ABSTRACT
PURPOSE: To evaluate postoperative outcomes between pars plana vitrectomy (PPV) and posterior episcleral buckle procedure (PEBP) in myopic eyes with retinal detachment (RD) and macular hole (MH). DESIGN: Retrospective nonrandomized comparative interventional trial. PARTICIPANTS AND INTERVENTION: The study included 30 phakic, highly myopic eyes (from 19-30 negative diopters) of 30 patients with an RD and MH. The patients were divided into two groups: They were assigned to PPV (15 eyes, group A) or to PEBP (15 eyes, group B). No significant (P > 0.01) differences in preoperative visual acuity (VA) between group A and group B eyes were found. Follow-up was 12 months. MAIN OUTCOME MEASURES: Anatomic attachment of the retina was determined, and VA was measured. RESULTS: Retinal reattachment was obtained on 11 of 15 (73.3%) eyes of group A and on 14 of 15 (93.3%) eyes of group B. In group A eyes the VA was substantially unmodified after surgical treatment, whereas in group B eyes the VA observed after surgical treatment increased significantly (P < 0.001) with respect to the preoperative values. CONCLUSIONS: PEBP resulted in better postoperative anatomic and functional results compared with PPV in eyes with extreme degrees of myopia, pronounced posterior staphyloma, and posterior vitreous schisis affected with RD caused by MH.
Subject(s)
Myopia/complications , Retinal Detachment/surgery , Retinal Perforations/surgery , Scleral Buckling , Vitrectomy , Adult , Aged , Female , Follow-Up Studies , Humans , Laser Coagulation , Male , Middle Aged , Retinal Detachment/diagnostic imaging , Retinal Detachment/etiology , Retinal Perforations/complications , Retinal Perforations/diagnostic imaging , Retrospective Studies , Treatment Outcome , Ultrasonography , Visual AcuitySubject(s)
Postoperative Complications , Vision Disorders/etiology , Vitrectomy/adverse effects , Vitreous Body/surgery , Electroretinography , Female , Humans , Male , Middle Aged , Postoperative Complications/physiopathology , Retina/physiopathology , Retrospective Studies , Vision Disorders/physiopathology , Visual Acuity/physiology , Visual FieldsABSTRACT
PURPOSE: Clear lens extraction is a surgical procedure to correct high axial myopia. The authors explain how this technique may lead to serious vitreoretinal complications. METHODS: The study included 41 eyes of 39 patients aged 25 to 58 years (mean, 37.5 years) with high axial myopia (14-29 diopters; mean, 19.5 diopters) operated on for retinal detachment after clear lens extraction. Retinal detachment occurred 1 month to 4 years after lens extraction, except for two eyes that also had intraoperative choroidal hemorrhages. RESULTS: Twenty-six of the 41 eyes had undergone 360 degree prophylactic retinopexy on preequatorial areas; in four eyes, the retinal breaks occurred along the edge of the prior circumferential photocoagulation. Seventeen eyes exhibited proliferative vitreoretinopathy of various grades. The retina was reattached in 36 eyes. Only nine eyes achieved final visual acuity of 20/60 or better. CONCLUSIONS: Although the authors do not report the actual incidence of retinal detachment after clear lens extraction, they indicate that potentially blinding complications can occur after this surgical procedure, despite prophylactic treatments.
Subject(s)
Lens, Crystalline/surgery , Myopia/surgery , Postoperative Complications , Retinal Detachment/etiology , Adult , Choroid Hemorrhage/etiology , Female , Humans , Intraoperative Complications , Male , Middle Aged , Myopia/physiopathology , Postoperative Complications/pathology , Reoperation , Retinal Detachment/pathology , Retinal Detachment/surgery , Retinal Perforations/drug therapy , Retinal Perforations/pathology , Vitreoretinopathy, Proliferative/etiology , Vitreoretinopathy, Proliferative/surgeryABSTRACT
In the rabbit the cervico-ocular reflex (COR) helps to maintain the gaze stability during passive head displacements, by increasing the gain and decreasing the phase lead of low frequency vestibular responses and by diminishing in amplitude the anticompensatory vestibular fast phases. These cervical influences appear only for horizontal stimulations, while they are scarce or absent in the vertical and sagittal planes. Ocular responses to horizontal body displacements are oriented in the horizontal plane and remain in the same plane when the head is statically pitched at various degrees, in spite of the directional changes in the extraocular muscle (EOM) lines of force with respect to space. Tension recordings from the EOMs show that the oculomotor system is differently activated depending upon the degree of head inclination. This change in the EOM activation is not observed when the body, instead of the head, is pitched. Furthermore, after bilateral labyrinthectomy (BL) the cervico-ocular responses lose their appropriate directionality. It is concluded that the information for determining the plane of the eye movements during cervical stimulations does not originate from the neck proprioception but is provided by the otolithic receptors.
