Results of vitrectomy in idiopathic Macular Hole

To evaluate the visual and anatomical outcomes and complications of vitrectomy with or without removal of internal limiting membrane [ILM] in idiopathic macular hole [IMH] at Labbafinejad Medical Center, Tehran-Iran, 1993-2003. Hospital records of patients who had undergone vitrectomy for IMH and completed 6 months of follow up were reviewed for demographic data and outcomes of surgery .The study was conducted on 30 eyes [46.7% right eyes] of 29 patients [69% female] with mean age of 65.2 +/- 5.6 years. Mean duration of symptoms was 3.2 +/- 3.7 months [66.7% less than 6 months]. Preoperatively macular holes were in stages 2, 3, and 4 in 3.0%, 36.7%, and 33.3%, respectively. ILM removal was performed in 21 eyes [70%]. Mean visual acuity was 099 +/- 0.6 LogMAR preoperatively which reached to 0.87 +/- 0.39 LogMAR postoperatively [P=0.05]. Single operation anatomical success rate was 80% [24 eyes] and final success rate was 86.7% [26 eyes]. Retinal breaks developed in 3 eyes [10%] intraoperatively. ILM removal had no effect on increasing the rate of macular hole closure. ILM removal has no significant role on closure of IMH with less than 6 months of duration

[Eye eviceration due to necrotizing sclertitis after ptrygium surgery with mitomycin C after 3 years]

To report a case of eviceration because of necrotizing scletitis 3 years after ptrygium surgery with mitomycin C. A 62-year-old diabetic woman with history of bilateral ptrygium surgery with MMC 3 years ago, was referred due to severe pain in her right eye. Visual acuity was counting fingers at 2 m. There was thinning and melting of the sclera with uveal prolapse that was more severe in the right eye. The patient was admitted with a diagnosis of necrotizing scleritis. She received topical and systemic medications, but the inflammatory process progressed. Eviceration of the right eye was performed. Adjunctive use of MMC can produce severe complications threatening visual acuity includes necrotizing scleritis which may eventually lead to eviceration

[ use of Mersilen mesh for wrapping of hydroxyapatite [HA] orbital implant: a new procedure with low complications]

To report the results of a wrapping technique for hydroxyapatite orbital implants by using mersilen mesh. This study is prospective interventional case series conducted on records of 55 consecutive patients who received a mersilen mesh-wrapped HA orbital implant after enucleation of a secondary procedure. We recorded results and potential problem before and after pegging due to mersilen mesh. Twenty nine males [52.7%] and 26 females [47.3%] underwent the procedure. Mean age was 27.6 +/- 13.7 [33 months to 71 years]. Average follow up was 19.1 +/- 8.1 [1 month to 68 months]. There were 28 [51%] primary enucleations and 27 [49%] secondary orbital implants. Thirty eight patients [65.5%] underwent peg placement. Average duration to pegging was 6.5 +/- 11.27 months [5 months to 39 months]. Before pegging, 2 patients [5.2%] had implant exposure; one after a primary implant and another following a secondary implant. One exposure resolved spontaneously and one case required a mucous membrane graft. None of the patients had socket inflammation after pegging. One case had exposure, 4 cases had granulation tissue, and 3 patients had discharge. Mersilen mesh is an alternative option to sclera as a wrapping material for porous orbital implants. It is simple to use, readily available, and low-cost