RESUMEN
PURPOSE: To study the effectiveness of fibrin sealant to control intraoperative bleeding during pars plana vitrectomy of proliferative diabetic retinopathy. METHODS: Intravitreal fibrin sealant was applied to 100 eyes of proliferative diabetic retinopathy patients prospectively. Preoperative fundus finding included longstanding vitreous hemmorrhages, preretinal macular hemorrhages and tractional retinal detachments. The male vs female ratio was 38: 52, and the mean age was 62.4 years. Panretinal laser photocoagulation was done in all patients preoperatively. RESULTS: In all of 100 (100%) eyes, intraoperative bleeding was controled. Intraoperative complication consisted overinjection of fibrin sealant in 2 eyes. Postoperative complications comprised transient IOP elevation in 20 eyes, mild epiretinal membrane in 1 eye, and delayed absorption of fibrin sealant in 1 eye. Average absorption time of fibrin sealant was 21 +/- 1.3 days. CONCLUSIONS: Fibrin sealant is an effective and safe tool to control intraoperative bleeding during pars plana vitrectomy.
Asunto(s)
Femenino , Humanos , Masculino , Absorción , Retinopatía Diabética , Membrana Epirretinal , Adhesivo de Tejido de Fibrina , Fibrina , Hemorragia , Complicaciones Intraoperatorias , Fotocoagulación , Complicaciones Posoperatorias , Estudios Prospectivos , Desprendimiento de Retina , Tracción , VitrectomíaRESUMEN
PURPOSE: We report one case of macular injury by Nd: YAG laser during aiming of the laser beam. METHODS: A 34-year-old man injured his right eye accidentally while aiming a Nd: YAG laser. He was referred to our ophthalmologic department because of diminished vision in the right eye at 2 hours after the accident. Central scotoma was noted. Best corrected visual acuity was 0.02 in the right eye. On fundus examination there were preretinal hemorrhage on the fovea, a full thickness macular hole of 1/3 optic disc diameter, parafoveal retinal edema and vitreous hemorrhage on inferior fundus. Seven days after the accident, a star shaped subretinal fibrosis and scar formation were seen on fundus examination and fluorescein angiography showed star shaped hyperfluorescence area on the fovea. Three months after the accident preretinal and vitreous hemorrhage were resolved and the macular hole was closed spontaneously, but the subretinal scar and fibrosis progressed and best corrected visual acuity remained as 0.02 in the right eye. RESULTS: Visual acuity was severely decreased due to Nd: YAG laser injury to the macula.