ABSTRACT
PURPOSE/METHODS: We recently encountered anterior segment ischemia in a young healthy girl with traumatic abducens nerve palsy after the Jensen procedure and ipsilateral recession of the medial rectus muscle. The patient was treated with topical dexamethasone and homatropine 2% and oral prednisone. RESULTS/CONCLUSION: The patient's condition improved, and six weeks postoperatively, visual acuity was 20/20. As this complication of anterior segment ischemia is potentially serious and unpredictable, we think that an alternative surgical approach should be used when treating patients with muscle palsies.
Subject(s)
Anterior Eye Segment/blood supply , Ischemia/etiology , Postoperative Complications , Abducens Nerve/surgery , Abducens Nerve Injury , Child , Cranial Nerve Diseases/etiology , Cranial Nerve Diseases/surgery , Eye Injuries/complications , Female , Humans , Oculomotor Muscles/surgery , Paralysis/etiology , Paralysis/surgery , Visual AcuityABSTRACT
In a prospective, open, pilot study, the authors evaluated the effects of intraocular injection of streptokinase on intraocular fibrin. The study was composed of nine patients in whom fibrinous exudate developed after pars plana vitrectomy. There were seven male and two female patients with a mean age of 44 years (range, 27 to 65 years). Fibrinous exudates were seen 1 to 22 days after surgery with obstruction of the view of the posterior segment. Each patient received a single intraocular injection of 1000 IU of purified streptokinase. Four hours after the streptokinase injection, complete dissolution of the fibrin was noted in each patient. There were no clinically detectable adverse effects from the intraocular administration of streptokinase. Streptokinase may be considered in the dissolution of intractable intraocular fibrinous exudates after vitrectomy.
Subject(s)
Fibrin/metabolism , Streptokinase/administration & dosage , Vitreous Body/metabolism , Adult , Aged , Cataract Extraction , Cell Count/drug effects , Endothelium, Corneal/metabolism , Evaluation Studies as Topic , Exudates and Transudates/metabolism , Female , Humans , Injections , Intraocular Pressure , Male , Middle Aged , Pilot Projects , Prospective Studies , Vitrectomy/adverse effectsABSTRACT
We evaluated the occurrence or progression of nuclear sclerosis of the crystalline lens in 100 eyes after vitrectomy for removal of idiopathic epiretinal membranes causing macular pucker. The follow-up period ranged from six to 99 months (average, 29 months). Visually significant nuclear sclerosis was present preoperatively in three of the operated on eyes and four of the fellow eyes. The rate of occurrence or progression of visually significant nuclear sclerosis was far greater in the operated on eyes (P less than .0001). Of 100 patients, 80 operated on eyes and 24 fellow eyes had visually significant nuclear sclerosis or had undergone previous cataract extraction at the conclusion of the study. Different concentrations of glucose in the intraocular irrigating solution did not affect occurrence of later nuclear sclerosis. Patients older than 50 years of age had a far greater incidence of later nuclear sclerosis than patients younger than 50 years of age (P = .0003). Nuclear sclerosis may be caused by altered lens metabolism after removal of part of the vitreous gel, since nuclear sclerosis also occurs in other conditions associated with vitreous liquefaction.
Subject(s)
Cataract/etiology , Retinal Diseases/surgery , Vitrectomy/adverse effects , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Follow-Up Studies , Glucose/metabolism , Humans , Incidence , Lens, Crystalline/pathology , Male , Middle Aged , Retinal Diseases/etiology , Sclerosis , Therapeutic IrrigationABSTRACT
A healthy 17-year-old girl presented with typical symptoms and physical features of Goldmann-Favre vitreoretinal degeneration. She had reduced visual acuity in both eyes and night blindness. Her parents were first cousins. Striking fundus features included typical maculopathy with a radiating stellate pattern surrounded by tiny vacuole-like pockets of retinoschisis throughout the posterior pole within the temporal vascular arcades. The fundus features were quite typical and permitted a firm diagnosis when combined with the other features of night blindness, gender, and electroretinogram (ERG) abnormalities.
Subject(s)
Macula Lutea , Retinal Degeneration/genetics , Vitreous Body , Adolescent , Eye Diseases/genetics , Eye Diseases/pathology , Female , Fluorescein Angiography , Fundus Oculi , Humans , Retinal Degeneration/pathology , Visual AcuityABSTRACT
We performed clinicopathologic correlation on ten surgically removed pigmented epiretinal membranes causing macular pucker. All cases occurred in eyes with existing retinal holes or tears, including eight cases of macular pucker after previous retinal detachment. These cases probably represented a limited form of proliferative vitreoretinopathy. All membranes contained pigment epithelial cells with polarity, basement membrane, and melanosomes. Cytoplasmic melanin granules accounted for the clinical feature of pigmentation in these eyes.
Subject(s)
Pigmentation , Retinal Diseases/pathology , Astrocytes/pathology , Collagen/metabolism , Female , Humans , Laser Therapy , Macula Lutea/pathology , Male , Membranes/metabolism , Membranes/pathology , Membranes/surgery , Microscopy, Electron , Middle Aged , Ophthalmoscopy , Postoperative Complications , Retinal Detachment/surgery , Retinal Diseases/etiology , Retinal Diseases/surgery , VitrectomyABSTRACT
Raised intraocular pressure is confirmed to be the principal complication following the use of sodium hyaluronate in cataract surgery and the value of the 'piping technique' limiting the use of sodium hyaluronate to the wound edges is demonstrated in reducing this hypertensive response. Difficulties with technique, differentiation between vitreous and sodium hyaluronate, damping effects and has dissipation fall into the category of problems rather than complications. A double cannula is described to remove as much sodium hyaluronate as possible at the end of surgery.
