachment (RD) patients (20 eyes) and 17 aphakic RD patients (17 eyes). Males were predominated in both groups. The time interval between cataract extraction and RD was 31 months on average in the pseudophakic group, 32 months with intact posterior capsule and 27 months with ruptured posterior capsule, and 148 months in the aphakic group. In 50% of cases with ruptured posterior capsule in the pseudophakic group, RD occurred within 1 year. The anatomic success rate was 95% in the pseudophakic group and 88% in the aphakic group. The most common cause of failure was the development of proliferative vitreoretinopathy. Visual acuities more than 20/40 after RD surgery were found in 13 pseudophakic (65%) and 6 aphakic (36%) eyes. Aphakic patients were more inclined to have silent RD than pseudophakic patients because of their poor visual acuity. Post-operative follow-up is required especially for the first 1 year in cases of damaged posterior capsule due to the high incidence of RD during this period.

Laser in Situ Keratomileusis Versus Laser Epithelial Keratomileusis for Low to Moderate Myopia

PURPOSE: To compare the efficacy, predictability, safety, and stability of Laser epithelial keratomileusis (LASEK) with conventional Laser in situ keratomileusis (LASIK) for correction of low to moderate myopia. METHODS: In this study, LASIK-treated 31 eyes of 17 patients and LASEK-treated 33 eyes of 17 patients were followed for 6 months. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), manifest refraction, IOP, topography, keratometry, pachymetry and specular examination were performed. RESULTS: Postoperative mean UCVA was logMAR 0.02+/-0.09 in LASIK group and logMAR 0.01+/-0.09 in LASEK group. Postoperative mean refraction was 0.04+/-0.36D in LASIK group and 0.07+/-0.28D in LASEK group and there was no significant difference between 2 groups (P>0.05). 71.0%(22 of 31) of LASIK eyes and 81.8%(27 of 33) of LASEK eyes had an uncorrected visual acuity of 20/20 or better at 6 months after surgery. 87.1%(27 of 31) of LASIK eyes and 97.0%(32 of 33) of LASEK eyes achieved predictability within +/-0.5D at 6 months follow up. There was no decrease in best-corrected visual acuity of two Snellen lines or more in both groups. CONCLUSIONS: In this study, there was no difference in postoperative mean UCVA and mean refraction in LASIK and LASEK group. However, LASEK group had better results in UCVA of more than 20/20 and predictability but there was no significant difference between 2 groups.

Morphologic and Immunohistochemical Studies of Attached Retina in Intravitreal Silicone Oil

Intraocular silicone oil is known to induce irreversible histological changes in retina. We enucleated an eyeball which was filled with silicone oil for 6 years following pars plana vitrectomy for the treatment of proliferative vitreoretinopathy. Purified 1000 cs silicone oil was used. The reattached retina tissue was examined histopathologically and immunohistochemically. Microscopic examination revealed severe retinal degenerations with many vaculoes in inner retina, the proliferation of glial cells, and the presence of phagocytes. The proliferation of the retinal pigment epithelium and the localized calcification of retinal tissues were also observed. Immunohistochemical study showed retinal tissue expressions of vimentin, S-100, and glial fibrillary acidic protein(GFAP). Electron microscopic examination of the retinal tissues demonstrated some phagocytes with large vacules, which probably had been filled with silicone oil. Our study confirmed that intravitreal silicone oil might damage the retinal tissues.

Angiographic Findings of Choroidal Lesions in Serous Retinal Detachment

PURPOSE: To study the relationship between the damage of retinal pigment epithelum and the lesion of choroidal vessels in various types of the serous retinal detachment(SRD) on fluorescein angiography(FAG) and indocyanine green angiography(ICGA). METHODS: FAG and ICGA were performed 81 eyes with various types of serous retinal detachment. The series comprised central serous chorioretinopathy(CSC, 63 eyes), toxemia of pregnancy(8 eyes), and Harada's disease(10 eyes). RESULTS: All the eyes showed dye leakage through the retinal pigment epithelium(RPE) by FAG. Of sixty-three eyes with CSC, sixty eyes showed choroidal tissue staining in late phase on ICGA. Delayed filling of ICG dye in early phase was present around the site of leakage on FAG in 48 eyes with CSC. In toxemia of pregnancy and Harada's disease, all the cases showed delayed choroidal circulation and leakage from choroidal vessels on ICGA. As a common feature, ICGA showed choroidal hypoperfusion or delayed choroidal circulation and choroidal vascular hyperpermeability in the three types of SRD. CONCLUSIONS: The authors presume that they might contribute to the damage of RPE. The pathogenesis of SRD may be related to the hypothesis fact that choroidal vascular hyperpermeability probably moves fluid into the subretinal space from the choroid.