Indications of partial evacuation of anterior chamber [paracentesis] with encircling silastic 3 mm band without vacuation of subretinal fluid in retinal detachment surgery

Incases of moderate size retinal tears between equator and exit of vortex veins with thick sclera and pre-operative ocular tension about 15 mm Hg Sen., to have an effective buckle with its effect seen in the fundus behind the cauterized area around the tear, the ocular tension should be maintained high by the end of operation. If ocular tension is found to be about 60 mmHg Sch., paracentesis is performed to lower the ocular tension to about 30 mm Hg Sch

Clinicopathologic study of non-hodgkin's malignant lymphomas of orbit, lids, lacrimal gland and conjunctiva in egypt, according to the recent immunopathology classification

A recent classification for non-Hodgkins malignant lymphomas of orbit, lacrimal gland, conjunctiva, and lids in Egypt including their immunopathology classifications is described. The study included seventy six cases

Bilateral exudative retinal detachment with signs of uveitis of known aetiology

Among about one thousand retinal detachment cases operated upon by encircling silastic 3 mm band without evacuation of subretinal fluid, in cases with or without tears, phakic or aphakic with about 95% success. Follow for years showed 14 cases [about1%] with the Following peculiarities, bilateral exudative retinal detachment and unilateral in three, signs of uveitis, all them recurred In the fouten cases different types of septic foci were found in their bodies

two types of adjustable sutures in squint surgery: the Mortada and the Jampolsky

The paper describes two types of adjustable sutures in squint surgery. Results are given of one hundred squint operations of all types at different ages using Jampolsky technique of adjustable sutures. Also results are given for one thousand and five hundred squint operations of all types in patients above 14 years of age operated upon performing Mortada method

Scleral collapse in the young giving complications in PPK makes P lamellar keratoplasty with intact recipient transparent descemet's membrane safer in deep non-adherent corneal opacities

This paper stresses that scleral collapse in young giving complications in P.P. Keratoplasty makes Partial lamellar Keratoplaty safer even in deep non adherent leucomata

Recent views and techniques for surgery of late cases of acute congestive closed angle glaucoma [with extensive peripheral anterior synechiae] whether primary or due to intumescent senile cataract

If compression gonioscopy shows presence of extensive peripheral anterior synechiae, the treatment of late cases of acute closed angle glaucoma whether primary or due to intumescent cataract must be changed to the recent views. Ten cases of each group of late acute closed angle glaucoma: 1. of primary type 2. due to intumescent cataract, were operated upon by described technique and followed for five years showed one hundred per cent success as regards normalization of ocular tension and improved visual acuity

Elasticity of the silastic encircling band in retinal detachment surgery and incidence of delayed exudative choroiditis. D.E.C.

Avoiding other factors predisposing to delayed exudative choroiditis, importance of degree of elasticity of the band was studied. Eight cms bands of various elasticities were used. Follow up for more than ten years showed that incidence of D.E.C. was more when the band was less elastic [more traumatising]. Eight cm bands when fully stretched on a ruler becoming 15 cms, 24 cms, and 30 cms were chosen. Fifty bands of each type were utilised showing incidence of D.E.C. as follows: [when fully stretched]: 15 cms 6%, 24 cms 4%, and 30 cms [more elastic - more soft - less traumatising] 2%. Discussion follows why nomenculature of D.E.C. is better than massive vitreous retraction, massive periretinal proliferation or proliferative vitreoretinopathy

Connections of lens fibers

Low and high power microscopic examination of just left to dry [without flame heat] fresh cortex smears of normal transparent lenses without stain show that transparent lens fibres connect by a transparent cement substance to form a network with spaces filled by transparent matrix substance. The connections of fibres may be end or at angles [usually at right angels]. Around many of the connections peculiar transparent round [spherical] areas are present that vary in size. i.Small when around two or three connections of fibres. Ii.Large when around more than three connections of fibres. Transparent round small or large areas found in transparent matrix represent areas around connections of finer fibres. the aim of the present paper is to study the areas of connections of lens fibres. on the slide leaving a thin layer of lens cortex. When the smear is just self dried [without heat of flame] and without stain,it is examined by low and high power microscope

Exudative retinal detachment long after successful encircling surgery due to delayed exudative choroiditis [DEC]

Twenty cases of exudative retinal detachment of unknown aetiology occurred long after success of surgery for retinal detachment with or without tears. The disease occurred in phakic or aphakic eyes mostly in patients between 50 and 60 years mostly with clear vitreous and without signs of uveitis. Incidence, time of occurrence after success of surgery, clinical picture, duration till retinal reattachment in curable cases, severity and prognosis of the disease are discussed

triad of scleral collapse semi-gel vitreous and firmly adherent hyalocapsular attachment in senile cataract extraction

In about one percent of senile cataract extractions there is the triad of scleral collapse with impending vitreous loss; semi gel vitreous; and firmly adherent hyalo-capsular attachment. The complete syndrome is characterized by; thin patient; deep anterior chamber after vitreous dehydration; thin elastic cornea and sclera mostly noted during performing the corneo-scleral section, followed by scleral collapse pushing forwards the dehydrated semi gel vitreous with convex anterior surface pushing forwards the lens and cornea. Due to firmly adherent hyalocapsular attachment, attempts at intracapsular extraction give rupture of both lens capsule and anterior hyaloid face with vitreous loss. Attempts to remove the lens capsule with its adherent anterior hyaloid membrane are accompanied by more vitreous loss and pulling on hyaloid base and pars plana giving retinodialysis. In such conditions: 1 - If noted before surgery the operation of choice is phacoemulsification. 2- And if noted after the corneo-scleral section the tendency for vitreous forward push must be treated by pars plana central vitrectomy followed by modern extra-capsular extraction without any attempt to remove [by pulling] the firmly adherent hyalocapsular membranes

Combined chemical vitrectomy and encircling silastic band without evacuation of subretinal fluid in rhegmatogenous retinal detachment

For recurrent retinal detachment with tears in which the fundus cerclage effect is not seen all around or behind the tear because of severe gel vitreo-retinal traction [pure vitreous disease]. 1- Pars plana chemical vitrectomy [by normal saline injection in middle of vitreous cavity] was used instead of mechanical vitrectomy. 2. Followed after few days [to allow chemical vitrectomy] by encircling silastic band without evaucation of subretinal fluid. As after vitrectomy [mechanical or chemical] the vitreous cavity contains fluid with low ocular tenison, so the immediate ocular tension after the encircling band must be only about 10 mm Hg. [Schiotz] above the pre-operative level [which is usually zero mm Hg. Schiotz], otherwise a tight cerclage is produced with pressure choroidopathy. Result of combined operation using the oblique cerclage for recurrent 6 cases with operable giant horse shoe tears and 4 cases with posterior small tear was 60 percent success

Delyed difuse exudative aseptic choroiditis produced by pressure of encircling silastic band without evacuation of subretinal fluid in retinal detachment surgery

1. Although the operation of encircling silastic 3 mm. band without evacuation of subretinal fluid gives a very high percentage of success [more than 90%] in retinal detachment surgery yet after a successful result for 3 to 4 months in 2% of cases an exudative diffuse aseptic choroiditis occurs, giving no perception of light in affected eye inspite of local and general corticosteroids and antibiotics. 2. The complcation has no definite relation to size of retinal tear, type of cautery used [cryo or diathermy], error of refraction or degree of reasonable raised ocular tension got immediately after the operation [about 15 mm. Hg. [Schiotz] above the preoperative level]. 3. As there is no ocular or general cause for such a syndrome it is explained on a vascular basis. Pressure of the ersircling band causes ifijury and dilatation of pressed choroidal

Surgery of macular hole with detachment by an oblique encircling silastic 3 mm band sutured to its middle S X 8 X 1 mm silicone plate pushed backwards by little finger on plate side to buckle the macular area without evacuation of subretinal fluid

An oblique encircling silastic 3 mm band sutured to its middle 8 X 8 X 1 mm silicone plate to buckle the macular area without evacuation of subretinal fluid [for cases of macular holes with retinal detachnient] is described. The ends of the band are pulled and tied on the stretch on the nasal side so that the ocular tension is 15 mm. Hg. [Schiotz] above the preoptrative level [The band being under the 4 recti muscles]. The silicone plate [between the sciera and the band] is pushed backwards by the little finger to buckle the cauterized macular area, and the encircling band is fixed to the sclera under the insertion of medial rectus muscle by a supramid suture

Surgery of senile peripheral cystic retinosehisis with encircling silastic 3 mm band without evacuation of the cyst fluid

1. 30 cases of peripheral cystic senile retinoschisis were treated by the encircling silastic 3 mm band at equator of the globe without evacuation of the cyst fluid [Mortada 1972] with 95% success. 2. The pressure of the silastic band approximates to come :n contact the splitte.d layers of the pars optica retinae and the retinochoroidopathy produced seals them together. 3. Application of cryo or diathermy cautery to retinal periphery infront of the band seals any unseen very tiny retinal tear and also prophylactic against recurrence of the lesion in another site

Surgery of senile peripheral cystic retinoschisis with encircling sflastie 3 nun band without evacuation of the cyst fluid

For large retinal tears extending posterior to the equator of the globe with retinal detachment the results of the following operations were compared [retinal tear edges cauterized by cryoprobt without evacuation of the subretinal fluid]. 1. Buckling by 5 mm silicone rod piece. 2. Encircling silastic 3 mm band placed at the equator. 3. Encircling silastic 3 mm band placed at the equator with a segmental 5 mm silicone rod [buckle for posterior part of the tear] placed behind the band. 4. The oblique encircling silastic 3 mm band passing behind the posterior edge of retinal tear on one side and passing to a bit anterior of equat6r on opposite meridian but always under the recti muscles. The last technique gave the best results as it is effective in coaptation of retinal tear edges to cauterized. choroid