A simple way to prevent indocyanine green from entering the subretinal space during vitrectomy for retinal detachment due to myopic macular hole.

PURPOSE: To present a safe and simple method of preventing indocyanine green (ICG) from entering the subretinal space in patients undergoing vitrectomy for retinal detachment caused by myopic macular hole. PATIENTS AND METHODS: Four consecutive highly myopic eyes (three phakic, one pseudophakic) with retinal detachment due to myopic macular hole were operated on by pars plana vitrectomy. The ICG-assisted peeling of the internal limiting membrane was performed after temporarily closing the macular hole by means of a small bubble of perfluorocarbon liquid (PFCL) in order to prevent ICG from entering the subretinal space. RESULTS: Retinal reattachment was successful in all patients, and anatomic closure of the macular hole occurred during the follow-up period (range 3 to 10 months). CONCLUSIONS: A small bubble of PFCL prevents ICG dye from entering the subretinal space during vitrectomy for retinal detachment due to macular hole in highly myopic eyes.

Decreased corneal complications after no-reflux, low-dose 5 fluorouracil subconjunctival injection following trabeculectomy.

In order to reduce corneal complications in 27 glaucomatous eyes that underwent trabeculectomy and postoperative subconjunctival injection of 5-fluorouracil we tried 1) a low-dose administration of 5-fluorouracil and 2) a modified subconjunctival injection technique. The mean total 5-fluorouracil dose was 18.0 +/- 6 mg. A life-table analysis showed a success rate, at 15 months, of 78% (+/- 7 S.E.). Four of the 27 eyes (13%) had corneal complications, limited to punctate keratopathy, with no corneal epithelial defects and/or abrasions. Our study shows that corneal complications decreased when the contact between 5-fluorouracil and the ocular surface was reduced.

Treatment of uncomplicated cases of rhegmatogenous retinal detachment with an expanding gas bubble.

We reviewed 55 consecutive cases of rhegmatogenous retinal detachment treated with pneumatic retinopexy as a primary procedure and followed up for a minimum of 1 year. 40 eyes were phakic, 11 aphakic and 4 pseudophakic. 0.6 ml of sulfur hexafluoride were injected into 42 eyes, while 0.3 ml of perfluoropropane were introduced into 13. Transconjunctival cryotherapy was performed in 51 eyes, while light coagulation was used as retinopexy after the retina was reattached in the remaining 4 cases. Of the 55 eyes undergoing treatment, 46 (83.6%) retinas were reattached with one operation. The benefits, complications and disadvantages of the procedure are reported.

[Reversibility of visual field defects in primary open-angle glaucoma]. / La réversibilité des déficits périmétriques dans le glaucome primitif à angle ouvert.

The course of the glaucomatous visual field seems to be best followed by computerized perimetry which allows threshold evaluation in a great number of locations and statistical analysis of the results. To determine the visual field defect reversibility, 16 patients (27 eyes) affected by uncontrolled open-angle glaucoma underwent visual field analysis before and after prescription of a new medical therapy. To avoid the "learning effect" and to decrease the influence of the heterogeneous component of long-term fluctuation, the visual field examination was repeated within 48 hours whenever a change in sensitivity was detected. In addition a total of 10 normal eyes in 10 patients were tested as a control group. A statistically significant threshold improvement was demonstrable after one week of therapy in 31.7% of the eyes.