Analgesia preemptiva com nepafenaco 0, 1% na fotocoagulação da retina / Preemptive analgesia of nepafenac 0. 1% in retinal photocoagulation

Objetivo: Avaliar o efeito preemptivo com nepafenaco 0,1% em pacientes submetidos à fotocoagulação da retina para tratamento da retinopatia diabética proliferativa. Métodos: Trinta pacientes foram submetidos à fotocoagulação com laser de argônio em ambos os olhos. O olho contralateral de cada paciente foi o controle. O nepafenaco e o placebo foram utilizados 30 minutos antes da aplicação do laser. Ambos os olhos foram fotocoagulados no mesmo dia. A intensidade da dor foi avaliada por meio da escala analógica visual e da escala descritiva de dor. Resultados: A análise da interação instilação versus nepafenaco mostrou que os pacientes do grupo placebo apresentaram níveis de dor semelhantes em ambos os olhos, e os do grupo nepafenaco apresentaram redução importante do nível de dor no olho em que foi instilado a suspensão de 0,1% quando comparado ao olho contralateral que recebeu placebo (p=0,023). Conclusão: Este estudo sugere que a suspensão de 0,1% de nepafenaco foi útil na analgesia preemptiva de pacientes submetidos à fotocoagulação de retina quando comparada ao placebo. .

Objective: To evaluate the preemptive effect of nepafenac 0,1% in patients undergoing retinal photocoagulation for the treatment of proliferative diabetic retinopathy Methods: Thirty patients underwent argon laser photocoagulation in both eyes. The contralateral eye of each patient was the control. The nepafenac and placebo were used 30 minutes before the application of the laser. Both eyes were photocoagulated in the same day. Pain intensity was assessed by visual analog scale and descriptive pain scale Results: The analysis of the interaction instillation versus nepafenac showed that patients in the placebo group had similar levels of pain in both eyes, and the nepafenac group had significant reduction in pain in the eye that was instilled suspension of 0,1% when compared to the contralateral eye which received placebo (p = 0.023). Conclusion: This study suggests that a suspension of 0,1% nepafenac helpful for preemptive analgesia in patients undergoing retinal photocoagulation compared to placebo. .

Resultados funcionales y anatómicos de la cirugía del desprendimiento de retina recurrente por vitreorretinopatía proliferativa / Functional and anatomical results of the recurrent retinal detachment surgery caused by proliferative vitreoretinopathy

OBJETIVOS: evaluar los resultados funcionales y anatómicos de la cirugía de desprendimiento de retina recurrente por vitreorretinopatía proliferativa. MÉTODOS: estudio observacional descriptivo retrospectivo en una serie de casos de 17 ojos diagnosticados de desprendimiento de retina recurrente por vitreorretinopatía proliferativa, que fueron intervenidos en el período comprendido entre enero 2010 y diciembre 2011. Los pacientes fueron seguidos hasta un mínimo de tres meses posteriores a la última intervención. Los resultados funcionales se evaluaron con la agudeza visual mejor corregida y los anatómicos a través del grado de readaptación retiniana y macular. RESULTADOS: fueron realizadas un total de 25 reintervenciones, rango 13. Se realizaron retinotomía/retinectomía en el 52 % de las cirugías, la mayoría con una extensión menor de 180º (84,6 %). El taponador que con mayor frecuencia se utilizó fue el aceite de silicona (23,92 %). La media de la agudeza visual mejor corregida posoperatoria fue de 1,28 logMAR, que mejoró en el 58,8 % de los ojos y fue inferior a 1,5 logMAR en el 90 % de ellos. El éxito de readaptación retiniana fue del 82,3 % (14 ojos). La readaptación macular se consiguió en el 100 % de los ojos. CONCLUSIONES: el tratamiento quirúrgico del desprendimiento de retina recurrente por proliferación vítreorretinal requiere la realización de diferentes opciones quirúrgicas para que resulte en reaplicación retiniana final y mejoría de la visión en los casos de alta complejidad.

OBJECTIVE: to assess the functional and anatomical results of surgery for recurrent retinal detachment caused by proliferative vitreoretinopathy. METHODS: retrospective, observational and descriptive study of a case series of 17 eyes diagnosed with recurrent retinal detachment caused by proliferative vitreo retinopathy were operated on in the period of January 2010 through December 2011. The patients were followed up for at least 3 months after the last surgery. Functional outcomes were assessed with best corrected visual acuity and the anatomical ones through the retinal and macular reattachment. RESULTS: a total of 25 reoperations were performed, a range of 1 to 3. Retinotomy and retinectomy were performed in 52 % of surgeries, most of them with an area less than 180° (84,6 %). The most frequently used tamponade was silicone oil (23,92 %). The mean postoperative best corrected visual acuity was 1,28 logMAR, improving in 58,8 % of eyes and being lower than 1,5 logMAR in 90 % of them. The retinal reattachment succeeded in 82,3 % (14 eyes). Macular reattachment occurred in 100 % of eyes. CONCLUSIONS: surgical treatment of the recurrent retinal detachment caused by vitreoretinal proliferation requires different surgical options to achieve the final retinal reattachment and visual improvement in highly complex cases.

Familial exudative vitreoretinopathy (FEVR) associated with infantile osteoporosis: case report / Vitreorretinopatia exsudativa familiar (FEVR) associada à osteoporose infantil: relato de caso

Familial exudative vitreoretinopathy (FEVR) is an inherited blinding condition characterized by abnormal development of the retinal vasculature. The authors describe a rare case of the disease associated with severe infantile osteoporosis in a young female patient. The patient was submitted to multiple vitreoretinal procedures in both eyes due to tractional macular detachments. The case was complicated by diffuse uveitis of difficult control in one eye, which stimulated proliferative vitreoretinopathy and retinal redetachment. The inflammatory potential of drugs used in the control of the osteoporosis, in contrast with the inherent inflammatory activity the disease, are discussed.

Relato de um caso incomum de vitreorretinopatia exsudativa familiar (FEVR) bilateral em criança do sexo feminino portadora de grave osteoporose infantil. A paciente foi submetida a vitrectomias sucessivas para correção de descolamentos tracionais maculares em ambos os olhos. O quadro foi complicado em um olho por uveíte difusa de difícil controle, que estimulava o aparecimento de proliferação vitreorretiniana de difícil abordagem, responsável por redescolamentos sucessivos da retina. Discute-se sobre o potencial pró-inflamatório de drogas usadas no controle da osteoporose, em contraste com a atividade inflamatória inerente à doença.

Surgical outcomes of transconjunctival sutureless 23-gauge vitrectomy with silicone oil injection.

AIMS: To evaluate the outcomes and complications of 23-gauge transconjunctival sutureless vitrectomy (TSV) with Silicone oil (SO) tamponade in complex vitreoretinal diseases. SETTINGS AND DESIGN: Ege university hospital ophthalmology department. Retrospective case series. MATERIALS AND METHODS: Forty eyes of 40 patients with diabetic tractional retinal detachment (DTRD) and proliferative vitreoretinopathy (PVR) were included in the study. Vitrectomy using 23-gauge system with SO endotamponade was performed. Peroperative and postoperative complications, anatomical and visual results were evaluated. STATISTICAL ANALYSIS USED: Paired Student's t-test. RESULTS: Simultaneous cataract surgery was performed in 17 eyes. Peroperative complications were posterior capsule rupture during phacoemulsification in one patient, vitreous and retinal incarceration in one patient. One eye required suture placement at the end of surgery due to SO leakage. Postoperatively, a small subconjunctival SO bubble in three patients, and hypotony in one patient (6 mmHg) were observed. Recurrent retinal detachment under SO occurred in one patient. Mean follow-up was 6.5 months (+/-2.7). Pre- and postoperative mean visual acuity was 2.22+/-0.91 logMAR and 1.11+/-0.8 logMAR, respectively ( P< 0.001). Mean intraocular pressure (IOP) on the first postoperative day was lower than preoperative IOP (11.3 +/-3.2 versus 14.0 +/-2.4 mmHg) ( P< 0.001). CONCLUSIONS: Twenty-three gauge instrumentation seems to be feasible, effective and safe for vitrectomy with SO injection in DTRD and PVR, and can be considered in the surgical management of these complex vitreoretinal diseases.

Analgesic Effects of Tramadol During Panretinal Photocoagulation

PURPOSE: To evaluate the effectiveness of tramadol for the reduction of pain in panretinal photocoagulation (PRP). METHODS: A double-masked randomized controlled study was performed. Fifty-eight eyes in 29 patients with proliferative diabetic retinopathy were enrolled. The eyes of the patients were randomized into two groups. Group A received an empty capsule. Group B received an oral intake of 100 mg tramadol. The capsule used in Group A had the same appearance as that used in Group B. Pain during PRP was assessed using a visual analog scale. Vital signs, including blood pressure and heart rate, were measured. RESULTS: The mean pain scores for groups A and B were 4.80+/-2.10 and 3.83+/-1.82 (p=0.09). There were no significant differences in the mean pain scores between the two groups. More patients in group A complained of greater pain than moderate intensity (visual analogue scale=4). Systemic blood pressure increased significantly in group A after laser treatment. However, there were no significant differences in the diastolic blood pressure changes between the two groups. We found no statistical correlation in the heart rate changes. CONCLUSIONS: We failed to prove that tramadol is effective for pain relief because of the small sample size. However, tramadol was effective for the relief of more severe pain. It was also found to stabilize vital sign changes, such as systolic blood pressure during PRP.

Transconjunctival retinopexy with active external drainage of subretinal fluid: a prospective pilot study of eight consecutive cases

PURPOSE: To describe an alternative surgical technique for the management of retinal detachment with no or minimal proliferative vitreoretinopathy (grade B) using transconjunctival retinopexy with active external drainage of subretinal fluid. METHODS: In a prospective, interventional study, eight consecutive patients with retinal detachment with no or minimal proliferative vitreoretinopathy (grade B) underwent transconjunctival retinopexy with active external drainage of subretinal fluid. Transconjunctival external drainage of subretinal fluid was achieved by using a 29 gauge needle placed in the subretinal space under indirect ophthalmoscopic monitoring. Active suction was performed (500 mmHg vacuum) using a vitrectomy line coupled to the needle. After retinal reattachment, cryotherapy was applied to the scleral region corresponding to the area of the retinal break(s). RESULTS: In all cases there was retinal attachment at the end of surgery. Retinal redetachment occurred in four pseudophakic patients who then underwent pars plana vitrectomy. The four phakic patients maintained retinal attachment during follow-up (13-20 months). CONCLUSION: Transconjunctival retinopexy with active external drainage of subretinal fluid represents a useful, faster, and cheaper alternative to scleral buckling for retinal detachments with no or minimal proliferative retinopathy in phakic patients and, unlike scleral buckling, is not associated with induced myopia.

OBJETIVO: Descrever uma técnica cirúrgica alternativa para o tratamento de descolamento da retina sem ou com mínima vitreorretinopatia proliferativa (grau B) usando uma retinopexia transconjuntival com drenagem externa do fluido sub-retiniano. MÉTODOS: Prospectivo estudo intervencional, com oito pacientes consecutivos com descolamento da retina com nenhum ou mínima vitreorretinopatia proliferativa (grau B) que foram submetidos a retinopexia transconjuntival com drenagem externa ativa do fluido sub-retiniano. A drenagem externa transconjuntival do fluido sub-retiniano foi realizada com agulha calibre 29 colocada no espaço sub-retiniano e moni torada pela oftalmoscopia binocular indireta. A sucção ativa foi realizada (vácuo de 500 mmHg) usando a linha de extração do vitreófago conectado a agulha. Após a colagem da retina, crioterapia foi aplicada na região escleral correspondente a área da(s) ruptura(s). RESULTADOS: Em todos os casos a retina aplicou no final da cirurgia. O redescolamento da retina ocorreu em 4 pacientes pseudofácicos, que foram submetidos a seguir a vitrectomia pars plana. Os 4 pacientes fácicos mantiveram a retina aplicada durante o seguimento (13 a 20 meses). CONCLUSÃO: A retinopexia transconjuntival com drenagem externa ativa do fluido sub-retiniano representa alternativa útil, rápida e barata a cirurgia do descolamento da retina com implante escleral em pacientes com nenhuma ou mínima vitreorretinopatia proliferativa, fácicos e diferente do implante escleral não está associada a indução da miopia.

Pars plana vitrectomy with silicone oil or gas endotamponade in HIV-related rhegmatogenous retinal detachments in Thai patients.

OBJECTIVE: To evaluate the efficacy and results of pars plana vitrectomy with endotamponade for retinal detachments caused by necrotizing retinitis in HIV patients. MATERIAL AND METHOD: The data of patients with HIV-related retinal detachment who underwent pars plana vitrectomy with silicone oil or gas endotamponade between January 2003 and June 2005 were retrospectively reviewed The outcome measures were demographic data, anatomical, and visual results. RESULTS: Of all 24 eyes from 20 patients, 19 eyes underwent pars plana vitrectomy with silicone oil tamponade and 5 eyes with long-acting gas tamponade. Mean follow up time was 13 months (range 2-33 months). The overall anatomical success was 83% (84% and 80% with silicone oil and gas tamponade, respectively). Final best corrected visual acuity was equal or better than 5/200 in 12 eyes (50%). Forty-six percent had stabled or improved vision at the end of follow-up. CONCLUSION: Pars plana vitrectomy with silicone oil or gas tamponade gives the high anatomical success rate in the repair of retinal detachments caused by necrotizing retinitis in HIV patients. There were the same reattachment rate and visual results between the two tamponade groups. However, the use of gas tamponade may be effective in patients with highly active antiretroviral therapy (HAART).

Perfluoroctano líquido como tamponante vitreorretiniano de curta duração no pós-operatório de portadores de descolamento de retina por ruptura gigante / Perfluoroctane liquid as a short-term vitreous-retinal tamponade in the postoperative period in patients with retinal detachment due to giant tears

OBJETIVOS: Relatar os resultados de vitrectomia via pars plana com utilização de perfluocarbono líquido (Perfluoroctano-Ophtalmos®), como tamponante vítreo-retiniano de curta duração, no pós-operatório de portadores de descolamento de retina, por ruptura gigante. MÉTODOS: Estudaram-se dez desses pacientes. Todos os casos eram complicados por vitreorretinopatia proliferativa grau B ou pior com rupturas que variavam em extensão de 90° a 210°. O perfluorocarbono líquido foi introduzido, por via pars plana, com o volume necessário para ultrapassar o limite posterior da ruptura, permanecendo no pós-operatório por cinco dias, estando os pacientes em decúbito dorsal. Após esse período submetiam-se a segunda intervenção para troca do perfluorocarbono líquido para gás ou óleo de silicone. RESULTADOS: Após período de acompanhamento médio de 16,2 ± 12,4 meses (2 a 43 meses), 80 por cento das retinas estavam aplicadas, sendo necessária a repetição desta técnica em 1 caso (10 por cento) caso e em 2 casos (20 por cento) não houve reaplicação da retina por vitreorretinopatia avançada. Houve melhora da acuidade visual em 5 casos (50 por cento). CONCLUSÃO: Observaram-se bons resultados quanto à aplicação da retina (80 por cento) e melhora da acuidade visual (50 por cento) quando do uso do perfluorocarbono líquido como tamponante vitreorretiniano de curta duração no pós-operatório de cirurgias de descolamento de retina por rupturas gigantes.

PURPOSE: To report pars plana vitrectomy results of intravitreous use of liquid perfluorocarbon as a short-term postoperative tamponade in retinal detachment due to giant tears in a series of patients. METHODS: Ten of those patients, all of them complicated by proliferative vitreoretinopathy grade B or worse, with tear extension varying from 90° to 210° were studied. Perfluorocarbon liquid was injected via pars plana until the posterior tear limit, remaining in the postoperative period during five days, with the patients in supine position. After this period, the patients underwent a second surgical procedure to exchange the liquid perfluorocarbon for gas or silicone oil. RESULTS: The retinas of eight patients were attached (80 percent) after a mean follow-up of 16.2 ± 12.4 months (from 2 to 43 months). It was necessary to repeat this technique in one (10 percent) case, and there was no attachment of the retina in two (20 percent) cases due to advanced proliferative vitreoretinopathy. Visual acuity improved in five (50 percent) cases. CONCLUSION: Good results (80 percent) and improvement of the visual acuity (50 percent) were observed with the use of intravitreous liquid perfluorocarbon as short-term tamponade in the postoperative period in patients with retinal detachments due to giant tears.

Extração do cristalino translúcido: resultados visuais e freqüência de vítreo-retinopatias / Clear lens extraction: visual outcomes and vitreoretinopathy frequence

OBJETIVO: Avaliar os resultados visuais e a freqüência de vítreo-retinopatias e descolamento de retina em pacientes, com e sem fotocoagulação profilática pré-operatória da retina pré-equatorial, submetidos à extração de cristalino translúcido (ECT) para correção de miopia. MÉTODOS: Trinta e cinco pacientes (60 olhos) foram submetidos à extração de cristalino translúcido na Fundação Altino Ventura com tempo mediano de acompanhamento de 20,5 meses, sendo divididos em 3 grupos: Grupo I (22 olhos) submetidos à fotocoagulação da retina periférica 360° pré-operatória; Grupo II (8 olhos) submetidos à fotocoagulação pré-operatória circundando lesões predisponentes e Grupo III (30 olhos) não submetidos à fotocoagulação pré-operatória. Foram avaliados a acuidade visual corrigida (AVL c/c), o equivalente esférico refracional (EE) e a presença de membrana neovascular sub-retiniana (MNVSR), lesões predisponentes e descolamento de retina (DR) pré e pós-operatórios. RESULTADOS: O valor mediano da acuidade visual corrigida AVLc/c melhorou de 0,2 no pré-operatório para 0,5 no pós-operatório e o equivalente esférico refracional EE de -17DE para -1,7DE. Não houve casos de descolamento de retina, mas surgiram áreas de tração vítreo-retiniana em 4 olhos (2 submetidos ao laser 360° e 2 olhos não submetidos ao laser) e 1 caso de membrana neovascular sub-retiniana. CONCLUSÃO: A extração de cristalino translúcido mostrou-se cirurgia eficaz e previsível nas reduções de altas miopias e, ainda, procedimento aparentemente seguro em pacientes com e sem fotocoagulação profilática da retina pré-equatorial. Tempo de acompanhamento maior dos pacientes e o aumento da amostra estudada podem ratificar sua segurança como procedimento refrativo.

PURPOSE: To evaluate visual results and vitreoretinopathy and retinal detachment frequencies in patients with and without prophylactic pre-equatorial retinal photocoagulation, who underwent clear lens extraction (CLE) to correct myopia. METHODS: Thirty-five patients (60 eyes) that underwent clear lens extraction at the "Fundação Altino Ventura" had median follow-up of 20.5 months. They were classified into 3 groups: Group I that was submitted to preoperative 360° preequatorial retinal photocoagulation; Group II that was submitted to prophylactic photocoagulation around predisposing lesions; and Group III that was not submitted to preoperative retinal photocoagulation. The presence of corrected visual acuity (CVA), refractional spherical equivalent (RSE) and choroidal neovascularization (CNV), predisposing lesions and retinal detachment (RD) was evaluated. RESULTS: Median corrected visual acuity value rose from 0.2 in the preoperative period to 0.5 in the postoperative period and refractional spherical equivalent decreased from -17SD to -1.7SD. There was no retinal detachment, but vitreous retinal traction areas appeared in 4 eyes (2 submitted to 360° laser and 2 not submitted to laser) and 1 case of choroidal neovascularization also occurred. CONCLUSIONS: Clear lens extraction was an effective and predictable surgery to reduce myopias and an apparently safe procedure in patients with and without prophylactic preequatorial retinal photocoagulation. A longer follow-up in a larger group may validate its safety as a refractive surgery.

Intravitreal low molecular weight heparin in PVR surgery.

PURPOSE: To evaluate the efficacy of low molecular weight heparin (LMWH) in prevention of postoperative fibrin formation following vitreoretinal surgery with proliferative vitreoretinopathy (PVR). MATERIAL AND METHODS: Thirty consecutive patients of retinal detachment with advanced PVR were enrolled in the study. They were randomised to study and control groups (n = 15 each). Study group patients received vitreoretinal surgery with 5 IU/cc of LMWH in vitrectomy infusion fluid. The control group patients received vitroretinal surgery without heparin in the infusion fluid. Patients were followed up at 1 week, 1 month and 3 months after surgery. Postoperative bleeding, media clarity, best-corrected visual acuity and success of the surgery at the end of 3 months were compared between the two groups. RESULTS: At each follow-up visit, the study group showed a better media clarity, which was statistically significant (P = 0.0042). The study group had a 50% better chance of retinal reattachment compared to the control group. Five patients had intraoperative bleeding in the study group (33%) compared to 3 patients in the control group (20%). CONCLUSION: Use of intravitreal LMWH prevents postoperative fibrin formation and is beneficial in repair of retinal detachments with PVR.

Utilización del Láser Erbium: yag de alta repetición (200 Hz) en cirugía vitreorretiniana / Laser Erbium utilization: hihg repetition Yag (200 Hz) in vitreoretinal surgery

Se evaluó la seguridad y eficacia de la utilización del Láser Erbium: YAG de alta repetición (200 Hz) durante la cirugía vitreorretiniana. Se realizaron 83 maniobras quirúrgicas en 32 ojos de 32 pacientes, para cortar y disecar membranas vítreas, incidir membranas epirretinianas, crear retinotomías relajantes, esclerotomías para puerto de entradas, iridectomías y capsulotomías anteriores y posteriores. El Láser Erbium YAG, es una herramienta rápida, precisa y eficiente durante la cirugía de vítreo. Su efectividad se calificó como excelente en 76 por ciento de las maniobras quirúrgicas. Algunas maniobras fueron realizadas de forma segura y hubiera sido imposible hacerlo con la instrumentación convencional. Existieron un 38.5 por ciento de complicaciones. En el 50 por ciento de los casos, los procedimientos realizados durante la cirugía, utilizaron al Láser Erbium: YAG como único instrumento. Se concluye que el Láser Erbium: YAG, puede ser una herramienta muy adecuada y eficiente para la cirugía de vítreo y retina

Necrosis retinal aguda: resultados de tratamiento / Acute retinal necrosis: treatment results

Se estudian 17 ojos de 13 pacientes con el diagnóstico de necrosis retinal aguda evaluados en el Hospital Clínico de la Universidad de Chile y en la Fundación Oftalmológica Los Andes con el propósito de evaluar las características clínicas y los resultados del tratamiento con fotocoagulación láser. Todos los pacientes eran inmunocompetentes, con edad promedio de 33 años, siendo la necrosis bilateral en el 39,8 por ciento. Se dividen los pacientes en grupo I, quienes presentaban enfermedad avanzada y/o desprendimiento de retina al momento del diagnóstico, y en grupo II a los cuales se les realizó el diagnóstico de forma relativamente precoz y recibieron tratamiento adecuado con aciclovir endovenoso y láser profiláctico. El desprendimiento de retina se presentó en todos los pacientes no tratados con láser y en el 20 por ciento de los tratados. Cinco pacientes con desprendimiento retinal y vitreorretinopatía proliferativa fueron manejados con vitrectomía con gas o aceite de silicona. La retina quedó aplicada en todos ellos pero sólo uno conservó visión útil. Los resultados visuales se relacionaron con la precocidad del diagnóstico, el tratamiento médico oportuno y el empleo de láser profiláctico

Será justificável a cirurgia para prolifraçäo vítreo-retiniana após trauma perfurante ocular? / Is surgery for proliferative vitreoretinopathy following perforating ocular injury justifiable?

Objetivo: Determinar o prognóstico e a satisfação dos pacientes com trauma ocular perfurante que foram submetidos à cirurgia para proliferação Vitreo-retiniana (PVR). Métodos: Prontuários sessenta pacientes foram reavaliados para caracterizar a taxa de sucesso cirúrgico anatômico e funcional. Trinta pacientes foram selecionados de modo aleatório e questionados por telefone. Resultados: Houve melhora visual para a maioria dos pacientes (58,3 por cento) apresentavam a retina colada no fianl do seguimento. Em média 2,89 cirurgias foram realizadas por olho. Dezenove (63,3 por cento) pacientes afirmaram que voltariam a operar novamente e 14 (46,6 por cento) que o ganho de campo periférico foi de benefício. Conclusão: Essa forma de tratamento deve ser oferecida e a decisão final deve ser tomada pelo paciente bem orientado e seu médico.

Tratamiento del desprendimiento de retina por desgarro retinal gigante: 1993 a 1995 / Treatment of retinal detachment by giant retinal tear: 1993 to 1995

Se presenta una serie de 21 pacientes con desprendimiento de retina por desgarro retinal gigante, operados por el autor durante 1993 y 1995. El 75 por ciento de los pacientes tienen más de 6 meses de evolución. Se describen las diferentes alternativas técnicas utilizadas en cuanto al uso de cerclaje escleral, lensectomía o conservación del cristalino o lente intraocular, uso de C3F8 o aceite de silicona como tamponamiento interno y sus resultados así como la asociación de éstos con factores pronósticos como el tiempo de evolución previo a la cirugía, la presencia de PVR y la primera técnica quirúrgica empleada. Concluímos que es una patología curable en más del 85 por ciento de los casos, en especial cuando los factores pronósticos aquí identificados son favorables y que la mejoría de los resultados frente a una serie presentada por el mismo autor en el congreso chileno de oftalmología anterior sería por una mejor comprensión de la patología, mayor experiencia y mejorías técnicas importantes como los lentes de AVI

Cirugía vitreorretinal: tres años de experiencia / Vitreo retinal surgery: 3 years of experience

Se analizan las técnicas utilizadas y los resultados anatómicos y visuales obtenidos en la cirugía del desprendimiento de retina simple y complicado con proliferación vitreorretinal y en la vitrectomía del paciente diabético. Se destaca el interés de la punción directa ab externo y el uso de gas endocular