A Case of Hyperoleon

The vitrectomy and silicone oil injection has been used occasionally for the advertent retinal detachment, but the silicone oil placement within the vitreous cavity may cause the complications in such as band keratopathy, emulsification of silicone oil, iritis and glaucoma, etc. Especially, in the phakic eyes, the silicone oil may enter the anterior chamber in the form of a suspension of fine globules resembling an inverted hypopyon and it is called the hyperoleon. The authors observed a case of hyperoleon 4 months after surgery, reporting it with the review of literatures.

Treatment of Retinal Detachment with Macular Hole: Paracentesis, Subretinal Fluid Drainage and Intravitreal Gas Injection

Six patients with macular hole and retinal detachment and no visible vitreoretinal connection examined by slitlamp and 3-mirror contact lens were treated by two methods. In two patients with relatively localized retinal detachment in central fundus, 0.7ml or more of pure SF6 gas was injected into vitreous cavity by 27 gauge needle after paracentesis was done because of keeping the large space of gas injection as preventmg the increase of lOP. In the remained 4 patients, 1.2ml or more of pure SF6 gas was injected into vitreous cavity after the subretinal fluid was released externally, and then paracentesis was done because of preventing the increase of lOP. After operation, all patients were placed in prone position for 6 hours or more in a day. In 5 of 6 patients, the retina remained attached duing more than 6 months. Even if 2 with posterior staphyloma in 6 patients were treated with two or more operations, 1 patient was failed. Although visual improvement at 6 months after operation was limited due to macular degeneration, the visual acuity were above 0.05 in 3 patients. This operation is simple and safe and not damaged en macula. This procedure is good surgical method in patients with retinal detachment wirh macular hole but without other breaks or visible vitreous adhesion or posterior staphyloma.

Treatment of Retinal Detachment with Macular Hole: Paracentesis, Subretinal Fluid Drainage and Intravitreal Gas Injection

Six patients with macular hole and retinal detachment and no visible vitreoretinal connection examined by slitlamp and 3-mirror contact lens were treated by two methods. In two patients with relatively localized retinal detachment in central fundus, 0.7ml or more of pure SF6 gas was injected into vitreous cavity by 27 gauge needle after paracentesis was done because of keeping the large space of gas injection as preventmg the increase of lOP. In the remained 4 patients, 1.2ml or more of pure SF6 gas was injected into vitreous cavity after the subretinal fluid was released externally, and then paracentesis was done because of preventing the increase of lOP. After operation, all patients were placed in prone position for 6 hours or more in a day. In 5 of 6 patients, the retina remained attached duing more than 6 months. Even if 2 with posterior staphyloma in 6 patients were treated with two or more operations, 1 patient was failed. Although visual improvement at 6 months after operation was limited due to macular degeneration, the visual acuity were above 0.05 in 3 patients. This operation is simple and safe and not damaged en macula. This procedure is good surgical method in patients with retinal detachment wirh macular hole but without other breaks or visible vitreous adhesion or posterior staphyloma.