Retinopexia neumática para el tratamiento de desprendimientos regmatógenos de retina seleccionados / Pneumatic Retinopexy for Treating Selected Rhegmatogenous Retinal Detachments

Objetivo: Determinar los resultados anatómicos y funcionales en pacientes operados de desprendimiento de retina regmatógeno con técnica de retinopexia neumática. Métodos: Se realizó un estudio descriptivo, longitudinal y prospectivo con pacientes operados con técnica de retinopexia neumática en el Centro Oftalmológico de Villa Clara entre junio del 2019 y abril del 2023. Resultados: La edad media de los pacientes estudiados fue de 62,1años. Los hombres fueron más afectados que las mujeres (60,6 por ciento). El 57,6 por ciento de los ojos tuvo agudeza visual mejor corregida de movimiento de manos al diagnóstico y el 93,9 por ciento mácula desprendida. En el 66,7 por ciento de las operaciones se utilizó el hexafloruro de azufre como tamponador. Se logró el éxito anatómico con una intervención en el 81,8 por ciento (IC 95 por ciento: 80-83,6 por ciento) de los casos. En estos, se alcanzó el éxito funcional en el 85,2 por ciento (IC 95 por ciento: 83,4 -87 por ciento). Los ojos con éxito anatómico alcanzaron como media una agudeza visual mejor corregida de 0,5 décimas (IC 95 por ciento: 0,2-0,7) y se logró una ganancia media de 0,4 décimas (IC 95 por ciento: 0,3-0,5). La complicación más frecuente fue la persistencia de líquido subretinal residual, el cual se presentó con más frecuencia en pacientes mayores de 60 años y desapareció como promedio a los 55,9 días sin necesidad de tratamiento. Conclusiones: La retinopexia neumática es una muy buena opción para tratar desprendimientos de retina seleccionados. En pacientes con ninguna o mínima vitreorretinopatía proliferativa, se logran buenos resultados anatómicos y funcionales(AU)

Objective: To determine the anatomical and functional results in patients operated on for rhegmatogenous retinal detachment using the pneumatic retinopexy technique. Methods: A descriptive, longitudinal and prospective study was conducted with patients operated on using the pneumatic retinopexy technique at Centro Oftalmológico, of Villa Clara Province, Cuba, between June 2019 and April 2023. Results: The mean age of the studied patients was 62.1 years. Men were more affected than women (60.6 percent). 57.6 percent of the eyes had best-corrected visual acuity of hand movement at diagnosis and 93.9 percent had detached macula. Sulfur hexafluoride was used as a buffer solution in 66.7 percent of the operations. Anatomical success was achieved with one operation in 81.8 percent (95 percent CI: 80-83.6 percent) of cases. In these, functional success was achieved in 85.2 percent (95 percent CI: 83.4-87 percent). The anatomically successful eyes achieved a mean best-corrected visual acuity of 0.5 tenths (95 percent CI: 0.2-0.7), apart from a mean gain of 0.4 tenths (95 percent CI: 0.3-0.5). The most frequent complication was the persistence of residual subretinal fluid, which occurred more frequently in patients older than 60 years and disappeared, on average, at 55.9 days without the need for treatment. Conclusions: Pneumatic retinopexy is a very good option to treat selected retinal detachments. In patients with no or minimal proliferative vitreoretinopathy, good anatomical and functional results are achieved(AU)

Tratamiento quirúrgico del divertículo de Zenker; un caso clínico; Hospital Militar Central de La Paz (COSSMIL) gestión 2022 / Surgical treatment of Zenker's diverticulum, a Clinical Case Central Military Hospital of La Paz (COSSMIL) gestión 2022

Se presenta un caso clínico de una paciente de 66 años de edad masculino que acude a nuestro hospital (COOSMIL), después de hacer una anamnesis donde el paciente manifiestas molestias como tos, regurgitación y mal alientos (halitosis) y se le hace exámenes complementarios y se llega a un diagnóstico de divertículo faringo-esofágico o Zenker. Esta patología no es muy frecuente, pero se presenta en ancianos por una alteración anatomo-funcional que es un debilitamiento del músculo esofágico Hay tres divertículos esofágicos de los cuales el divertículo de Zenker es el más común aunque es relativamente raro que se presente, en la mayoría de las personas en edad seniles. Después de analizar el tamaño y forma del divertículo de este paciente se toma la decisión de una intervención quirúrgica el más acertado por el tamaño que mide es la diverticulectomia este tratamiento quirúrgico actualmente se continúa realizando en esta patología y con buen pronóstico de vida del paciente. Actualmente, el paciente se encuentra en buen estado salud y su recuperación es favorable desde la operación hasta el momento.

A case of a male patient of 66 years old was referred to our hospital (COSSMIL), after making an anamnesis in which the patient manifested cough, regurgitation and bad breath (halitosis). After further examination a the diagnosis is pharyngo-esophageal diverticulum or Zenker. This condition is rare, but sometimes it happens in elders due to an anatomical and functional alteration caused by is an esophagus muscle weakening. There are three esophageal diverticula in which the Zenker diverticulum is the most common but relatively rarely to occur in elder people. Before analyzing the size and shape of the diverticulum in this patient, the decision is proceed with surgery, the most recommended solution for measuring the size of the diverticulectomy. is The surgical treatment is still being applied in this pathology, with a high probability of success. Currently, the patient is in good health and the recovery from surgery is favorable so far.

Prognostic Factors in Idiopathic Macular Hole Surgery

We evaluated the relationship between the surgical success of idiopathic macular hole and sex, age, duration, epiretinal membrane, preoperative visual acuity, size of the hole, and surgical method. Of all 25 eyes in 23 patients, 14 eyes(56%)showed anatomical success(disappearance of the hole), and 17 eyes(68%)functional success(the final visual acuity of 0.15 or more with more than one line improvement). There were statistically significant differences of anatomical(p=0.001)and functional success(p=0.020)between the Group I where its macular hole was less than one-fourth of the optic disc in size and the other group, and anatomical success(p=0.039)between the group with the age of less than 70 years(Group A)and the other group. In Group I, anatomical and functional success were both 92%(11 eyes/12 eyes). In Group A, anatomical and functional success were 72%(13 eyes/18 eyes)and 77%(14 eyes/18 eyes), respectively, and there was statistically significant relationship between size of the hole and anatomical success(p=0.024), and difference of anatomical success between the group with duration of less than 6 months and the other group(p=0.023). Good surgical result may be expected in the idiopathic macular hole of the age of less than 70 years with about 350 micrometer or less in size and duration of less than 6 months.

Surgical Result of Vitrectomy in Ocular Trauma

We reviewed 49 patients(50 eyes) who had undergone pars plana vitrectomy for the traumatized eyes during the last 4 years. We divided patients into 4 groups according to the characteristics of ocular injuries-anterior segment Injury, posterior penetrating injury, intraocular foreign body and blunt injury. We analyzed surgical results and compared surgical outcomes according to timing of vitrectomy performed(within 2 weeks VS more than 2 weeks after trauma). Anatomical success was achieved in 36 eyes(72.0%) and functional success was achieved in 23 eyes(46.0%). The main causes of functional and anatomical failure were macular pucker and phthisis bulbi respectively. The anatomical and functional success rates were higher when vitrectomy was performed within 2 weeks after trauma. In posterior penetrating injury group, however, anatomical success rate was lower when vitrectomy was performed more than 2 weeks after trauma. The frequency of retinal detachment was higher when vitrectomy was performed more than 2 weeks after trauma. In cases of intraocular foreign body, retinal detachments were developed in all patients after vitrectomy performed more than 2 weeks after trauma. If vitrectomy is required for patients with ocular injury, we suggest vitrectomy within 2 weeks after frauma for better chance to perserve the globe and for salvaging vision.